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Co-Trigger: Lupron and Pregnyl/HCG Patient Instructions

Storage: Store BOTH Lupron and HCG at room temperature until ready to trigger.

Special Considerations: Please disregard the instructions on the box of HCG 10,000IU. The medication should be administered as follows.

Supplies: Lupron: BD insulin syringe microfine 28 gauge x ½” 1ml to draw up and inject trigger, HCG: 3 mL syringe to mix HCG Trigger, 22 gauge 1½ inch needle to mix HCG Trigger, BD insulin syringe microfine, 28 gauge x ½” 1ml to inject HCG trigger, alcohol swabs.

General Instructions

  1. Your dose of HCG will be 1500 IU- that is equal to 15 units in the insulin syringe.
  2. Your dose of Lupron will be 40 units in the insulin syringe.
  3. You will inject the leuprolide immediately after injecting the HCG. This is to be done at the exact time as instructed by your nurse.

Instructions for HCG Trigger

  1. Wash your hands and work on a clean, dry surface.
  2. Tighten the 22 gauge 1 ½” needle onto the syringe.
  3. Pull back on the plunger of the syringe to fill the syringe with 1 mL of air.
  4. Inject the 1 mL of air into the vial of bacteriostatic water. Hold the vial upside down and withdraw 1 mL of bacteriostatic water.
  5. Inject the 1 mL of bacteriostatic water into the vial of powder. Withdraw the needle and syringe from the vial and discard them.
  6. Gently swirl around the contents of the vial until the powder is dissolved.
  7. Take the orange cap off the insulin syringe and place the tip of the needle in the vial of reconstituted HCG.
  8. WITHDRAW ONLY 15 UNITS OF THE LIQUID. Discard the vial of leftover reconstituted HCG.
  9. Place the insulin syringe with the 15 units of HCG to the side until it is time to inject it.

Instructions for Lupron Trigger

  1. Use a new insulin syringe to draw up straight Lupron from the vial for your dose.
  2. Your dose of Lupron will be 40 units.


  1. Choose an injection site on your abdomen (see image).
  2. Clean the area with an alcohol swab and allow to dry.
  3. Insert the needle straight into the skin- do not go in at an angle.
  4. Push the plunger all the way down, then wait 5 seconds before removing the needle from the skin.
  5. At the exact time you were previously instructed, inject the 15 units HCG under the skin. Immediately after injecting the HCG, inject the 40 units of Lupron trigger.

Questions about Medications or Instructions

If you have questions, please call us at 216-285-5028, Monday through Friday, 8 a.m. – 4 p.m. If you need assistance over the weekend, call the same number to reach our on-call doctor.