Menopur (Menotrophin)

Menopur acts on the reproductive hormone pathway to support ovarian follicular development and ovulation.

• Anovulatory infertility: promotes follicular growth and ovulation in women who do not ovulate spontaneously.
• Assisted reproductive technology cycles: provides controlled ovarian stimulation to obtain multiple mature oocytes for IVF or ICSI.
• Ovulation induction in polycystic ovary syndrome: facilitates development of a dominant follicle and triggers ovulation.

• Menotrophin contains both follicle‑stimulating hormone (FSH) and luteinizing hormone (LH) analogues that bind to their respective gonadotropin receptors on ovarian granulosa and theca cells. Activation of FSH receptors promotes granulosa cell proliferation and estradiol synthesis, while LH receptor activation supports theca cell androgen production and final follicular maturation, together leading to the development of a dominant follicle and subsequent ovulation.

Menopur may be associated with a range of adverse reactions, varying in frequency and severity.

Common Side Effects

• Injection site pain: mild discomfort or erythema at the subcutaneous injection site.
• Abdominal bloating: transient abdominal distension or discomfort.
• Nausea: mild nausea without vomiting.
• Headache: mild to moderate headache.
• Vaginal spotting: occasional light bleeding between cycles.
• Ovarian cysts: small functional cysts that resolve spontaneously.

Serious or Rare Side Effects

• Ovarian hyperstimulation syndrome: severe ovarian enlargement with fluid shifts.
• Multiple pregnancy: increased risk of twins or higher‑order gestations.
• Severe allergic reaction: anaphylaxis or angioedema.
• Thromboembolic events: deep vein thrombosis or pulmonary embolism.
• Ectopic pregnancy: implantation outside the uterine cavity.
• Severe abdominal pain: may indicate complications such as ovarian torsion.

Prior to initiating Menopur, clinicians should consider several precautionary measures to ensure safe use.

• Baseline assessment: obtain ovarian reserve testing and ultrasound to guide dosing.
• Monitor response: perform serial ultrasounds and estradiol measurements during stimulation.
• OHSS risk: assess risk factors such as polycystic ovary syndrome and adjust protocol accordingly.
• Pregnancy status: confirm patient is not already pregnant before starting therapy.
• Contraindications: avoid use in known hypersensitivity to menotrophin or gonadotropins.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Menopur can interact with other medicines or substances that affect ovarian response or hormone metabolism.

Major Interactions (Avoid)

• GnRH antagonists: may blunt the stimulatory effect of menotrophin.
• Dopamine agonists: can reduce prolactin levels and alter ovarian response.
• High-dose estrogen therapy: may interfere with follicular development.

Moderate Interactions (Monitor Closely)

• Anticoagulants: increased risk of bleeding with ovarian cyst rupture.
• Thyroid hormone replacement: altered metabolism may affect response.
• Steroid hormones (e.g., corticosteroids): may influence hormone balance during stimulation.