Human Menopausal Gonadotropins

Human menopausal gonadtropins (hMG) are often used for women who don't ovulate due to problems with their pituitary gland. hMG acts directly on the ovaries to stimulate ovulation. It is an injected medicine. Menotropins, which contain two gonadotropin hormones LH and FSH, are the type of hMG used for fertility treatment. Those approved for usage in the United States are:

  • Pergonal®
  • Repronex®
  • Humegon®
  • Bravelle™

This class of injectable fertility drugs has been available and in clinical use for over 30 years. Since FSH and LH are necessary for follicle development, the menotropin drugs contain either a combination of FSH and LH (Pergonal, Repronex, and Humegon) or FSH alone (Bravelle).

gonadtropin
Gonadtropin releasing
hormone molecule

Menotropins containing FSH alone actually have a very small amount of LH in them, and specialists who use the urinary-derived FSH preparations also depend on your body to produce some LH during your stimulation cycle. Since various HMG products are on the market, your reproductive endocrinologist (RE) must decide which medication is appropriate for you.

You should discuss the plusses and minuses of the different fertility drugs with your doctor before filling your prescription, as the proper drugs, proper doses, and proper stimulation protocol can make or break an IUI or in-vitro fertilization (IVF) cycle.

While Pergonal and Humegon are approved by the FDA for intramuscular (IM, into the muscle) injection only, Repronex is approved for both IM and subcutaneous (SQ, directly under the skin) usage. Many reproductive endocrinologists allow their patients to inject Pergonal and Humegon subcutaneously. Due to some minor impurities in these preparations, subcutaneous injection can cause a local skin reaction such as itching, redness, and burning.

The menotropins are used during ovulation induction for "superovulation" with IUI or in-vitro fertilization. The dosage of HMG used to stimulate follicle development varies according to many factors, and must be individualized and/or personalized to each woman's particular situation. The dose should be based on several factors that include, and aren't limited to:

  • Whether the medicines are being used for intrauterine insemination (IUI) vs. in-vitro fertilization (IVF)
  • Age
  • Height and weight (body mass index)
  • Results of cycle day three testing for ovarian reserve
  • Prior response to stimulation medicines

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