Hmg-Lepori (Luteinising Hormone (Human), Follicle-Stimulating Hormone)

Hmg‑Lepori is employed in fertility practice to address specific reproductive challenges.

• Treatment of infertility caused by anovulation, such as in polycystic ovary syndrome.
• Induction of ovulation as part of assisted reproductive technology (ART) protocols, including in vitro fertilisation.
• Support of follicular development during controlled ovarian stimulation cycles.
• Use in combination with other gonadotropins or hormonal agents to optimise oocyte yield.
• Preparation for egg retrieval in donor cycles.
• Adjunct in luteal phase support when indicated.

• Hmg‑Lepori provides exogenous luteinising hormone (LH) and follicle‑stimulating hormone (FSH), which bind to their respective G‑protein‑coupled receptors on ovarian granulosa and theca cells. Activation of the FSH receptor stimulates aromatase activity and follicular growth, while LH receptor activation promotes theca cell androgen production and final maturation of the dominant follicle, culminating in ovulation. The combined hormonal stimulus mimics the natural mid‑cycle surge, facilitating the cascade of events required for oocyte release.

Adverse reactions to Hmg‑Lepori have been reported, ranging from mild to serious.

Common

• Injection site pain, redness, swelling, or bruising that usually resolves within a few days.
• Mild abdominal discomfort, bloating, or pelvic pressure that may accompany follicular growth.
• Transient headache, often described as mild to moderate intensity.

Serious

• Ovarian hyperstimulation syndrome (OHSS), presenting with rapid weight gain, abdominal distension, nausea, and shortness of breath.
• Severe allergic reactions, including rash, itching, swelling, or anaphylaxis requiring emergency treatment.
• Thromboembolic events such as deep vein thrombosis or pulmonary embolism, which are rare but potentially life‑threatening.

Before initiating Hmg‑Lepori, clinicians should evaluate several safety considerations to minimise risk.

• Confirm diagnosis of anovulatory infertility and suitability for gonadotropin therapy.
• Assess for ovarian cysts, polycystic ovary syndrome, or prior episodes of OHSS.
• Review personal and family history of thromboembolic disease or clotting disorders.
• Evaluate for hypersensitivity to any component of the preparation.
• Counsel patients on signs of OHSS and when to seek immediate medical attention.
• Avoid use in pregnancy; the drug is contraindicated once conception is confirmed.

Hmg‑Lepori may interact with other medications or substances that affect ovarian response or coagulation.

Avoid

• Concurrent use of other gonadotropins or high‑dose estrogen preparations that could exacerbate ovarian stimulation.
• Medications known to increase the risk of thrombosis, such as oral contraceptives containing estrogen, unless specifically indicated.

Use with caution

• Anticoagulant therapy (e.g., warfarin, direct oral anticoagulants) due to potential additive bleeding risk.
• Aromatase inhibitors or selective estrogen receptor modulators, which may alter follicular dynamics.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs) that could mask early signs of OHSS.