What are the main side effects of HCG trigger shots. How do trigger shots work in fertility treatments. What is the success rate of HCG trigger shots in IVF and IUI procedures. When should you consider using a trigger shot for conception. How much do HCG trigger shots cost compared to other fertility treatments.

Understanding HCG Trigger Shots in Fertility Treatments

Human chorionic gonadotropin (HCG) trigger shots are a crucial component in many fertility treatments. These shots contain hormones that mimic the body’s natural luteinizing hormone (LH), which plays a vital role in egg maturation and ovulation. HCG trigger shots are designed to help pinpoint the optimal time for conception, whether through natural means or assisted reproductive technologies.

HCG trigger shots are typically used in conjunction with other fertility treatments, such as intrauterine insemination (IUI) and in vitro fertilization (IVF). They can be particularly beneficial for individuals or couples facing various fertility challenges, including:

• Unexplained infertility
• Endometriosis
• Uterine fibroids
• Primary ovary insufficiency (POI)
• Polycystic ovary syndrome (PCOS)
• Anovulation

Additionally, HCG trigger shots can be helpful for same-sex couples pursuing fertility treatments.

Types of HCG Trigger Shots: Ovidrel, Novarel, and Pregnyl

There are three primary types of HCG trigger shots available on the market:

1. Ovidrel: Contains 250 micrograms (µg) of recombinant-HCG derived from Chinese hamster ovary (CHO) cells.
2. Novarel: Available in vials of 5,000 or 10,000 USP of chorionic gonadotropin, derived from the urine of pregnant individuals.
3. Pregnyl: Contains 10,000 USP of chorionic gonadotropin, also derived from the urine of pregnant individuals.

The choice of medication and dosage is typically determined by a fertility specialist based on the individual’s unique situation and treatment plan.

Lupron: An Alternative Trigger Shot

In some cases, particularly for individuals at risk of ovarian hyperstimulation syndrome (OHSS), a different type of trigger shot called Lupron may be recommended. Lupron contains a GnRH agonist, which indirectly stimulates ovulation by promoting LH production. This alternative can be safer for those prone to OHSS, a potentially serious condition characterized by swollen ovaries and various symptoms ranging from mild discomfort to severe complications.

HCG Trigger Shot Side Effects: What to Expect

While HCG trigger shots are generally well-tolerated, some individuals may experience side effects. Common side effects can include:

• Injection site reactions (redness, swelling, or discomfort)
• Headache
• Nausea
• Bloating
• Breast tenderness
• Mood swings

In rare cases, more severe side effects may occur, such as:

• Ovarian hyperstimulation syndrome (OHSS)
• Allergic reactions
• Blood clots
• Multiple pregnancies

It’s essential to discuss potential side effects with your healthcare provider and report any unusual symptoms promptly.

Understanding Ovarian Hyperstimulation Syndrome (OHSS)

OHSS is a potential complication associated with fertility treatments, including HCG trigger shots. Symptoms of OHSS can range from mild to severe and may include:

• Pelvic discomfort
• Nausea
• Vomiting
• Diarrhea
• Abdominal bloating
• Weight gain
• Shortness of breath (in severe cases)
• Blood clots (in severe cases)

If you experience any of these symptoms, especially severe ones, it’s crucial to seek medical attention immediately.

HCG Trigger Shots in IUI Procedures: Process and Timing

Intrauterine insemination (IUI) is a common fertility treatment that can be enhanced with the use of HCG trigger shots. The process typically involves the following steps:

1. Possible administration of oral or injectable medication to stimulate egg production
2. Monitoring of egg development through ultrasound or other methods
3. Administration of the HCG trigger shot to induce ovulation
4. Timing of the IUI procedure to coincide with the ovulation window
5. Insertion of prepared sperm directly into the uterine cavity

The use of HCG trigger shots in IUI procedures can help increase the chances of successful conception by ensuring that the insemination is timed precisely with ovulation.

Timing Considerations for IUI with HCG Trigger Shots

Proper timing is crucial for the success of IUI procedures using HCG trigger shots. Ovulation typically occurs 36 to 38 hours after the administration of the trigger shot. Your fertility specialist will determine the optimal time for the IUI procedure based on this timeline and other individual factors.

The Role of HCG Trigger Shots in IVF Treatment

In vitro fertilization (IVF) is a more complex fertility treatment that also incorporates HCG trigger shots. The IVF process with trigger shots typically includes:

1. Administration of medications to stimulate egg production (8-14 days)
2. Monitoring of follicle development through ultrasound and blood tests
3. HCG trigger shot to finalize egg maturation
4. Egg retrieval procedure (performed under sedation)
5. Fertilization of eggs with sperm in a laboratory setting
6. Embryo culture and potential genetic testing
7. Embryo transfer into the uterus

The HCG trigger shot plays a crucial role in ensuring that the eggs are at the optimal stage of maturity for retrieval and subsequent fertilization.

Maximizing IVF Success with HCG Trigger Shots

The precise timing of the HCG trigger shot in IVF cycles is critical for maximizing the number and quality of eggs retrieved. Your fertility specialist will closely monitor your follicle development and hormone levels to determine the ideal time for administering the trigger shot, typically 34-36 hours before the scheduled egg retrieval.

Success Rates and Factors Influencing Trigger Shot Effectiveness

The success rates of fertility treatments involving HCG trigger shots can vary widely depending on numerous factors, including:

• Age of the individual or couple
• Underlying cause of infertility
• Overall health and lifestyle factors
• Quality of eggs and sperm
• Type of fertility treatment (IUI vs. IVF)
• Experience and expertise of the fertility clinic

For IUI procedures, success rates typically range from 10-20% per cycle, while IVF success rates can vary from 20-50% per cycle, depending on the factors mentioned above.

Improving Your Chances of Success with Trigger Shots

To maximize the effectiveness of HCG trigger shots and overall fertility treatment success, consider the following tips:

• Follow your doctor’s instructions precisely
• Maintain a healthy lifestyle, including a balanced diet and regular exercise
• Manage stress through relaxation techniques or counseling
• Avoid smoking, excessive alcohol consumption, and recreational drugs
• Take prescribed fertility medications and supplements as directed
• Attend all scheduled appointments and monitoring sessions

Remember that fertility treatments often require patience and persistence, as multiple cycles may be necessary to achieve success.

Cost Considerations: HCG Trigger Shots and Associated Fertility Treatments

The cost of HCG trigger shots is just one component of the overall expense associated with fertility treatments. Here’s a breakdown of typical costs:

• HCG trigger shots: $50 to $250 per shot
• IUI procedure: $300 to $1,000 or more per cycle
• IVF treatment: $15,000 or more per cycle

It’s important to note that these figures are estimates and can vary significantly depending on factors such as geographic location, clinic fees, additional medications, and required tests. Many fertility clinics offer financing options or package deals for multiple treatment cycles.

Insurance Coverage for HCG Trigger Shots and Fertility Treatments

Insurance coverage for fertility treatments, including HCG trigger shots, can vary widely depending on your location and insurance provider. Some states mandate insurance coverage for fertility treatments, while others do not. It’s essential to check with your insurance provider to understand your specific coverage and any potential out-of-pocket expenses.

Preparing for Your HCG Trigger Shot: Tips and Considerations

If you’re scheduled to receive an HCG trigger shot as part of your fertility treatment, here are some tips to help you prepare:

• Familiarize yourself with the injection process (if self-administering)
• Ensure you have all necessary supplies (e.g., syringes, alcohol wipes)
• Choose a comfortable, clean area for the injection
• Follow proper storage instructions for the medication
• Have a partner or friend available for support if needed
• Plan your schedule around the injection time and subsequent procedures
• Discuss any concerns or questions with your healthcare provider

Remember that your fertility clinic will provide detailed instructions and support throughout the process.

Potential Emotional Impact of Fertility Treatments

Undergoing fertility treatments, including HCG trigger shots, can be emotionally challenging. It’s important to acknowledge and address the potential psychological impact of this journey. Consider the following strategies to support your emotional well-being:

• Join a support group for individuals or couples undergoing fertility treatments
• Seek counseling or therapy to process your emotions and develop coping strategies
• Practice self-care activities that bring you joy and relaxation
• Communicate openly with your partner about your feelings and expectations
• Set realistic expectations and remember that setbacks are common in fertility journeys

Remember that it’s okay to seek help and support throughout your fertility treatment process.

What Is It, Side Effects, Success Rate

Trigger shots are a hormonal fertility treatment that can bump up your baby-making odds by helping you ovulate or time ovulation.

Assisted reproductive technology (ART) can seem crazy complicated if you’re new to the fertility fam. But don’t worry! We got you covered.

Here’s a deep dive into the trigger shot and how it may increase your chances of conception 👶.

Standard trigger shots contain human chorionic gonadotropin (hCG). The hCG works like the luteinizing hormone (LH), a hormone produced by the pituitary gland. LH helps your eggies mature, prepare for fertilization, and ovulate.

This can be useful if:

Why not just use LH? hCG is used instead because the half-life of LH is really short — meaning it doesn’t stay around long in the body — so it can’t be used for trigger injections.

Trigger shots can be injected under the skin (subcutaneously) or into your muscle (intramuscularly). Most folks DIY it, but some peeps prefer to take it at a doctor’s office.

The options: Ovidrel, Novarel, or Pregnyl

The three head honchos of trigger shots are:

• Ovidrel contains 250 micrograms (µg) of recombinant-hCG. The hormones are sourced from Chinese hamster ovary (CHO) (yes this is a real thing).
• Novarel is available in vials of 5,000 or 10,000 USP of chorionic gonadotropin. It’s derived from the urine of pregnant people.
• Pregnyl has 10,000 USP of chorionic gonadotropin. It’s also derived from pregnant people’s pee.

Your doc will let you know which medication and dosage will be the most egg-cellent for your unique situation.

Lupron, the other trigger shot

Lupron is a type of trigger shot that stimulates LH production. But instead of using hCG, it contains a GnRH agonist — a type of drug that indirectly stimulates ovulation.

Lupron is usually limited to (and might be the safest option) for folks at risk of ovarian hyperstimulation syndrome (OHSS). This condition can happen if the extra hCG hormones cause your ovaries to swell.

OHSS *can* be life threatening if severe. Some folks experience pelvic discomfort, nausea, vomiting, or diarrhea. But severe cases can cause blood clots and shortness of breath.

Trigger shots are usually combined with other fertility treatments. This includes intrauterine insemination (IUI) and in vitro fertilization (IVF). Here’s the deets.

IUI

IUI (aka artificial insemination) is a popular procedure that can increase your chance of bun-in-oven status by injecting sperm right into the uterine cavity. This procedure can be done with or without a trigger shot.

Here are the basics of using IUI with the trigger shot:

1. You may or may not be given an oral or injectable medication to stimulate egg production.
2. Meanwhile, collected semen is “washed” in a lab. That means the seminal fluid is removed so there’s a higher concentration of sperm.
3. Your doctor will monitor egg development via ultrasound or discuss other ways to time IUI, such as ovulation predictor kits.
4. You’ll use a trigger shot to help the ovaries leggo your eggos once your doc gives you the go-ahead.
5. During your ovulation window your doc will complete the IUI procedure.

IVF

IVF is a complex, multi-step procedure where the sperm and egg are combined outside of the uterus in a lab. The resulting embryo (or embryos) is then transferred to the uterus.

Here’s the DL:

1. You’ll take a medication for 8 to 14 days to help you produce more eggs.
2. You’ll take a trigger shot to make sure your eggs are ready to be collected.
3. Your doc will collect your eggs. The amount of eggs depends on your individual situation. (P.S. Don’t worry about the pain. You’ll be placed under sedation.)
4. The eggs are combined with sperm to create embryo(s) in a lab. You and your doc will discuss how many embryos you want to transfer depending on your situation and pregnancy maximizing goals.
5. The embryo(s) are inserted into your uterus during the transfer procedure.

Trigger shots can help folks with any type of infertility, including unexplained infertility and conditions that makes conception more difficult like:

• endometriosis
• uterine fibroids
• primary ovary insufficiency (POI)
• polycystic ovary syndrome (PCOS)
• anovulation (when your body doesn’t release eggs on its own)

Trigger shots can also help to time ovulation in noninfertile same sex couples.

Trigger shots usually range from $50 to $250. But the total cost of fertility treatments used with the trigger shot can be hella pricey.

IUI can cost $300 to $1,000 or more, and IVF can cost around $15,000 or more, according to Planned Parenthood. The precise price depends on your insurance and what tests or medications you’ll need.

Ovulation timing is uber important to enhance the success of your conception session. The trigger shot helps you pinpoint the timeframe. After taking the shot, ovulation usually occurs within 36 to 38 hours. But the exact timing is up for debate.

With IUI, a 2020 study saw higher pregnancy rates in folks who were inseminated 42 hours after the trigger shot. But another study found no major difference between folks inseminated immediately after a trigger shot or those inseminated 36 to 40 hours later.

With IVF, you take the shot once your follicles are big enough. (Your doc will let you know.) Then your eggs are retrieved about 36 hours after you take the shot.

Trigger shots are typically considered safe. But it can come with side effects like:

• bloating
• stomach or pelvic pain
• abdominal pain or tenderness at the injection site

Ovarian hyperstimulation syndrome (OHSS) is also a risk, which is when extra hCG makes your ovaries to swell and fill with fluid. This is why folks at risk of the syndrome may be given the Lupron trigger shot that doesn’t contain hCG. Although it’s rare, severe OHSS can be a medical emergency.

Signs of OHSS include:

• pelvic discomfort
• nausea
• vomiting
• diarrhea
• abdominal bloating
• blood clots (in severe cases)
• rapid weight gain (in severe cases)
• shortness of breath (in severe cases)

Let your doc know if you have any side effects that last for more than a few days.

The hormone in trigger shots (hCG) is the same hormone used to detect pregnancy. So if you take a pregnancy test right after the shot, you might get a false positive. To avoid this, your doc may give you a date to take a pregnancy test.

You can also wait for your period and see if Aunt Flo misses her monthly visit. Or, you can ask your doc for a blood test. This can sometimes confirm a pregnancy sooner than an at-home pee test.

Some studies have found trigger shots are associated with higher pregnancy rates when used in IUI cycles, but the results are inconsistent.

In a 2017 study, researchers compared pregnancy rates between people who took a trigger shot with IUI. They found that 18.1 percent of peeps who took the shot got pregnant — only 5.8 percent of those who didn’t take the shot got pregnant.

Just keep in mind, everyone is different. Success rates depend can on:

• age
• type of infertility
• use of fertility drugs
• other underlying conditions

Trigger shots contain the “pregnancy hormone” hCG. They can, well, trigger ovulation and increase your chances of getting pregnant. They’re commonly used alongside IUI or IVF treatments.

Your doctor can help you come up with a top notch fertility treatment based on your unique situation.

Just remember, infertility is NOTHING to be ashamed of. It can take a long time to find the right mix of treatments ❤️. In the meantime, finding infertility support may help you on your journey to bébé.

Novarel injectable Uses, Side Effects & Warnings

Generic Name: human chorionic gonadotropin (HCG) (injectable) (HUE man KORE ee ON ik goe NAD oh TRO pin)
Brand Name: Novarel, Ovidrel, Pregnyl

Medically reviewed by Drugs.com on Dec 7, 2020. Written by Cerner Multum.

What is HCG?

Novarel is a hormone that supports the normal development of an egg in a woman’s ovary, and stimulates the release of the egg during ovulation.

HCG is used to cause ovulation and to treat infertility in women, and to increase sperm count in men. HCG is also used in young boys when their testicles have not dropped down into the scrotum normally. This can be caused by a pituitary gland disorder.

HCG may also be used for other purposes not listed in this medication guide.

Warnings

Novarel is given as an injection under the skin or into a muscle. If you use Novarel at home, your doctor, nurse, or pharmacist will give you specific instructions on how and where to inject this medicine. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Call your doctor at once if you have any of these signs of a blood clot: pain, warmth, redness, numbness, or tingling in your arm or leg; confusion, extreme dizziness, or severe headache.

Some women using this medicine have developed a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment cycle. OHSS can be a life-threatening condition. Call your doctor right away if you have any symptoms of OHSS: severe pelvic pain, swelling of the hands or legs, stomach pain and swelling, shortness of breath, weight gain, diarrhea, nausea or vomiting, and urinating less than normal.

HCG can cause early puberty in young boys. Call your doctor if a boy using this medicine shows early signs of puberty, such as a deepened voice, pubic hair growth, and increased acne or sweating.

Using this medicine can increase your chances of having a multiple pregnancy (twins, triplets, quadruplets, etc). A multiple pregnancy is a high-risk pregnancy for the mother and for the babies. Follow your doctor’s instructions about any special care you may need during your pregnancy.

Although HCG can help you become pregnant, this medication is in the FDA pregnancy category X. This means that using the medication once you are pregnant can cause birth defects in the baby. Do not use this medication if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

Before taking this medicine

You should not use this medication if you have ever had an allergic reaction to HCG, or if you have:

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

• a thyroid or adrenal gland disorder;

• an ovarian cyst;

• premature puberty;

• cancer or a tumor of the breast, ovary, uterus, prostate, hypothalamus, or pituitary gland;

• undiagnosed uterine bleeding;

• heart disease;

• kidney disease;

• epilepsy;

• migraines; or

• asthma.

Although HCG can help you become pregnant, this medication is in the FDA pregnancy category X. This means that using the medication once you are pregnant can cause birth defects in the baby. Do not use this medication if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

It is not known whether HCG passes into breast milk. Do not use HCG without telling your doctor if you are breast-feeding a baby.

How should I use HCG?

Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

HCG is given as an injection under the skin or into a muscle. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject Novarel if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

To be sure this medication is helping your condition, your doctor will need to check you on a regular basis. Do not miss any scheduled appointments.

Some brands of HCG come in powder form with a separate liquid that you must mix together and draw into a syringe. Other brands are provided in single-dose prefilled syringes.

Do not use the medication if it has changed colors or the liquid has any particles in it. Call your doctor for a new prescription.

Store the powder form of HCG at room temperature away from light, moisture, and heat.

After mixing the powder with the liquid you must keep the mixture in the refrigerator. If you are using the Pregnyl brand of HCG, throw away any mixed medicine that you have not used within 60 days after mixing. If you are using the Novarel brand of HCG, throw away any mixed medicine that you have not used within 30 days after mixing.

Store Ovidrel prefilled syringes in the refrigerator. You may also store Ovidrel at room temperature protected from light, but you must use it within 30 days.

Carefully follow the mixing, storage, and expiration instructions that come with the brand of HCG you are using. Ask your doctor or pharmacist if you have questions about how long your mixed medicine can be stored and at what temperature.

What happens if I miss a dose?

Contact your doctor if you miss a dose of HCG.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of Novarel. An overdose of HCG is not expected to produce life-threatening symptoms.

What should I avoid while using HCG?

Follow your doctor’s instructions about any restrictions on food, beverages, or activity while you are using HCG.

HCG side effects

Stop using HCG and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these signs of a blood clot: pain, warmth, redness, numbness, or tingling in your arm or leg; confusion, extreme dizziness, or severe headache.

Some women using Novarel have developed a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment cycle. OHSS can be a life-threatening condition. Call your doctor right away if you have any of the following symptoms of OHSS:

• severe pelvic pain;

• swelling of the hands or legs;

• stomach pain and swelling;

• shortness of breath;

• weight gain;

• diarrhea;

• nausea or vomiting; or

• urinating less than normal.

This medication can cause early puberty in young boys. Call your doctor if a boy using this medicine shows early signs of puberty, such as a deepened voice, pubic hair growth, and increased acne or sweating.

Less serious side effects may include:

• headache;

• feeling restless or irritable;

• mild swelling or water weight gain;

• depression;

• breast tenderness or swelling; or

• pain, swelling, or irritation where the injection is given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect HCG?

There may be other drugs that can interact with HCG. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Does Novarel interact with my other drugs?

Enter other medications to view a detailed report.

More about Novarel (chorionic gonadotropin (hcg))

Consumer resources

Other brands

HCG, Pregnyl, Ovidrel, Chorex, Profasi

Professional resources

Related treatment guides

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Copyright 1996-2021 Cerner Multum, Inc. Version: 2.03.

What is a trigger shot? – Apricity

The trigger injection or ‘trigger shot’ as it is also known, is a hormonal injection used in fertility therapy. Brand names in the UK include Choragon, Ovitrelle, and Pregnyl, among others. A trigger shot usually contains a hormone called human chorionic gonadotropin, or HCG. It is hCG which triggers an ovary to mature and release an egg.

Why do I need a trigger shot?

Women undergoing IVF treatment do a trigger shot so that eggs are matured for collection. Once you have the injection, your ovaries are sent into a cycle of development which allows for egg collection at a specific time which will be outlined by your fertility team.

When should I take the trigger shot?

You will be given careful guidance on this topic by your Apricity advisor. It is important to follow the timing instructions exactly as delays of just a few hours can cause issues with your treatment cycle. Essentially, in most cases the trigger shot needs to be taken 36 hours before egg collection, or a day and a half prior. So if you have a midday appointment for egg collection on Tuesday, you would take the trigger shot at midnight on the Sunday prior. There are some variations to this time window and your advisor will inform you if your case is one of those.

 The trigger shot timing is in line with the development of your follicles, which your clinical team will have been tracking. The trigger shot tends to be done when a good number of follicles have grown to their optimal size. Under or overdeveloped eggs have a lower chance of conception success.

Do I inject trigger shots myself?

Generally yes, especially as the 36 hour window from injection to collection often means the shot is usually taken in the evening and sometimes late in the evening. We ensure that an Apricity advisor is available at the time of the injection in case you have any last minute questions.

I have missed my trigger shot. What do I do?

If you are late taking your trigger shot, it is imperative you let your Apricity advisor or clinic know as soon as possible, as there may be things that they can do to try and salvage the situation. It is not possible to retrieve an egg after the ovary has released it, so it’s important to try and resolve this as soon as possible. In certain circumstances, it may be feasible to adjust your egg collection time.

Will the trigger injection be painful?

There are in fact two ways of administering the trigger injection. It can either be given into the muscle (intramuscular) or under the skin (subcutaneous), which is the most common route. An intramuscular injection will feel the same as getting a vaccine shot at your GP and can cause more bruising than when injecting under the skin. 

Women occasionally report that subcutaneous injections cause the site to become red, inflamed and itchy for a day or two. Either way, the side effects immediately post injection are usually minimal.

Potential trigger shot side effects

Most women do not experience any side effects following the trigger injection, apart from perhaps some local irritation at the injection site, which is usually transient. At this stage of your treatment, it is not uncommon to have been already experiencing some abdominal discomfort or mild bloating due to the combined effect of the treatment hormones and the increase in the size of the ovaries. Following the trigger injection, these symptoms can sometimes increase. As this is not intended to be an exhaustive list of side effects, do not hesitate to seek advice if you are concerned about any new symptoms.

Make sure to monitor any abdominal discomfort or bloating as this can sometimes be associated with Ovarian Hyperstimulation Syndrome. Contact your Apricity advisor if you have any concerns.

If you’re interested in getting started with Apricity, use the link below to book a free call with a fertility advisor at a time that suits you.

Book a free call

Recommended articles:

Ovidrel and Trigger Shots for Fertility Treatment

Ovidrel (choriogonadotropin alfa injection) is a fertility drug used to enhance and trigger ovulation. Ovidrel is a type of injectable medication that’s also known as a “trigger shot.” It may be used by itself or along with other fertility drugs. Ovidrel may be used in a cycle with timed sexual intercourse, intrauterine insemination (IUI), or in vitro fertilization (IVF) to improve the odds of pregnancy with each cycle.

Overview

Ovidrel is composed of recombinant human chorionic gonadotropin (r-hCG). Recombinant fertility drugs are made in a laboratory using DNA technology. They are molecularly similar to hormones made by the body. In the case of r-hCG, the lab-made hormone is similar to the body’s natural luteinizing hormone (LH). LH is the hormone that triggers ovulation during the menstrual cycle.

krisanapong detraphiphat / Getty Images

r-hCG and u-hCG Injections

Currently, there’s no generic version of recombinant human chorionic gonadotropin. However, the urinary extracted version of chorionic gonadotropin for injection (u-hCG), which is a similar fertility medication, is available in generic form. u-hCG is created by extracting and purifying hCG hormone from the urine of pregnant women. Brand names for u-hCG include Chorex, Novarel, Pregnyl, and Profasi.

While this article focuses on Ovidrel, much of the information can also be applied to urinary extracted chorionic gonadotropin.

Both forms of chorionic gonadotropin (r-hCG and u-hCG) are used in a similar way and offer comparable results, although some side effects may be slightly different.      

How Ovidrel Works

Ovidrel (injected r-hCG) acts very similar to the body’s luteinizing hormone (LH) that spikes just before ovulation. The role of LH in the female reproductive system is to stimulate the maturing egg (still in its follicle in the ovary) to complete the stages of growth just before ovulation. Typically, there is a surge of LH about 36 hours before the follicle releases the egg.

Your body reacts to hCG the same way it does to LH.

When you inject Ovidrel (or any form of chorionic gonadotropin) into your body, as long as follicles in the ovary are at the right stage of maturation, hCG triggers the eggs to go through a final growth spurt and ovulate (be released from the follicles) within 36 hours.

This is why it’s sometimes called a “trigger shot” or “trigger injection.”

When Ovidrel is used during a cycle with timed sexual intercourse or along with IUI, intercourse or the insemination procedure will be timed to occur just before the egg(s) ovulate, in order to maximize the odds for pregnancy.

When Ovidrel is used during an IVF cycle, your doctor doesn’t want the eggs to ovulate and leave the ovary on their own. Once the eggs ovulate, they can’t be retrieved for the IVF procedure. Instead, your doctor will schedule the egg retrieval for just before the expected ovulation time following the Ovidrel injection.

This is why it’s extremely important to follow your doctor’s directions on when to give yourself the Ovidrel injection as the timing is crucial down to the hour.

If you don’t or can’t give yourself the injection at the exact time your doctor prescribed, let your doctor’s office know right away.

When Ovidrel Is Used

Ovidrel may be used in a fertility treatment protocol for:

Ovidrel may be used alone, but it’s usually given along with other fertility drugs. For example:

• It may be used along with the fertility drug Clomid.
• It is frequently used along with gonadotropins (like Gonal-F or Follistim).
• It is frequently used in an IUI cycle, with or without other fertility drugs.
• It is almost always used during IVF treatment.

Unsubstantiated Use of Ovidrel for Weight Loss

Ovidrel and other forms of hCG have also been used in weight loss protocols, outside of the world of infertility and fertility treatments. There’s little to no evidence, however, that Ovidrel can help you lose weight.

When It’s Not Used

Ovidrel is not recommended in women with primary ovarian insufficiency or those with very poor ovarian reserves. The medication (and fertility drugs in general) may not be effective for these women.

If you are at high risk of developing ovarian hyperstimulation syndrome (OHSS), your doctor may forgo Ovidrel. OHSS is one of the possible risks of fertility drug use. You may be at high risk for OHSS if:

• You’ve experienced moderate to severe OHSS during previous fertility treatment cycles.
• Your estrogen levels are very high before your scheduled Ovidrel shot.
• Your ovaries have “overreacted” to the fertility drugs already given and produced “too many” follicles. (How much is too many will depend on your treatment protocol and your doctor’s opinion.)

Sometimes, your doctor will cancel your fertility treatment cycle mid-cycle based on the results of hormonal blood work and ultrasound monitoring of your ovaries. You might have the Ovidrel shot already at home, but be told not to use it.

If your doctor instructs you to not give yourself Ovidrel mid-cycle, it’s extremely important you follow these instructions. Going through with the injection could put your health at risk. Severe OHSS can be life-threatening.

If you’ve ever had an allergic reaction to Ovidrel or to other forms of injectable hCG, you also should not use the medication in future cycles.

Can You Use Ovidrel If You Have PCOS?

Women with polycystic ovarian syndrome (PCOS) may be at a higher risk of developing ovarian hyperstimulation syndrome (OHSS). However, this doesn’t necessarily mean you can’t use Ovidrel. In fact, Ovidrel is frequently used in fertility treatment cycles for women with PCOS. Talk to your doctor if you have concerns.

Timing and Administration

Exactly when you take Ovidrel will partially depend on whether it’s being used on its own, alongside Clomid, with gonadotropins, as part of an IUI cycle, or as part of an IVF cycle. However, the general usage of Ovidrel is similar regardless of the fertility treatment protocol.

Ovidrel is a liquid and it comes in a pre-filled, ready-to-inject device that’s relatively easy to use. Ovidrel is given as a subcutaneous injection. This means it’s injected into the fatty tissue just below the skin. (This is as opposed to intramuscular injection, like progesterone, that needs to be injected into the muscle.)

Always follow your doctor’s exact instructions for the day and time of day to give yourself the injection. Giving yourself the injection even just a few hours off from the prescribed time can cause problems for your treatment cycle.

What You’ll Need

When you’re ready to give yourself the injection, make sure you have everything you need ready:

• The Ovidrel prefilled syringe
• The instructions (which you should read carefully first)
• Alcohol swabs for medical use
• Gauze
• A container safe to dispose of the needle into

How to Give Yourself the Injection

Make sure the area you’re placing your supplies on is clean, dry, and flat, then follow these steps.

1. Wash your hands in warm soapy water for at least 30 seconds. Dry them on a clean paper towel. If a friend or family member will be doing the injection for you, make sure they thoroughly wash their hands.
2. Carefully remove an Ovidrel pre-filled syringe from the box.
3. Aiming the needle upward, remove the safety cap covering the needle.
4. While still pointing the needle upward, remove any air bubbles trapped in the syringe by gently tapping the side.
5. Carefully push the plunger on the needle pushing the excess air up and out, until just a tiny droplet of medication appears at the tip of the needle.
6. Choose the spot you’ll inject the medication; it should be an area on the abdomen and near the belly button, but at least one inch away from the belly button itself.
7. Use one of the alcohol swabs to disinfect the chosen injection site.
8. Let the area air-dry. Don’t blow on it to make it dry faster—this would blow germs back onto the area you just cleaned.
9. Take the Ovidrel needle into one hand with a finger on the plunger and your other fingers on the canister. With your other hand, pinch the skin of your chosen injection site. Your goal is to create a generous fold of fatty tissue to inject the needle into.
10. Insert the full needle into the pinched area at an angle of about 45 to 90 degrees.
11. Once the needle is in, let go of the pinched skin. Now, slowly and carefully push the plunger on the Ovidrel syringe until all the medication is dispensed.
12. Once all the medication is given, gently remove the needle from your belly. Use a gauze pad to apply gentle pressure to the site of injection. Any bleeding shouldn’t last long.

Place the used Ovidrel syringe into an approved sharps container. Don’t place it in your regular trashcan as it could be a threat to the safety of others. Talk to your fertility clinic’s nurse or doctor about how you should dispose of your needles in your state or country. Laws regulating what’s legal and what’s not for needle disposal vary by locality.

Note: If your doctor prescribed u-hCG, instead of Ovidrel’s r-hCG, you may need to prepare the needle for injections yourself. Your fertility clinic will provide instructions on what to do. If you’re unsure, don’t be afraid to call and ask.

Risks and Possible Side Effects

Most women do not experience any significant side effects beyond local discomfort at the injection point. In clinical trials of Ovidrel, one in three women using the medication for IVF treatment experienced at least one adverse effect. For those using it for ovulation stimulation only (like with an IUI cycle), one in four women experienced at least one adverse effect.

Some of the more common adverse effects of Ovidrel include:

• Injection site pain or bruising
• Upset stomach
• Abdominal pain
• Nausea
• Vomiting 

Whenever fertility drugs are used, there is a risk of developing ovarian hyperstimulation syndrome (OHSS). OHSS is more often related to the use of gonadotropins along with Ovidrel, than from taking Ovidrel by itself.

Still, you should be aware of the possible symptoms. Talk to your doctor if you experience OHSS symptoms or have any questions.

Ovulation and Pregnancy

Ovulation typically occurs within 24 to 36 hours of an Ovidrel injection. If you’re having timed sexual intercourse with an Ovidrel shot, your doctor will likely recommend you have sex the night of the injection and every night after for two to three days.

If you’ve planned an IUI or IVF cycle, your doctor will give you instructions on when to come into the office. The optimal time is based on when you gave yourself the trigger shot.

Will Ovidrel Help You Get Pregnant?

Giving the odds of pregnancy success for those using Ovidrel is tricky because success depends on so many factors. For example, if you have a 28-year old IVF patient with a good prognosis using Ovidrel and compare her to a 41-year-old woman having an IUI cycle using Ovidrel, the success rates will vary significantly.

One study published in 2017 looked at whether an r-hCG shot (Ovidrel) improved IUI pregnancy success rates when compared to cycles where they relied on the natural LH surge, used r-hCG, or timed the injection to occur at the same time as the natural LH surge.

The researchers found a significant improvement in pregnancy success for cycles that used r-hCG and especially, those that combined an r-hCG injection with the body’s LH surge.

The clinical pregnancy rate per cycle was:

• 18% overall
• 18.2% for those that received an r-hCG shot
• Only 5.8% for cycles with no r-hCG shot
• 30.7% for those who received the trigger shot at the same time as their body’s natural LH surge

Most studies do not find a difference in pregnancy success rates when comparing r-hCG (like Ovidrel) and u-hCG (urinary extracted hCG).

When to Take a Pregnancy Test

Ovidrel is molecularly similar to the hormone hCG, which is the pregnancy hormone that pregnancy tests detect in the urine. This means that if you take a pregnancy test soon after your trigger shot, you may get a positive result—even though you’re likely not pregnant (yet).

Ideally, you should not take a pregnancy test until 14 days after your trigger shot. This is the best timing for a pregnancy test with or without having used Ovidrel as taking a pregnancy test too early can lead to false negatives.

Cost

Your cost for Ovidrel will partially depend on whether you have insurance coverage for fertility treatments and which pharmacy you purchase the drug from.

Generally speaking, Ovidrel costs between $100 and $200.

Ovidrel vs. Pregnyl

Sometimes people refer to Pregnyl as the “generic” version of Ovidrel, but this isn’t technically correct. Pregnyl is a brand name of urinary extracted hCG (u-hCG).

A Cochrane Database study compared possible adverse effects and clinical pregnancy success rates between Ovidrel and Pregnyl. The study included 18 random control trials, involving almost 3,000 participants. The researchers concluded that there was no evidence that live birth rates, ongoing pregnancy rates, or the rate of developing OHSS was significantly different between the two medications.

A Word From Verywell

Navigating the world of trigger shots, particularly knowing if and when to include fertility medications (and which ones) into your journey toward pregnancy can be confusing and stressful. Your doctor will be the best resource to decide which fertility medications and treatments will be most effective for you.

In many cases, these medications, including Ovidrel, can greatly improve your shot at making a baby—and once you get the hang of the injections and optimal timing, the process may feel less daunting.

Why am I Getting hCG Shots for Fertility Treatment?

Posted on December 30, 2020
in Treatments & Meds
by Elena Donovan Mauer

It gets tricky keeping track of all those meds and acronyms along the fertility path. FSH, AMH, IVF, IUI…and now, add hCG to the getting-pregnant mix. If you’ve been prescribed hCG shots for fertility, there are a few important things you should know.

hCG decoded

hCG stands for human chorionic gonadotropin, so you literally will never use its full name in conversation. This is a pregnancy hormone—you may know it as the one that a pregnancy test detects in a woman’s urine.

In fertility treatments, hCG shots are used as a tag team partner with other medications to help a woman ovulate.

The other medications—injections of FSH (follicle stimulating hormone) and/or LH (luteinizing hormone)—stimulate the ovaries to grow the follicles allowing the eggs within them to mature. Then, the hCG shot helps the egg finish maturing and then release, says David Diaz, MD, reproductive endocrinologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

hCG may have the brand name Pregnyl, Ovidrel, Novarel or Profasi. You might get prescribed them if you’re not ovulating, if an ovulation drug like Clomid didn’t work for you, or if you’re doing IUI (intrauterine insemination) or IVF (in vitro fertilization).

According to Dr. Diaz, in certain cases of male infertility, hCG may also be used to help increase sperm production.

The basic timeline

Here’s how it works (for women, at least):

The FSH and LH injections usually begin on day three of a woman’s period, to get those follicles going, and continue daily for about 10 to 12 days after that. The doctor will keep tabs on the follicle status with ultrasounds. Once the eggs become mature enough (woo-hoo!), you’ll get the hCG shot, which basically says, “Ovulation? And go!” Most women ovulate 36 to 40 hours after an hCG shot, according to the Society for Assisted Reproductive Technology (SART).

When you’re ovulating, it’s time for fertilization, whether that’s through sex, IUI or IVF.

On pins and needles

You’ll likely give yourself your hCG shot or ask a loved one (who can handle it) to do it for you. A doctor and/or nurse will likely walk you through the injection process. Dosage varies depending on which brand of hCG you’re prescribed.

hCG shots are done subcutaneously (small needle injected just under the skin) OR intramuscularly (larger needle injected into the muscle) depending on your physician’s protocol. If it’s Profasi, Novarel or Pregnyl, the medication will probably be in powder form, and you’ll have to mix it with a specific amount of liquid to dilute it before you inject, says SART. Ovidrel is premixed and thus slightly more convenient. As convenient as a timed injection can be, that is.

The drawbacks

There are some side effects to hCG shots that you should look out for. You might have minor pain at the injection site or feel a slight cramping or mild bloating as the mature egg sac releases its fluid and the egg itself.

Not too bad, right? However, there are some more major side effects to watch for. In some cases, women can get ovarian hyperstimulation syndrome (OHSS). In OHSS, the glut of hormones overwhelm the ovaries, causing them to become swollen and painful. Mild OHSS will go away after a week or so if you don’t get pregnant—maybe longer if you do get pregnant. But severe OHSS can cause some pretty scary health problems. Tell your doctor if you have any of these symptoms so they can keep an eye out for OHSS:

• Substantial abdominal pain or tenderness
• Bloating that is increasing daily
• Daily weight gain
• Severe, persistent nausea and vomiting
• Swelling and pain in your legs
• Decreased urination
• Shortness of breath/difficulty breathing

Important disclaimer(!)

After you get the shot, hCG will be in your urine. Remember, hCG is the same hormone that a pregnancy test picks up, so there’s a chance you could get a false positive on a pregnancy test. In fact, you truly can’t trust the results of a test taken within 10 days after taking the hCG shot, according to SART.

Our advice? Step away from the pregnancy tests. Don’t even pick one up, and skip that aisle at the drugstore. Save those bad boys for later. We’re pretty sure you’re going to need them.

Common Side Effects of the HCG Trigger Shot

HCG, or human chorionic gonadotropin, is a drug given to mature eggs from artificially stimulated ovaries during assisted reproductive technology, or ART procedures. HCG is usually given 34 to 36 hours before egg retrieval, since release usually occurs naturally 36-plus hours after administration, the University of Maryland Medical Center explains. HCG can be given as a recombinant, or laboratory-made drug, or in an injection derived from the urine of pregnant women. HCG in either form can have side effects.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Common Side Effects

Some side effects of HCG are mild and common. While these symptoms are usually short-lived, worsening symptoms should be reported to your doctor, as they could be early signs of ovarian hyperstimulation syndrome 1. Soreness at the injection site may occur; redness or swelling should be reported to your doctor.

Allergic Reactions

Herbal Remedies for Dermatitis Stasis

As with any drug, allergic reactions can occur to the proteins in HCG. These include rashes, hives, swelling, shortness of breath, lightheadness or collapse. Report any potential signs of allergy to your doctor immediately.

Ovarian Hyperstimulation

The most serious side effect of HCG when given to induce egg release in fertility procedures is the development of ovarian hyperstimulation syndrome, or OHSS 1. Ovarian hyperstimulation occurs when large number of follicles are matured after HCG is given. Some fertility clinics will not give HCG in an ART cycle if the estradiol level is over a certain number, to prevent OHSS from developing. Others will not transfer embryos if OHSS is present, because pregnancy will drive hormone levels even higher.

Side effects of mild OHSS include mild swelling, abdominal discomfort and weight gain. Fluid may accumulate in the lungs, making breathing difficult. Nausea, vomiting and diarrhea may deplete already dry blood volume. OHSS can be fatal in rare cases, the U.S. National Library of Medicine states.

• The most serious side effect of HCG when given to induce egg release in fertility procedures is the development of ovarian hyperstimulation syndrome, or OHSS 1.
• Some fertility clinics will not give HCG in an ART cycle if the estradiol level is over a certain number, to prevent OHSS from developing.

What is the Trigger Shot?

10 Nov What is the Trigger Shot?

There is a lot of information out there about the injectable fertility medications used to stimulate ovarian follicles to produce higher-than-normal numbers of mature eggs. The most common versions of these medications come in the form of the follicle-stimulating hormone (FSH), with common pharmaceutical names such as Bravelle, Fertinex, Follistim, and Gonal-F.

What we don’t talk about as often is the trigger shot that is used to officially release those mature eggs.

This shot is the final step in many fertility patients’ gonadotropic hormone therapy. Most often, it is administered as part of the IVF timeline so we can retrieve all of the mature eggs. However, these shots may also be used as part of less-invasive fertility treatment measures (more on that below).

Trigger Shots 101: The Basics

Here are some of the trigger shot basics you should know if injectable fertility medications are part of your fertility treatment plan.

1. Trigger shots release human chorionic gonadotropin (hCG)

Commonly referred to as the “pregnancy hormone,” hCG is what most home pregnancy tests are looking for to signify you’re pregnant. The hormone is produced in the body when it recognizes an egg is fertilized. As a trigger shot, however, hCG acts more like luteinizing hormone (LH), which is made in the pituitary gland right before you ovulate.

In this case, we administer more than the normal levels of hCG to get your body to release the multiple mature eggs waiting for release in your ovaries.

The shots are administered in your skin or muscle, and are typically self-administered. Your fertility specialist will work closely with you to learn more about how to administer injectable medications as well as tips for minimizing discomfort.

2. There are multiple brands out there

Ovidrel, Novarel or Pregnyl  are some of the most common trigger shot brands.

If your fertility specialist feels you are at higher risk for developing a more severe fertility medication side effect called ovarian hyperstimulation syndrome (OHSS), s/he may prescribe a trigger shot called Lupron instead. Lupron is not an hCG (hormone) trigger shot. Instead, it uses an agonist (drug) that stimulates a response in your body using receptors.

3. Trigger shots are used for more than IVF

While trigger shots are always used as part of an IVF protocol, they are also used for other, less invasive forms of fertility support.

• Timing intercourse at home. If you would like to avoid IUI or IVF to start, we can time your menstrual cycle and use a combination of ovarian stimulation and a trigger shot to help you get pregnant at home. With this method, we monitor your follicles here in our office and when they’re ready (mature), we give you the green light for the trigger shot. You’ll time sexual intercourse from there.
• Intrauterine insemination (IUI). If you’d like to have a little more control over ensuring the sperm are in proximity to the released egg(s), we can also use trigger shots in conjunction with IUI. In this case, you’d administer the trigger shot and we’d schedule your insemination procedure for a number of hours afterwards.

Many couples prefer to use these options first, before pursuing IVF in the hopes they’ll get pregnant without it.

4. Who is a good candidate for a trigger shot?

The best candidates for using a trigger shot are those who aren’t ovulating regularly (or at all). Your doctor may also recommend the combination of fertility medications and a trigger shot if you have unexplained infertility (Click Here to read more about UI). And, as mentioned above, we use them for any woman participating in in-vitro fertilization.

Note about patients with PCOS: If you have PCOS, it’s important that you are very careful when using ovarian stimulating hormones to get pregnant. Many women with PCOS have a wealth of healthy eggs in their fallopian tubes. If your doctor isn’t careful about using the right fertility medication (typically the less-powerful, oral Clomid dose), at the right dosage, you can wind up with multiples via timed intercourse or IUI.

Also, it’s worth noting that some women who use fertility medications never use the trigger shot because they ovulate on their own with the assistance of the egg follicle boost. Fertility specialists always want to use a “less is more” approach to fertility treatments whenever possible. Whether or not your situation warrants the use of a trigger shot depends on your infertility diagnosis and ovulation history.

5. When should you NOT use a trigger shot?

There are also patients who should not use a trigger shot as part of their fertility treatment protocol unless the physician can make a very good case for it. These include women with:

Also, if you’ve had a history of ovarian hyperstimulation syndrome (OHSS) or your doctor feels you’re a high-risk candidate, s/he’ll use Lupron rather than hormone-based trigger shots.

Are you in the process of researching fertility specialists who can help you get pregnant? Schedule an appointment with the Fertility Center or Dallas.

90,000 TRIGGER SHOT: WHAT IT IS, HOW IT WORKS, SIDE EFFECTS AND MUCH MORE – HEALTH

When it comes to assisted reproductive technology (ART), you need to learn something new. If you are just starting this journey, all sorts of new t

will probably pop up in your head.

Contents:

When it comes to assisted reproductive technology (ART), you need to learn something new.If you’re just starting this journey, all sorts of new terms are likely to pop up in your head.

The trigger shot is often used during intercourse, intrauterine insemination (IUI) or in vitro fertilization (IVF). If the vaccination is part of your protocol, your doctor will tell you when and how to do it in connection with other medications and procedures.

Here’s a little more about what a trigger shot is, what you can experience when using it, and what the success rate is with this type of treatment.

What is a trigger?

Whether you call it Ovidrel, Novarel, or Pregnil, the standard trigger shot contains the same thing: Human Chorionic Gonadotropin (HCG).

You might be better off knowing hCG as the “pregnancy hormone”. However, when used as a trigger, HCG is more like luteinizing hormone (LH), which is produced in the pituitary gland.

LH is secreted just before ovulation and is responsible for preparing the eggs for maturation and subsequent release from the ovary.

Trigger shots are part of the so-called gonadotropin therapy. This type of fertility treatment has been used in various ways in recent times. century (really!), And over the past 30 years it has become more refined.

Gonadotropins stimulate the ovaries, so they are useful if:

• You have no ovulation at all
• Your ovulation is considered “weak”
• You want to control ovulation in other procedures

There is also a new version of the trigger shot called Lupron …It uses an agonist (drug) instead of hCG (a hormone) to stimulate the release of LH.

Your doctor may advise you to use Lupron if you have a higher risk of developing a complication called ovarian hyperstimulation syndrome (OHSS), or if there are other reasons why a traditional trigger shot is not ideal for you.

Trigger shots are given once per cycle before ovulation. They can be injected into a muscle (intramuscularly) or under the skin (subcutaneously). Most often they are self-administered, and many women prefer to inject under the skin on their belly.

Related: 9 Questions About Fertility Treatment to Ask Your Doctor

What Does the Trigger Do?

While other gonadotropins such as follicle stimulating hormone (FSH) and LH work for both the growth and maturation of eggs, the hCG trigger shot helps the ovaries release mature eggs during ovulation.

Time of intercourse / IUI

Timed intercourse or IUI means your doctor can pinpoint when ovulation is likely and then calculate the timing of sex or IUI for best results.Here are the steps:

1. Your doctor will monitor your follicles until they are ready.
2. You will give the injection as directed.
3. Your doctor will schedule your procedure (or tell you to have sex) to coincide with ovulation a specified number of hours after the injection.

IVF

In IVF, a trigger is used before egg retrieval to facilitate a process called meiosis. In meiosis, eggs undergo an important division, where their chromosomes go from 46 to 23, preparing them for fertilization.

Before the eggs are naturally released, your doctor will order an egg retrieval procedure to collect them for fertilization in the laboratory. After fertilization, the embryos will be transferred back to the uterus for implantation.

Who fires the shot?

Again, the trigger is done as part of fertility treatment. It is usually used with other medicines and should be carefully calculated and monitored. ART procedures are very delicate, individual processes.Your doctor will customize your specific protocol based on what worked or didn’t work in the past.

Trigger is mainly used in combination with other drugs to help with:

• anovulation (when your body does not release eggs on its own)
• unexplained infertility (when the cause of infertility is unknown)
• in vitro fertilization (for various reasons of infertility )

There are a number of uses and dosages.For example, if this is your first IUI cycle, your doctor may wait to see if you are ovulating on your own before adding a trigger shot to your protocol.

Or, if you have had a trigger shot in the past, your doctor may adjust the dosage for optimal effectiveness or in response to any side effects.

How is the trigger time calculated?

Ovulation usually occurs approximately 36-40 hours after trigger insertion. Because vaccination is used differently for IUI and IVF, this means timing is important when compared to other procedures you are doing.

Your doctor may have very specific instructions that you must follow, so if you have questions about your protocol it is a good idea to call the office quickly.

IUI

With the IUI, your doctor will monitor your follicles with ultrasound as you approach ovulation or in the middle of your menstrual cycle.

Your doctor will most likely give you the go-ahead for an injection when your follicles are 15 to 20 millimeters in size and your endometrium (uterine lining) is at least 7-8 millimeters thick.But the individual characteristics differ from doctor to doctor.

Your IUI is usually performed at the same time as ovulation – 24 to 36 hours after the injection. Thereafter, your doctor may also suggest taking progesterone supplements (oral or vaginal) to help with implantation.

IVF

The timing is the same as with IVF. Your doctor will monitor your ovaries with ultrasound and give you a green light to fire a trigger shot when your follicles are at the size specified by your clinic.It can be 15 to 22 millimeters. This is usually between 8 and 12 days of your cycle.

After you give the shot, you schedule an egg retrieval for 36 hours. The eggs are then fertilized with the sperm of your partner or donor. The fertilized eggs are then either transferred (for fresh transfer) 3-5 days after retrieval, or frozen (for later transfer).

Related: Self-help with IVF: 5 women share their experiences

Side effects of a trigger shot

There are various side effects that can occur when using a trigger shot.Most often it is bloating and pain in the abdomen or pelvis. You may also experience pain or tenderness at the injection site.

OHSS is also a risk. In OHSS, the ovaries swell and fill with fluid. Mild cases can cause abdominal discomfort, bloating, and gastrointestinal problems such as nausea, vomiting, or diarrhea.

Severe OHSS is rare and may require urgent medical attention. Signs include rapid weight gain (over 2 pounds per day) and bloating, as well as severe abdominal discomfort or severe nausea / vomiting.

Other possible symptoms of this syndrome include:

• blood clots
• difficulty breathing
• decreased urine output

Related: How to increase your chances of getting pregnant

When to take a pregnancy test

Beware of false positives!

Because the trigger shot contains hCG, you can get a positive pregnancy test without getting pregnant if you get the test too soon after the shot.

Mayo Clinic recommends waiting at least 2 weeks after vaccination to take a pregnancy test. This is because it can take 10 to 14 days for a shot from your system.

And if you are undergoing ART, your doctor may order you a beta blood test (initial) to measure hCG. Therefore, if you are worried about false positives, consider waiting for a blood draw for the most reliable results.

Related: How soon after IUI can you take a pregnancy test?

“Testing” the Trigger

If you are wondering how long a trigger shot (and the hCG hormone) stays in your body, you can try “testing” the shot.

This means that you will take a pregnancy test every day and watch the line get lighter. A lighter, lighter result can show you that the hormone is leaving your system.

Of course, if you continue testing until the line is barely visible – only to see it come back and get darker – you could actually be pregnant. It is still recommended to have a blood test at the doctor’s office for confirmation, but this method is useful if you are the type of person who simply cannot wait.(We totally understand.)

To try it yourself, consider getting cheap pregnancy tests – not the ones at your local pharmacy, which cost $ 16 to $ 20 per pack of just three! It is important to use the same test type for each test so that the sensitivity is the same.

It is also helpful to test at the same time every day, for example, immediately after waking up. This way, you do not drink too much water, which can affect the concentration of your urine and therefore the test results.

Buy inexpensive pregnancy test strips online.

Trigger Shot Success Rates for Your Protocol

The success rate of the trigger shot itself is difficult to determine. This is because it is often used in combination with other medicines or treatments to treat infertility. The trigger shot is an important part of IVF because of the function it performs with meiosis, so it is almost impossible to study the effects of the shot in isolation.

However, 2017 Study on IUI loops compared loops with and without a trigger. The pregnancy rate with IUI and without vaccination was 5.8%. After firing the trigger, this figure rose to 18.2%. And when the trigger shot was timed to coincide with a woman’s natural LH surge, the pregnancy rate was an impressive 30.8 percent.

Another over study looked specifically at the timing of the shot. Surprisingly, the researchers found a higher pregnancy rate in cycles when the vaccine was given after IUI (19.6 percent) rather than 24 to 32 hours before the procedure (10.9 percent).The standard was to get vaccinated before the IUI, which is why these results are so important.

More research needs to be done in this area before the timeline can be changed everywhere.

Related: IUI Success Stories From Parents

Conclusion

If you’re curious about the trigger and wondering if it might work for you, make an appointment to speak with your doctor. Again, the shot is only used during controlled cycles when you are having intercourse, IUI, or IVF.

To use it, you will need to make regular appointments to keep track of the follicle size and the thickness of the uterine lining. It may sound time consuming, but couples have found success using this method in combination with other fertility treatments.

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June 2, 2020

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The hCG blood test is one of the most important monitoring tools for developing pregnancy.

What is HCG?

HCG is a two-unit protein. The alpha particles of the hormone are similar to biologically active substances secreted by the pituitary gland. Beta particles are unique. The mass of the CG molecule is approximately 46 kDa. During pregnancy, glycoprotein is synthesized in the placenta. The biological properties of hCG are in many ways similar to the properties of other hormones: luteinizing and follicle-stimulating. In some malignant diseases, hCG begins to produce tumor cells.In a non-pregnant woman and a healthy man, the hormone is practically absent in blood tests.

In obstetrics and gynecology, the b-hCG test, along with ultrasound, is used to monitor pregnancy throughout the entire period. Deviations in the readings of the analysis are the basis for further examination and require the consultation of a geneticist. Artificial increase in hCG levels is used in the IVF process. As a result of hCG injections in women, the maturation and release of the egg is stimulated, the production of estrogen and progesterone increases.In men, the administration of exogenous hCG activates the increase in the number of spermatozoa.

It has been proven that the substance also has the properties of a corticotropic hormone. HCG acts on the adrenal glands by stimulating the synthesis of steroids in their cortex. Thus, he is involved in preparing the body of a pregnant woman for the upcoming physiological stress. Since the fetus is perceived by the mother’s body as foreign, some immunosuppressive effects of hormones, including hCG, are required for its normal development.

HCG promotes maturation of placental tissues. Thanks to him and other hormones, its functional activity increases and the number of chorionic villi increases.

Without the hormone, the normal development of the embryo is not possible. HCG ensures the production of estrogens and progesterone, and also maintains their balance in the body of the expectant mother. Therefore, any pregnancy support program always contains regular tests for the level of hCG.

Types of analyzes for hCG

Blood test for hCG (beta particles)

Measuring total hCG is the most reliable way to diagnose and monitor pregnancy.Other indications for the test include menstrual irregularities, oncological tumors of the trophoblast, and in men, malignant tumors of the testicles.

Analysis of urine for hCG (beta particles)

Compared to blood, the urine of the expectant mother contains less of the hormone. Therefore, the determination of the concentration of a substance in the urine can diagnose pregnancy only from a period of 8-10 days. Like laboratory research, pharmacy tests are also based on the determination of hCG in urine. Home tests have a lower threshold of sensitivity than laboratory tests, and, accordingly, a lower degree of reliability.A positive result requires a visit to an obstetrician-gynecologist to confirm a normal pregnancy.

Analysis for free hCG (subunit of beta-hCG)

The range of application of this test is wide enough. In oncology, it is in demand as a marker of malignant tumors. Measurement of the amount of independent hCG particles in the blood is informative for testicular cancer in men. In addition, this indicator is important in the diagnosis of trophoblastic tumors in women. It is included in the 1st and 2nd pregnancy screenings.The study helps to assess the degree of risk of such congenital fetal abnormalities as Down syndrome and Edwards syndrome.

The role of the hormone in the diagnosis of pregnancy

Analysis for the amount of total hCG takes a special place in confirming early pregnancy. This is due to the fact that the hormone begins to be actively secreted already a few days after the attachment of the ovum to the wall of the uterus. With the normal development of the embryo, the level of the substance doubles every 1.5-2 days.By the tenth week, the amount of hCG in a woman’s analyzes can reach maximum values ​​- up to 225,000 IU / ml.

Simultaneously with blood for total hCG, other examinations are prescribed for the pregnant woman. So the patient must visit the ultrasound scanning room at least three times. Several examinations may be required over the course of nine months.
Comprehensive screenings for the 1st and 2nd trimesters also include a hCG test.

When to donate blood for hCG

A blood test for the hormone is taken as needed.The first time it is assigned directly to the diagnosis of the pregnancy itself. The second – as part of screening with ultrasound and other tests. Screening is designed to identify among pregnant women a risk group for congenital fetal abnormalities.

Approximate dates of studies on hCG:

• Confirmation of pregnancy – 6 days after conception
• First – from 11 to 13 weeks
• Second from 19 to 23 weeks
• Screening for the 3rd trimester is performed after 28 weeks of gestation.

How to prepare for a blood test

Preparing for a hCG test involves a number of standard requirements for hormone testing. The analysis is taken on an empty stomach, after an overnight fast in the morning or afternoon. You should come to the treatment room in good health. In order for the results of the hCG test to be as reliable as possible, it is recommended 2-3 days before:

• Stop drinking alcohol
• Eliminate spicy and fatty foods from the diet
• Cancel Strength Training
• A couple of hours before donating blood, exclude smoking.

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90,000 hCG, human chorionic gonadotropin, indications for prescription, rules for preparing for the test, interpretation of results and normal indicators.

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication.In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.

We remind you that an independent interpretation of the results is unacceptable, the information below is for reference only.

Human chorionic gonadotropin (hCG, β-hCG, beta-hCG, Human Chorionic Gonadotropin): indications for prescription, rules for preparing for the test, interpretation of results and normal indicators.

Chorionic gonadotropin is a hormone produced by the outer membrane of the embryo, and is normally determined in the blood and urine of a woman only at the onset of pregnancy.

Chorionic gonadotropin consists of two subunits – alpha and beta. The beta subunit (β-hCG) used for the immunometric determination of the hormone is unique. To monitor the course of pregnancy, the definition of the beta subunit of hCG is used.The level of beta-hCG blood already on the 6-8 day after conception allows diagnosing pregnancy (the concentration of beta-hCG in the urine reaches the diagnostic level 1 to 2 days later than in the blood serum).

HCG has a multifaceted effect on the body of a pregnant woman: it affects the development of the embryo and fetus, stimulates the synthesis of estrogens and androgens by ovarian cells, promotes the functional activity of the chorion and placenta, and ensures the successful course of pregnancy.

The introduction of hCG into the body of non-pregnant women stimulates ovulation and the synthesis of sex hormones necessary for conception.In men, this hormone enhances the formation of seminal fluid, activates the production of gonadosteroids.

In early pregnancy and up to the 2nd trimester, β-hCG supports the production of hormones necessary to maintain pregnancy, and in male fetuses it stimulates cells responsible for the formation and development of the male reproductive system.

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Indications for determining the level of hCG in women

1. Absence of menstruation (amenorrhea).
2. Exclusion / confirmation of pregnancy, including ectopic (ectopic).
3. Diagnosis of the condition of the fetus at different stages of pregnancy.
4. Assessment of the state of the placenta at different stages of pregnancy.
5. Dynamic observation of the development of the fetus during pregnancy, including in the diagnosis of malformations.
6. Suspicion of the presence of neoplastic diseases of the reproductive system, such as cystic drift (a rare pathology of the ovum, in which, instead of the development of the embryo, chorionic villi grow), chorionepithelioma (a malignant tumor that develops from the epithelium of the ovum villi).
7. Carrying out artificial termination of pregnancy.

Indications for determining the level of hCG in men:

Suspected testicular tumor.

Deadline of this study – 1 working day, excluding the day of taking the biomaterial.

Rules for preparing for the delivery of a blood test to determine the level of hCG

nonspecific: it is enough to refrain from smoking and drinking alcohol on the eve of the procedure, to limit stress effects and intense physical activity during the week; blood donation is carried out on an empty stomach.

Determination of hCG in the blood is possible already on the 6-8th day after conception. The use of urinary test systems (rapid pregnancy tests) will be informative starting from the 7th day after fertilization of the egg. To confirm the result, it is recommended to re-determine the level of the hormone a few days after the first analysis.

You can take a blood test for hCG (thyroid stimulating hormone, thyrotropin, Thyroid StimulatingHormone, TSH) at the nearest medical office of INVITRO.The list of offices where biomaterial is accepted for laboratory research is presented in the “Addresses” section.

Causes Leading to High β-hCG Levels

1. Multiple pregnancy.

2. Incorrectly set timing of pregnancy.

1. Pathologically proceeding pregnancy: the appearance of edema, increased blood pressure, loss of protein in the urine (gestosis), convulsions (eclampsia), toxicosis.
2. The presence of chronic diseases in a pregnant woman (for example, diabetes mellitus).
3. Multiple fetal malformations (in such a situation, the determination of the level of β-hCG is used in conjunction with other indicators, the so-called “triple test.” This study is used as a screening, and not for diagnosis.).

Reasons for recording a decrease in the level of β-hCG

1. Incorrectly established pregnancy dates.
2. Ectopic pregnancy.
3. Frozen pregnancy.
4. Threatened miscarriage.
5. Pathology of the fetus or placenta (including placental insufficiency).
6. Intrauterine fetal death (in this case, it is informative to determine the level of the hormone in the first and second trimesters).

During abortions, the level of β-hCG is also monitored, according to the dynamics of growth / fall of which one can judge the completeness of the manipulation performed.

Determination of the level of hCG, in addition to establishing the fact of early pregnancy, is included in the screening examination of pregnant women in the first trimester, along with an ultrasound scan.