An hMG injection (human menopausal gonadotropin, or menotropins) delivers both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activity, purified from the urine of postmenopausal women.[1] In the US, it is sold as Menopur and approved to grow multiple egg follicles during IVF.[1] Randomized trials found it about as effective as recombinant FSH.[6][7] Combined with hCG, it is also used to start sperm production in men whose pituitary makes too little FSH and LH.[5]

This profile covers what hMG is, what the research shows, hMG vs recombinant FSH, use in men, dosage, side effects including OHSS, and legal status.

What is hMG (menotropins)?

After menopause, the pituitary releases large amounts of FSH and LH, which pass into the urine. hMG is extracted and purified from that urine.[1] Each Menopur vial contains 75 IU of FSH activity and 75 IU of LH activity, and hCG is detectable in the product.[1]

FSH drives the growth of ovarian follicles (in women) and supports sperm production (in men). LH activity helps make the hormones the follicles need. hMG alone usually grows and matures follicles; a separate hCG dose is then needed to trigger ovulation.[1]

US approvals by FDA:

  • Pergonal (Serono, 1975): the earliest menotropins approval listed in Drugs@FDA, now discontinued.[3]
  • Repronex (Ferring, 1999): now discontinued.[4]
  • Menopur (Ferring, 2004): development of multiple follicles and pregnancy in ovulatory women as part of an assisted reproductive technology (ART) cycle.[2][1]

Because it acts on reproductive hormones, hMG belongs to our hormonal peptides and sexual health categories.

What the research shows: hMG vs recombinant FSH

The main question in IVF is whether adding LH activity (hMG) beats pure recombinant FSH (rFSH).

  • MERiT (2006): 731 women after a long GnRH agonist protocol. Ongoing pregnancy was 27% with highly purified hMG and 22% with rFSH. hMG was non-inferior, but superiority could not be concluded. rFSH produced more eggs (11.8 vs 10.0), while hMG produced a higher share of top-quality embryos (11.3% vs 9.0%).[6]
  • MEGASET (2012): 749 women in a GnRH antagonist cycle with a single blastocyst transferred. Ongoing pregnancy was 30% vs 27%, and cumulative live birth 40% vs 38%, for hMG vs rFSH.[7]
  • MEGASET-HR (2020): 620 women expected to over-respond. Cumulative live birth was similar (50.6% vs 51.5%), but OHSS was less common with hMG (9.7% vs 21.4%).[8] Several authors worked for Ferring, Menopur’s maker.[8]
  • Meta-analysis (2008): across 7 trials and 2,159 women on a long agonist protocol, hMG gave a 4% higher live birth rate than rFSH.[9]
  • Cochrane review (2026 update): across 59 trials and 18,119 women, live births were probably slightly lower and OHSS probably higher with rFSH than with hMG (moderate certainty). The authors noted many trials were sponsored by industry.[10]

hMG has also long been used for ovulation induction. A 1994 Russian study in women with hypogonadotropic amenorrhea found excess estradiol in hMG-stimulated cycles and added low-dose dexamethasone to correct it.[14]

hMG for men

The US Menopur label covers women only, so prescribing it for men in the US is off-label.[1] The UK label lists hypogonadotropic hypogonadism in men: hMG with hCG to stimulate sperm production. It notes men with primary testicular failure usually do not respond.[5]

  • 2014 meta-analysis: across 44 gonadotropin studies, 75% of men with hypogonadotropic hypogonadism and azoospermia produced sperm. Success was higher with hCG plus FSH and with onset after puberty. Urinary and recombinant FSH worked similarly.[11]
  • 2025 meta-analysis: in 41 studies with 1,673 men, 78% produced sperm after a median of 18 months, and hCG plus FSH beat hCG alone.[12]
  • Chinese cohort: 223 azoospermic men with congenital hypogonadotropic hypogonadism received hCG plus hMG. Testicular size rose from 2.1 to 8.1 mL, 64% produced sperm (on average after 14 months), and 19 of 34 men trying for a child achieved a pregnancy.[13]

For the LH half of this pairing, see our hCG profile. Kisspeptin-10 is an experimental approach that prompts the body’s own release of LH and FSH instead.

hMG dosage

The Menopur label dose for IVF, given under the skin:[1]

StepLabel instruction
Start225 IU daily from cycle day 2 or 3 (after GnRH agonist suppression)
AdjustAfter 5 days, based on ultrasound and estradiol; no more often than every 2 days, by no more than 150 IU
Maximum450 IU a day; no more than 20 days
TriggerhCG once follicles are ready; withhold hCG if OHSS risk is high

With 75 IU vials, a 225 IU dose means three vials. The label says to use it immediately after mixing and discard any leftover.[1]

For men (UK label), hCG 1,000 to 2,000 IU two to three times a week comes first. Menotrophin 75 or 150 IU is then added two or three times weekly, for at least 3 to 4 months.[5] For unit-to-syringe conversions, see our peptide calculator.

hMG side effects

In two IVF and ICSI trials with 434 women, reactions seen in 2% or more were:[1]

Side effectRate
Abdominal pain6.7%
OHSS6.2%
Headache6.2%
Injection site pain or reaction3.9%
Abdominal cramps3.0%
Abdominal enlargement2.3%
Injection site inflammation2.3%

Serious risks on the label:[1]

  • OHSS: rapid fluid shifts into the abdomen and chest, peaking about 7 to 10 days after treatment. It occurred in 7.2% of 373 women in the label’s main IVF trial (run in Europe and Israel).
  • Multiple pregnancy: 35.3% of 85 pregnancies in that trial were multiples.
  • Blood clots and lung problems: rare, including stroke and pulmonary embolism, sometimes fatal.
  • Ovarian torsion, ectopic pregnancy and miscarriage.

Menopur is contraindicated in pregnancy and in women with primary ovarian failure, uncontrolled thyroid or adrenal disease, or pituitary tumors.[1]

  • Prescription only: Menopur is a prescription biologic, used under a fertility specialist with ultrasound monitoring.[1][2]
  • Men: off-label in the US; on-label in the UK for male hypogonadotropic hypogonadism.[1][5]
  • Sport: WADA’s 2026 list bans LH and chorionic gonadotrophin in males under S2.2.1, at all times. WADA does not name hMG, but it contains LH activity and traces of hCG, so in our reading it is banned for male athletes.[15][1]

This is general information, not legal advice.

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