Menopur (Menotrophin)

• Menopur is a gonadotropin used in reproductive endocrinology to stimulate ovarian function in several clinical scenarios.
• Infertility due to anovulation: promotes follicular growth and ovulation in women who do not ovulate spontaneously.
• Assisted reproductive technology (ART): provides controlled ovarian stimulation for in‑vitro fertilisation and intracytoplasmic sperm injection cycles.
• Hypogonadotropic hypogonadism: replaces deficient FSH and LH activity to restore normal gonadal hormone production.

• Menotropin contains both follicle‑stimulating hormone (FSH) and luteinising hormone (LH) activity. After subcutaneous or intramuscular injection it binds to FSH and LH receptors on ovarian granulosa and theca cells, activating intracellular cAMP pathways that stimulate estrogen synthesis, follicular maturation and eventual ovulation, thereby facilitating conception.

Menopur may be associated with a range of adverse reactions, most of which are related to its hormonal activity.

Common Side Effects

• Injection site pain or erythema.
• Mild abdominal discomfort or bloating.
• Headache.
• Nausea.
• Mild ovarian hyperstimulation symptoms such as mild ascites.

Serious or Rare Side Effects

• Ovarian hyperstimulation syndrome (OHSS) with severe abdominal pain, rapid weight gain, and respiratory distress.
• Thromboembolic events.
• Allergic reactions including rash, urticaria, or anaphylaxis.
• Multiple pregnancy.
• Ectopic pregnancy.

• Before initiating Menopur therapy, clinicians should assess patient history and monitor response closely.
• Risk of OHSS: evaluate baseline ovarian reserve and adjust dose accordingly.
• Pregnancy status: avoid use in confirmed pregnancy.
• Thromboembolic risk: consider patient’s clotting history.
• Allergy assessment: screen for hypersensitivity to gonadotropins.
• Drug interactions: review concomitant hormonal therapies.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Menopur can interact with other agents that influence ovarian response or coagulation.

Major Interactions (Avoid)

• Concurrent use of other gonadotropins or high‑dose estrogen preparations, which may markedly increase OHSS risk.
• Anticoagulants in patients with severe OHSS, due to heightened thrombotic potential.

Moderate Interactions (Monitor Closely)

• Corticosteroids, which may alter hormone metabolism.
• Thyroid hormone replacement, requiring monitoring of thyroid function tests.
• Dopamine agonists used for OHSS prophylaxis, needing dose adjustments.