Menotropins

Summary

Menotropins (human menopausal gonadotropins, hMG) is a purified preparation of FSH and LH derived from postmenopausal urine. It is used to stimulate follicular development in anovulatory women undergoing assisted reproductive technology (ART) and to stimulate spermatogenesis in hypogonadotropic hypogonadal men. It is typically administered with human chorionic gonadotropin (hCG) to trigger ovulation or support luteal function.

Mechanism of Action

Menotropins contain follicle-stimulating hormone (FSH) and luteinizing hormone (LH) extracted from the urine of postmenopausal women. FSH stimulates follicular growth and maturation in females and spermatogenesis in males; LH triggers ovulation and supports corpus luteum formation in females and testosterone production in males.

Routes of Administration

Goals & Uses

• Controlled ovarian hyperstimulationReproductive EndocrinologyHigh
• Ovarian stimulation for ART/IVFReproductive EndocrinologyHigh
• Spermatogenesis induction in hypogonadotropic hypogonadismMale FertilityModerate
• Induction of ovulation in anovulatory womenReproductive EndocrinologyHigh

Contraindications

• Sex hormone-dependent tumorsOncologyHigh
• PregnancyPopulationHighPotential fetal risk or insufficient safety data
• Primary ovarian failure / hypergonadotropic hypogonadismEndocrineHigh
• Ovarian cysts or enlargement not due to PCOSGynecologyModerate
• Uncontrolled thyroid or adrenal dysfunctionEndocrinologyHigh
• Abnormal uterine bleeding of undetermined causeGynecologyHigh

Adverse Effects

• Injection site reactionsLocalCommon
• Multiple gestationReproductiveCommon
• HeadacheNeurologicCommonPain in the head or upper neck
• Thromboembolic eventsCardiovascularRare
• Abdominal pain and bloatingGastrointestinalCommon
• Ovarian hyperstimulation syndrome (OHSS)ReproductiveUncommon

Drug Interactions

• Human Chorionic Gonadotropin (hCG)Low
• GnRH antagonists (e.g., cetrorelix, ganirelix)Low
• Clomiphene citrateLow
• GnRH agonists (e.g., leuprolide)Low

Population Constraints

• Pediatric patientsAgeAbsolute
• Polycystic ovary syndrome (PCOS)EndocrineRelative
• Renal or hepatic impairmentOrgan DysfunctionRelative
• Women over 40 yearsAgeRelative

Regulatory Status

• European UnionApprovedApproved: Anovulation including PCOS unresponsive to clomiphene, Controlled ovarian hyperstimulation for ART, Male hypogonadotropic hypogonadism with infertilityMultiple products approved via EMA; Menopur widely used across EU member states
• United StatesApprovedApproved: Induction of ovulation and pregnancy in anovulatory infertile women, Stimulation of multiple follicle development in ovulatory women for ART, Induction of spermatogenesis in men with primary and secondary hypogonadotropic hypogonadismApproved brands include Menopur and Repronex (FDA-approved). Pergonal was withdrawn from the US market.
• United KingdomApprovedApproved: Ovulation induction, Controlled ovarian stimulation for ART, Male infertility due to hypogonadotropic hypogonadismApproved by MHRA; Menopur available in the UK post-Brexit under national authorization

Approved by the FDA in the United States. Multiple brand formulations approved in the EU and UK. Requires close monitoring due to risk of ovarian hyperstimulation syndrome (OHSS).

Evidence & Sources

No sources recorded yet.