Menopur (Menotrophin)

Menopur, a gonadotropin preparation, is used to stimulate ovarian function in several reproductive disorders.

• Anovulation: induces ovulation in women who do not ovulate spontaneously.
• Assisted reproductive technology (IVF): supports controlled ovarian hyperstimulation to produce multiple follicles for IVF cycles.
• Hypogonadotropic hypogonadism: provides FSH/LH activity to stimulate ovarian function in women with deficient gonadotropin secretion.

• Menotrophin contains both follicle‑stimulating hormone (FSH) and luteinizing hormone (LH). After subcutaneous injection, the hormones bind to FSH and LH receptors on ovarian granulosa and theca cells, activating intracellular signaling pathways that promote follicular growth, estradiol synthesis, and final oocyte maturation, ultimately leading to ovulation or the retrieval of multiple oocytes for assisted reproduction. The combined activity mimics the natural pituitary output and enhances the endogenous hormonal milieu during the follicular phase.

Menopur may cause a range of adverse reactions, most of which are related to ovarian stimulation.

Common Side Effects

• Injection site pain: mild soreness, redness or swelling at the injection site.
• Abdominal discomfort: bloating, cramping or mild pelvic pain.
• Nausea: occasional feeling of queasiness or upset stomach.
• Headache: transient mild to moderate headache.

Serious or Rare Side Effects

• Severe ovarian hyperstimulation syndrome (OHSS): rapid weight gain, abdominal distension, shortness of breath.
• Multiple pregnancy: increased chance of twins or higher-order gestations.
• Ovarian torsion: acute pelvic pain due to twisted ovary.
• Allergic reaction: rash, itching, swelling or anaphylaxis.

Before using Menopur, healthcare providers should consider several precautionary measures to ensure patient safety.

• Monitor ovarian response: use serial ultrasound and estradiol measurements to adjust dose.
• Assess OHSS risk: evaluate patient history, age and baseline ovarian reserve before treatment.
• Avoid use in pregnancy: Menopur is contraindicated once pregnancy is confirmed.
• Review thyroid function: uncontrolled thyroid disease may affect treatment outcomes.
• Consider thromboembolic risk: patients with clotting disorders require careful monitoring.
• Store at 2‑8 °C: keep refrigerated, protect from light, do not freeze or shake.

Menopur can interact with other medications that influence ovarian stimulation or coagulation pathways.

Major Interactions (Avoid)

• Concurrent use of other gonadotropins: may excessively increase ovarian response and OHSS risk.
• High‑dose estrogen therapy: can alter follicular development and reduce efficacy.
• GnRH agonist/antagonist protocols not matched to dose: may cause over‑stimulation.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin, heparin): increased risk of thromboembolic events with OHSS.
• Thyroid hormone replacement: dose adjustments may be needed based on hormonal changes.
• Antidiabetic agents: OHSS can affect glucose metabolism, requiring closer monitoring.