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HMG injection in IVF and IUI
HMG (human menopausal gonadotropin) is an egg-growth injection that contains the hormones FSH and LH. It helps the ovaries grow one or more eggs in IUI cycles and several eggs in IVF. The dose and the number of days are decided by the doctor and adjusted after scans.
Watch the videos
In these videos our fertility specialist shows HMG injections and how they are used; the second video is in Hindi.
What HMG does
The ovary needs FSH to grow follicles, the small sacs that hold the eggs. HMG supplies FSH and LH, purified from urine, so that follicles grow in a controlled way. In IUI the aim is one or two mature eggs; in IVF the aim is several, so that several embryos can be made.
HMG and recombinant FSH
Recombinant FSH is made in a laboratory and contains FSH alone. HMG contains LH activity as well. Both are effective, and the choice depends on the woman, the protocol and sometimes on availability. Some plans use both together.
How gonadotropin injections are given
Depending on the product, HMG is given under the skin or into the muscle, usually once a day. Many women learn to give the injections at home. Follicle-tracking scans every few days show how the eggs are growing, and the dose may be changed.
Side effects
- Soreness or bruising where the needle goes in.
- Bloating and tenderness as the ovaries enlarge.
- Twins or more in IUI cycles if several eggs grow, which is why the scans matter.
- Rarely, over-stimulation (OHSS): seek help at once for a swollen, tight belly, breathlessness or passing very little urine.
What is in HMG
HMG, human menopausal gonadotropin, is a purified medicine with both FSH-like and LH-like activity. FSH helps the follicles grow, and LH activity helps the ovary make estrogen and supports the final stages of egg growth.
Who may be given HMG
- Women whose own LH is very low, for example when the brain's hormone signals to the ovaries are too weak, because they need LH activity for eggs to grow.
- Some women in IUI cycles or IVF cycles, as chosen by the doctor.
- Some men with very low pituitary hormones, together with hCG, to start sperm production under specialist care.
Mixing and storing HMG
HMG often comes as a powder with a liquid to mix it with. The nurse will show you how to mix it gently, without shaking, and draw it into the syringe. Some brands come as a ready pen. Store it as written on the pack and use each mixed dose straight away unless the pack says otherwise.
Monitoring on HMG
Scans, and sometimes estradiol blood tests, are done every few days to see how many follicles are growing and how fast. The dose is adjusted from these results, which is why HMG is never taken on a fixed plan without visits. If more follicles grow than planned, the cycle may be changed to lower the risk of twins and over-stimulation.
HMG in IUI cycles
For IUI, HMG is given in small amounts daily for several days, and scans follow how the follicles respond. In IUI, a small number of growing eggs is safer than many. When the scans show too many, the plan is changed or the cycle is called off, to keep the chance of twins, triplets and over-stimulation low.
Questions to ask before starting HMG
- How many days of injections do you expect, and when is my first scan?
- How do I mix, store and give this brand?
- What should I do if I miss a dose or am late?
- Which symptoms should make me call the clinic at once?
Please do not take HMG without a doctor's plan: it is always given with scans. See also our pages on IVF injections and ovulation induction.
Questions about HMG injections
What is an HMG injection used for?
HMG helps the ovaries grow eggs. It is used in IUI cycles to grow one or two eggs and in IVF to grow several.
What is the HMG injection dose?
There is no single dose. Your doctor sets it for your age, egg reserve and response, and changes it after the scans.
Is HMG better than recombinant FSH?
Neither is better for everyone. HMG also contains LH activity; the choice depends on the woman and the plan.
Can HMG cause twins?
In IUI cycles it can, if more than one egg grows. Scans help spot this, and the cycle may be stopped if too many follicles grow.
Where is the HMG injection given?
Under the skin or into the muscle, depending on the product. The nurse shows you how.
Is HMG used for men?
Sometimes. In men with very low pituitary hormones, HMG may be given with hCG under specialist care to start sperm production.
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What you read here explains fertility care in general terms and cannot replace a consultation. Decisions about your own care should be made with a doctor who knows your history and has seen you. We do not carry out or offer sex determination of any kind, which is prohibited by law in India under the PCPNDT Act.