Menopur (Menotrophin)

• Menopur is a gonadotropin used in reproductive medicine to stimulate ovarian function.
• Infertility due to anovulation: induces follicular development to achieve ovulation in women who do not ovulate spontaneously.
• Controlled ovarian stimulation for IVF/ICSI: supports multiple follicle growth to increase the number of oocytes retrieved during assisted reproductive cycles.
• Hypogonadotropic hypogonadism: replaces deficient endogenous gonadotropins to restore normal ovarian activity in patients with pituitary hormone deficiency.

• Menotrophin contains both follicle‑stimulating hormone (FSH) and luteinizing hormone (LH) activity. After subcutaneous or intramuscular injection, the molecule binds to FSH and LH receptors on ovarian granulosa and theca cells, activating intracellular cyclic AMP pathways. This stimulation promotes folliculogenesis, estrogen synthesis, and final oocyte maturation, thereby facilitating ovulation. The combined FSH/LH effect mimics the natural pituitary surge, ensuring coordinated growth of the dominant follicle and luteinization of the corpus luteum.

Menopur may be associated with a range of adverse reactions, which are generally classified by frequency and severity.

Common Side Effects

• Injection site pain or erythema: mild discomfort, redness, or swelling at the injection site.
• Ovarian hyperstimulation syndrome (mild): abdominal bloating, mild nausea, and transient weight gain.
• Headache: tension‑type or mild migraine‑like pain.
• Gastrointestinal upset: nausea, abdominal discomfort, or diarrhea.

Serious or Rare Side Effects

• Ovarian hyperstimulation syndrome (severe): rapid weight gain, severe abdominal pain, ascites, or respiratory distress requiring hospitalization.
• Thromboembolic events: deep vein thrombosis or pulmonary embolism.
• Allergic reaction: anaphylaxis, urticaria, or angioedema.

Prior to initiating Menopur therapy, clinicians should consider several safety considerations to minimize risk.

• Assess baseline ovarian reserve: evaluate antral follicle count and AMH levels to tailor dosing.
• Monitor for ovarian hyperstimulation: perform serial ultrasounds and estradiol measurements during stimulation cycles.
• Review concomitant hormone therapies: adjust or discontinue other gonadotropins or GnRH analogues as advised.
• Contraindications: avoid use in active ovarian cysts, uncontrolled thyroid disease, or estrogen‑dependent tumors.
• Store at 2‑8 °C: keep refrigerated, protect from light, do not freeze or shake the vial.

Menopur can interact with other medications that affect hormonal balance or ovarian response.

Major Interactions (Avoid)

• GnRH agonists used for down‑regulation: concurrent use may blunt Menotrophin efficacy.
• High‑dose estrogen therapy: may counteract follicular stimulation and increase risk of thrombosis.
• Anticoagulants (e.g., warfarin): heightened risk of bleeding if severe ovarian hyperstimulation occurs.

Moderate Interactions (Monitor Closely)

• Thyroid hormone replacement: altered metabolism may affect ovarian response; monitor thyroid function tests.
• Steroid hormones (e.g., corticosteroids): may influence follicular development; adjust dose if needed.
• Other gonadotropins: combined use can increase risk of excessive ovarian response; monitor closely.