Menotropins

Ovarian stimulation

Menotropins, also called hMG, stimulates the ovaries to develop follicles. Each follicle can contain an egg. Menopur is one prescription medicine containing menotropins.⁴⁹⁰

Composition

Menotropins is a mixture extracted from human urine. It provides follicle-stimulating hormone, or FSH, and luteinizing hormone activity. In Menopur, hCG supplies much of that LH activity.^491,492

Its place in fertility treatment

In IVF, stimulation comes before egg retrieval, fertilization and embryo transfer. The treatment plan also determines when final egg maturation is triggered. The drugs used at each stage have different jobs.^490,492

Product label	Who it covers
US Menopur	Ovulatory women undergoing assisted reproductive treatment.
UK Menopur 600 IU	Anovulatory infertility, assisted reproduction, and selected male infertility treated with hCG.
New Zealand multidose Menopur	Anovulatory infertility after clomiphene failure and assisted reproduction.

What happened in the trials?

The main studies compare pregnancy and live birth after a defined fertility-treatment plan.

87 of 373

Women with a continuing pregnancy after one IVF cycle. The label defines continuing pregnancy by a fetal heartbeat at least ten weeks after embryo transfer. The reported rate was 23%.⁴⁹⁰

Continuing-pregnancy comparison

The comparison group had 73 continuing pregnancies among 354 women receiving recombinant FSH. The Canadian label reports rates of 23.3% with Menopur and 20.6% with recombinant FSH. Menopur met the trial's standard for similar effectiveness.⁴⁹³

Study	What happened
MERIT: 731 women undergoing IVF	Ongoing pregnancy: 26.7% with highly purified hMG and 22.3% with recombinant FSH.
MEGASET: 749 women treated, single-blastocyst transfer	Cumulative live birth: 40% with highly purified hMG and 38% with recombinant FSH, including frozen transfers initiated within one year.
MEGASET-HR: 620 predicted high responders	Cumulative live birth: 50.6% with highly purified hMG and 51.5% with recombinant FSH. OHSS: 9.7% and 21.4%, respectively.

Women who are anovulatory

CS002 enrolled 184 women with WHO group II anovulatory infertility who had not ovulated or conceived with clomiphene. Ovulation rates in the intent-to-treat analysis were 83.5% with Menopur and 84.9% with recombinant FSH. Singleton live-birth rates were comparable.⁴⁹²

A newer formulation study

A 2026 paper compared a prefilled highly purified hMG pen with the US-approved powder. The trial randomized 405 women, and 401 received treatment. The pen met the study's standard for similar effectiveness on its main measure, fertilized eggs; the paper reported fresh-transfer live-birth rates of 44.1% and 42.2%.^498,499

Age, setting and diagnosis

Research in China, Russia and men with hormone deficiency adds to the picture.

Women aged 35 and older

A Chinese randomized trial enrolled 127 women aged 35 or older starting IVF or ICSI. Recombinant FSH produced more eggs. Live birth favored highly purified hMG numerically, but the estimate was imprecise: odds ratio 1.9, with a 95% confidence interval of 0.9 to 3.9.⁵⁰⁰

A Chinese PCOS study

A 2021 retrospective study compared 49 women who started ovarian stimulation with highly purified hMG plus recombinant FSH and 47 who started with recombinant FSH alone. It reported a higher live-birth percentage with the combination. The displayed abstract gives no event counts or denominator for that percentage.⁵⁰¹

A Russian clinical-practice study

A study across 13 centers in northwestern Russia followed 1,504 patients receiving highly purified menotropins. It recorded 613 births after 1,423 embryo transfers. This was an observational study without a comparison group.⁵⁰²

Male fertility

The UK Menopur 600 IU label includes selected men with hypogonadotropic hypogonadism, a condition involving low pituitary hormone stimulation. Treatment combines menotropins with hCG. An early study followed 21 men given hCG first; 14 later added hMG, and sperm recovery differed according to their prior development and history of undescended testes.^491,503

What needs monitoring?

Ovarian response changes during a treatment cycle.

Common side effects

The US pooled safety table covers 434 women. Abdominal pain occurred in 29, headache in 27, injection-site pain or reactions in 17, and abdominal cramps in 13. The same table records OHSS in 27 women.⁴⁹⁰

Ovarian hyperstimulation syndrome

OHSS can cause enlarged ovaries and fluid shifts that affect the abdomen, lungs and circulation. Severe abdominal or pelvic pain, rapid weight gain, persistent vomiting, trouble breathing or reduced urination need prompt medical assessment. Symptoms can appear after stimulation has stopped and may become more severe if pregnancy occurs.^490,492

Other risks

Product warnings cover blood clots, ovarian torsion, ectopic pregnancy and multiple pregnancy. In assisted reproduction, the chance of multiple pregnancy also depends on the number and quality of embryos transferred and the patient's age.^490,492

Questions about cancer

Ovarian and other reproductive-system tumors have been reported after fertility treatment involving several medicines. The product labels leave the relationship between gonadotropin treatment and these tumors unresolved.^490,492

Check the exact medicine

Labels, formulations and pack notices vary by country.

Recent pack and manufacturing notices

A Swiss notice in June 2026 corrected Italian storage text in specified Menopur multidose batches. An earlier EMA notice in April 2023 described manufacturing changes and supply disruption. These notices identify particular products, dates and markets.^504,505

Half-life measurements

The US label reports an FSH half-life of 11 to 13 hours in healthy women whose pituitary function was suppressed. UK and New Zealand labels report about 30 hours after repeated subcutaneous dosing in another study setting. Both values describe the FSH component.^490,491,492

Competitive sport

The 2026 WADA list prohibits CG and LH in male athletes at all times. Menotropins provides these activities. Athletes need their exact medicine checked against the applicable rules; the published 2027 list retains the male category.^506,507,491

Common questions

Results, side effects and practical questions about fertility treatment.

01 How should Menopur be stored, and what if mixing or a dose goes wrong?

Use the storage directions for the exact product and country label because packaging differs. A June 2026 Swiss notice corrected the Italian storage text for specified multidose batches. If a vial was stored, mixed, or used incorrectly, contact the dispensing pharmacy or fertility clinic before using it.^490,504

02 How is Menopur different from Gonal-F, Follistim, or low-dose hCG?

Menopur provides urinary-derived FSH and LH activity; recombinant FSH and hCG products are different medicines or protocol components. In selected predicted high responders, MEGASET-HR found six-month cumulative live birth of 50.6% with HP-hMG and 51.5% with recombinant FSH. OHSS was 9.7% with HP-hMG and 21.4% with recombinant FSH in that protocol.^490,496,508

03 How much does Menopur cost, and what if it is out of stock?

The cited primary sources give no current cash price, insurer rule or universal supply status. A 2023 European notice concerned a dated quality-related shortage, while a 2026 Swiss notice concerned storage wording for specified batches. The dispensing pharmacy and fertility clinic can confirm current supply and case-specific cost.^505,504

04 What is Menopur, and what is in it?

Menopur is a fertility medicine containing urinary-derived FSH and LH activity. The US vial provides 75 IU of FSH activity and 75 IU of LH activity and says hCG is detected. Current UK, New Zealand, and Canadian product texts explain that hCG contributes to LH activity.^{490,491,492,493}

05 Is Menopur used for male fertility?

The current US Menopur label has no male indication. The current UK Menopur 600 SmPC includes male hypogonadotrophic hypogonadism when Menopur is combined with hCG. In the 1985 study, men received hCG first; those needing further treatment added historical hMG.^490,491,503

06 What side effects should I watch for?

Common label reactions include abdominal cramps, fullness or pain, headache, and injection-site pain. Ovarian hyperstimulation syndrome, or OHSS, is an excessive ovarian response that can worsen after stimulation ends and can cause severe pelvic pain, rapid weight change, vomiting, reduced urine, or breathing trouble. Those symptoms need prompt contact with the treating clinic or urgent care.⁴⁹⁰

07 What are the chances of pregnancy or live birth?

In the US label trial, 87 of 373 Menopur recipients, or 23%, had a continuing pregnancy and 98, or 26%, had a clinical pregnancy. MEGASET-HR reported cumulative live birth per cycle start of 50.6% with HP-hMG and 51.5% with recombinant FSH after eligible frozen transfers. A Russian 13-center observational cohort reported 752 clinical pregnancies and 613 births among 1,423 transfers, with no comparator and other ART components in the protocols.^{490,496,508,502}

08 Does Menopur improve egg quality or follicle response?

The trials behind this chapter measured follicles, oocytes, pregnancy, and live birth rather than one universal egg-quality outcome. In a 127-woman trial of patients age 35 or older, recombinant FSH produced more leading follicles and oocytes, while live birth did not show superiority for HP-hMG.⁵⁰⁰

09 How long does Menopur take to work or stay in the body?

A stimulation cycle is adjusted to follicle response on ultrasound and sometimes estradiol; half-life does not set a fixed number of days. The US label reports an 11 to 13 hour FSH half-life after repeated exposure, while a UK Menopur 150 SmPC reports 30 plus or minus 11 hours subcutaneously and 27 plus or minus 9 hours intramuscularly. Both are FSH activity values from specific studies in downregulated or pituitary-suppressed healthy women.^490,509

10 What if I miss a dose or make a dosing mistake?

Do not improvise a catch-up dose or repeat a dose after an error. Use the exact product instructions and contact the fertility clinic or dispensing pharmacy for the case-specific next step.⁴⁹⁰

11 Does age or low AMH change the evidence?

Age and ovarian reserve change which evidence applies. MEGASET-HR enrolled predicted high responders age 21 to 35 with AMH at least 5 ng/mL, while the Chongqing trial enrolled 127 women age 35 or older under a different protocol.^496,508,500

12 Does Menopur interact with other fertility medicines?

The current US label says human drug-interaction studies have not been conducted. Fertility protocols use different medicines at different stages, and the clinic coordinates those combinations.⁴⁹⁰

13 What is OHSS, and when can it appear?

OHSS is an excessive ovarian response that can cause enlarged ovaries, fluid shifts, pain, vomiting, breathing problems, blood clots, or kidney injury. The US label says it can begin or worsen after treatment stops and can last longer if pregnancy occurs. Severe or rapidly worsening symptoms need urgent medical assessment.⁴⁹⁰

14 Does Menopur raise the chance of twins?

Multiple pregnancy is a known risk of gonadotropin treatment. In the US pivotal label trial, 30 of 85 diagnosed pregnancies, or 35.3%, were multiple pregnancies. That percentage uses diagnosed pregnancies as its denominator; there were 373 Menopur recipients overall.⁴⁹⁰

15 Does Menopur raise cancer risk?

Ovarian and other reproductive-system tumors have been reported in women who received more than one infertility medicine. The current US label says a causal relationship has not been established.^490,510