Menotropin (also called human menopausal gonadotropin or hMG) is a
hormonally active medication for the treatment of
fertility disturbances
Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal state ...
. Frequently the plural is used as the medication is a mixture of
gonadotropins. Menotropins are extracted from the urine of
postmenopausal women.
Description and usage
Urine of postmenopausal women reflects the hypergonadotropic state of
menopause -levels of
follicle stimulating hormone
Follicle-stimulating hormone (FSH) is a gonadotropin, a glycoprotein polypeptide hormone. FSH is synthesized and secreted by the gonadotropic cells of the anterior pituitary gland and regulates the development, growth, pubertal maturation, an ...
(FSH) and
luteinizing hormone (LH) are high - and contain a mixture of these gonadotropins.
[ Other protein substances may be present, including small amounts of human chorionic gonadotropin (hCG).][ In 1949 Piero Donini found a relatively simple method to extract gonadotropins from urine of postmenopausal women.][
Menotropin preparations are designed for use in selected women where they stimulate the ovaries to mature follicles, thus making them more fertile. They are administered by typically daily injection, intramuscularly or subcutaneously, for about ten days under close supervision to adjust dose and duration of therapy. They can also be used in ]hypogonadal
Hypogonadism means diminished functional activity of the human gonad, gonads—the testicle, testes or the ovary, ovaries—that may result in diminished biosynthesis, production of sex hormones. Low androgen (e.g., testosterone) levels are refer ...
men to stimulate sperm production.
Human urinary-derived menotropin preparations are exposed to the theoretical risk of infection from menopausal donors of urine. Nevertheless, the failure to irrefutably demonstrate infectivity following intracerebral inoculation with urine from transmissible spongiform encephalopathy (TSE)-infected hosts suggests that the risk associated with products derived from urine is merely theoretical.
Recombinant gonadotropins have to a large degree replaced hMG in fertility treatments. The recombinant process allows for the production of pure FSH or LH not "contaminated" by other proteins that may be present after urinary extraction. While some head-on studies seem not to suggest that "pure FSH" gives better results than hMG, others claim that recombinant FSH is more efficient and reduces costs. A Cochrane Collaboration analysis did not reveal major differences in clinical outcomes when comparing urinary versus recombinant FSH.
The Practice Committee of the American Society for Reproductive Medicine reported: ''“Compared with earlier crude animal extracts, modern highly purified urinary and recombinant gonadotropin products have clearly superior quality, specific activity, and performance. There are no confirmed differences in safety, purity, or clinical efficacy among the various available urinary or recombinant gonadotropin products.”''
List of hMG preparations
A number of drug companies have and had marketed hMG preparations that include:
See also
* Gonadotropin preparations
References
{{GnRH and gonadotropin receptor modulators
Drugs acting on the genito-urinary system
Gonadotropin-releasing hormone and gonadotropins
Human female endocrine system