Pubergen Overdosage

The toxicity of human chorionic gonadotropic hormone is very low. However, too high a dose may lead to hyperstimulation of the ovaries. (See unwanted Hyperstimulation as follows.)
Unwanted/Hyperstimulation: During treatment of female patients, determinations of oestrogen levels and assessment of ovarian size and if possible, ultrasonography should be performed prior to treatment and at regular intervals during treatment. High dosages may cause oestrogen levels to rise excessively rapidly, e.g. more than doubling on 2-3 consecutive days, and possibly reaching excessively high preovulatory values. The diagnosis of unwanted ovarian hyperstimulation, on may be confirmed by ultrasound examination.
If unwanted hyperstimulation occurs, (i.e. not as port of a treatment preparing for IVF/ET or GIFT or other assisted reproduction techniques), the administration of HMG should be discontinued immediately, hCG must not be given, because the administration of an hLH - active gonadotropin at this stage may induce, in addition to multiple ovulations, the ovarian hyperstimulation. This warming is particularly important with respect to patients with polycystic ovarian disease.
The severe form of ovarian hyperstimulation syndrome may be life threatening and is characterized by large ovarian cyst (prone to rupture), acute abdominal pain. ascites, very often hydrothorax and occasionally thromboembolic phenomena.
In the male: Treatment with hCG leads to increased androgen production.
Therefore: Patients with latent or overt cardiac failure, renal dysfunction, hypertension, epilepsy or migraine (or history of these conditions) should be kept under close medical supervision, since aggravation or recurrence may occasionally be induced as a result increased androgen production.
hCG should be used cautiously in prepubertal boys to avoid premature epiphyseal closure or precocious sexual development. Skeletal maturation should be monitored regularly.