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HMG

Extensively Studied FDA Approved

Human Menopausal Gonadotropin | FSH/LH Fertility Hormone

Dose 75-150 IU for ovulation induction; 150-300 IU for IVF
Frequency Daily during stimulation phase (7-12 days)
Cycle 7-12 days per cycle
Storage Lyophilized: Room temperature. Reconstituted: 2-8°C, use immediately after reconstitution
Accumulation Plotter

Human Menopausal Gonadotropin (HMG) is a hormonally active medication containing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in a 1:1 ratio, extracted from the urine of postmenopausal women. FDA-approved for fertility treatment, HMG stimulates ovarian follicle development in women and spermatogenesis in men. While largely replaced by recombinant gonadotropins in some settings, HMG remains an effective and cost-efficient option for ovulation induction and assisted reproduction.

Mechanism of Action

HMG acts on gonadal tissue through two mechanisms: FSH stimulates growth and maturation of ovarian follicles containing eggs in women, and promotes spermatogenesis in men. LH stimulates ovulation and corpus luteum formation in women, and Leydig cells in men to produce testosterone. Highly purified HMG (HP-hMG) has enhanced FSH receptor activity with reduced inactive proteins. The LH component modifies follicular development and decreases intermediate-sized follicles, potentially resulting in safer, more controlled stimulation.

Key Benefits

  • FDA-approved for fertility treatment
  • Stimulates ovarian follicle development
  • Contains both FSH and LH naturally
  • Promotes spermatogenesis in men
  • Cost-effective alternative to recombinant FSH
  • LH activity may improve fertilization rates
  • Long clinical track record
  • Lower OHSS incidence with HP-hMG
Type
Gonadotropin mixture

Female Fertility (FDA-Approved)

  • Ovulation Induction

    Stimulates follicular development in anovulatory women.

  • IVF Stimulation

    Used in IVF protocols to stimulate multiple follicle development.

  • PCOS Ovulation

    Effective for inducing ovulation in polycystic ovary syndrome patients.

Male Fertility

  • Spermatogenesis

    FSH promotes sperm production; LH stimulates testosterone for sperm development.

  • Hypogonadotropic Hypogonadism

    Treats male infertility due to insufficient gonadotropin production.

Testosterone Support

  • LH Replacement

    LH component stimulates testicular testosterone production.

HMG is administered via intramuscular or subcutaneous injection. Treatment typically starts on day 2-3 of the menstrual cycle and continues for 7-12 days with monitoring. Dosing is individualized based on follicular response monitored by ultrasound and estradiol levels.

GoalDoseFrequencyRoute
Ovulation induction75-150 IUDailyIM or SubQ
IVF stimulation150-300 IUDaily for 7-12 daysIM or SubQ
Male fertility75-150 IU2-3x weeklyIM or SubQ

Reconstitution Instructions

Materials Needed:
  • Lyophilized powder vial
  • Sterile diluent (provided)
  • Syringes
  • Alcohol swabs
  1. 1 Add provided diluent to powder vial
  2. 2 Gently swirl until dissolved
  3. 3 Draw prescribed dose into syringe
  4. 4 Inject intramuscularly or subcutaneously
  5. 5 Use immediately after reconstitution
hCG

hCG is typically used to trigger ovulation after HMG-induced follicular development.

synergistic
GnRH agonists

Often used in combination protocols for IVF to prevent premature LH surge.

sequential
Clomiphene

May be used in sequential protocols for ovulation induction.

sequential
Gonadorelin

Different mechanisms; may be used in different fertility protocols.

compatible
Days 1-3

Follicular recruitment begins

Days 4-7

Follicular growth continues; monitoring required

Days 8-12

Follicles reach mature size; trigger ovulation

Post-trigger

Ovulation occurs ~36 hours after hCG trigger

Common Side Effects

  • Injection site reactions
  • Abdominal discomfort
  • Ovarian enlargement
  • Mood changes
  • Headache

Stop Signs - Discontinue if:

  • Severe abdominal pain or bloating
  • Rapid weight gain
  • Difficulty breathing
  • Nausea and vomiting
  • Decreased urination

Contraindications

  • Primary ovarian failure
  • Uncontrolled thyroid or adrenal dysfunction
  • Sex hormone-dependent tumors
  • Abnormal uterine bleeding of unknown cause
  • Ovarian cysts (not due to PCOS)
  • Pregnancy

Good Signs

  • White lyophilized powder
  • Pharmaceutical grade product
  • Proper cold chain maintained
  • Clear solution after reconstitution

Warning Signs

  • Research-grade products lack quality assurance

Bad Signs

  • Discolored powder or solution
  • Particulates visible
  • Exposed to temperature extremes
  • Human Menopausal Gonadotropin
    ScienceDirect (2024)

    HMG contains FSH and LH in 1:1 ratio extracted from postmenopausal urine.

  • HMG vs Recombinant FSH in PCOS Patients Undergoing IVF
    PMC/NCBI (2013)

    No significant differences in pregnancy rates between FSH alone, rFSH+HMG, and rFSH+rLH groups.

  • Effect of HMG and HP-FSH on IVF Outcomes
    Human Reproduction (1996)

    Beneficial effects of HMG on fertilization rates and pre-embryo development compared to HP-FSH.

  • Generic hMG vs Costly FSH for Ovulation Induction
    PubMed (2001)

    Generic hMG products do not adversely affect pregnancy rates and are appropriate cost-effective alternatives.

Disclaimer

This information is for educational and research purposes only. Consult a healthcare professional before use.