HMG (human menopausal gonadotropin) also goes by the generic name menotropin, and is a hormonally active medication used in the treatment of fertility disorders. Menotropin preparations are designed to stimulate the ovaries to mature and grow the follicles in a woman’s body to make them more fertile.
HMG is typically administered through daily injections, both intramuscularly and subcutaneously, for a period lasting for about ten days. Doctors will be monitoring a patient over this time to be able to supervise the injections, adjusting the dose and duration of the hormonal therapy. HMG can also be used for infertility treatment in hypogonadal men to stimulate and increase sperm production. .
How HMG Works
The key active ingredient menotropin is extracted from the urine of postmenopausal women, reflecting the hypergonadotropic state of menopause—levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) are high—and contain a mixture of these gonadotropins. Small amounts of human chorionic gonadotropin (HCG) may also be present in the substance.
Some may find the urinary ingredients undesirable because of the theoretical risk of infection, but these fears have yet to be proven justifiable and remain theoretical. This following tests of intracerebral inoculation with urine from TSE-infected hosts, which suggests that the risk associated with products containing the main active ingredient is nonexistant
For many IVF clinics, recombinant gonadotropins have replaced HMG in fertility treatments, because of the stigma surrounding the active ingredient. The recombinant process, after all, allows for the production of pure FSH or LH without the “contamination (refuted above)” by other proteins in the urinary extraction process. The success of gonadrotropins, however, has not been conclusively confirmed as better than the “pure FSH” in HMG, even though some studies seem to suggest that recombinant FSH is more effective and at a reduced cost. A Cochrane Collaboration analysis revealed no significant difference between the two, comparing the benefits and drawbacks of urinary and recombinant FSH.
How HMG is Used
HMG injections will be taken along with the Lupron injections a few days before a woman starts her period. Lupron puts your ovaries on “hold” to prevent them from releasing the eggs before doctors are ready to collect them, and HMG will stimulates their development and maturation. The objective of this medication regimen is to produce as many eggs as possible for their eventual harvest, with 6 to 12 eggs developing on average.
Lupron and HMG injections will be taken every day for about ten days in which a patient will be monitored with ultrasound and possibly estradiol blood tests. Once the eggs are almost mature you will stop taking the Lupron and HMG, and will then take only a single injection of HCG hormone, which triggers the final stages of egg maturation. The eggs are then nonsurgically removed from the ovaries 36 hours after the HCG injection.
References
Detailed Explanation of IVF. (n.d.). Retrieved from www.cnyfertility.com: http://cnyfertility.com/fertility-treatments/in-vitro-fertilization/detailed-explanation-of-ivf/
Menotropin. (2014, July 25). Retrieved from www.wikipedia.com: http://en.wikipedia.org/wiki/Menotropin
