Menopur (Menotrophin)

Menopur (menotrophin) acts on the hypothalamic‑pituitary‑gonadal axis to support ovarian stimulation in infertility treatment.

• Induction of ovulation in women with anovulation or oligo‑ovulation: promotes follicular growth and triggers ovulation.
• Controlled ovarian hyperstimulation for in‑vitro fertilisation (IVF): provides FSH and LH activity to develop multiple mature follicles.
• Assisted reproductive techniques such as intracytoplasmic sperm injection (ICSI): enhances oocyte yield for laboratory fertilisation procedures.

• Menotrophin contains both follicle‑stimulating hormone (FSH) and luteinizing hormone (LH) isoforms that bind to their respective receptors on ovarian granulosa and theca cells. Activation of FSH receptors stimulates follicular recruitment and estrogen production, while LH receptor activation supports theca cell androgen synthesis and final follicular maturation, together facilitating ovulation. The combined activity mimics the natural gonadotropin surge, allowing controlled ovarian stimulation in assisted reproduction cycles.

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

Common Side Effects

• Injection site pain: mild discomfort or erythema at the injection site.
• Abdominal bloating: transient abdominal distension or discomfort.
• Headache: mild to moderate headache.
• Nausea: occasional nausea without vomiting.

Serious or Rare Side Effects

• Ovarian hyperstimulation syndrome (OHSS): severe fluid shift and ovarian enlargement.
• Multiple pregnancy: increased risk of twins or higher‑order gestations.
• Thromboembolic events: rare blood clot formation.

Before initiating Menopur therapy, clinicians should consider several precautionary measures to minimize risks.

• Assess ovarian reserve: evaluate baseline follicle count and hormone levels.
• Monitor estradiol levels: regular serum estradiol testing during stimulation.
• Ultrasound surveillance: perform serial transvaginal ultrasounds to track follicle growth.
• Adjust dose in high responders: reduce dosage if rapid follicular response observed.
• Contraindications: avoid use in pregnancy, uncontrolled thyroid disease, or active ovarian cysts.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Menopur can interact with other medications or hormonal agents, influencing its efficacy or safety.

Major Interactions (Avoid)

• GnRH agonists/antagonists: concurrent use may alter gonadotropin response.
• Oral contraceptives: must be discontinued before stimulation to avoid suppression.
• Dopamine agonists (e.g., bromocriptine): may reduce prolactin‑mediated effects.

Moderate Interactions (Monitor Closely)

• Thyroid hormone replacement: monitor thyroid function as gonadotropins can affect hormone balance.
• Anticoagulants: OHSS risk may increase bleeding tendency.
• Steroids: may affect ovarian response; adjust monitoring.