Pregnyl

Characteristics:
The active ingredient is human chorionic gonadotropin, which is derived from the urine of pregnant women. Pregnyl stimulates the production of steroid hormones in the gonads by the effect of the human luteinizing hormone (LH). In females, the drug causes increased synthesis of progesterone and estrogen after ovulation, in the male patients pregnyl stimulates the synthesis of testosterone. There was no appearance of antibodies against human chorionic gonadotropin when taking pregnyl.
The maximum concentration of human chorionic gonadotropin (hCG) in blood plasma of women is determined after 20 hours, the men - 6 hours (after intramuscular injection once daily). Significant differences in pharmacokinetics between men and women are due for the most part a considerable thickness of subcutaneous fat in women in the buttocks. After intramuscular injection of hCG is well absorbed into the bloodstream. The half-life is 33 hours pregnyl. Approximately 80% of the drug is destroyed in the kidney tissue. Elimination - in the urine.

Indications:
Men:
• Reduced fertility associated with idiopathic disspermiey;
• hypogonadotropic hypogonadism;
• the delay in sexual development in boys related to the lack of gonadotrophic function of pituitary cells;
• cryptorchidism (except due to anatomic occlusion).

Women:
• In ART (assisted reproductive technology) to prepare the follicle to puncture for purpose of controlled ovarian hyperstimulation;
• induction of ovulation for infertility is associated with the violation of maturation of the follicle or anovulation;
• support the luteal phase of the menstrual cycle (including the time of controlled ovarian hyperstimulation in assisted reproductive technologies) in combination with analogues of gonadotropin-releasing hormone or other drugs to stimulate ovulation in female infertility caused by anovulation due to insufficient activity of endogenous estrogens ( WHO classification - Group I ovarian failure).

How to use:
Before the introduction of freeze-dried active substance is added pregnyl attached solvent. Slowly injected intramuscularly. The prepared solution can not be stored, since the further preservation of the sterility of the solution is not guaranteed. These doses are approximate and must be treated individually adjusted physician depending on the required response to the introduction of pregnyl.
Preparation of the follicle to puncture or induction of ovulation: a single dose is administered at a dosage pregnyl 3000-10 000 IU.
Support the luteal phase of the menstrual cycle: a dose of 1000-3000 IU once a day. Total appointed by 2-3 injections: 1 every once in nine days after the replanting of an embryo or after ovulation (e.g., after ovulation stimulation for 3, 6 and 9 days).
For male infertility due to disorders of spermatogenesis process is prescribed in combination with follicle-stimulating hormone 1 time per day or 2-3 times a week for at least 3 months to improve the quality and quantity of semen. Can be used as monotherapy. Drug is given by 1000-2000 IU. During pregnyl intake to suspend replacement testosterone treatment, if any.
Delayed sexual development in boys should be prescribed a dose of 1500 IU of treatment - not less than 6 months. The drug is administered 2-3 times a week.
Cryptorchidism: for children under 2 years are prescribed at a dose of 250 IU 2 times in 7 days course of not less than 6 months with 2 to 6 years - 2 times in 7 days on the course of 500-1000 IU 6 months for children over 6 years - 2 every 7 days during 6 months of 1500 IU. In case of insufficient effect of treatment can be repeated.

Side effects:
Women:
• ovarian hyperstimulation syndrome,
• unwanted ovarian hyperstimulation.
Symptoms of mild ovarian in hyperstimulation: nausea, abdominal pain, diarrhea, chest pain, slight or moderate increase in the size of the ovaries or the appearance of ovarian cysts. Symptoms of severe ovarian hyperstimulation: the development of large ovarian cysts (which have a tendency to rupture), weight gain, the appearance of ascites, the development of thromboembolic complications and hydrothorax.

Men: fluid retention and sodium in the body due to the higher education of androgens, proliferative changes in prostatic tissue, gynecomastia, erection and increase penis size by increasing the concentration of testosterone in the blood, hypersensitivity nipples, a slight increase in testicle in the inguinal canals, personality changes, characteristic of the first phase of puberty.

Men and women: possible violations at the injection site due to the biological origin of pregnyl (pain, redness, bruising, itching, swelling). It is also possible hypersensitivity reactions (fever, rash).

Contraindications:
• Adrogenic tumor (suspected or established breast carcinoma in men, prostate carcinoma);
• untreated endocrine disorders (adrenal insufficiency, hypothyroidism, hyperprolactinemia);
• Women's infertility associated with obstruction of the fallopian tubes;
• ovarian cancer,
• Allergic reactions to gonadotrophic hormones or any of the components pregnyl.

Pregnancy:
Pregnyl is not contraindicated in pregnancy, be appointed to support the luteal phase of the menstrual cycle. However, the drug is not recommended to nursing mothers.

Interactions with other drugs:
It is not known.

Overdose:
Human chorionic gonadotropin is characterized by extremely low toxicity. Symptoms of acute overdose with parenteral administration are not described. Women on the background of an overdose may ovarian hyperstimulation.

Product:
Lyophilized powder for solution for injection in vials of 1500 IU, 5000 IU. The set includes a solvent. In carton 3 capsules  in blisters.

Storage:
Pregnyl should be stored in a refrigerator in dark conditions at a temperature of 2-15 ° C for up to 3 years. During transportation to comply with the specified temperature conditions.

Ingredients:
Active ingredient: human chorionic gonadotropin.
Auxiliary ingredients: mannitol, sodium dihydrogen phosphate anhydrous, sodium hydrogen phosphate anhydrous, sodium carboxymethylcellulose.
Solvent composition: 0.9% sodium chloride.

Extras:
There is an increased risk of multiple pregnancy in ovulation induction human chorionic gonadotropin. In the case of assisted reproductive technology increases the likelihood of miscarriage. If there is an indication of violation of tubal patency - increases the risk of ectopic (tubal) pregnancy. In the latter case, after the localization of the uterine pregnancy to confirm gestational sac ultrasound of the uterus. Before the appointment of the drug to exclude uncontrolled endocrinopathies origin (thyroid dysfunction, pituitary or adrenal glands).
The appointment for women with infertility due to impaired maturation of the follicle or anovulation may lead to unwanted ovarian hyperstimulation with concomitant administration of follicle-stimulating hormone. In these cases before therapy and during its application (at regular intervals) is required ultrasound monitoring to assess the development of the follicle. It is also recommended to periodically determine the content of estradiol in the blood serum. The rapid increase in estradiol (2 times for 2-3 days) may indicate the development of a large number of follicles. Unwanted ovarian hyperstimulation may be confirmed by ultrasound examination of ovaries. In the case of confirmation of the diagnosis should immediately stop the introduction of products containing follicle-stimulating hormone, since there is a risk for the development of ovarian hyperstimulation syndrome and multiple ovulation induction.
Symptoms of mild ovarian hyperstimulation: nausea, abdominal pain, diarrhea, chest pain, slight or moderate increase in the size of the ovaries or the appearance of ovarian cysts. Symptoms of severe ovarian hyperstimulation: the development of large ovarian cysts (which have a tendency to rupture), weight gain, the appearance of ascites, the development of thromboembolic complications and hydrothorax.
Introduction of human chorionic gonadotropin causes an increase in the synthesis of androgens, so there may be a deterioration of general condition with severe or recurrent or latent cardiovascular disease, migraine headaches (including migraine history), hypertension, renal dysfunction, epilepsy. 
In order to prevent premature sexual maturation and epiphyseal in young men at puberty, must be used with caution them to the drug during this period. In this case, the intake should be under the control of the state of the musculoskeletal system.

Attention!
Before using the drug you should consult your doctor. This instruction is given a free transfer and is designed for educational purposes only.