When You Can't Find Pregnyl, What Are Your Options?

Your doctor prescribed Pregnyl, but your pharmacy can't get it. Your fertility cycle has a deadline. What do you do?

First, take a breath. While the Pregnyl shortage is real and frustrating, there are legitimate alternatives that may work just as well for your treatment plan. The key is working with your doctor to find the right one for your situation.

Let's look at what Pregnyl does, how it works, and which alternatives might be a fit.

What Is Pregnyl and What Does It Do?

Pregnyl is a brand-name injectable containing human chorionic gonadotropin (hCG). It's most commonly used as a "trigger shot" in fertility treatment — the injection that tells your ovaries to release mature eggs at just the right time.

hCG works because it mimics luteinizing hormone (LH), the natural hormone that triggers ovulation. By giving a large dose of hCG at a precise point in your cycle, your doctor can control exactly when ovulation occurs, which is critical for timed intercourse, IUI, or IVF egg retrieval.

Pregnyl is also used in men for hypogonadotropic hypogonadism (where the brain doesn't signal the testes to produce testosterone) and in boys for cryptorchidism (undescended testes).

For the full breakdown, see our guide on how Pregnyl works.

How Does Pregnyl Work?

Pregnyl contains hCG extracted from the urine of pregnant women. When injected, it binds to the same receptors as LH throughout the body. In the ovaries, this triggers the final maturation and release of eggs from follicles. In the testes, it stimulates testosterone production.

The key thing to understand about alternatives is this: any medication that can reliably trigger that LH-like surge can potentially replace Pregnyl in your protocol. That's the basis for the alternatives below.

Alternative #1: Ovidrel (Choriogonadotropin Alfa)

Ovidrel is probably the most common alternative to Pregnyl. It contains recombinant hCG — meaning the hCG is made in a laboratory using genetic engineering rather than extracted from urine.

Key differences from Pregnyl:

• Pre-filled syringe: No mixing required. This is a significant convenience advantage.
• Subcutaneous injection: Goes just under the skin rather than deep into the muscle. Many patients find this less intimidating.
• Consistent dosing: Because it's manufactured synthetically, each dose is more precisely standardized.
• Standard dose: 250 mcg (approximately equivalent to 6,500 IU of urinary hCG).

Cost: Ovidrel typically costs $100-$250 per pre-filled syringe without insurance, comparable to Pregnyl.

Ovidrel is widely used in IVF and IUI protocols and is often the first alternative doctors reach for when Pregnyl isn't available. However, Ovidrel has also experienced its own supply issues at times.

Alternative #2: Novarel

Novarel is another brand of urinary-derived hCG — essentially the same active ingredient as Pregnyl, made by a different manufacturer (Ferring Pharmaceuticals).

Key points:

• Same type of hCG as Pregnyl (extracted from human urine)
• Same route of administration (intramuscular injection)
• Same reconstitution process (powder + diluent)
• Available in 10,000 unit vials

For most purposes, Novarel and Pregnyl are interchangeable. If your pharmacy can get Novarel but not Pregnyl, this may be the simplest switch. Your doctor likely won't need to change anything else about your protocol.

Cost: Similar to Pregnyl, typically $90-$220 per vial without insurance.

Alternative #3: Lupron (Leuprolide) Trigger

This one is different from the others. Lupron (leuprolide acetate) is a GnRH agonist — it works by a completely different mechanism than hCG. Instead of directly mimicking LH, Lupron causes your pituitary gland to release a surge of your own natural LH (and FSH), which then triggers ovulation.

When it's used:

• Primarily in IVF protocols that use a GnRH antagonist (like Ganirelix or Cetrotide) for suppression
• Often preferred for patients at high risk of OHSS (ovarian hyperstimulation syndrome)
• Cannot be used in protocols already using a GnRH agonist for suppression (like long Lupron protocols)

Advantages:

• Significantly lower risk of OHSS compared to hCG triggers
• Widely available (not affected by hCG shortages)

Limitations:

• Not suitable for all protocols
• May result in lower progesterone production, requiring more aggressive luteal phase support
• Not appropriate for timed intercourse or IUI cycles in most cases

A Lupron trigger is not a simple swap — it requires your doctor to specifically design your protocol around it. But for IVF patients who are flexible on protocol, it's a legitimate option that sidesteps the hCG shortage entirely.

Alternative #4: Generic Chorionic Gonadotropin

Generic versions of chorionic gonadotropin exist and may be available when brand-name Pregnyl is not. These contain the same urinary-derived hCG and work identically. Ask your pharmacist whether a generic hCG product is available from their distributor.

Cost: Generic hCG may cost $80-$200 per 10,000 unit vial, potentially saving you money compared to brand-name options.

What About Compounded hCG?

Compounding pharmacies have historically prepared hCG, but regulations in this area have changed significantly. The FDA has taken enforcement actions against some compounded hCG products. Discuss with your doctor whether compounded hCG is still a safe and legal option in your state.

How to Decide Which Alternative Is Right for You

This isn't a decision to make on your own. Your reproductive endocrinologist or prescribing doctor should guide this choice based on:

• Your specific treatment protocol (IVF, IUI, timed intercourse)
• Your OHSS risk profile
• What's actually available at your pharmacy
• Your insurance coverage
• Whether you're comfortable with intramuscular vs. subcutaneous injection

The most important thing is to communicate with your care team early if you can't find Pregnyl. Don't wait until the day you need the injection to tell them there's a problem.

Final Thoughts

Not being able to find Pregnyl is stressful, but it doesn't mean your treatment has to stop. Ovidrel, Novarel, Lupron triggers, and generic hCG all offer real paths forward.

Start by checking Medfinder to see if Pregnyl or its alternatives are available near you. Then talk to your doctor about which option fits your protocol best. For more on the shortage, see our Pregnyl shortage update for 2026.