Your Patients Can't Find Pregnyl. Here's How You Can Help.

You've written the prescription. Your patient's cycle is timed. And then you get the call: "My pharmacy doesn't have Pregnyl. What do I do?"

If you prescribe Pregnyl (chorionic gonadotropin) — whether for ovulation induction, IVF trigger shots, male hypogonadism, or cryptorchidism — you've likely dealt with this scenario repeatedly since the hCG shortage began. The question isn't whether your patients will face availability problems; it's how prepared your practice is to handle them.

This guide provides a practical framework for helping patients navigate Pregnyl access challenges in 2026.

Current Availability Snapshot

As of early 2026, the availability of injectable hCG products remains inconsistent:

• Pregnyl (Organon): Available intermittently; supply varies significantly by distributor and pharmacy type.
• Novarel (Ferring): Similar availability pattern to Pregnyl.
• Ovidrel (EMD Serono): Generally more consistently available; pre-filled syringe format eliminates reconstitution.
• Generic chorionic gonadotropin: Variable availability through different distributors.

Specialty pharmacies focused on fertility medications typically maintain better stock than retail chains. For current availability data, Medfinder for Providers provides real-time pharmacy stock information by location.

Why Patients Can't Find Pregnyl

Understanding the root causes helps you counsel patients and set realistic expectations:

1. Limited manufacturers: Only three companies produce FDA-approved injectable hCG in the U.S. (Organon, Ferring, EMD Serono). Any single disruption ripples across the entire market.
2. Biological production complexity: Urinary-derived hCG products (Pregnyl, Novarel) depend on biological source material, making production less predictable than synthetic manufacturing.
3. Pharmacy stocking patterns: Most retail pharmacies don't routinely stock Pregnyl. It's a special-order item that may take days to procure — time that patients on active cycles don't have.
4. Compounding restrictions: FDA enforcement against compounded hCG has removed a historical supply buffer.
5. Demand growth: Steady year-over-year increases in ART cycles continue to pressure available supply.

For the patient perspective, our article on why Pregnyl is hard to find explains these factors in accessible language you can share.

What Providers Can Do: 5 Practical Steps

Step 1: Discuss Medication Access at Cycle Start

Don't wait for the trigger day to discover a supply problem. At the beginning of every cycle that will require hCG:

• Confirm which pharmacy the patient plans to use
• Advise them to verify stock or place the order early (1-2 weeks ahead if possible)
• Provide a backup plan: alternative pharmacies and alternative medications

This single step prevents the majority of last-minute access crises.

Step 2: Maintain Specialty Pharmacy Relationships

Build and maintain relationships with 2-3 specialty pharmacies that focus on fertility medications. Benefits include:

• Priority access to limited-supply medications
• Direct communication channels when supply tightens
• Overnight shipping capability for urgent needs
• Staff who understand fertility protocols and timing requirements

Your clinical coordinators should have these pharmacy contacts readily available — not buried in a drawer.

Step 3: Pre-Authorize Alternative Protocols

Develop standardized backup protocols so your team can pivot quickly when hCG is unavailable:

• Pregnyl ↔ Novarel: Generally directly interchangeable at equivalent doses. Can switch without protocol modification.
• Pregnyl → Ovidrel: 250 mcg subcutaneous Ovidrel replaces the standard hCG trigger. Note the different route (SC vs. IM) and ensure patient education.
• hCG → Lupron trigger: Appropriate for IVF patients on GnRH antagonist protocols. Requires enhanced luteal phase support. Document the protocol clearly.

Having these alternatives pre-approved in your clinical protocols eliminates decision-making delays during time-sensitive situations.

Step 4: Empower Your Staff

Your nurses, clinical coordinators, and patient navigators are your front line for medication access issues. Equip them with:

• A current list of preferred specialty pharmacies and their contact information
• Access to Medfinder for Providers for real-time stock checks
• Clear guidelines on when to escalate to the physician (e.g., protocol change required vs. simple pharmacy switch)
• Patient-facing resources to share, including tips for finding Pregnyl in stock

Step 5: Communicate Proactively with Patients

Patients who understand the situation cope better and problem-solve more effectively. Consider:

• Adding a brief note to your new-patient materials about potential fertility medication shortages
• Sharing reliable resources like Medfinder during orientation appointments
• Training front-desk and nursing staff to address shortage questions with empathy and practical guidance

Alternatives to Pregnyl: Quick Reference

When Pregnyl is unavailable, these are your clinical options:

• Novarel: Same active ingredient (urinary hCG), same route (IM), same dosing. Closest direct substitute.
• Ovidrel: Recombinant hCG, 250 mcg SC. Pre-filled syringe. More convenient for patients; no reconstitution.
• Lupron trigger: 1-4 mg leuprolide SC. For antagonist IVF protocols only. Significantly reduces OHSS risk. Requires robust luteal support.
• Generic chorionic gonadotropin: Same as Pregnyl in a non-branded formulation. Check distributor availability.

For the patient-facing version of this comparison, direct patients to our alternatives to Pregnyl article.

Workflow Tips for Busy Practices

• Create a "medication access" flag in your EMR that triggers a pharmacy verification step at cycle initiation.
• Designate one team member as your medication access coordinator during active shortage periods.
• Batch pharmacy outreach: Check stock for multiple patients at once rather than one-off calls.
• Track which pharmacies have stock: Maintain a simple shared document your team updates when they confirm availability anywhere.
• Use Medfinder as a first-line tool before making phone calls — it's faster and gives you broader visibility.

Final Thoughts

Medication shortages are frustrating for everyone — patients, providers, and pharmacy staff alike. But practices that build shortage preparedness into their standard workflows experience fewer cycle disruptions and better patient satisfaction.

The Pregnyl shortage isn't going away overnight. By planning ahead, maintaining pharmacy relationships, and keeping your team informed, you can minimize the impact on your patients' care.

For the clinical perspective on the shortage itself, see our Pregnyl shortage briefing for providers. And share Medfinder with your patients — it's a tool that gives them agency during a frustrating situation.