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Human chorionic gonadotropin (hCG, brand
name Pregnyl, Novarel, Ovidrel) is a hormone closely
similar in its biologic effect to LH, which
induces ovulation. hCG initiates follicular changes,
triggering ovulation approximately 36 to 48 hours later.
Retrieval must occur before ovulation or the IVF cycle will be "lost". hCG is also secreted by the placenta
during pregnancy.
Room temperature storage is adequate prior
to dilution of hCG. Ovidrel comes as a pre filled syringe and is injected subcutaneously.
Side effects similar to those encountered
with the above mentioned medications may be briefly
noticed.
hCG Injection (intramuscular products; see instructions for Ovidrel):
1. Timing of hCG is critical and
should be performed within 30 minutes of the designated
time.
2. Wash and dry hands thoroughly.
3. Assemble supplies: one 3cc syringe, one 22 gauge
1.5" needle and one 25 gauge 1.5"needle, 2
alcohol wipes, one tissue, and medication. If using Ovidrel, reconstitution is not necessary.
4. Remove all wrappings, snap off plastic caps from
medication.
5. Attach syringe and needle. Pull the syringe plunger
back until its tip is at the proper dose mark. (1cc
or 1ml).
6. Wipe each vial with alcohol wipes.
7. Remove cover from the needle, insert straight and
firmly into the center rubber top of the water. Push
the plunger all the way in.
8. Turn the vial upside down.
9. With the tip of the needle in the liquid medication,
pull plunger of syringe to fill to 1cc of water then
remove.
10. Insert water into the powder and gently roll between
hands with needle inside. The powder dissolves rapidly.
Holding the vial upside down, slowly pull back on the
plunger to obtain all the medication, then remove the
needle. Do not let the plunger reach the end of the
syringe.
11. Remove air bubbles from the syringe by firmly flicking
with a finger. 
12. Change needle to a 25 gauge 1.5"needle.
13. Choose injection site, as done for injectable gonadotropins,
and pinch skin with the left hand.
14. Hold syringe and alcohol wipe in right hand.
15. Wipe skin and slide alcohol wipe under left thumb.
16. Holding the syringe like a dart, perpendicular to
the skin, inject 1 1/2" and quickly inject medication
then withdraw needle briskly.
17. Slide alcohol wipe over the area then with tissue.
18. Dispose of supplies safely in a strong container.
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