Menopur (Menotrophin)

Menopur is a gonadotropin used in reproductive medicine to stimulate ovarian activity during infertility treatment.

• Anovulatory infertility: stimulates follicular growth and estrogen production to enable ovulation in women who do not ovulate spontaneously.
• Assisted reproductive technology cycles: provides combined FSH and LH activity for controlled ovarian hyperstimulation, improving egg yield for IVF or ICSI.
• In vitro fertilization protocols: supports multiple follicle development, increasing the number of oocytes available for retrieval.

• Menotropin is a purified preparation containing both follicle‑stimulating hormone (FSH) and luteinizing hormone (LH) activity. After subcutaneous or intramuscular injection, the FSH component binds to FSH receptors on ovarian granulosa cells, promoting follicular recruitment, growth, and estradiol synthesis. The LH component activates LH receptors on theca cells, stimulating androgen production that serves as substrate for estrogen formation and supporting final follicular maturation and ovulation.

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

Common Side Effects

• Injection site pain or erythema: mild discomfort, redness, or swelling at the injection site.
• Abdominal bloating or discomfort: transient fullness or mild abdominal pain.
• Nausea or mild headache: occasional gastrointestinal upset or headache.
• Mild ovarian hyperstimulation: limited follicular response without severe complications.

Serious or Rare Side Effects

• Ovarian hyperstimulation syndrome (OHSS): potentially severe fluid shift, abdominal distension, and respiratory compromise.
• Multiple pregnancy: increased risk of twins or higher‑order gestations.
• Severe allergic reaction: anaphylaxis, urticaria, or angioedema requiring immediate medical attention.

When using Menopur, clinicians should observe specific precautions to minimize risks and ensure optimal outcomes.

• Monitor ovarian response: perform serial ultrasound and estradiol measurements to adjust dose.
• Assess risk of OHSS: limit stimulation in patients with prior severe OHSS or high follicle count.
• Avoid use in uncontrolled thyroid disease: correct thyroid function before initiating therapy.
• Review for ovarian cysts or tumors: contraindicated in active ovarian pathology.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Menopur can interact with other medications, affecting its efficacy or safety profile.

Major Interactions (Avoid)

• GnRH agonists: may amplify ovarian response and increase OHSS risk.
• Estrogen‑containing contraceptives: can blunt stimulation effect and should be discontinued before treatment.
• Anticoagulants: heightened bleeding risk if severe OHSS occurs.

Moderate Interactions (Monitor Closely)

• Thyroid hormone therapy: monitor thyroid levels as gonadotropins may alter hormone metabolism.
• Corticosteroids: may affect follicular response; adjust dose as needed.
• Insulin‑sensitizing agents: monitor glucose control during stimulation cycles.