Menopur (Menotrophin)

• Menopur, a gonadotropin used in reproductive medicine, is indicated for several infertility‑related conditions.
• Infertility due to anovulation: stimulates follicular growth to induce ovulation in women who do not ovulate spontaneously.
• Assisted reproductive technology (ART) protocols: provides controlled ovarian stimulation to optimize egg retrieval for in‑vitro fertilisation cycles.
• Controlled ovarian stimulation: supports the development of multiple follicles, enhancing the number of oocytes available for fertilisation.

• Menotropin contains both follicle‑stimulating hormone (FSH) and luteinising hormone (LH) activity. After subcutaneous injection, the FSH component binds to FSH receptors on ovarian granulosa cells, promoting follicle maturation and estrogen synthesis. The LH component activates LH receptors on theca cells, stimulating androgen production that serves as substrate for estrogen formation, together facilitating follicular development and ovulation. The combined activity mimics the natural pituitary gonadotropin surge, coordinating the endocrine events required for successful ovulation.

Menopur may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Injection site pain or erythema
• Abdominal bloating or discomfort
• Mild headache
• Nausea

Serious or Rare Side Effects

• Ovarian hyperstimulation syndrome (severe) with rapid weight gain, ascites, or respiratory distress
• Multiple pregnancy (twins or higher-order)
• Thromboembolic events such as deep vein thrombosis
• Allergic reaction including rash, urticaria, or anaphylaxis

When using Menopur, clinicians should observe several precautionary measures to ensure patient safety.

• Monitor ovarian response: perform regular ultrasound and serum estradiol assessments.
• Avoid use in active ovarian cysts: postpone treatment until cyst resolution.
• Assess thromboembolic risk: evaluate personal or family history of clotting disorders.
• Use caution in hormone‑sensitive cancers: consider alternative protocols if malignancy is present.
• Pregnancy testing required: confirm negative pregnancy test before initiating therapy.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

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

Major Interactions (Avoid)

• GnRH agonists or antagonists: may blunt the intended ovarian stimulation response.
• Estrogen‑containing contraceptives: suppress endogenous gonadotropin activity, reducing effectiveness.
• High‑dose corticosteroids: can alter hormone metabolism and affect follicular development.

Moderate Interactions (Monitor Closely)

• Anticoagulants: increased risk of thrombosis if ovarian hyperstimulation occurs.
• Insulin sensitizers (e.g., metformin): may modify ovarian response, requiring dose adjustments.
• Selective serotonin reuptake inhibitors (SSRIs): potential impact on hormone levels, monitor clinical response.