Index of drugs

Stimulation of the development of many ovarian follicles in patients participating in the program of medically assisted reproduction.

1 vial contains 75 IU menotropin (hMG), equivalent to 75 IU. FSH and 75 IU LH.

Human menopausal gonadotropin (containing follicle-stimulating and luteinizing hormones in equal proportions), obtained from the urine of women during menopause. The most important effect of the drug is the development of a mature Graafian follicle. After intramuscular or subcutaneous administration of T_0,5 LH is 2.2 hours, FSH - 2.9 hours.

Hypersensitivity to menotropin or auxiliary substances of the preparation. A tumor of the hypothalamus or pituitary gland. Ovarian enlargement or cyst not associated with polycystic ovary syndrome. Haemorrhages from the genital tract of unknown cause. Ovarian, uterine or breast cancer. The preparation should not be used if the appropriate response to treatment can not be achieved due to: primary ovarian failure, fibrous uterine cancer or abnormal development of the genital organs not allowing the maintenance of pregnancy.

Before starting treatment, the causes of infertility should be analyzed and any contraindications to pregnancy should be assessed. In particular, hypothyroidism, adrenal insufficiency, hyperprolactinemia, pituitary tumor or hypothalamus should be excluded. Particularly cautiously use in patients with known risk factors for thromboembolic complications. In women with overexploitation of the ovaries, hCG should not be used to induce ovulation - the patient should be sexually abstinent or use a contraceptive for at least 4 days. Because ovarian hyperstimulation syndrome (OHSS) can develop rapidly (from 24 hours to several days) to a severe clinical condition, the patient should be observed for at least 2 weeks after hCG administration. If severe OHSS is diagnosed, administration of gonadotrophins should be discontinued, hospitalized and appropriate OHSS treatment should be instituted.

Do not use during pregnancy and breast-feeding.

Very common: ovarian cysts, headache, reactions at the injection site (pain, redness, bruising, swelling, irritation). Common: mild to moderate ovarian hyperstimulation syndrome (OHSS), abdominal pain, nausea, vomiting, diarrhea, abdominal cramps, bloating. Uncommon: heavy OHSS. Rare: ovarian torsion as a complication of OHSS. Very rare: thromboembolic complications (usually associated with severe OHSS), mild allergic reactions (erythema, rash, swelling of the face).
In patients undergoing ovulation induction, there is a greater risk of multiple pregnancy as well as pregnancy loss (as a result of miscarriage or nuisance) compared to the natural conception rate. An ectopic pregnancy may also occur, especially in women with a history of tubal disease. The incidence of congenital defects after using reproduction technology may be slightly higher than after natural fertilization.

Intramuscularly. Treatment with the preparation should be carried out under the supervision of a physician experienced in the treatment of infertility. Doses should be selected individually, depending on the clinical response.Stimulation of the development of many ovarian follicles in women participating in assisted reproduction programs150-225 IU daily from the 2-3 day of the menstrual cycle until the maturity of the ovarian follicles is reached (between the 5th and the 20th day, usually the 10th day). Depending on the clinical response, the dose can be changed, the maximum daily dose is 450 IU. Within 24-48 hours after the last injection of the preparation, 5,000-10,000 IU should be administered at one time. hCG. The preparation may also be used during treatment with gonadoliberin agonists (GnRH), administered to suppress the sudden increase in endogenous LH and control the tonic release of LH. Typically, administration of hMG begins approximately 2 weeks after the start of treatment with a GnRH agonist (150-225 IU).menotropin daily for the first 7 days, then the dose is modified depending on the response of the ovaries) and the administration of both drugs continues until adequate maturity of the follicles.Lack of ovulation caused by severe LH and FSH deficiency. In women with hypogonadotropic hypogonadism, the goal of treatment with the preparation is to develop a single mature Graafian follicle from which the oocyte will be released after hCG administration. Because these patients do not menstruate and have low levels of endogenous estrogens, treatment can be started at any time. Treatment should start at a dose of 75-150 IU. per day. The dose of the preparation can be increased by 150 IU. every 7-14 days; Stimulation time can be extended in each cycle over 5 weeks. Once an optimal response is obtained, within 24-48 hours after the last administration of menotropin, 5,000-10,000 IU should be injected once. hCG. The sexual intercourse or intrauterine fertilization is recommended on the day of hCG and the following day. Luteal phase support should be taken into account in the absence of luteinising substances (LH / hCG) after ovulation, which can lead to premature loss of the corpus luteum. In case of excessive response, treatment should be discontinued and start in the Next menstrual cycle from a smaller dose.