Menopur (Menotrophin)

Menotropin is used in reproductive hormone therapy to support ovarian stimulation.

• Infertility due to anovulation: promotes follicular growth and ovulation in women who do not ovulate spontaneously.
• Assisted reproductive technology (ART) protocols: provides controlled ovarian hyperstimulation for in‑vitro fertilisation cycles.
• Induction of ovulation in women undergoing IVF: enhances estrogen production and oocyte maturation to improve IVF success rates.

• Menotropin contains both follicle‑stimulating hormone (FSH) and luteinising hormone (LH) activity. The FSH component binds to FSH receptors on granulosa cells, stimulating estrogen synthesis and follicle growth, while the LH component activates LH receptors on theca cells, supporting androgen production that is converted to estrogen. Together they drive coordinated ovarian follicular development and trigger ovulation.

Menotropin may cause a range of adverse reactions, most of which are related to its ovarian‑stimulating properties.

Common Side Effects

• Injection site pain or erythema: mild discomfort at the subcutaneous injection site.
• Abdominal bloating or discomfort: transient abdominal fullness during follicular growth.
• Mild headache: occasional tension‑type headache.
• Mood changes: brief emotional lability or irritability.

Serious or Rare Side Effects

• Severe ovarian hyperstimulation syndrome (OHSS): rapid fluid shift, abdominal pain, and possible hospitalization.
• Thromboembolic events: rare clot formation in veins or arteries.
• Allergic reactions: rash, urticaria, or anaphylaxis.
• Multiple pregnancy: increased chance of twins or higher-order gestations.
• Ovarian torsion: acute pelvic pain requiring surgical intervention.

Careful patient evaluation and monitoring are essential when using Menotropin.

• Patient assessment: evaluate ovarian reserve, baseline hormone levels, and ultrasound findings before initiating therapy.
• Monitoring: perform serial transvaginal ultrasounds and estradiol measurements to adjust dosing and detect early signs of OHSS.
• Risk of OHSS: avoid or use reduced doses in patients with polycystic ovary syndrome or high baseline estradiol.
• Pregnancy considerations: discontinue Menotropin once pregnancy is confirmed to prevent overstimulation.
• Contraindications: do not use in the presence of 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.

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

Major Interactions (Avoid)

• Concurrent use of other gonadotropins: may cause excessive ovarian stimulation and severe OHSS.
• Estrogen‑containing therapies: can alter the intended ovarian response and increase thrombotic risk.
• Anticoagulants: heightened risk of bleeding if OHSS leads to vascular leakage.

Moderate Interactions (Monitor Closely)

• Corticosteroids: may affect follicular development and require dose adjustment.
• Thyroid hormone replacement: altered metabolism may influence ovarian response.
• Antihypertensive agents: monitor blood pressure as fluid shifts occur with OHSS.
• NSAIDs: may mask pain symptoms of OHSS; use with caution.
• Oral contraceptives: should be discontinued before initiating Menotropin to ensure effective stimulation.