Fertility treatment with hCG injections

Please read this important information you must know before starting fertility treatment with hCG injections

Before fertility treatment is started your doctor will want to check the functioning of your adrenal glands and thyroid gland, and that you do not have tumours of the pituitary or hypothalamic glands in the brain, or higher than normal blood levels of a hormone called prolactin, all of which can affect fertility.

In women, before fertility treatment is started your doctor will need to check the functioning of your ovaries using ultrasound and a blood test to measure your oestrogen levels. During treatment, these tests, as well as tests to measure the level of oestrogen in your urine, will need to be carried out at regular intervals until the follicles develop.

During your fertility treatment, if your blood or urine tests show high levels of oestrogen, or if an ultrasound scan shows excessive development of follicles in your ovaries, this indicates that your ovaries may be overstimulated, which could lead to a dangerous syndrome called ovarian hyperstimulation syndrome (OHSS). Treatment with this medicine should not be given and you should not have sex, or use barrier contraception for at least four days.

This medicine can itself also cause over-stimulation of the ovaries (OHSS). For this reason, it is important to tell your doctor immediately if you experience pain or swelling of the abdomen, weight gain, difficulty breathing, increased thirst, decreased urine output, nausea, vomiting and diarrhoea after having the injection. If your ovaries are overstimulated you should not have sex, or use barrier contraception for at least four days.

If this treatment does result in pregnancy, there are a few risks that you should be aware of. You should discuss these with your doctor before starting treatment. Pregnancy following treatment with hCG injections is more likely to result in a multiple pregnancy (twins or more) than if you had conceived naturally. This carries an increased risk of problems for the mother during the pregnancy, and at or around the time of birth. There is a greater risk of miscarriage or abortion in women having fertility treatment than in the general population. There may also be a slightly higher risk of your baby being born with physical defects. There is a slightly higher risk of an ectopic pregnancy (where a fertilised egg implants outside the uterus) after IVF treatment than in the general population.