HMG 75 IU: Research and Clinical Profile of Human Menopausal Gonadotropin

HMG (Human Menopausal Gonadotropin) 75 IU is a medication containing a 1:1 ratio of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activity, derived from the urine of postmenopausal women . The 75 IU formulation represents the standard unit dose for this gonadotropin preparation, which is widely used in assisted reproductive technology (ART) and the treatment of infertility in both women and men .

What is HMG 75 IU?

HMG 75 IU, also known as menotropin, is a highly purified gonadotropin preparation. Each vial contains 75 IU of FSH activity and 75 IU of LH activity . The LH activity is primarily contributed by human chorionic gonadotropin (hCG), which is naturally present in the urine of postmenopausal women and acts similarly to LH in the body .

Key Identifiers:

• Active Substance: Menotropin (highly purified human menopausal gonadotropin)

• Composition: 75 IU FSH + 75 IU LH per vial

• Form: Lyophilized powder and solvent for injectable solution 

• Route of Administration: Intramuscular (IM) or subcutaneous (SC) 

• Status: Prescription medication; FDA-approved for specific fertility indications

The product is typically supplied as a powder that requires reconstitution with the provided sterile solvent immediately before use . Each vial is for single use only.

Mechanism of Action

HMG 75 IU works by directly stimulating the ovaries and testes through its FSH and LH activity:

In Women:

• FSH: Stimulates the growth and development of ovarian follicles, each containing an egg 

• LH: Works synergistically with FSH to promote final follicular maturation and trigger ovulation, though a separate hCG trigger is typically required 

In Men:

• FSH: Stimulates Sertoli cells to support spermatogenesis 

• LH: Stimulates Leydig cells to produce testosterone, which is essential for sperm production 

The 75 IU dose is considered a low starting dose, often used as a baseline from which adjustments are made based on individual patient response .

Clinical Indications

HMG 75 IU is indicated for the treatment of infertility in the following clinical situations:

In Women:

In Men:

HMG 75 IU is used in combination with hCG to stimulate spermatogenesis in men with hypogonadotropic hypogonadism .

Dosing Information

Female Anovulation

The recommended starting dose is 75-150 IU daily (1-2 vials), administered for at least 7 days . Dosing is individualized based on ultrasound monitoring of follicle development and estradiol levels. Dose adjustments should be made no more frequently than once every 7 days, with increments of 37.5-75 IU. The maximum daily dose should not exceed 225 IU .

Ovarian Stimulation for IVF/ART

Treatment typically begins on cycle day 2 or 3 with doses of 150-225 IU daily, adjusted according to ovarian response .

Male Hypogonadism

The recommended dose is 150 IU three times per week, administered concurrently with hCG for a minimum of 4 months .

Clinical Research Context

• Case Study: A 29-year-old woman with congenital hypogonadotropic hypogonadism began with 75 IU HMG, increased to 150 IU after 6 days, and achieved successful ovulation and pregnancy after dosage adjustment 

• Pulsatile Administration: Research using a portable pump delivering 75 IU/day in 16 subcutaneous pulses every 90 minutes demonstrated high ovulation rates with reduced side effects, allowing patients to maintain normal daily activities 

Reconstitution and Administration

Reconstitution:

1. Reconstitute immediately before use under aseptic conditions

2. Inject the solvent into the powder vial; the powder dissolves rapidly forming a clear solution 

3. Use the reconstituted solution immediately; discard any unused portion 

Administration:

• Intramuscular: Inject slowly to minimize pain and leakage at the injection site 

• Subcutaneous: May be used as an alternative route 

Combining Doses: If a dose greater than 75 IU is required (e.g., 150 IU), the reconstituted solution from one vial can be drawn into a syringe and used to reconstitute a second vial, then aspirated to administer the combined dose in a single injection .

Monitoring and Precautions

Ovarian Hyperstimulation Syndrome (OHSS):
This is the most significant risk associated with HMG therapy. If excessive ovarian response is observed, treatment should be discontinued and hCG administration delayed to prevent OHSS .

Monitoring:

• Clinical monitoring must include regular transvaginal ultrasound

• Estradiol levels may be measured to assess ovarian response

• Treatment cycles should be abandoned if no response occurs after 4 weeks 

Pregnancy Risk:
If more than 2 follicles mature, hCG administration is typically withheld due to the risk of multiple pregnancy .

Frequently Asked Questions

What is HMG 75 IU?

HMG 75 IU is a medication containing 75 IU each of FSH and LH, used to treat infertility by stimulating the ovaries or testes .

What are the indications for HMG 75 IU?

It is indicated for anovulatory infertility, controlled ovarian stimulation in ART, and treatment of male hypogonadism .

What is the starting dose for women?

The recommended starting dose is 75-150 IU daily for at least 7 days .

Is HMG 75 IU FDA-approved?

Yes, HMG is an FDA-approved prescription medication for specific fertility indications.

What is the main risk of HMG treatment?

Ovarian hyperstimulation syndrome (OHSS) is the most significant risk. Monitoring is essential to prevent this complication .

How is HMG 75 IU administered?

It is administered by intramuscular or subcutaneous injection, starting under strict specialist supervision .

Can HMG be used in men?

Yes, HMG is used in combination with hCG to stimulate spermatogenesis in men with hypogonadotropic hypogonadism .