Menopur (Menotrophin)

Menopur, a human menopausal gonadotropin, is used in fertility treatment protocols that rely on ovarian stimulation.

• Infertility due to anovulation: stimulates follicular growth to enable ovulation in women who do not ovulate spontaneously.
• Controlled ovarian hyperstimulation for in‑vitro fertilisation (IVF): provides FSH/LH activity to produce multiple mature oocytes for retrieval.
• Assisted reproductive technology (ART) protocols: supports ovarian response in various ART cycles, including intracytoplasmic sperm injection (ICSI) and embryo transfer.

• Menotrophin is a purified preparation of human menopausal gonadotropin containing both follicle‑stimulating hormone (FSH) and luteinizing hormone (LH) isoforms. After subcutaneous or intramuscular injection, the FSH component binds to receptors on granulosa cells, promoting follicular recruitment and estrogen synthesis, while the LH component activates receptors on theca cells and mature follicles, supporting androgen production and final oocyte maturation. The combined activity mimics the natural pituitary surge, facilitating ovulation.

Menopur may cause a range of adverse reactions, most of which are related to its hormonal activity and injection site.

Common Side Effects

• Injection site pain: mild to moderate discomfort at the injection site.
• Abdominal bloating: sensation of fullness or swelling in the lower abdomen.
• Nausea: occasional feeling of queasiness.
• Headache: mild to moderate head pain.
• Mild ovarian hyperstimulation: early signs of increased ovarian response.
• Mood changes: transient emotional fluctuations.

Serious or Rare Side Effects

• Severe ovarian hyperstimulation syndrome: rapid weight gain, abdominal pain, and fluid accumulation.
• Multiple pregnancy: increased likelihood of twins or higher-order gestations.
• Ovarian torsion: acute pelvic pain due to twisted ovary.
• Allergic reaction/anaphylaxis: rash, itching, swelling, or difficulty breathing.
• Thromboembolic events: blood clots in veins or arteries.

When using Menopur, several precautions should be observed to ensure safety and effectiveness.

• Pregnancy testing: confirm non‑pregnant status before initiating therapy.
• Ovarian monitoring: perform ultrasound and estradiol measurements to detect hyperstimulation.
• Thyroid function: assess in patients with known thyroid disease as gonadotropins may affect hormone levels.
• Estrogen‑sensitive tumors: use with caution in patients with a history of hormone‑dependent cancer.
• Allergy: avoid if known hypersensitivity to menotropin or any excipients.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Menopur can interact with other medications, requiring careful management.

Major Interactions (Avoid)

• GnRH agonists: concurrent use may blunt ovarian response.
• Oral contraceptives: suppress endogenous gonadotropins, reducing efficacy of Menopur.
• Estrogen‑containing medications: increase risk of ovarian hyperstimulation.

Moderate Interactions (Monitor Closely)

• Anticoagulants: OHSS may increase thrombotic risk, monitor coagulation parameters.
• Thyroid hormone replacement: adjust dose as gonadotropins may affect thyroid binding proteins.
• Diuretics: may mask fluid shifts associated with OHSS.