Human Menopausal Gonadotrophin
Indications
Human Menopausal Gonadotrophin is used for:
Female infertility, Male infertility, In vitro fertilisation procedures or other assisted conception techniques
Adult Dose
Parenteral
Female infertility
Adult: 75-150 units of FSH daily via IM or SC inj; adjust gradually until adequate response is achieved. Treatment is stopped and followed after 1 or 2 days by single dose of chorionic gonadotrophin 5000-10,000 units.
In menstruating patients, start within the 1st 7 days of menstrual cycle. Alternatively, 3 equal doses IM or SC, each providing 225-375 units of FSH on alternate days followed by chorionic gonadotrophin 1 wk after the 1st dose. Stop treatment if no response is seen in 3 wk. Course may be repeated twice more, if necessary.
Male infertility
Adult: Stimulate spermatogenesis with chorionic gonadotrophin, then with human menopausal gonadotrophin in a dose of 75 or 150 units of FSH 2 or 3 times wkly by IM or SC. Treatment should be continued for at least 3 or 4 mth.
In vitro fertilisation procedures or other assisted conception techniques
Adult: (In conjunction with chorionic gonadotrophin and sometimes clomiphene citrate or a gonadorelin analogue.) 75-300 units of FSH daily via IM or SC inj usually beginning on the 2nd or 3rd day of menstrual cycle.
Combined regimen: 100 mg clomiphene citrate on days 2-6, with human menopausal gonadotrophins beginning on day 5 in a dose providing 150-225 units of FSH daily. Continue until an adequate response is obtained; final inj of human menopausal gonadotrophins is followed 1-2 days later with up to 10,000 units of chorionic gonadotrophin.
Child Dose
Renal Dose
Administration
Contra Indications
Ovarian cysts or enlargement not caused by polycystic ovarian syndrome; tumors of breast, uterus, ovaries, testes or prostate; vaginal bleeding of unknown cause; pregnancy and lactation.
Precautions
Hyperprolactinemia or tumors of the pituitary or hypothalamus. Ovarian enlargement at risk of rupture, care in pelvic examinations. Risk of multiple births.
Pregnancy-Lactation
Interactions
Drugs with luteinising hormone activity may increase risk of ovarian hyperstimulation syndrome.
Adverse Effects
Side effects of Human Menopausal Gonadotrophin :
Ovarian hyperstimulation, risk of multiple pregnancy and miscarriage, hypersensitivity and local reactions at Inj site, nausea, vomiting, joint pain, fever. In men, gynecomastia, acne, weight gain.
Potentially Fatal: Rupture of ovarian cysts and intraperitoneal haemorrhage.
Mechanism of Action
Human menopausal gonadotrophins possess both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activities.