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Hormonal & reproductive

Menotropins (human menopausal gonadotropin, hMG)

Also called hMG, HMG, menotropins, Menopur, Pergonal, Repronex, human menopausal gonadotrophin

Menotropins is a fertility drug made from purified urine of women after menopause, which naturally contains high levels of two reproductive hormones, FSH and LH. Doctors use it during IVF to make the ovaries grow several eggs at once. It is FDA-approved and sold in the US as Menopur.

FDA-approvedApproved by the FDA for at least one use after large human trials.

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Illustrative chain. The exact sequence has not been published in a source we could verify.

Overview

Menotropins is a fertility drug made from purified urine of women after menopause, which naturally contains high levels of two reproductive hormones, FSH and LH. Doctors use it during IVF to make the ovaries grow several eggs at once. It is FDA-approved and sold in the US as Menopur.

How it works

Established: FSH acts on the ovary to make follicles (the fluid sacs that hold eggs) grow and mature, and LH activity supports the hormone production that goes with this. In most cases menotropins only grows the follicles, so a separate hCG injection is given to trigger the final egg maturation and release. Doctors track the response with ultrasound and blood estradiol levels.

What research shows

  • FDA label: approved to develop multiple follicles and achieve pregnancy in ovulatory women undergoing ART (IVF or ICSI).
  • In the US registration IVF trial, ovarian hyperstimulation syndrome occurred in 7.2% of 373 treated women and 35.3% of 85 pregnancies were multiples (label).
  • Pooled analysis of 42 trials (9,606 patients): live birth rates were not significantly different between recombinant FSH and urine-derived gonadotropins (reported in a 2019 review).
  • Meta-analysis of 16 studies (4,040 patients): highly purified hMG gave fewer eggs and needed higher doses than recombinant FSH, with similar pregnancy rates (same review).

Doses studied in people

Study or labelDose usedSource
FDA label (Menopur) — ovarian stimulation for ART in ovulatory womenStart 225 IU/day subcutaneously; adjust by no more than 150 IU at a time, no more often than every 2 days; maximum 450 IU/day; no more than 20 days of treatment, followed by an hCG trigger1

Label dosing for supervised fertility treatment only; dosing is individualized by a fertility specialist using ultrasound and hormone monitoring.

Read this first: these are the amounts given to participants in published studies or written on official prescribing labels, reported for reference. They are not recommendations. Trial doses were chosen for specific patients under medical supervision, and a dose that is safe in one person can be harmful in another.

Safety

  • Ovarian hyperstimulation syndrome (OHSS), which can cause fluid shifts and, in severe cases, blood clots and lung complications (label warning).
  • Higher chance of twins or more (35% of pregnancies in the registration trial), ovarian enlargement, ovarian torsion, ectopic pregnancy and miscarriage (label).
  • Common side effects in the IVF trial: abdominal pain (6.7%), headache (6.2%), OHSS (6.2%) and injection-site pain or reactions (label).
  • Contraindicated in pregnancy, primary ovarian failure, sex-hormone-dependent tumors, pituitary or hypothalamic tumors, unexplained uterine bleeding and unexplained ovarian cysts (label).
  • Because it is made from human urine, it contains some non-hormone protein impurities that vary by batch (2019 review).

Report side effects of any drug or product to the FDA through MedWatch. For a possible poisoning in the US, call Poison Control at 1-800-222-1222.

Storage and stability

Per label: unmixed powder kept refrigerated or at room temperature (3–25°C), protected from light; used right after mixing.

General lab handling, not instructions for personal use. See Storage and stability.

History

Gonadotropins were first extracted from postmenopausal women's urine in 1950, and Serono registered early preparations in Italy that year; its Pergonal product contained 75 IU FSH and 75 IU LH. In 1962 Lunenfeld and colleagues reported the first pregnancy after hMG stimulation followed by an hCG trigger. By 1981, hMG/hCG protocols had become standard for IVF stimulation. Ferring's purified product Menopur was approved by the FDA in October 2004, and like other gonadotropins it was moved to a biologic license in March 2020. Recombinant FSH products (1997 onward) are the main alternative.

Common questions

Is menotropins (hMG) FDA-approved?

Yes. It is approved as Menopur to stimulate egg development in women undergoing IVF or ICSI 13.

How does hMG compare with recombinant FSH?

Large pooled analyses found similar live birth and pregnancy rates, although recombinant FSH tends to yield a few more eggs 2.

What are the main risks?

The main risks are ovarian hyperstimulation syndrome, multiple pregnancy, ovarian torsion and blood clots 1.

Is hMG banned in sport?

It is not named on the WADA list, but its LH component falls under a class banned at all times for male athletes 5.

Related compounds

Hormonal & reproductiveFDA-approvedFlashcard

Gonadorelin

GnRH · LHRH

Gonadorelin is a synthetic copy of GnRH, the brain hormone that tells the pituitary to release LH and FSH.

Hormonal & reproductiveEarly human dataFlashcard

Kisspeptin-10

KP-10 · metastin 45-54

Kisspeptin-10 is the shortest active piece of kisspeptin, a natural hormone that acts as the 'on switch' for the brain's reproductive hormone system.

Hormonal & reproductiveFDA-approvedFlashcard

Leuprolide

leuprorelin · Lupron Depot

Leuprolide is a lab-made version of the brain hormone GnRH.

Sources

  1. MENOPUR (menotropins for injection) prescribing information (FDA, 2014) FDA label
  2. Lunenfeld B et al. The development of gonadotropins for clinical use in the treatment of infertility. Front Endocrinol 2019;10:429 PubMed review
  3. FDA: List of approved NDAs for biological products deemed to be BLAs on March 23, 2020 Regulatory
  4. FDA: Notice to compounders — changes that affect compounding as of March 23, 2020 Regulatory
  5. WADA Prohibited List Regulatory

Last reviewed 2026-10-26 · How we research · Found an error? See our corrections policy.