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In the U.S.—

Humegon

Pergonal

In Canada—

Humegon

Pergonal

Other commonly used names are human menopausal gonadotropins (hMG); human gonadotropins; menotrophin.

• Gonadotropin
• Infertility therapy adjunct

Menotropins (men-oh-TROE-pins ) are a mixture of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) that are naturally produced by the pituitary gland.

Use in females

FSH is primarily responsible for stimulating growth of the ovarian follicle, which includes the developing egg, the cells surrounding the egg that produce the hormones needed to support a pregnancy, and the fluid around the egg. As the follicle grows, an increasing amount of the hormone estrogen is produced by the cells in the follicle and released into the bloodstream. Estrogen causes the endometrium (lining of the uterus) to thicken before ovulation occurs. The higher blood levels of estrogen will also tell the hypothalamus and pituitary gland to slow the production and release of FSH.

LH also helps to increase the amount of estrogen produced by the follicle cells. However, its main function is to cause ovulation. The sharp rise in the blood level of LH that triggers ovulation is called the LH surge. After ovulation, the group of hormone-producing follicle cells become the corpus luteum, which will produce estrogen and large amounts of another hormone, progesterone. Progesterone causes the endometrium to mature so that it can support implantation of the fertilized egg or embryo. If implantation of a fertilized egg does not occur, the levels of estrogen and progesterone decrease, the endometrium sloughs off, and menstruation occurs.

Menotropins are usually given in combination with human chorionic gonadotropin (hCG). The actions of hCG are almost the same as those of LH. It is given to simulate the natural LH surge. This results in ovulation at an expected time.

Many women choosing treatment with menotropins have already tried clomiphene (e.g., Serophene) and have not been able to conceive yet. Menotropins may also be used to cause the ovary to produce several follicles, which can then be harvested for use in gamete intrafallopian transfer (GIFT) or in vitro fertilization (IVF).

Use in males

Menotropins are used to stimulate the production of sperm in some forms of male infertility.

Menotropins are to be given only by or under the supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of receiving the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For menotropins, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to menotropins. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—If you become pregnant as a result of using this medicine, there is an increased chance of a multiple pregnancy.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of menotropins. Make sure you tell your doctor if you have any other medical problems, especially:

• Cyst on ovary—Menotropins can cause further growth of cysts on the ovary

• Unusual vaginal bleeding—Some irregular vaginal bleeding is a sign that the endometrium is growing too rapidly, possibly of endometrial cancer, or some hormone imbalances; the increases in estrogen production caused by menotropins can make these problems worse. If a hormonal imbalance is present, it should be treated before beginning menotropins therapy

Dosing—

The dose of menotropins will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of menotropins. If your dose is different, do not change it unless your doctor tells you to do so.

• For injection dosage form:
  • For causing ovulation to help in becoming pregnant:
    • Adults—75 Units of FSH and 75 Units of LH injected into a muscle once a day for seven or more days. Usually your doctor will give you another medicine called human chorionic gonadotropin (hCG) the day after the last dose of menotropins.
  • For help in becoming pregnant while using other pregnancy-promoting methods (assisted reproductive technology [ART]):
    • Adults—150 Units of FSH and 150 Units of LH injected into a muscle once a day for seven or more days. Usually your doctor will give you another medicine called human chorionic gonadotropin (hCG) the day after the last dose of menotropins.
  • For producing sperm:
    • Adults—75 Units of FSH and 75 Units of LH injected into a muscle three times a week for four or more months. Usually your doctor will give you another medicine called chorionic gonadotropin before and during treatment with menotropins. If needed, your doctor may increase your dose to 150 Units of FSH and 150 Units of LH three times a week after four months.

It is very important that your doctor check your progress at regular visits to make sure that the medicine is working properly and to check for unwanted effects. Your doctor will likely want to watch the development of the ovarian follicle(s) by measuring the amount of estrogen in your bloodstream and by checking the size of the follicle(s) with ultrasound examinations.

For females only:

• If your doctor has asked you to record your basal body temperatures (BBTs) daily, make sure that you do this every day. It is important that intercourse take place around the time of ovulation to give you the best chance of becoming pregnant. Follow your doctor's instructions carefully .

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• For females only
  • More common
    • Bloating (mild);  pain, swelling, or irritation at place of injection;  rash at place of injection or on body;  stomach or pelvic pain 
    
    
  • Less common or rare
    • Abdominal or stomach pain (severe);  bloating (moderate to severe);  decreased amount of urine;  feeling of indigestion;  nausea, vomiting, or diarrhea (continuing or severe);  pelvic pain (severe);  shortness of breath;  swelling of the lower legs;  weight gain (rapid) 
    
    

• For males only
  • More common
    • Dizziness;  fainting;  headache;  irregular heartbeat;  loss of appetite;  more frequent nosebleeds;  shortness of breath 
    
    

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if the following side effect continues or is bothersome:

• For males only
  • Less common
    • Enlargement of breasts 
    
    

After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time check with your doctor if you notice any of the following side effects:

• For females only
  • Abdominal or stomach pain (severe);  bloating (moderate to severe);  decreased amount of urine;  feeling of indigestion;  nausea, vomiting, or diarrhea (continuing or severe);  pelvic pain (severe);  shortness of breath;  weight gain (rapid) 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 08/04/1997