Menotropins

DEA Class; Rx

Common Brand Names; Menopur, Repronex

Indicated for patients with oligoanovulation

Indicated for the stimulation of spermatogenesis in males with primary or secondary hypogonadotropic hypogonadism and resultant oligospermia.

For the treatment of infertility in females.

Pregnancy; may cause fetal harm

Hypersensitivity

High levels of FSH indicating primary ovarian failure

Presence of uncontrolled nongonadal endocrinopathies (eg, thyroid, adrenal, or pituitary disorders)

Sex hormone dependent tumors of the reproductive tract and accessory organ

Tumors of pituitary gland or hypothalamus

Abnormal uterine bleeding of undetermined origin

Ovarian cysts or enlargement of undetermined origin, not due to polycystic ovary syndrome

• Heachache (34%)
• Abdominal pain (18%)
• Nausea (12%)
• OHSS (13%-dose related)
• Injection site pain (4-12%)
• 1-10%
• Flushing (2.4%)
• Dizziness (2.6%)
• Malaise (2.8%)
• Migraine (2.4%)
• Breast tenderness (1.8%)
• Hot flashes (0.6-2.6%)
• Menstrual irregularities (3.2%)
• Abdominal cramping/fullness (6%)
• Constipation (1.6%)
• Diarrhea (2.8%)
• Ovarian disease (3.8%)
• Vaginal hemorrhage (3.2%)
• Back pain (3.2%)
• Cough increased (1.6-2.6%)
• Respiratory disorder (3.9-5.8%)
• Flu-like syndrome (1.3-2.6%)
• Ovarian enlargement & hyperstimulation
• Arterial thromboembolism (rare but potentially fatal)
• Gynecomastia in males
• Hemoperitoneum

Should be administered only by physicians thoroughly experienced in fertility disorders

Hypersensitivity/anaphylactic reactions reported

Ovarian hyperstimulation syndrome (OHSS) reported; OHSS is a medical event distinct from uncomplicated ovarian enlargement and may progress rapidly to become a serious medical event; characterized by dramatic increase in vascular permeability, which can result in a rapid accumulation of fluid in the peritoneal cavity, thorax, and potentially, the pericardium

Use lowest effect dose to minimize abnormal ovarian enlargement; if ovaries are enlarged on last day of therapy, do not administer hCG because of risk for OHSS

May cause pulmonary and vascular complications (eg, atelectasis, ARDS)

Ovarian torsion has been reported after treatment with gonadotropins

Multi-fetal gestation and births have been reported with all gonadotropin therapy

Incidence of congenital malformations after some ART (specifically IVF or ICSI) may be slightly higher than after spontaneous conception (likely due to parental characteristics)

Since infertile women undergoing ART often have tubal abnormalities, the incidence of ectopic pregnancy may be increased

Increased incidence of spontaneous abortion and ovarian neoplasms observed (without causality)

Pregnancy Category: X

Lactation: Not known whether drug is excreted in breast milk; use caution