Choriogonadotropin Alfa

Indications

Choriogonadotropin Alfa is used for: Anovulatory infertility, Adjunct to IVF procedures and other assisted conception techniques

Adult Dose

Induction of Ovulation & Pregnancy 250 mcg SC one day following last dose of follicle stimulating agent; use only after adequate follicular development has been determined; hold treatment if there is excessive ovarian response 5,000-10,000 units 1 day following last dose of menotropins Induction of Spermatogenesis Hypogonadotropic and hypogonadism in males: 1000-2000 units 2-3 times/week (may require 2-3 months of therapy); if needed, add follitropin alfa or menopausal gonadotropin to induce spermatogenesis; continue hCG therapy at dose required to maintain testosterone levels

Child Dose

Prepubertal Cryptorchidism Not Caused By Anatomical Obstruction May institute therapy between ages of 4 and 9 4,000 units IM 3 times/week for 3 weeks 5,000 units IM every second day for 4 injections 15 injections of 500 to 1,000 units IM over a period of 6 weeks 500 units IM 3 times/week for 4-6 weeks; if course of treatment not successful, begin another 1 month later, giving 1,000 units/injection Male Hypogonadotropic Hypogonadism 500-1,000 units IM 3 times/week for 3 weeks, followed by same dose twice/week for 3 weeks 4,000 units IM 3 times/week for 6-9 months; following that dosage may be reduced to 2,000 units 3 times/week for an additional 3 months

Renal Dose

Administration

Contra Indications

Ovarian enlargement or cyst (unless caused by polycystic ovarian disease); ectopic pregnancy in previous 3 months; active thromboembolic disorders; hypothalamus, pituitary, ovarian, uterine or mammary malignancy; gynaecological haemorrhage of unknown etiology; primary ovarian failure; sexual organ malformations and fibroid uterine tumors incompatible with pregnancy; postmenopausal women. Uncontrolled thyroid or adrenal dysfunction. Pregnancy and lactation.

Precautions

Asthma, epilepsy, migraine, CV disorders, renal disorders; infertility caused by hyperprolactinaemia, pituitary or hypothalamic tumors; clinically significant systemic diseases where pregnancy could exacerbate the condition. Monitor carefully estradiol levels and ovarian response based on ultrasound prior to and during stimulation therapy. Multiple pregnancy. Lactation: Not known if distributed in breast milk; use caution

Pregnancy-Lactation

Pregnancy Category: X Lactation: Not known if distributed in breast milk; use caution

Interactions

Adverse Effects

Side effects of Choriogonadotropin Alfa : 1-10% Ovarian cyst (3%), Ovarian hyperstimulation (2-3%), Abdominal pain (3-4%), Nausea (3%), Vomiting (3%), Injection site inflammation (<2%) <1% Breast pain, Cervical lesion, Cough, Albuminuria, Back pain, Breast pain, Cardiac arrhythmia, Dizziness, Emotional lability, Genial herpes, Hyperglycemia, Pruritus, Urinary tract infection, Vaginal hemorrhage, Vaginitis Frequency Not Defined Headache, Irritability, Depression, Edema, Restlessness, Gynecomastia, Precocious puberty, Fatigue, Arterial thrombus, Ovarian hyperstimulation syndrome

Mechanism of Action

Choriogonadotropin alfa is a recombinant form of chorionic gonadotrophin. Its effects mimic those of leuteinizing hormone, which triggers ovulation and formation of the corpus luteum in women and stimulates the production of testosterone by the testes in men.