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hMG

Also known as Human menopausal gonadotropin, Menotropin, Menotrophin, Highly purified hMG, Menopur, Repronex

Menotropin: FSH and LH activity purified from postmenopausal urine, an approved IVF drug used off-label in men.

clinically proven Hormonal & sexual approved drug

At a glance

Category
Hormonal & sexual
Status
approved drug
Made from
human-derived Purified from the urine of postmenopausal women, whose pituitary output of FSH and LH is high and is excreted in the urine, then concentrated and purified from large donor pools 1.
Route
subcutaneous injection after reconstitution of the powder with the supplied diluent
Half-life
The FSH activity has a longer effective half-life, of the order of a day, than the LH activity, which is one reason a daily injection sustains follicular stimulation
Onset
In IVF, follicles grow over an 8 to 12 day stimulation phase; in off-label male use, effects on spermatogenesis take weeks to months
Molecular weight
FSH and LH are each roughly 30,000 g/mol glycoproteins; because glycosylation varies, the product is measured and dosed by bioactivity (IU), not by weight
Sequence
Not a single peptide: a mixture of the glycoprotein hormones FSH and LH activity, each a heterodimer of a shared alpha subunit and a hormone-specific beta subunit, heavily glycosylated; the product is standardised by biological activity in international units rather than by mass

Menotropin is an approved fertility medicine. The highly purified product (Menopur) is indicated for the development of multiple follicles and pregnancy in ovulatory women undergoing an assisted-reproduction (IVF) cycle; each vial contains 75 International Units of FSH activity and 75 International Units of LH activity, extracted from the urine of postmenopausal women 1. Repronex and generic menotropins are similar preparations, and older products were also used to induce ovulation. There is extensive off-label use in men and in bodybuilding to supply FSH and LH activity for testicular function and fertility, usually alongside hCG; much of the material circulating for that purpose is not pharmaceutically manufactured. In sport, menotropin is not named on the WADA Prohibited List, but it contains luteinizing-hormone activity, and LH is prohibited in males as a testosterone-stimulating peptide (S2.2.1), so a male athlete using it would be prohibited 3.

Doping status: Prohibited in males through its LH activity (WADA S2.2.1); not restricted in females

Checked against the WADA 2026 Prohibited List. For a specific product and country, Global DRO is the lookup athletes are expected to use — the List names substances, not brand names.

Like urinary hCG, menotropin is a purified fraction of pooled human urine - relevant to anyone weighing the donor-pool question, or keeping a diet or observance that excludes human-derived material. Recombinant FSH and recombinant LH exist as non-urine-derived alternatives, but each is a single hormone, not the combined FSH-plus-LH activity that defines menotropin.

Mechanism of action

Menotropin supplies both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activity. FSH drives follicular growth in women and supports Sertoli-cell function and spermatogenesis in men; LH drives the steroid-producing cells - the ovarian theca and granulosa in women, the testicular Leydig cells in men, where it is the direct signal for testosterone. The material is purified from postmenopausal urine, in which both hormones are naturally elevated. In the highly purified product the LH activity is standardised to match the FSH activity at 75 IU each, with the LH activity provided largely by co-purified hCG 1.

In IVF the point is controlled ovarian stimulation: exogenous FSH recruits a cohort of follicles while the LH activity supports the steroid environment. Because a urinary FSH-plus-LH mixture is not identical to pure recombinant FSH, the two give somewhat different follicular growth, oocyte and embryo quality, and endocrine profiles - differences that were mapped directly in head-to-head trials 2.

The off-label male rationale turns on that FSH content. Unlike hCG, which mimics LH only, menotropin also delivers FSH. Exogenous testosterone or anabolic steroids suppress both pituitary LH and FSH; hCG can substitute for the missing LH signal to the Leydig cells and restore testosterone, but it does nothing for FSH, which spermatogenesis also requires. Menotropin - or menotropin with hCG, or recombinant FSH with hCG - is used to supply that missing FSH arm to preserve or restart sperm production. The reasoning is coherent, but this is not a registered use and it has not been tested in large trials.

What the research shows

The evidence for the licensed IVF use is strong and registrational: highly purified menotropin has been compared head-to-head with recombinant FSH in large randomised trials and shown to be at least as effective 2. The off-label use in men rests on extrapolation from the established treatment of hypogonadotropic hypogonadism and on small studies, not on large randomised trials with fertility outcomes.

Research in humans

The pivotal comparison is the MERiT trial (Andersen, Devroey and Arce, 2006): 731 women undergoing IVF after a long GnRH-agonist protocol were randomised to highly purified menotropin or recombinant FSH, with ongoing pregnancy as the primary endpoint. Recombinant FSH retrieved slightly more oocytes, but menotropin produced a higher proportion of top-quality embryos, and the ongoing pregnancy rate was 27 percent with menotropin versus 22 percent with recombinant FSH - non-inferiority was established 2. In men with hypogonadotropic hypogonadism, FSH-containing gonadotropin regimens (typically with hCG) restore testosterone and, over months, spermatogenesis; this is the clinical basis borrowed for the off-label practice. Evidence specifically for recovering the axis after anabolic-steroid use is limited and largely observational.

Animal and lab research

Gonadotropin physiology - FSH on the Sertoli cell and follicle, LH on the Leydig and theca cell - is well established in animals and underpins the mechanism. It supports the rationale rather than any particular human schedule.

Caveats. The robust evidence is about pregnancy rates in women undergoing IVF; it does not transfer automatically to the doses, durations and goals of off-label male use, which lacks comparable trials. Urinary menotropin preparations vary between manufacturers in their LH-to-FSH activity and purity. Material sold outside pharmacies for bodybuilding is of unverified content and potency, and being a pooled-urine product carries the donor-sourcing considerations noted under origin.

What it is used for

  • Assisted reproduction: development of multiple follicles for IVF in ovulatory women 1
  • Ovulation induction with older menotropin products and generics
  • Hypogonadotropic hypogonadism in women or men, to induce gamete development - in men combined with hCG
  • Off-label alongside testosterone, or in post-cycle recovery after anabolic-steroid use, to supply the FSH activity that hCG alone does not provide, usually together with hCG

Dosing

Dose
IVF: commonly 150 to 450 International Units subcutaneously per day, with a 225 IU starting dose on the Menopur label. Every figure is in international units of biological activity, never milligrams.
Frequency
once daily during the stimulation phase, then stopped at the hCG trigger
Route
subcutaneous, after reconstituting the powder with the supplied diluent
Duration
roughly 8 to 12 days per IVF cycle until the trigger; months when the goal is restoring spermatogenesis
  • The 225 IU per day starting dose and the 75 IU FSH plus 75 IU LH per-vial composition are taken from the Menopur label 1.
  • In IVF the dose is titrated to the follicular response measured by ultrasound and estradiol; the figures here describe documented practice, not advice.
  • Off-label male and post-cycle regimens are not derived from any approved schedule and circulate among users; they are set out as a circulating protocol below.
  • Because the dose is expressed in international units of biological activity, it must never be entered into a milligram-based syringe calculator - the two are not interchangeable.

These figures describe what the literature and published protocols report. They are not advice and not a dosing instruction.

Protocols

Menopur (multiple follicular development in IVF)

approved product information

Source: MENOPUR (menotropins for injection) prescribing information, DailyMed

Cycle day 2 or 3, after pituitary suppression225 IU subcutaneously once daily
During stimulationAdjusted to the follicular response, individualised, to a maximum in the label of 450 IU per day
When follicles are matureMenotropin stopped and ovulation triggered with hCG

The lyophilised powder is reconstituted with the supplied 2 mL of 0.9 percent sodium chloride; several 75 IU powder vials can be dissolved in a single diluent vial to make up the daily dose, which is then injected subcutaneously. Use immediately after reconstitution.

Highly purified menotropin versus recombinant FSH, MERiT trial

published trial

Source: Human Reproduction, 2006 - Andersen, Devroey, Arce; randomised, assessor-blind, 731 women

Down-regulationLong GnRH-agonist protocol, then controlled ovarian stimulation with highly purified menotropin (or recombinant FSH in the comparator arm)
Day 3One or two embryos transferred

Ongoing pregnancy was 27 percent with menotropin and 22 percent with recombinant FSH, establishing non-inferiority. The trial also documented real pharmacodynamic differences between the urinary FSH-plus-LH mixture and pure recombinant FSH in follicular growth, embryo quality and endocrine response.

Off-label male fertility and testosterone recovery

user protocol — not validated

Source: Pattern followed in male-fertility and bodybuilding practice

This is not a validated schedule. It is a pattern that circulates among users and sellers, reproduced because it is what people actually follow — not because it has been tested. No trial established these doses, this interval or this duration, and nobody is checking what is in the vial. Treat every number below as an assertion, not a finding.

Alongside hCGMenotropin commonly 75 to 150 IU subcutaneously two to three times weekly, to add the FSH activity hCG lacks
Post-steroid recoveryCombined with hCG and often a SERM such as clomifene or tamoxifen

None of this comes from an approved schedule for men. The premise - that hCG restores the LH signal but not FSH, so menotropin supplies the missing FSH arm for spermatogenesis - is mechanistically coherent, but it has not been tested in large trials, urinary product varies in its LH-to-FSH activity, and non-pharmaceutical material is of unknown content. It differs sharply from the licensed use, which is a daily, ultrasound-monitored regimen in women undergoing IVF.

Schedules are reproduced as their source states them. Units, IU and milligrams explains why the figures are not interchangeable between products.

Reconstitution

Vial sizes
75 IU FSH + 75 IU LH per vial (lyophilised powder)
Solvent
0.9 percent sodium chloride for injection, 2 mL supplied with the powder
Storage
Powder stored refrigerated or at room temperature (3 to 25 degrees C), protected from light; use immediately after reconstitution

Worked example

Up to several 75 IU powder vials can be dissolved in a single 2 mL diluent vial to make one subcutaneous injection; the dose is counted in international units of FSH activity, not in milligrams or in syringe units.

Menotropin is dosed by biological activity in international units. The insulin-syringe calculator on this site converts milligrams to units and must not be used for it - enter no milligram figure. Swirl gently to dissolve; do not shake a glycoprotein hormone.

Safety

Side effects

  • Ovarian hyperstimulation syndrome in women: ovarian enlargement, fluid shifts, abdominal distension and, in severe cases, thromboembolism - the principal serious risk of gonadotropin stimulation
  • Injection-site reactions, headache, abdominal pain and bloating, and nausea
  • Multiple pregnancy when used for ovulation or IVF
  • Ovarian enlargement and cyst formation
  • Hypersensitivity reactions, reported with urinary-derived gonadotropins
  • In off-label male use: a rise in estradiol with the increase in testosterone, and the acne, gynaecomastia and mood effects that follow from it

Do not use if

  • Primary ovarian failure or a high baseline FSH, where the ovary will not respond
  • Uncontrolled thyroid or adrenal dysfunction, or an untreated pituitary tumour
  • Known or suspected pregnancy
  • Abnormal uterine bleeding of undetermined cause, or an ovarian cyst or enlargement not due to polycystic ovary syndrome
  • Sex-hormone-dependent tumours of the reproductive tract; prostate or breast cancer in men
  • Known hypersensitivity to menotropin

Interactions

No clinically significant metabolic drug interactions are established; the important interactions are hormonal and intentional. Menotropin is used with an hCG trigger in IVF and with hCG in off-label male protocols, and its action is set against the pituitary suppression produced by the GnRH agonists or antagonists used in the same cycles. Combining it with hCG for ovulation induction markedly raises the risk of ovarian hyperstimulation and multiple pregnancy.

Sources