Uses
Gonad-stimulating
principle.
Brand name
Humegon (Organon); Pergonal (Serono).
General Description
Pituitary hormones prepared from the urine of postmenopausalwomen whose ovarian tissue does not respondto gonadotropin are available for medicinal use as theproduct menotropins (Pergonal). The latter has FSH andLH gonadotropin activity in a 1:1 ratio. Menotropins areuseful in the treatment of anovular women whose ovariesrespond to pituitary gonadotropins but who have a gonadotropindeficiency caused by either pituitary or hypothalamusmalfunction. Usually, menotropins are administeredintramuscularly in an initial dose of 75 IU of FSHand 75 IU of LH daily for 9 to 12 days, followed by 10,000IU of chorionic gonadotropin 1 day after the last dose ofmenotropins.
Biochem/physiol Actions
Gonadotropin interacts with members of the GPCR (G-protein coupled receptor family), and upon activation they induce adenylyl cyclase. This hormone is synthesized in male reproductive tract and has high concentration in semen, especially the a subunit. This subunit is linked with spermatogenesis, and lower levels are present in males with aberrant semen quality.
Clinical Use
Menotropins are a natural product that is obtained from the urine of postmenopausal women and
then biologically standardized (international units [IU]) for FSH and LH activities in an
approximate ratio of 1:1. Menotropins are used in males with primary (hypothalamic) or
secondary (pituitary) hypogonadism to stimulate spermatogenesis, providing they have been
treated previously with human chorionic gonadotropin (hCG; a peptide hormone of placental
origin that has activity very similar to LH) to effect masculinization (increased
testosterone inducing ovulation in women who are having difficulty ovulating as a result of either
hypothalamic or pituitary hormonal dysfunction. The menotropins are given for 7 to 12 days, and
after clinical evaluation (via ultrasound) indicates the presence of a mature follicle, a single
dose of hCG is given to simulate the typical LH surge that normally triggers ovulation. Also,
women use the combination of menotropins and hCG to promote the development of multiple
follicles when they are participating in an IVF program requiring the recruitment of follicles.
Side effects
Side effects: Headache, mild stomach pain/bloating, redness/pain at the injection site, breast tenderness, or dizziness may occur.
Serious side effects, including: vaginal bleeding, flu-like symptoms (such as fever, chills, joint pain, muscle ache, tiredness).
