MenotropHins

Indications & Dose:

Female: Anovulatory infertility. Super ovulation for IVF.

Male: Used with HCG in to stimulate spermatogenesis in those with primary hypogonadotrophic hypogonadism.. Stimulation of ovarian follicular, growth prior to induction of ovulation by HCG; induction of multiple follicles in ovulatory patients participating in an in vitro fertilization program; stimulation of spermatogenesis in men with primary or secondary hypogonadotropic hypogonadism (in conjunction with HCG)

DOSAGE

Adult

• Women: IM 75 IU FSH/LH qd for 7-12 days, followed by 10,000 IU HCG 1 day after last dose of menotropins; repeat for at least 2 more cycles if evidence of ovulation, but no pregnancy, then increase to 150 IU FSH/LH qd for 7-12 days, followed by 10,000 IU HCG 1 day after last dose of menotropins, repeat as above

• Men: IM 75 IU FSH/LH 3 times/wk with HCG 2000 IU 2 times/wk for 4 mo (following pretreatment with HCG alone 5000 IU 3 times/wk for 4-6 mo)

ADMINISTRATION: IM or SC (ONLY as per manufacturers instruction) administration. The lower abdomen (alternating sides) should be used for subcutaneous administration. 

Contraindications:

Women: Primary ovarian failure, abnormal bleeding; thyroid, adrenal dysfunction; organic intracranial lesion, ovarian cysts, pregnancy; men: primary testicular failure, normal pituitary function, infertility disorder other than hyopgonadotropic hypogonadisin

Female: Undiagnosed vaginal bleeding, tumours of the uterus, ovaries, breasts.

Male: Tumours of testes or prostate. 

Side Effects:

CNS: Chills, dizziness, febrile reactions, headache, malaise, stroke

CV: Tachycardia, venous, arterial thromboembolism

GI: Abdominal pain, bloating, cramps, diarrhea, nausea, vomiting

GU: Adnexal torsion, ectopic pregnancy, hemoperitoneum, hyperstimulation syndrome (sudden ovarian enlargement and ascites, with or without pain or pleural effusion), ovarian cysts, ovarian enlargement (20%)

MS: Joint pains, musculoskeletal aches

RESP: Acute respiratory distress syndrome, atelectasis, dyspnea, tochypnea

SKIN: Body rashes, pain, rash, irritation at inj site

MISC: Gynecomastia (men)

DRUG INTERACTIONS: Clomiphene, other drugs that stimulate ovulation.

SPECIAL CONSIDERATIONS

PATIENTIFAMILY EDUCATION

• Multiple births occur in approximately 20% of women treated with menotropins and HCG

• Couple should engage in intercourse daily, beginning on the day prior to HCG administration, until ovulation occurs

• Ovarian enlargement regresses without treatment in 2-3 wk

MONITORING PARAMETERS

• Urinary estrogen; do not administer HCG if > 150 µg/24 hr (increased risk of hyperstimulation of ovaries syndrome)

• Sonographic visualization of ovaries; estradiol levels 

Cautions:

Precautions:

Treat endocrine disorders or intracranial lesions before therapy. Monitor oestrogen levels and follicular development regularly. In men exclude other causes of infertility prior to treatment. 

Interaction:

Warnings:

Adverse Effects:

Lactations:

Pregnancy categoryx

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: