How to Mix hCG and Give (human chorionic gonadotropin)

The hCG injection is an important step in the IVF (In-Vitro Fertilization) cycle. Review the online injection video in the IVF class at: https://www.uwhealth.org/IVFClass.

If you would like the injection site marked, please ask the nurse to do this once you are near the time you will be taking it.

If you have questions about the injection, please call us at (608) 824-6160. After hours you can still call this number and ask to have the doctor on call paged.

The timing of this injection is very important. If you do not know what time you should take it once you are told the day, please call to ask.

Supplies

• One 10 mL vial of bacteriostatic water (diluent)

• One vial of 10,000 U of hCG (powder)

• Alcohol wipe

• One 3 mL syringe

• One fill needle = 18G 1-1/2”

• One injecting needle = 22G 1-1/2”
  

NOTE: Follow these instructions only, rather than any instructions that may be included from your pharmacy.

To Prepare hCG

1. Wash hands with soap and water. Place medicine on a clean, dry surface.

2. Remove pop-top from both vials and swab the rubber stoppers with alcohol.

3. Attach fill needle (18 gauge 1-1/2”) to the syringe. Remove needle cover.

4. Draw air into the syringe by pulling out the plunger to the 1 mL mark.

5. Push needle into diluent vial and inject air.

6. Without taking the needle out, turn the vial upside down and withdraw 1 mL of diluent into the syringe.

7. Inject the 1 mL of diluent into the vial of powdered hCG.

8. Without taking the needle out, gently swirl the vial until powder is fully dissolved.

9. Turn the diluted hCG vial upside down and withdraw the hCG by pulling back on the plunger.

10. Check for air bubbles in the syringe. To remove any air bubbles:
    o Flick the syringe with your finger to make the bubbles rise to the needle.
    o Push gently on the plunger to push the air out.

11. Put needle cover back on the needle and replace the needle with the injection needle (22 gauge 1-1/2”). You are now ready to inject the hCG.
    

Giving the Injection of hCG

HCG is by intramuscular injection into the hip.

1. First, locate the Ventrogluteal (hip) site.
   a. Have the patient lay on their side.
   b. Place the heel of your hand (using your left hand if injecting into the right hip or the right hand if injecting into the left hip) over the patient’s greater trochanter and feel for the anterior superior iliac spine with your index finger.
   c. The middle finger then slides across to make a peace-sign pointing up to the iliac crest.
   d. The injection site is the middle of this peace-sign.

   

2. To inject, firmly spread the skin tight around the injection site. Position the needle at a right angle to the skin.

3. Quickly insert the needle straight through the skin and deep into the muscle. Insert the needle all the way up to the hub. Release the skin.

4. To inject the hCG, push in the plunger with a slow, steady motion. You do not need to pull back on the plunger before injection to check for blood in the syringe.

5. Withdraw the needle and cover the injection site with cotton. Apply a small amount of pressure until bleeding stops. If needed, cover site with a bandage.

6. Throw away used needles & syringe in Sharps container.