Follicle Stimulating Hormone/ Luteinising Hormone (Human Menopausal Gonadotrophin)

Registered South African indications:

• Infertility
• Oligospermia

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Pregnancy
• Breastfeeding
• Tumours of the pituitary or hypothalamic glands
• Testicular tumours 
• Prostate carcinoma 
• Ovarian, uterine or mammary carcinoma 
• Gynaecological haemorrhage of unknown aetiology 
• Ovarian cysts or enlarged ovaries not due to polycystic ovarian disease 
• Primary ovarian failure
• Malformation of sexual organs incompatible with pregnancy 
• Fibroid tumours of the uterus incompatible with pregnancy 
• Structural abnormalities in which a satisfactory outcome cannot be expected

Cautions

• Renal impairment
• Hepatic impairment
• Hypothyroidism
• Adrenocortical deficiency
• Hyperprolactinemia
• History of tubal disease 
• Multiple drug regimens for infertility treatment
• Risk factors for thromboembolic events
• Polycystic ovarian disease

Forms avail. in SA and covered in this monograph: inj

Ovulation induction
- WHO group II anovulation infertility, including polycystic ovarian disease, in women who have been unresponsive to other treatment

• IM/SC: 75-150 IU, dly; Titrate by 37.5 IU at intervals of 1 week; Max: 225 IU/24hrs; Treatment duration: 7 days

Start within the initial 7 days of the menstrual cycle

If a patient fails to respond adequately after 4 weeks of treatment, that cycle
should be abandoned and the patient should recommence treatment at a higher starting dose than in the abandoned cycle

Controlled ovarian hyperstimulation to induce the development of multiple follicles
- Assisted reproductive technologies
- Gamete intra-fallopian transfer
- Intracytoplasmic sperm injection

• IM/SC: Initial: 150-225 IU, dly for 5 days; Titrate by 150 IU/dose; Max: 450 IU/24hrs: Max treatment duration: 20 days

Start approximately 2 weeks after the start of agonist treatment

In protocols not involving downregulation with GnRH agonist, therapy should start on day 2 or 3 of the menstrual cycle

Oligospermia (additional agent required)
- some types of azoospermia, hypogonadism, eunuchoidism

• IM/SC: Initial: 75 IU, every alternate day; Maintenance: 75-150 IU/week; Treatment duration: 90-120 days

Should be initiated by a specialist

Use immediately after reconstitution

Not indicated for use in children

Pregnancy

• FDA Pregnancy Category X

Breastfeeding

• Contraindicated

Renal Impairment

• Caution; no information available

Hepatic Impairment

• Caution; no information available

Elderly

• Not indicated for use in geriatric patients

Central Nervous System Disorders

• Headache

Cardiovascular Disorders

• Deep vein thrombosis

Gastrointestinal Disorders

• Abdominal pain
• Enlarged abdomen
• Nausea and vomiting

Genitourinary Disorders

• Ovarian hyperstimulation

Skin and Subcutaneous Tissue Disorders

• Injection site reactions 

No information available

• Urinary oestrogen
• 17 beta-oestradiol levels
• Ultrasound
• Luitenizing hormone
• Progesterone level
• Albumin
• Basal body temperature 
• Signs and symptoms of ovarian hyperstimulation syndrome

Menotropins is a purified combination of follicle stimulating hormone and luteinizing hormone extracted from the urine of postmenopausal women. Treatment provides ovarian follicular growth and maturation in females who do not have primary ovarian failure.

Follicle-stimulating hormone/ Luitenizing hormone

Injection (per ml) 75 IU/75 IU 

• Menopur (Ferring) originator