Menopur (Menotrophin)

Menopur, a gonadotropin used in reproductive hormone therapy, is indicated for the following clinical situations:

• Anovulatory infertility: induces ovulation in women who do not ovulate spontaneously.
• Assisted reproductive technology cycles: provides controlled ovarian stimulation to support egg retrieval for IVF/ICSI.
• Intrauterine insemination preparation: enhances follicular development to improve success rates.

• Menopur contains menotropin, a purified preparation of follicle‑stimulating hormone (FSH) and luteinizing hormone (LH). After subcutaneous or intramuscular injection, the FSH component binds to FSH receptors on ovarian granulosa cells, promoting follicular growth and estrogen synthesis, while the LH component activates LH receptors on theca cells, supporting steroidogenesis and final follicle maturation.

Menopur may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Injection site pain or erythema: mild discomfort at the administration site.
• Abdominal bloating: transient abdominal distension.
• Nausea: occasional mild nausea.
• Headache: occasional mild headache.

Serious or Rare Side Effects

• Ovarian hyperstimulation syndrome (OHSS): potentially severe fluid shift and organ dysfunction.
• Multiple pregnancy: increased risk of twins or higher order gestations.
• Allergic reaction or anaphylaxis: rare but may include rash, swelling, or respiratory distress.
• Ovarian torsion: rare twisting of the ovary causing acute pain.
• Thromboembolic events: rare clot formation in veins or arteries.

Before initiating Menopur therapy, clinicians should consider several safety measures.

• Patient assessment: evaluate ovarian reserve and baseline hormone levels.
• Monitoring: perform serial ultrasound and estradiol measurements during stimulation.
• OHSS risk: adjust dose or discontinue in patients at high risk for ovarian hyperstimulation syndrome.
• Multiple pregnancy: counsel patients about the increased likelihood of twins or higher order gestations.
• Contraindications: avoid use in confirmed pregnancy, active ovarian cysts, or uncontrolled thyroid disease.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

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

Major Interactions (Avoid)

• GnRH agonists or antagonists: may alter ovarian response if not properly timed.
• Hormonal contraceptives: can suppress the intended ovarian stimulation.
• Thyroid hormone therapy: may modify gonadotropin activity and affect outcomes.

Moderate Interactions (Monitor Closely)

• Anticoagulants: increased risk of bleeding at injection sites.
• Corticosteroids: may influence follicular development and response.
• Diuretics: can mask early signs of OHSS, requiring careful monitoring.