Menotrophin is a purified, sterile preparation of gonadotropins extracted from the urine of postmenopausal women. It contains a mixture of Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) in an approximate 1:1 ratio. It is a key therapeutic agent in Assisted Reproductive Technology (ART) for controlled ovarian stimulation in women and for stimulating spermatogenesis in men with hypogonadotropic hypogonadism. In the Indian context, it is a cornerstone of infertility treatment protocols, often used in combination with other hormones like hCG.
Adult: HIGHLY INDIVIDUALIZED. Women (Ovulation Induction): Typically 75-150 IU daily IM/SC, starting on day 2-5 of cycle, adjusted based on response (ultrasound/estradiol). Max 225 IU/day often used. Women (ART): 150-450 IU/day in divided or single dose. Men (Hypogonadism): 75 IU IM/SC three times weekly, in conjunction with hCG.
Note: For intramuscular (IM) or subcutaneous (SC) injection only. Reconstitute the lyophilized powder with the provided sterile solvent (Sodium Chloride 0.9%). Gently swirl to dissolve. Do not shake vigorously. Administer immediately after reconstitution. Rotate injection sites. SC administration is often preferred for patient self-administration. Must be administered under the supervision of a fertility specialist with regular monitoring via transvaginal ultrasound and serum estradiol levels.
Menotrophin acts as a direct substitute for endogenous pituitary gonadotropins (FSH and LH). In women, FSH stimulates the growth and maturation of ovarian follicles (specifically the granulosa cells), while LH supports theca cell androgen production, which is aromatized to estrogen within the follicle. This combined action leads to follicular development, increased estradiol production, and endometrial proliferation. In men, FSH is essential for initiating and maintaining spermatogenesis by acting on Sertoli cells, while LH stimulates Leydig cells to produce testosterone.
Pregnancy: CATEGORY X. Menotrophin is used to induce ovulation and achieve pregnancy. However, it is contraindicated during an established pregnancy due to lack of benefit and potential fetal harm (risk of multiple gestation). Treatment must be discontinued once pregnancy is confirmed.
Driving: Generally safe, but patients should be cautioned that side effects like dizziness, visual disturbances, or fatigue could impair the ability to drive or operate machinery.
| GnRH Agonists (e.g., Leuprolide, Buserelin) | Used in combination in ART 'long protocols' to prevent premature LH surge. Requires careful timing. | Major |
| GnRH Antagonists (e.g., Cetrorelix, Ganirelix) | Used in combination in ART 'antagonist protocols' to prevent premature LH surge. | Major |
| Clomiphene Citrate | May be used sequentially before menotrophin. Can increase risk of OHSS. | Moderate |
| hCG (Human Chorionic Gonadotropin) | Used to trigger final oocyte maturation after menotrophin stimulation. Critical interaction that defines the treatment endpoint. Incorrect timing can cause OHSS or poor oocyte yield. | Major |
| Other Gonadotropins (Recombinant FSH/LH) | May be used in combination. Additive/synergistic effects increase OHSS risk. | Major |