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ClinicalDual gonadotropin for fertility and testicular function

Human Menopausal Gonadotropin (HMG)

Also indexed as HMG, Menotropins, Menopur, Repronex

Human Menopausal Gonadotropin (HMG) is a purified preparation of gonadotropins extracted from the urine of postmenopausal women, containing both Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) activity in approximately equal ratios. In clinical medicine it is used to stimulate ovulation in women and spermatogenesis in men, particularly those with hypogonadotropic hypogonadism. In performance and fertility contexts, HMG is used alongside or after hCG to restore or maintain testicular function, intratesticular testosterone production, and sperm output.

Overview

Following subcutaneous or intramuscular injection, FSH and LH are absorbed into systemic circulation and distribute to gonadal tissue. FSH has a longer half-life (~24–36h) due to higher sialic acid content on glycan chains, which reduces receptor-mediated clearance. LH is cleared more rapidly (~20h). Bioavailability via subQ is approximately 70–75% for FSH. In men on exogenous androgens, gonadotropin suppression is reversed at the gonadal level, allowing intratesticular testosterone to recover even in the presence of exogenous testosterone-mediated pituitary suppression.

Proposed mechanism

FSH acts on Sertoli cells in the testes to stimulate spermatogenesis and support sperm maturation, while the LH component (or LH-like activity) acts on Leydig cells via the LH/hCG receptor to stimulate testosterone biosynthesis from cholesterol through the cAMP-PKA signaling cascade. Together, these hormonal signals restore the two-cell, two-gonadotropin system required for full testicular function, including intratesticular testosterone concentrations necessary for normal sperm production. In women, FSH drives follicular recruitment and maturation while LH triggers ovulation and luteinization of the dominant follicle.

What the evidence supports

Randomised controlled trial data in humans exists and supports use in specific contexts.

Graded Clinical

Findings supported by randomised, controlled trials in humans, with pre-registered endpoints and published results.

Key citations

Representative primary sources, including results that did not favour the compound.

  1. [1]

    Bouloux PM et al. — First International Norditropin Study Group. Induction of spermatogenesis by recombinant follicle-stimulating hormone in azoospermic men with hypogonadotropic hypogonadism

    · Human Reproduction, 17(11):2835–2843 · 2002

  2. [2]

    Cochrane Review: Urinary gonadotrophins versus recombinant gonadotrophins for ovarian stimulation in IVF/ICSI cycles

    · Cochrane Database of Systematic Reviews, CD005354 · 2017

  3. [3]

    Liu PY, Baker HW — Gonadotropin therapy in males: pathophysiology and evidence base

    · Asian Journal of Andrology, 11(1):3–14 · 2009

Citation records in this build are illustrative placeholders for the design.

Reference information for research purposes. Not medical advice, and not a recommendation to use any compound. Many entries describe substances that are not approved for human use.

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