Editing Human chorionic gonadotropin (section)

===Fertility===
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| tradename         =  Novarel, Pregnyl
| Drugs.com         = {{drugs.com|monograph|gonadotropin-chorionic}}
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| CAS_number = 9002-61-3
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| C=1105 | H=1770 | N=318 | O=336 | S=26
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Human chorionic gonadotropin injection is extensively used for [[final maturation induction]] in lieu of [[luteinizing hormone]]. In the presence of one or more mature ovarian follicles, ovulation can be triggered by the administration of HCG. As [[ovulation]] will happen between 38 and 40 hours after a single HCG injection,<ref>[http://www.medscape.com/viewarticle/473515 HCG Injection After Ovulation Induction With Clomiphene Citrate] at Medscape. By Peter Kovacs. Posted: 04/23/2004</ref> procedures can be scheduled to take advantage of this time sequence,<ref name=ivf.com>{{cite web | title = Ovulation Induction | url = http://www.ivf.com/ovind.html | work = IVF.com | archive-url = https://web.archive.org/web/20120226141802/http://www.ivf.com/ovind.html | archive-date=2012-02-26 | access-date = 7 March 2010 }}</ref>{{Unreliable medical source|date=December 2011}} such as [[intrauterine insemination]] or sexual intercourse. Also, patients that undergo [[IVF]], in general, receive HCG to trigger the ovulation process, but have an [[oocyte retrieval]] performed at about 34 to 36 hours after injection, a few hours before the eggs actually would be released from the ovary.{{cn|date=September 2023}}

As hCG supports the [[corpus luteum]], administration of hCG is used in certain circumstances to enhance the production of [[progesterone]].

Several vaccines against human chorionic gonadotropin (hCG) for the prevention of pregnancy are currently in clinical trials.<ref name="Talwar_2015">{{cite journal | vauthors = Talwar GP, Gupta JC, Rulli SB, Sharma RS, Nand KN, Bandivdekar AH, Atrey N, Singh P | title = Advances in development of a contraceptive vaccine against human chorionic gonadotropin | journal = Expert Opinion on Biological Therapy | volume = 15 | issue = 8 | pages = 1183–1190 | year = 2015 | pmid = 26160491 | doi = 
10.1517/14712598.2015.1049943 | hdl = 11336/76410 | s2cid = 10315692 | hdl-access = free }}</ref>

====Use in males====
In males, hCG injections are used to stimulate the [[Leydig cell]]s to synthesize [[testosterone]].<ref>{{cite journal | vauthors = Riccetti L, De Pascali F, Gilioli L, Potì F, Giva LB, Marino M, Tagliavini S, Trenti T, Fanelli F, Mezzullo M, Pagotto U, Simoni M, Casarini L | title = Human LH and hCG stimulate differently the early signalling pathways but result in equal testosterone synthesis in mouse Leydig cells in vitro | journal = Reproductive Biology and Endocrinology | volume = 15 | issue = 1 | pages = 2 | date = January 2017 | pmid = 28056997 | doi = 10.1186/s12958-016-0224-3 | pmc = 5217336 | doi-access = free }}</ref> The intratesticular testosterone is necessary for [[spermatogenesis]] from the [[sertoli cells]]. Typical medical uses for hCG in males include treating certain types of [[hypogonadism]] (either as monotherapy, or, more commonly, in combination with [[Testosterone (medication)|exogenous testosterone]]), as well as to either treat or prevent infertility, for example, during testosterone replacement therapy hCG is often used to restore or maintain fertility and prevent testicular atrophy.<ref>{{cite journal | vauthors = Kim ED, Crosnoe L, Bar-Chama N, Khera M, Lipshultz LI | title = The treatment of hypogonadism in men of reproductive age | journal = Fertility and Sterility | volume = 99 | issue = 3 | pages = 718–724 | date = March 2013 | pmid = 23219010 | doi = 10.1016/j.fertnstert.2012.10.052 | doi-access = free }}</ref><ref name="e876">{{cite journal | vauthors = Lee JA, Ramasamy R | title = Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men | journal = Translational Andrology and Urology | volume = 7 | issue = Suppl 3 | pages = S348–S352 | date = July 2018 | pmid = 30159241 | doi = 10.21037/tau.2018.04.11 | publisher = AME Publishing Company | doi-access = free | pmc = 6087849 }}</ref>

====HCG Pubergen, Pregnyl warnings====
In the case of female patients who want to be treated with HCG Pubergen, Pregnyl:{{cn|date=August 2022}}
a) Since infertile female patients who undergo medically assisted reproduction (especially those who need [[In vitro fertilisation|in vitro fertilization]]), are known to often be suffering from<!-- !  check for tone !--> tubal abnormalities, after a treatment with this drug they might experience many more [[ectopic pregnancies]]. This is why early ultrasound confirmation at the beginning of a pregnancy (to see whether the pregnancy is intrauterine or not) is crucial. Pregnancies that have occurred after a treatment with this drug have a higher risk of [[multiple pregnancy]]. Female patients who have thrombosis, severe obesity, or thrombophilia should not be prescribed this medicine as they have a higher risk of arterial or venous thromboembolic events after or during a treatment with HCG Pubergen, Pregnyl. b)Female patients who have been treated with this medicine are usually more prone to pregnancy losses.{{cn|date=September 2023}}

In the case of male patients: A prolonged treatment with HCG Pubergen, Pregnyl is known to regularly lead to increased production of androgen. Therefore: Patients who have overt or latent cardiac failure, hypertension, renal dysfunction, migraines, or epilepsy might not be allowed to start using this medicine or may require a lower dose of HCG Pubergen, Pregnyl. This drug should be used with extreme caution in the treatment of [[prepubescent]] teenagers in order to reduce the risk of precocious sexual development or premature epiphyseal closure. This type of patients' skeletal maturation should be closely and regularly monitored.{{cn|date=September 2023}}

Both male and female patients who have the following medical conditions must not start a treatment with HCG Pubergen, Pregnyl: (1) Hypersensitivity to this drug or to any of its main ingredients. (2) Known or possible androgen-dependent tumors for example male breast carcinoma or prostatic carcinoma.