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) a s a function of hCG injection method (subcutaneous vs. intramuscular) among infertile women undergoing ovulation induction. Design: Prospective, randomized clinical trial. Setting: Major urban infertility referral center. Patient(s): Women presenting for infertility evaluation and ovulation induc tion. Intervention(s): Controlled ovarian hyperstimulation was followed by 5,000 IU urinary (nonrecombinant) hCG injection, given intramuscularly (i.m.) or subcutaneously (s.c.). Main Outcome Measure(s): Serum hCG levels measured 24 hours after administr ation of hCG, and patient tolerability of injected hCG. Result(s): There were no statistically significant differences in age or bo dy 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 adve rse events were registered by any patient receiving hCG by either injection method. In this non-IVF population, two pregnancies were established in ea ch subgroup (4 of 28, or similar to 14% pregnancy rate). Conclusion(s): The s.c. administration of 5,000 IU hCG (reconstituted in vo l. = 0.5 mL) was well tolerated by all women in this study and was associat ed with postinjection serum hCG levels similar to those observed after admi nistration 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) under going ovulation induction, but additional data are needed to study the appr opriateness of s.c. hCG administration in heavier patients. (C) 2001 by Ame rican Society for Reproductive Medicine.