3 ampoules of 1 ml
5000 IU
Injectable use only
HCG Solution

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

* Keep this leaflet. You may need to read it again.

* If you have any further questions, ask your doctor or pharmacist.

* This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

* If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed int his leaflet.

Human Chorionic Gonadotropin or HCG

Human Chorionic Gonadotropin or HCG is a powerful polypeptide hormone found in pregnant women. There were numerous reported benefits of administering HCG to a host of varying patients, and while some were indeed beneficial others would prove to be quite ridiculous. HCG was initially used to treat the following:

• Froehlich’s Syndrome
• Cryptochidism
• Obesity
• Depression
• Female Infertility
• Uterine Bleeding
• Amenorrhea

HCG extract was no longer used as a science had developed the means of filtering and purifying the urine of pregnant women to obtain a cleaner more sanitary HCG hormone. It is still used in a therapeutic setting, most commonly for:

  • Cryptochidism
  • Female Infertility
  • Hypogonadism (Low Testosterone)
  • Weight Loss

HCG is also regularly used by many anabolic steroid users as a secondary item alongside anabolic steroid use or after use has been discontinued. During anabolic steroid use, the idea behind supplementation is to combat hormonal suppression that occurs due to steroid use. Use after anabolic steroid use is implemented in order to enhance or produce a more efficient recovery. Both points of use are, however, highly debated among numerous steroid users.

Functions & Traits

Human Chorionic Gonadotropin (HCG) is a polypeptide hormone found in pregnant women during the early stages of pregnancy.

The hormone is created in the placenta and is largely responsible for the continued production of progesterone, which itself is an essential hormone to pregnancy.

The HCG hormone is also the standard measuring tool in pregnancy test. Once conception occurs, HCG levels begin to increase and can be detected by a standard home pregnancy test. The hormone will then peak approximately 8-12 weeks into pregnancy and then gradually decrease until birth.

When examining the functions and traits of HCG the only one of notable worth in both therapeutic or performance settings is in its ability to mimic the Luteinizing Hormone (LH). While perhaps slightly simplistic, HCG is exogenous LH, the primary gonadotropin along with Follicle Stimulating Hormone (FSH). This is beneficial to the female patient as such gonadotropins stimulate conception; LH is also the primary gonadotropin responsible for the stimulation of natural testosterone production. This is the precise reason some anabolic steroid users will use it and the primary reason it is used in many low testosterone treatment plans. When LH is released, it signals to the testicles to produce more testosterone, which is more than beneficial if natural LH production is low.

HCG, while we can call it exogenous LH is not LH but rather mimics the hormone.  This makes it beneficial to the steroid user post cycle as it will prime the body for the total Post Cycle Therapy (PCT) to come, which will normally include Selective Estrogen Receptor Modulators (SERM’s).

While its functions do not change despite the purpose of use, as we look at the effects of HCG we will find use needs to be regulated heavily.

1. What is HCG

HCG contains the hormone known as human chorionic gonadotropin (hCG), which belongs to a group of medicines called gonadotropins. These are important for fertility and reproduction.

HCG is obtained from the urine of pregnant women. HCG has the same effect on the body as luteinising hormone (LH), which is produced in the pituitary gland of men and women.

The pituitary is a small hormone-producing gland located at the base of the brain.

Together with another pituitary hormone, follicle-stimulating hormone (FSH), LH regulates the function of the reproductive organs (ovaries in women and testicles in men).

These hormones are necessary for the normal growth and ripening of egg and sperm cells.

In Women
• In women, FSH and LH cause the monthly ripening of an egg cell in one of the ovaries. LH is also needed for ovulation: the release of the egg cell. If the body does not produce enough FSH and LH on its own, this can lead to low fertility. Daily injections of FSH can lead to ripening of the egg cell. HCG ensures that ovulation takes place afterwards.

• HCG can also be given in assisted reproductive techniques, both before and after ovulation.

In Men
• In men, HCG can be used on its own or together with an FSH-containing product, when there is underdevelopment of the sex glands or when there are problems with the formation of sperm.

2. What you need to know before you use HCG

Warnings and precautions

Talk to your doctor or pharmacist before using this medicine.

For men and women:

Please inform your doctor if you:

• have uncontrolled pituitary gland or hypothalamic problems.
• have an underactive thyroid gland (hypothyroidism).
• have adrenal glands that are not working properly (adrenocortical insufficiency).
• have high prolactin levels in the blood (hyperprolactinemia).
• have any other medical conditions (for example, diabetes, heart disease, or any other long-term disease).

Allergic reactions
Allergic reactions, both generalized and local, including swelling of the face, lips,
tongue, and/or throat that may cause difficulty in breathing or swallowing (angioedema and anaphylaxis) have been reported. If you have an allergic reaction, stop taking HCG and seek immediate medical assistance. (See also Section 4 Possible side effects).

Misuse for weight control
HCG must not be used for weight loss. HCG has no effect on fat metabolism (burning fat), distribution of fat or appetite.

Chance of having ovarian hyperstimulation syndrome (OHSS)

Treatment with gonadotropic hormones like HCG may cause ovarian hyperstimulation syndrome (OHSS). This is a serious medical condition where the ovaries are overly stimulated and the growing follicles become larger than normal. In rare cases, severe OHSS may be life-threatening. Therefore, close supervision by your doctor is very important. To check the effects of treatment, your doctor will do ultrasound scans of your ovaries. Your doctor may also check blood hormone levels. (See also Section 4 Possible side effects).

OHSS causes fluid to build up suddenly in your stomach and chest areas and can cause blood clots to form.

Call your doctor right away if you have:

• severe abdominal swelling and pain in the stomach area (abdomen)
• feeling sick (nausea)
• vomiting
• sudden weight gain due to fluid build-up
• diarrhea
• decreased urine output
• trouble breathing

Ovarian Torsion

Ovarian torsion is the twisting of an ovary. Twisting of the ovary could cause the blood
flow to the ovary to be cut off.

Before starting to use this medicine, it is important to inform your doctor if you:

• have ever had ovarian hyperstimulation syndrome OHSS
• are pregnant or think that you may be pregnant
• have ever had stomach (abdominal) surgery
• have ever had a twisting of an ovary
• have past or current cysts in your ovary or ovaries

Chance of having multiple births or birth defects

In pregnancies occurring after treatment with gonadotropic preparations, there
is an increased risk of having twins or multiple pregnancies. Multiple pregnancies carry an increased health risk for both the mother and her babies during pregnancy and around the time of birth. Furthermore, multiple pregnancies and characteristics of the patients undergoing fertility treatment
(e.g. age of the female, sperm characteristics) may be associated with an
increased risk of congenital anomalies.

Chance of having pregnancy complications
In women undergoing fertility treatment there is a slightly increased risk of a pregnancy outside of the uterus (an ectopic pregnancy). Therefore, your doctor should perform an early ultrasound examination to exclude the possibility of  pregnancy outside the uterus.

Miscarriage

In women undergoing fertility treatment there may be a slightly higher risk of
miscarriage.

Chance of having a blood clot (thrombosis)
Treatment with HCG (like pregnancy itself) may increase the risk of the formation of a blood clot in a blood vessel (thrombosis), most often in the veins of the legs or the lungs.

Blood clots can lead to serious medical conditions, such as:

• blockage in your lungs (pulmonary embolus)
• stroke
• heart attack
• blood vessel problems (thrombophlebitis)
• reduced blood flow to the vital organs that may result in organ damage
• reduced blood flow to your arm or leg that may result in a loss of your arm or leg

Please discuss this with your doctor, before starting treatment, especially if:

• you already know you have an increased risk of blood clots
• you, or anyone in your immediate family, have ever had a blood clot
• you are severely overweight

For up to 10 days after administration of HCG, a pregnancy test may give a false-positive result.

If you are a man:

Antibody formation

If the treatment with HCG is not working, consult with your door who may perform additional tests.

Treatment with HCG (hCG) can cause the body to produce substances that act against hCG (antibodies to hCG). In rare cases this could result in ineffective treatment.

Androgen production

Treatment with hCG leads to increased androgen (male sexual hormone) production.

Therefore extra supervision by the doctor is necessary

• in the treatment of boys who have not reached puberty. This is because HCG can
cause early sexual development and delay growth.
• if you have or have ever had: – heart or blood vessel disease – kidney disease
– epilepsy
– migraine headaches because worsening or recurrence may occasionally be induced as a result of increased production of androgens (male sexual hormones).

Using other medicines

Interactions of HCG with other medicines have not been investigated; interactions with commonly used medicines can therefore not be excluded.

Please tell your doctor or pharmacist if you are taking or have recently taken any other
medicines, including medicines obtained without a prescription.

For up to ten days after administration, HCG may result in a false positive pregnancy test.

Pregnancy and breast-feeding

You must not use HCG during pregnancy. HCG may be used to support a (possible)
pregnancy during the period just after ovulation (luteal phase).

If you are breast-feeding, ask your doctor for advice before taking this medicine. Use
of HCG can be considered while nursing a baby.

Driving and using machines

As far as is known, HCG has no effect on the ability to drive or operate machines.

HCG contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per injection, i.e. essentially ‘sodium-free’.

3. Side effects of HCG

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Most of these reactions are of a mild nature and go away on their own.

Common side effects occur in less than 1 in 10 patients.

Uncommon side effects occur in less than 1 in 100 patients.

Rare side effects occur in less than 1 in 1000 patients.

HCG can cause bruising, pain, redness, swelling and itching at the site of injection.

Allergic reactions are rare, and mostly involve pain or rash at the injection site.

In rare cases generalized hypersensitivity can occur, such as a rash on several areas of the body, or fever (see section 2 Warnings and precautions).

If you are a woman

A possible complication of treatment with gonadotropic hormones like HCG is unwanted over stimulation of the ovaries.

The chance of having this complication can be reduced by carefully monitoring the number of maturing follicles (small round sacs in your ovaries that contain the eggs).

Your doctor will do ultrasound scans of your ovaries to carefully monitor the number of maturing follicles. Your doctor may also check blood hormone levels.

The first symptoms of ovarian overstimulation may be noticed as pain in the stomach (abdomen), feeling sick or diarrhea. Ovarian overstimulation may develop into a medical condition called
ovarian hyperstimulation syndrome (OHSS), which can be a serious medical problem.

In more severe cases this may lead to enlargement of the ovaries, collection of fluid in the abdomen and/or chest (which may cause sudden weight gain due to fluid build-up) or clots in the blood vessels (See also Section 2 Warnings and precautions).

Contact your doctor without delay if you have pain in the stomach (abdomen) or any of the other symptoms of ovarian hyperstimulation, even if they occur some days after the administration of HCG has been given.

Rarely, blood clots may occur without unwanted overstimulation of the ovaries (see also section 2. Before you use HCG).

If you are a man

In men, fluid and salt may be retained in the tissues, marked usually by swelling of the ankles or feet and, in rare cases, enlargement of the breasts. This may be caused by increased androgen production due to treatment with hCG. If any of these symptoms appear, tell your doctor immediately.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

4. How to use HCG

Dosage
Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Your doctor will decide on the dose of HCG to be given and will supervise your first injection.

In female patients one injection is usually given to induce ovulation and up to 3 injections to support the luteal phase that follows.

In male patients the injections are given 2 or 3 times a week. The treatment will last from a few weeks to at least 3 months, depending on the problem being treated.

The length of treatment depends on the time needed for development of sperm and the period in which an improvement can be expected.

How the injections are given The HCG solution can be injected slowly into muscles (for instance, in the buttock, the upper leg or the upper arm) or just under the skin for instance, in the lower abdomen).

5. What HCG looks like and contents of the pack

One pack contains 3 vials of 1 ml glass vial contains 5000 IU of human Chorionic Gonadotrophin (hCG)

This leaflet was last revised in Jan 2019 – HCG – Bavarian Medicines

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