Gonadotropin human menopausal

Stimulation of spermatogenesis in gonadotropin (FSH, LH) deficiency can be achieved by injection of HMG and HCG. HMG or human menopausal gonadotropin is obtained from the urine of postmenopausal women and is rich in FSH activity. HCG, human chorionic gonadotropin, from the urine of pregnant women, acts like LH. 

The menotropins, human menopausal gonadotropin (HMG) and urofollitropin are prepared from the urine of postmenopausal women. HMG has approximately equal amounts of FSH an LH. Urofollitropin has only FSH activity. Follitropin alpha and follitropin beta are two FSH products which are made with recombinant DNA technology. Lutropin alpha is recombinant human LH. Human chorionic gonadotropin (HCG) is produced in the placenta and excreted in the urine. It has mainly LH activity. Choriogonadotropin alpha is the world s first recombinant chorionic gonadotropin (r-hCG) for the treatment of anovulation, the most common cause of infertility in women. 

Human menopausal gonadotropin (hMG) Urine of postmenopausal women Induction of ovulation... 

The first commercial gonadotropin product was extracted from the urine of postmenopausal women, which contains a substance with FSH-like properties (but with 4% of the potency of FSH) and an LH-like substance. This purified extract of FSH and LH is known as menotropins, or human menopausal gonadotropins (hMG). 

Menon DK. Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. Fertil Steril 2003 79 1659-61. 

Resistance of activated protein C and deep calf vein thrombosis has been reported during controlled ovarian stimulation for in vitro fertilization (18). The thrombosis occurred on the eighth day of human menopausal gonadotropin use and before human chorionic gonadotropin was given. 

Urine-derived urofollitropin and recombinant FSH appear to be equally effective and well tolerated for induction of ovulation (34). However, it is unclear whether human menopausal gonadotropins have a higher risk of overstimulation and ovarian hyperstimulation syndrome than urofollitropin in women with polycystic ovary syndrome. 

A generalized allergic reaction to human menopausal gonadotropin (Pergonal) has been described during controlled ovarian hyperstimulation (40). In this case a desensitization protocol allowed the patient to complete her treatment cycle without further problems. Subsequently recombinant follicle stimulating hormone was used successfully and uneventfully. 

A subfertile man treated with human menopausal gonadotropin + human chorionic gonadotropin (hMG + hCG) developed a malignant teratoma of the testis however, in view of his history a cause-and-effect relation was dubious (43). 

Shushan A, Paltiel O, Iscovich J, Elchalal U, Peretz T, Schenker JG. Human menopausal gonadotropin and the risk of epithelial ovarian cancer. Fertil Steril 1996 65(l) 13-8. 

FSH has been commercially available since the 1960s. It was first extracted from the urine of postmenopausal women, which contains a substance with FSH-like properties (but with 4% of the potency) and an LH-like substance. This purified extract of FSH and LH, derived from the urine of postmenopausal women, remains available and is known as menotropins, or human menopausal gonadotropins (hMG). A purified preparation of human FSH, also extracted from the urine of postmenopausal women, contains virtually no LH and is know as urofollitropin, or urinary FSH (uFSH). In 1996, a synthetic modified form of FSH became available, known as follitropin alpha, or recombinant FSH (rFSH). Preparations of rFSH have batch-to-batch consistency and are free from possible urinary contaminants. The cost of rFSH is about three times that of hMG. It is controversial whether in vitro fertilization protocols using rFSH are significantly more successful than protocols using uFSH or hMG. 

Human menopausal gonadotropin, uFSH or rFSH should be administered only by a physician experienced in treating infertility. Before treatment of women, a thorough gynecologic evaluation must be performed to rule out uterine, tubal, or ovarian diseases as well as pregnancy. In cases of irregular bleeding, uterine cancer should be ruled out. 

Total inhibin, measured on day 8 of human menopausal gonadotropin (hMG) in down-regulated cycles, is significantly correlated with estradiol levels, and is correlated with pregnancy (M5). 

L2. Laufer, N., DeChemey, A. H., Tarlatzis, B. C., and Naftolin, F., The association between preovulatory serum 17 beta-estradiol pattern and conception in human menopausal gonadotropin-human chorionic gonadotropin stimulation. Fertil. Steril. 46, 73—76 (1986). 

Silverberg, K., Burns, W., Olive, D., Riehl, R., and Schenken, R., Serum progesterone levels predict success of in vitro fertilization/embryo transfer in patients stimulated with leupro-lide acetate and human menopausal gonadotropins. J. Clin. Endocrinol. Metab. 73, 797—803 (1990). 

Radioimmunoassay may be used to measure the urinary ratio of total (free plus conjugated) testosterone to LH. Testosterone is measured in nmol/ litre, and LH in International Units of HMG-IR2/ litre (Human Menopausal Gonadotropin 2nd International Reference Preparation). A ratio in excess of 200 is abnormal. (R. V. Brooks et at, J. Steroid Biochem., 1979, 77, 913-917.)... 

The first gonadotropins available for clinical use were extracted from the urine of postmenopausal women. Human menopausal gonadotropin (hMG) is in limited supply and contains other proteins, which may be allergenic, as well as luteinizing hormone. Purified preparations of follicle-stimulating hormone (FSH urofoUitropin and highly purified urofoUitropin) are also extracted from... 

The numbers of women who had used clomiphene or human menopausal gonadotropin were too small to make more differentiated calculations, but the incidence of melanoma seemed to correspond to that in the general population. 

Human menopausal gonadotropin-CoA reductase inhibitors Sertraline, paroxetine, fluvoxamine, and fluoxetine may inhibit the metabolism of lovastatin and simvastatin resulting in myosis and rhabdomyolysis although its inhibition is weak, these combinations are best avoided. 

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