title: Periovulatory serum human chorionic gonadotropin (hCG) concentrations following subcutaneous and intramuscular nonrecombinant hCG use during ovulation induction: a prospective, randomized trial.
abstract: 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.
authors.affiliation: Georgia Reproductive Specialists, Atlanta, Georgia, USA. dr.sills@ivf.com
authors.forename: E S
authors.initials: ES
authors.lastname: Sills
authors.forename: C D
authors.initials: CD
authors.lastname: Drews
authors.forename: M
authors.initials: M
authors.lastname: Perloe
authors.forename: C R
authors.initials: CR
authors.lastname: Kaplan
authors.forename: M J
authors.initials: MJ
authors.lastname: Tucker
mesh_terms: 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
chemical_list: D006063:Chorionic Gonadotropin; D011994:Recombinant Proteins