Human chorionic gonadotropin (hCG) is one of those fabulously fickle things known as a hormone. But unlike some of the more famous female hormones — like progesterone or estrogen — it’s not always there, hanging out in your body in fluctuating amounts.
It’s actually typically made by the cells in a placenta, so it’s pretty special to pregnancy.
The hormone hCG tells your body to produce high amounts of progesterone, which helps to support and maintain pregnancy. If it’s been a couple weeks since you ovulated and now you’re pregnant, it’s possible to detect hCG in your urine and blood.
While hCG is produced naturally during pregnancy, the hormone is also used as a treatment for certain health conditions. (The market versions of this hormone are even derived from the urine of pregnant women!)
The Food and Drug Administration (FDA) has approved uses for hCG that are different for men and women, but it can be used as a fertility treatment for both.
The most common FDA-approved use of hCG is as an injection to treat infertility in women. If you have trouble conceiving, your doctor may prescribe hCG in combination with other drugs — such as menotropins (Menopur, Repronex) and urofollitropin (Bravelle) — to boost your fertility.
That’s because hCG can act similarly to luteinizing hormone (LH), a chemical produced by the pituitary gland that stimulates ovulation.
Some fertility problems are due to a woman having trouble producing LH. And since LH stimulates ovulation and ovulation is necessary for pregnancy — well, hCG can often help out here.
If you’re doing in vitro fertilization (IVF), you may also be prescribed hCG to boost your body’s chances of keeping a pregnancy.
You’ll typically get 5,000 to 10,000 units of hCG to inject subcutaneously or intramuscularly on a schedule determined by a doctor. This may sound scary, but we’ll walk you through how to do these injections.
It’s important to note that while hCG can help you become pregnant, it can harm the baby if you are pregnant. Don’t use hCG if you know that you’re pregnant, and notify your doctor right away if you become pregnant during treatment.
Don’t use hCG in amounts larger than recommended, or for a longer period than recommended.
In adult men, hCG is given as an injection to treat hypogonadism, a condition that causes the body to have trouble producing the male sex hormone testosterone.
A boost of hCG can stimulate production of testosterone, which can increase sperm production — and therefore, in cases where sperm count may be low, fertility.
Most men receive a dosage of 1,000 to 4,000 units of hCG injected into a muscle two to three times a week for several weeks or months.
You’ll receive your doses of hCG from your local pharmacy as either a liquid or as a powder that’s ready to mix.
If you get liquid medication, store it in the fridge — within three hours of receiving it from the pharmacy — until you’re ready to use it.
Don’t use hCG liquid that hasn’t been refrigerated. But because cold liquid can be uncomfortable going in, feel free to warm it in your hand before the injection.
If receive hCG powder, you’ll need to tap into your inner chemist and mix it with the vial of sterile water that comes with it to prepare it for injection. (You can’t use regular tap or bottled water.)
Keep the powder at room temperature before use. Pull 1 milliliter (or cubic centimeters — abbreviated “cc” on a syringe) of water from the vial into a syringe and then squirt it into the vial containing the powder.
Mix by gently rolling the vial around slowly. Don’t shake the vial with the water and powder mixture. (No, this wouldn’t cause some sort of explosion — but it’s not advised and could make the medication ineffective.)
Draw the mixed fluid back into the syringe and point it upward. Gently flick it until all air bubbles collect on top, and then push the plunger a little bit until the bubbles are gone. Then you’re ready to inject.
Where you inject hCG into your body depends on the instructions your doctor has given you. Follow your doctor’s instructions carefully.
Your doctor may give you your first injection of hCG. They’ll show you how to do this yourself at home if you require many injections — or if you need to inject at a time of day when your clinic isn’t open. You should only inject hCG yourself if you feel completely comfortable doing so.
HCG’s usually injected subcutaneously, into the layer of fat just under the skin and above your muscles. This is good news — fat is your friend and tends to make the injection fairly painless. To do this, your doctor or pharmacist will typically give you a short 30-gauge needle.
The lower abdomen is a common injection site for hCG. It’s an easy site to inject, because there’s usually more subcutaneous fat in this area. Stick to the semi-circle area below your belly button and above your pubic region. Be sure to stay at least one inch away from your belly button.
Front or outer thigh
The outer thigh is another popular hCG injection site because usually there’s more fat there than in other parts of the body. This makes a subcutaneous injection easier and less painful. Choose an injection site away from your knee on the thick, outside part of your thigh.
The front of your thigh will work, too. Just be sure you can take a big pinch of skin and fat together — in other words, for a subcutaneous injection, you want to avoid muscle.
The fatty part of the upper arm is a good location as well, but unless you’re a contortionist, you’re less likely to be able to do this one on your own. Have a partner or friend — as long as you trust them with the task! — do the injection here.
For some people, it’s necessary to inject hCG directly into the body’s muscles with a thicker 22.5-gauge needle. This leads to a quicker rate of absorption.
Injecting directly into muscle is usually more painful than injecting into the subcutaneous layer of fat below the skin. But don’t fret — when done right, it shouldn’t hurt terribly, and you shouldn’t bleed much.
The rounded muscle around your shoulder, called the deltoid muscle, is a place on the body where you can safely give yourself an intramuscular injection. Avoid injecting yourself in the knobby, top part of this muscle.
Again, this location can be hard to reach on your own, so you may want to ask someone else — someone with a steady hand — to do the injection.
Upper outer buttocks
In some cases, you might be instructed to inject hCG directly into the muscle on the upper outer part of your buttocks, near your hip. Either the ventrogluteal muscle or the dorsogluteal muscle will work.
Again, if this makes you feel like you have to be a contortionist, it might be easiest to ask a partner or friend to do the injection — just make sure they use our handy steps, below, to do it right!
Gather all the supplies you need:
- alcohol wipes
- liquid hCG
- needles and syringes
- puncture-proof sharps container given to you by your doctor for appropriate disposal of needles and syringes
Wash your hands well with soap and warm water, getting the back of your hands, in between your fingers, and under your fingernails.
You should scrub your hands together with water and soap before rinsing for at least 20 seconds. This is the amount of time it takes to sing the “Happy Birthday” song twice, and is the amount of time recommended by the
Dry your hands with a clean towel, and then wipe down your chosen injection site with a sterile alcohol wipe and allow it to dry before injecting hCG.
Make sure the syringe you’re using is full and doesn’t have any air on top when you hold the needle upright. Clear air and bubbles by pushing the plunger down just enough to clear them out.
Hold a 1- to 2-inch fold of skin gently with one hand so that the skin and fat beneath are between your fingers. Since hCG comes in pre-filled syringes or in mixtures you make in an exact dose, there’s no need for measuring.
Bring the filled needle to your skin at a straight, 90-degree angle, and stick the needle into your skin, just deep enough to enter the subcutaneous layer of fat above your muscle.
Don’t push too deeply. But don’t worry — this isn’t likely to be an issue, since the pharmacy probably gave you a short-gauge needle that wouldn’t reach the muscle layer, anyway.
Slowly press the plunger, emptying the needle into this layer of fat. Keep the needle in place for 10 seconds after you’ve pushed in the hCG, and then keep holding your skin as you slowly pull the needle out.
As you pull the needle out, release your pinched skin. Do not rub or touch the injection site. If it begins to bleed, press the area lightly with clean gauze and cover it with a bandage.
Dispose of your needle and syringe in your secure sharps container.
Congratulations — that’s it!
Follow the steps above, but instead of pinching a fold of skin, stretch the skin over your injection site with a few fingers of one hand as you push the needle into your muscle. Continue holding your skin until you pull the needle out and place it into your sharps bin.
You may have a little more bleeding, but this is completely OK. Just dab the site with some gauze, or gently hold the gauze there until the bleeding stops.
Pay special attention to the directions on the packet and any extra instructions your doctor gives you. Each time you give yourself a shot, thoroughly wash your hands and pick out a clean syringe to use.
It’s possible to bleed, bruise, or scar from injections. Injections can also be painful if you don’t have the right technique. Here are some tips to make your shots more comfortable, and so that they leave less of a mark:
- Don’t inject the roots of body hair, or wounded or bruised areas.
- Make sure your skin is completely clean and dry before you perform your injection. Allow the alcohol to dry off your skin to reduce stinging.
- Numb the injection site on your skin by rubbing it with an ice cube for a few seconds before cleaning your skin with the alcohol swab.
- Relax the muscles around the area of your body you’re about to inject. (“Relaxing” can be particularly hard the first time, but we promise it gets easier!)
- Rotate your injection sites to avoid bruising, pain, and scarring — for example, one butt cheek one day, the other butt cheek the next. You can ask your doctor for a chart to track the injection sites you’ve used.
- Take your hCG or sterile water out of the refrigerator 15 minutes beforehand so it hits room temperature before you inject it. Like brain freeze when you eat something that’s super cold, a cold injection can be a little jarring.
The first step in disposing your needles properly is to secure a puncture-proof sharps container. You can get one from your doctor. The FDA has a
Put your needles and syringes in your sharps bin immediately after you’ve used them. This reduces the risks — to you and others — of accidentally being pricked, cut, or punctured. Keep your sharps bin away from children and pets!
Avoid overfilling your sharps bin. At three-quarters full, it’s time to follow the guidelines in step 2 for proper disposal.
If you’re traveling, carry a small travel-sized sharps bin with you. Check with transportation agencies such as the Transportation Security Administration (TSA) for the latest rules on how to handle your sharps. Keep all your medications clearly labeled and accompany them with a doctor’s letter or prescription — or both, to be safe.
How and where you dispose your sharps bin depends on where you live. Learn how your municipality handles sharps by checking with your local health department or trash pickup company. Some common disposal methods include the following:
- sharps drop boxes or supervised collection sites at doctor’s offices, hospitals, pharmacies, health departments, medical waste facilities, police stations, or fire stations
- mail-back programs of clearly labeled sharps
- public household hazardous waste collection sites
- residential special waste pick-up services provided by your community, often for a fee on request or a regular schedule
Local sharps disposal
To find out how sharps are handled in your area, call the Safe Needle Disposal hotline at 1-800-643-1643 or email firstname.lastname@example.org.
The hormone hCG isn’t for everyone. Avoid taking it if you have:
Injections of hCG are common in IVF, IUIs, and other fertility treatment. It may seem daunting at first, but giving yourself a shot can become no big deal — and may even make you feel empowered.
As always, listen carefully to your doctor’s directions when taking hCG — but we hope this guide has helped as well.