HMG
Urinary-extracted gonadotropin preparation containing FSH and LH in 1:1 ratio
- Class
- Fertility gonadotropin
- Half-life
- ~24–36 h (FSH)
- Route
- Subcutaneous (SubQ)
- Cadence
- Multiple per week
- Evidence
- Human clinical trials
Overview
HMG (human menopausal gonadotropin, also called menotropin) is a prescription fertility medication extracted and purified from the urine of postmenopausal women. It contains equal amounts of two pituitary hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — that together drive egg maturation in women and sperm production in men. It's FDA-approved for controlled ovarian stimulation in IVF and for treating certain types of infertility caused by low gonadotropin levels.
The compound has been used in fertility medicine since the 1960s. In women undergoing IVF, HMG stimulates the ovaries to produce multiple mature eggs in a single cycle — typical protocols produce 10–20 follicles depending on the person's ovarian reserve. In men with hypogonadotropic hypogonadism (pituitary failure), HMG can restart spermatogenesis when combined with hCG. Brand names include Menopur, Pergonal, and Repronex; all are bioequivalent but differ slightly in purification method.
HMG is given by subcutaneous injection — the same self-injection technique used for insulin. Dosing is highly individualized and requires close monitoring with bloodwork (estradiol, LH) and ultrasound to track follicle development. The biggest risk is ovarian hyperstimulation syndrome (OHSS) — a potentially serious condition where the ovaries swell and fluid shifts into the abdomen and chest. About 5% of women on ovarian stimulation develop moderate-to-severe OHSS; high responders (young, lean, PCOS) face higher risk.
Safety considerations
A few of the safety signals worth knowing — the full list, with dosing context and what to monitor, is inside AIx Core.
- Ovarian hyperstimulation syndrome (OHSS) is the primary risk — about 5% of IVF cycles result in moderate-to-severe OHSS. Severe cases involve massive ovarian enlargement, ascites, pleural effusion, and risk of thromboembolism. Women with PCOS, high antral follicle count, or AMH >5 ng/mL face 15–20% risk.
- Multiple pregnancy is common when HMG is used for ovulation induction (not IVF) — about 20% of pregnancies are multiples, 80% of those being twins. IVF with single-embryo transfer eliminates this risk.
- Prescription-only, regulated drug. Unlike research peptides, pharmaceutical HMG is subject to FDA/EMA quality control. Counterfeit or veterinary-grade 'HMG' sold in grey markets is not equivalent.
+ 2 more safety notes inside AIx Core →
Commonly monitored
Markers and signals people track when researching HMG.
- Estradiol (E2) levels — tracked every 2–3 days during stimulation to gauge ovarian response and OHSS risk
- Follicle count and size via transvaginal ultrasound — determines trigger timing
- Body weight and abdominal girth — early warning signs of fluid retention (OHSS)
- In men: semen analysis every 3 months, serum testosterone, LH, FSH
- Symptoms of OHSS: bloating, nausea, rapid weight gain, shortness of breath
Frequently asked questions
What is HMG?
Urinary-extracted gonadotropin preparation containing FSH and LH in 1:1 ratio. HMG (human menopausal gonadotropin, also called menotropin) is a prescription fertility medication extracted and purified from the urine of postmenopausal women. It contains equal amounts of two pituitary hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — that together drive egg maturation in women and sperm production in men. It's FDA-approved for controlled ovarian stimulation in IVF and for treating certain types of infertility caused by low gonadotropin levels.
How is HMG administered?
Subcutaneous (SubQ), typically multiple per week.
What is the half-life of HMG?
~24–36 h (FSH) — LH component clears faster (~6 h); FSH persists longer to support follicle growth.
Is HMG approved for human use?
HMG is investigational — not approved by the FDA, EMA, or MHRA for human use at the time of writing.
What does the evidence show for HMG?
Evidence tier: Human clinical trials. MEGASET-HR trial (2020, n=620 high responders): HP-hMG reduced overall OHSS incidence vs recombinant FSH, with ongoing pregnancy rates of 54.5% vs 48% in fresh transfers — first large trial showing both safety and efficacy edge in high-risk patients.
What is commonly monitored when researching HMG?
Commonly tracked markers + signals: Estradiol (E2) levels — tracked every 2–3 days during stimulation to gauge ovarian response and OHSS risk, Follicle count and size via transvaginal ultrasound — determines trigger timing, Body weight and abdominal girth — early warning signs of fluid retention (OHSS), In men: semen analysis every 3 months, serum testosterone, LH, FSH, Symptoms of OHSS: bloating, nausea, rapid weight gain, shortness of breath.
Open this in AIx Core for the full picture
Mechanism breakdown, receptor pathway diagram, full safety list, monitored items, source citations, and one-tap add-to-protocol. Free with any account.