Periovulatory serum human chorionic gonadotropin (hCG) concentrations following subcutaneous and intramuscular nonrecombinant hCG use during ovulation induction: a prospective, randomized trial.
OBJECTIVE
To describe serum levels of human chorionic gonadotropin (hCG) as a function of hCG injection method (subcutaneous vs. intramuscular) among infertile women undergoing ovulation induction.


METHODS
Prospective, randomized clinical trial.


METHODS
Major urban infertility referral center.


METHODS
Women presenting for infertility evaluation and ovulation induction.


METHODS
Controlled ovarian hyperstimulation was followed by 5,000 IU urinary (nonrecombinant) hCG injection, given intramuscularly (i.m.) or subcutaneously (s.c.).


METHODS
Serum hCG levels measured 24 hours after administration of hCG, and patient tolerability of injected hCG.


RESULTS
There were no statistically significant differences in age or body mass index (BMI) among patients receiving hCG s.c. (n = 13) or i.m. (n = 15). Mean [IQR (25; 75)] serum hCG levels in the s.c. and i.m. groups were 171.7 [27.0; 207.0] and 142.2 [102.5; 157.5] mIU/mL, respectively. No adverse events were registered by any patient receiving hCG by either injection method. In this non-IVF population, two pregnancies were established in each subgroup (4 of 28, or approximately 14% pregnancy rate).


CONCLUSIONS
The s.c. administration of 5,000 IU hCG (reconstituted in vol. = 0.5 mL) was well tolerated by all women in this study and was associated with postinjection serum hCG levels similar to those observed after administration of an equivalent i.m. hCG dose. This investigation suggests that clinical use of s.c. hCG is suitable for lean women (e.g., BMI <30) undergoing ovulation induction, but additional data are needed to study the appropriateness of s.c. hCG administration in heavier patients.
Sills
E S
ES
Georgia Reproductive Specialists, Atlanta, Georgia, USA. dr.sills@ivf.com
Drews
C D
CD
Perloe
M
M
Kaplan
C R
CR
Tucker
M J
MJ
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D010060:Ovulation; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins
D006063:Chorionic Gonadotropin; D011994:Recombinant Proteins