Provider Briefing: The Pregnyl (hCG) Shortage in 2026

The intermittent shortage of Pregnyl (chorionic gonadotropin for injection) and other hCG products continues to affect clinical practice across reproductive endocrinology, urology, and endocrinology. This briefing provides an updated overview of the shortage landscape, prescribing implications, and practical resources to help your patients maintain access to care.

Shortage Timeline

Injectable hCG products have experienced supply disruptions since approximately 2020. Key milestones include:

• 2020-2021: Initial shortages reported as manufacturing challenges emerged. FDA added certain hCG products to the Drug Shortages database.
• 2022-2023: FDA enforcement actions against compounded hCG products removed a significant source of supply from the market, increasing demand on FDA-approved products like Pregnyl, Novarel, and Ovidrel.
• 2024-2025: Ongoing intermittent availability. Some improvement as manufacturers adjusted production, but demand continued to outpace consistent supply.
• 2026 (current): Availability remains inconsistent. Pregnyl is available at some pharmacies and distributors but frequently out of stock at others. The situation varies by region and distribution channel.

Prescribing Implications

The shortage has several practical implications for prescribers:

Protocol Flexibility

Clinicians should be prepared to modify trigger protocols based on available hCG supply. Key considerations:

• Urinary hCG products (Pregnyl, Novarel) are generally interchangeable at equivalent doses for ovulation triggering.
• Recombinant hCG (Ovidrel) at 250 mcg provides an LH surge approximately equivalent to 6,500 IU of urinary hCG. Dose adjustment considerations may apply for certain patient populations.
• GnRH agonist (Lupron) triggers are an appropriate alternative for IVF patients on antagonist protocols, particularly those at elevated OHSS risk. Lupron triggers require enhanced luteal phase support.

Advance Planning

Given inconsistent supply, consider discussing medication sourcing with patients at the start of their cycle — not at the point of trigger. Early identification of supply issues allows time for protocol adjustment without compromising cycle outcomes.

Documentation

When substituting alternative products due to shortage, document the clinical rationale in the patient's record. This supports insurance coverage and provides medicolegal clarity.

Current Availability Picture

As of early 2026, the availability of hCG products breaks down approximately as follows:

• Pregnyl (Organon): Intermittently available. Specialty pharmacies and fertility-focused distributors generally have better access than retail chains.
• Novarel (Ferring): Similar intermittent availability to Pregnyl.
• Ovidrel (EMD Serono): Generally more consistently available than urinary-derived products, though it has experienced its own periodic supply tightness.
• Generic chorionic gonadotropin: Available from some generic manufacturers; supply varies by distributor.

For real-time stock data across pharmacies, Medfinder for Providers offers a tool to check current availability by location.

Cost and Access Considerations

The financial landscape for hCG products in 2026:

• Cash price: Pregnyl and Novarel typically cost $100-$250 per 10,000 unit vial. Ovidrel costs $100-$250 per pre-filled syringe. Generic hCG may be available for $80-$200.
• Insurance coverage: Highly variable. States with fertility treatment mandates generally provide better coverage. Many commercial plans require prior authorization for hCG products. Some plans classify hCG as a fertility medication and apply separate benefit limits.
• Patient assistance: Organon and other manufacturers may offer patient support programs. NeedyMeds and organizations like RESOLVE provide additional financial resources for fertility patients.

For patients facing cost barriers, our patient-facing guide on saving money on Pregnyl provides detailed discount and assistance options you can share.

Tools and Resources for Your Practice

Several resources can help you and your staff manage the shortage more effectively:

• Medfinder for Providers: Real-time pharmacy stock lookup for Pregnyl and alternatives. Useful for your clinical coordinators and patient navigators.
• FDA Drug Shortages Database: Official shortage listings and estimated resolution timelines (accessdata.fda.gov).
• ASRM Practice Committee Guidance: The American Society for Reproductive Medicine has published guidance on managing fertility medication shortages.
• Specialty pharmacy partnerships: Establishing relationships with 2-3 specialty pharmacies that focus on fertility medications can provide more reliable access for your patients.

Looking Ahead

The fundamental factors driving the hCG shortage — limited manufacturing capacity for biological products, a small number of producers, and growing demand — are unlikely to resolve quickly. However, several trends may improve the situation over time:

• Increased use of GnRH agonist triggers in appropriate protocols reduces overall hCG demand.
• Manufacturer capacity investments may gradually increase supply.
• Greater awareness of real-time stock tools reduces inefficiency in the supply chain.

In the meantime, the most effective strategy remains proactive planning, protocol flexibility, and strong pharmacy relationships.

Final Thoughts

The Pregnyl shortage is a supply-side problem that creates a patient-side crisis — especially for time-sensitive fertility cycles. As a provider, your role in early communication, protocol adaptability, and resource awareness can make the difference between a completed cycle and a canceled one.

Encourage your patients to use Medfinder to check stock availability. For a complementary resource, our provider's guide to helping patients find Pregnyl offers actionable workflow recommendations for clinical teams.

We're committed to keeping providers informed as this situation evolves.