How many times are injections of human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) administered?

HCG and HMG Injection Frequency

For ovulation induction in IUI, HCG is given as a single injection of 5,000-10,000 IU one day after the last dose of HMG, while HMG is administered daily at 75 IU or lower doses until follicular maturation is achieved. 1, 2

Specific Dosing Protocols

For Ovulation Induction (IUI Context)

HMG (Human Menopausal Gonadotropin):

• Daily administration at 75 IU or lower until follicular maturation 3
• Continue until the dominant follicle reaches approximately 18mm diameter 3
• Higher doses (>75 IU) increase multiple pregnancy rates without improving pregnancy rates 3

HCG (Human Chorionic Gonadotropin):

• Single injection of 5,000-10,000 IU 1, 2
• Given one day after the last HMG dose 1, 2
• The 10,000 IU dose is specifically recommended in menotropin labeling 1
• IUI should be performed 24-40 hours after HCG injection 3

For Male Hypogonadotropic Hypogonadism

If treating male infertility (different context):

• HCG: 1,500-2,000 IU twice weekly 4, 5
• HMG: 75-150 IU twice weekly when combined with HCG 4, 6
• Treatment duration: typically 6-24 months 5

Critical Timing Considerations

The timing sequence is crucial:

1. HMG is given repeatedly (daily) during follicular stimulation phase
2. HCG is given as a single trigger injection when follicles are mature
3. IUI is performed 24-40 hours post-HCG 3

Important Caveats

• Do not use higher HMG doses - doses above 75 IU increase multiple pregnancy risk (6-14% with 2-4 follicles) without improving outcomes 3
• The HCG injection serves as the ovulation trigger, not a repeated medication 1
• Some protocols may include additional luteal phase HCG support (single or repeated injections) in WHO Group I anovulatory women, which reduces luteal phase defects and improves pregnancy rates 7

The fundamental principle: HMG is given multiple times to stimulate follicle growth; HCG is given once to trigger ovulation.