Menotropin (hMG): what the trials show, status and safety

Summary

Menotropin, usually shortened to hMG, is a fertility medicine extracted from the urine of women after the menopause. It carries the activity of two hormones at once, and the second activity comes mostly from added pregnancy hormone hCG. It is prescription-only in all seven markets on this page, and an American biological product since 2020. Pooled trials give it a modest edge over laboratory-made FSH for live birth, at moderate confidence, from a body of evidence in which many of the individual studies were paid for by manufacturers.

Key findings at a glance

• Prescription-only in every market covered here. The American product is licensed as a biological product under application BLA021663, and since 23 March 2020 it no longer qualifies for the pharmacy compounding exemptions ^[1], ^[2].
• It is not a peptide. The American regulator registers menotropins as a mixture rather than a defined substance, under identifier 5Y9QQM372Q, and no PubChem entry exists at all ^[3], ^[4].
• The luteinising activity comes mostly from added pregnancy hormone. British product information says that activity is primarily driven by hCG, and the American text states that hCG is detected in the finished medicine ^[5], ^[6].
• Pooled trials reported live birth less often with laboratory-made FSH than with hMG. Across 4,793 women in 15 studies the odds of a live birth with recombinant FSH were about a sixth lower, odds ratio 0.83 (range 0.73 to 0.95), at moderate confidence. Against highly purified urinary FSH the same review found probably little or no difference, odds ratio 1.02 (range 0.86 to 1.21) in 2,956 women from 15 studies ^[7].
• Ovarian overstimulation was probably more frequent with recombinant FSH, odds ratio 1.42 (range 1.12 to 1.80) across 9,813 women in 37 studies, again at moderate confidence ^[7].
• The three large head-to-head trials showed only that hMG was not worse. Ongoing pregnancy ran at 27 against 22 percent in MERiT, odds ratio 1.25 (range 0.89 to 1.75), then 30 against 27 percent in MEGASET and 35.5 against 30.7 percent in MEGASET-HR ^[8], ^[9], ^[10].
• In women predicted to respond strongly, MEGASET-HR reported less overstimulation and the same number of births. Overstimulation occurred in 9.7 against 21.4 percent, a difference of -11.7 percentage points (range -17.3 to -6.1), while cumulative live birth stood at 50.6 against 51.5 percent ^[10].
• The pregnancy hormone inside hMG reaches the bloodstream. Mean hCG in treated women measured 2.5 and 2.9 IU/l during stimulation, which is why the medicine is prohibited for male athletes under section S2.2.1 ^[11], ^[12].
• The licensed uses disagree across markets. British product information names men whose pituitary gland fails to signal the testicles, a condition called hypogonadotropic hypogonadism; the American label and the German product information cover female infertility only ^[5], ^[6], ^[13].

What it is

Menotropin is not one substance but a mixture of hormones drawn from human urine. The American product information defines it as a preparation of gonadotropins with FSH and LH activity, extracted from the urine of women after the menopause and then purified further ^[6].

FSH, follicle-stimulating hormone, makes the fluid-filled sacs in the ovary that hold eggs grow. LH, luteinising hormone, supplies the building blocks for oestrogen and drives testosterone production in the testicles. Menotropin carries both activities in one vial ^[6], ^[5].

The second activity has an unusual origin. Manufacturers may add hCG, the pregnancy hormone, taken from the urine of pregnant women, in order to reach the declared total LH activity. British product information says that activity is primarily driven by hCG, with a minimal contribution from LH itself ^[5], ^[13].

Ferring sells the medicine as Menopur in the United States, the United Kingdom, Ireland, Switzerland and Canada, and as Menogon HP in Germany ^[6], ^[5], ^[14], ^[15], ^[16], ^[13]. IBSA sells Merional in other markets, among them Saudi Arabia ^[17].

Three older American products are gone. Repronex, Pergonal and Humegon are all discontinued, and Canada cancelled Repronex in 2019 ^[18], ^[19].

The medicine class is older than any of those names. Serum gonadotrophin from pregnant mares was first used to stimulate the ovaries in 1930 and was withdrawn because patients formed antibodies against it. The first baby conceived after treatment with urinary menopausal gonadotropin was born in 1961 ^[20].

Strength is not a weight. It is biological activity measured in animal assays against the Fourth International Standard for urinary FSH and LH, agreed in November 2000. The ovary weight gain test in female rats measures the FSH side, the seminal vesicle test in male rats the LH side ^[6].

Quick facts

How it works

Menotropin works through the two receptors that the pituitary hormones use, which is why it can replace them when the pituitary gland cannot do the job ^[6].

• On the cells lining the egg sac. The FSH part binds the FSH receptor on these granulosa cells, the egg sacs grow, and male hormones are converted into oestrogen inside them ^[6].
• On the layer just outside the sac, and on the testicles in men. The LH activity binds the shared LH and hCG receptor of the theca cells. In the ovary it delivers the male hormones that oestrogen is made from; in the testicle it drives testosterone production ^[6], ^[5].
• The LH signal is really an hCG signal. Both hormones use the same receptor, and the added hCG carries most of the declared activity. That substitution is measurable in the blood of treated women ^[5], ^[11].
• It does not release the egg. Menotropin grows the follicles; a separate hCG injection triggers release. That is why the approved texts describe two medicines rather than one ^[6], ^[13].

The nearest relatives differ by what they leave out. Recombinant FSH, made in cell culture, contains no LH activity at all. Urinary FSH, also drawn from urine, likewise carries FSH only. Pure hCG preparations carry the LH-type activity without any FSH ^[21], ^[7].

What the trials found

The evidence is unusually large for a urinary extract, and it points one way without pointing far. Pooled trials give hMG a small advantage over laboratory-made FSH in fertility treatment, while the three biggest single trials only ever showed that it was not worse.

Pregnancy and live birth in assisted reproduction

Meta-analysis, moderate confidence The current Cochrane review searched to 31 March 2025 and applied a checklist that excluded studies it could not trust. The whole review covered 59 studies in 18,119 women ^[7].

For live birth, 4,793 women from 15 studies were compared. Live birth was probably lower with recombinant FSH than with hMG, odds ratio 0.83 (range 0.73 to 0.95). Read the other way round, the urinary medicine came out slightly ahead ^[7].

Clinical pregnancy pointed the same way in 4,839 women from 15 studies, odds ratio 0.87 (range 0.76 to 0.98) for recombinant FSH ^[7].

The advantage is specific to that one comparison. Set against highly purified urinary FSH, which carries no LH activity either, recombinant FSH came out level: probably little or no difference in live birth, odds ratio 1.02 (range 0.86 to 1.21) in 2,956 women from 15 studies, and none in overstimulation, odds ratio 1.01 (range 0.67 to 1.53) in 3,640 women from 18 studies ^[7].

The authors set out the limits plainly. Selection bias was often unclear, reporting was selectively done, and the risk of other bias was high. They record that many studies were paid for by the pharmaceutical industry. The review itself had no funding ^[7].

Overstimulation of the ovaries

Meta-analysis, moderate confidence Ovarian hyperstimulation syndrome was probably more frequent with recombinant FSH, odds ratio 1.42 (range 1.12 to 1.80), across 9,813 women in 37 studies ^[7].

Non-inferiority trial A non-inferiority trial asks only whether the new option is not worse than the old one, never whether it is better. MEGASET-HR tested 620 women whose anti-Müllerian hormone reached at least 5 ng/ml, a blood marker of how many eggs are left, meaning strong responders. Overstimulation occurred in 9.7 percent on hMG against 21.4 percent on recombinant FSH, a difference of -11.7 percentage points (range -17.3 to -6.1) ^[10].

Early pregnancy losses followed the same pattern, 14.5 against 25.5 percent, a difference of -11.0 percentage points (range -18.8 to -3.14). Cumulative live birth, however, was flat: 50.6 against 51.5 percent, a difference of -0.8 percentage points (range -8.7 to 7.1), even though the comparison group received 43 more embryo transfers ^[10].

The three large head-to-head trials

Randomised, assessor-blind MERiT treated 731 women, 363 on highly purified hMG and 368 on recombinant FSH. Ongoing pregnancy reached 27 against 22 percent, odds ratio 1.25 (range 0.89 to 1.75). The trial set out to show superiority and did not: only non-inferiority was established ^[8].

Randomised, assessor-blind MEGASET treated 749 women across 25 centres in seven countries, and every one of them had a single five-day-old embryo, a blastocyst, put back. Ongoing pregnancy was 30 against 27 percent among those who completed treatment as planned, and 29 against 27 percent when everyone randomised was counted whatever they finished. Cumulative live birth after frozen transfers within a year was 40 against 38 percent ^[9].

Randomised, assessor-blind MEGASET-HR treated 620 strong responders across 31 centres and reported 35.5 against 30.7 percent, a difference of 4.7 percentage points (range -2.7 to 12.1). Non-inferiority again, superiority again not shown ^[10].

The American approval rested on an earlier study of the same shape. Of 373 women treated, 87 reached continuing pregnancy, or 23 percent, confirmed by ultrasound at least ten weeks after transfer. Clinical pregnancy, a secondary measure without the power to settle anything, stood at 98 of 373, or 26 percent ^[6].

Egg numbers against embryo quality

Randomised, assessor-blind Inside MERiT the two medicines traded places. Recombinant FSH yielded more eggs, 11.8 against 10.0 (p below 0.001), while hMG produced a higher share of top quality embryos, 11.3 against 9.0 percent (p = 0.044). The appearance of the womb lining on ultrasound also shifted towards the denser, hyperechogenic pattern under recombinant FSH (p = 0.023) ^[8].

Blinded re-scoring A second look at the same 731 women and 7,535 eggs weakened that finding. Local scoring gave 11.3 against 9.0 percent, but central scoring by a panel of three embryologists gave 9.5 against 8.0 percent, which is no real difference ^[23].

Where a top quality embryo was transferred, outcomes still favoured hMG. Live birth and continuing pregnancy both ran at 48 against 32 percent (p = 0.038), and ongoing implantation at 41 against 27 percent (p = 0.032) ^[23].

Randomised, assessor-blind The hormone measurements explain part of the difference. On hMG the blood carried more androstenedione, the raw material the body turns into oestrogen and testosterone, more total testosterone, and a higher share of testosterone circulating unbound, known as the free androgen index (p below 0.001 for all three). At the end of stimulation oestradiol was higher on hMG (p = 0.031) and progesterone higher on recombinant FSH (p below 0.001), while LH in the blood did not differ at all ^[11].

Ovulation induction in polycystic ovary syndrome

Meta-analysis, low to very low confidence A separate Cochrane review searched to March 2024 and covered 15 studies in 2,348 women who had not conceived on clomifene or letrozole ^[24].

For births, recombinant FSH and the urinary products may differ little or not at all. The risk ratio was 1.21 (range 0.83 to 1.78) from 505 women in five randomised studies, at low confidence ^[24].

The narrower comparison of hMG against purified urinary FSH stays genuinely unresolved. Live birth gave a risk ratio of 1.44 (range 0.55 to 3.76) in two studies with 79 women. Multiple pregnancy gave 6.56 (range 0.28 to 152.45) in three studies with 102 women and overstimulation 7.07 (range 0.42 to 117.81) in two studies with 53 women. Both of those point towards more events with hMG, but each range runs from almost nothing to more than a hundredfold, so nothing follows from them. Confidence was very low throughout ^[24].

Men with congenital hypogonadotropic hypogonadism

Observational The largest series treated 223 men who produced no sperm and had never gone through puberty, with hCG and hMG together, over 5,109 person-months. Testicular volume rose from 2.1 plus or minus 1.6 to 8.1 plus or minus 4.6 ml and total testosterone from 0.9 plus or minus 0.5 to 15.1 plus or minus 8.2 nmol/l, both p below 0.001 ^[25].

Half the men had sperm in their semen by 15 months, the middle value of the group (range 13.5 to 16.5 months). In all, 143 of 223 men, or 64 percent, produced any sperm, on average after 14 plus or minus 8 months ^[25].

The counts stayed below the World Health Organization reference values, at 11.7 million per ml, with the middle half of the men between 2.1 and 24.4 million. The share of sperm swimming forward reached 36.9 plus or minus 20.2 percent. Of 34 men who wanted children, 19 saw a partner conceive ^[25].

Meta-analysis, low confidence Assisted reproduction in this group produced 388 pregnancies among 709 patients. That is an effectiveness of 46 percent (range 39 to 53 percent), and the individual studies disagreed with one another a great deal (I-squared 73.06 percent). Fertilisation, implantation and live birth reached 72, 36 and 40 percent, no different from infertility of other causes ^[26].

Comparative study, low confidence A study in 64 men with central hypogonadism put 33 on hCG alone against 31 on hCG with hMG. Testicular volume rose from 3.08 plus or minus 2.44 to 8.92 plus or minus 5.37 ml (p below 0.001), and 52 of 64 counted as responders on that measure, or 81.2 percent. Sperm production, however, was found in only two of the 64 ^[27].

Pen against powder

Randomised crossover The liquid pen matches the powder. In 76 women randomised and 56 analysed, the pen delivered 12 percent more FSH in total over time and 17 percent more at the peak, ratios of 1.12 (90 percent range 1.0562 to 1.1889) and 1.17 (90 percent range 1.0946 to 1.2490). Both sit inside the band of 0.8000 to 1.2500 within which two products count as equivalent ^[28].

What is still unknown

• What else is in the vial. Mass spectrometry of five batches put non-gonadotropin proteins at roughly 20 to 30 percent of total protein, with more than 200 such proteins identified. Beta-hCG made up 18 to 47 percent and beta-LH only 0.9 to 1.2 percent, and the shared alpha subunit was heavily oxidised, at a relative abundance of 20 percent of all gonadotropin measured. The sugar pattern on the hCG matched the placental comparison product rather than a pituitary one, which fits an origin in pregnancy urine. The work came mainly from a competing manufacturer and has no independent confirmation ^[29].
• Where the medicine sits in the body, and how it is broken down. Neither has been studied in humans for this product ^[6].
• Whether hMG beats purified urinary FSH for ovulation induction. The ranges span several orders of magnitude and the confidence is very low ^[24].
• What lies behind the grey-market use after anabolic steroids. hMG circulates outside medical supply under the heading of post-cycle therapy. That is a grey-market phenomenon, not a tested use: no controlled trial has examined it. The clinical review of steroid withdrawal describes hCG and clomifene being taken illegally at the end of a steroid course, and it does not mention hMG at all ^[30].
• Whether repeated ovarian stimulation raises the risk of ovarian tumours. Rare benign and malignant cases are reported, and a causal link is neither shown nor ruled out ^[6].

Side effects and safety

The American label carries no boxed warning. The serious risks sit in the warnings section instead, and the first of them is the reason the medicine needs close supervision ^[6].

• Overstimulation of the ovaries. Blood vessels leak, so fluid gathers quickly in the abdomen and the chest, and sometimes around the heart. Warning signs are severe lower abdominal pain, nausea, vomiting and weight gain ^[6].
• How bad it can get. Low blood volume, thickened blood, electrolyte disturbance, fluid in the abdomen, bleeding into it, fluid around the lung, acute breathing failure and clots are all listed. Liver test changes are described, with or without changes on biopsy ^[6].
• When it happens. The syndrome arrives after treatment stops and peaks roughly seven to ten days afterwards. If pregnancy follows, it runs more often, more severely and for longer, so monitoring continues for at least two weeks after the hCG injection ^[6].
• How often. It affected 6.2 percent of 434 women in the two pooled approval studies and 7.2 percent of the 373 women in the assisted reproduction study ^[6].
• Multiple pregnancy. Ultrasound found more than one fetus in 30 of 85 pregnancies in that study, or 35.3 percent. The label requires that the woman and her partner be advised of this risk before treatment begins ^[6].
• Common complaints. In European product information, abdominal pain, abdominal swelling, nausea, pelvic pain, headache and injection site reactions are all common, meaning between one in 100 and one in ten. The American label counted, in the same 434 women, abdominal pain in 6.7 percent, headache in 6.2 percent, injection site pain or reaction in 3.9 percent, abdominal cramps in 3.0 percent, and an enlarged abdomen and injection site inflammation in 2.3 percent each ^[5], ^[6].
• Less often. Vomiting, abdominal discomfort, diarrhoea, tiredness, dizziness, ovarian cysts, breast complaints, acne and rash are uncommon, meaning between one in 1,000 and one in 100. Visual disturbance, muscle and joint pain, itching, hives and twisting of the ovary are rare, between one in 10,000 and one in 1,000. Allergic and anaphylactic reactions have no established frequency ^[5].
• Four further warnings. The American label gives each of these its own subsection: twisting of the ovary, malformations in the child, pregnancy outside the womb and miscarriage ^[6].
• Also reported. Thrombophlebitis occurred in under 1 percent of the American study group, and hot flushes come from post-marketing reports, where neither frequency nor cause can be established ^[6].
• Ruled out entirely. Pituitary or hypothalamic tumours and known allergy to the medicine bar its use anywhere. For women, ovarian, uterine or breast cancer, pregnancy and breastfeeding, unexplained gynaecological bleeding, ovarian cysts not caused by polycystic ovary syndrome, primary ovarian failure and malformations of the reproductive organs that rule out a pregnancy are added. For men, testicular tumours and prostate cancer ^[5], ^[6].
• Other conditions that bar it. High FSH levels indicating primary ovarian failure, uncontrolled thyroid, adrenal or pituitary disease, sex hormone dependent tumours of the reproductive tract, and unexplained uterine bleeding ^[6].

The supervision this needs is substantial. Before treatment the American label requires a full gynaecological and hormonal work-up, a diagnosis, exclusion of pregnancy and assessment of the male partner. During a severe episode it lists daily checks of fluid balance, weight, blood counts, electrolytes, kidney values, clotting, an electrocardiogram for potassium and abdominal girth ^[6].

The German product information requires the first injection under medical supervision, and treats self-injection as suitable only for well motivated, trained patients with expert advice on hand ^[13].

One question specific to urinary medicines deserves a plain answer. Pituitary-derived gonadotropin transmitted Creutzfeldt-Jakob disease and left the market in the late 1980s. For urine, no infectivity has ever been demonstrated, and no confirmed transmission exists ^[20], ^[31].

Neither donor urine nor finished product can be tested for prions. The assessment therefore rests on how likely infectivity in urine is, on the choice of donors, and on the purification steps ^[31].

An expert meeting in Buenos Aires in April 2004 concluded that the risk is low, and that urinary gonadotropins appear safe in this respect ^[31].

Why this page lists no doses

Menotropin is prescription-only in all seven markets covered here, and its licensed use is steered by ultrasound scans and hormone measurements as treatment proceeds. Choosing an amount, adjusting it, and timing the separate hCG injection belong in the approved product information and with the clinical team. The figure 75 IU on this page describes what a vial contains, not what anyone takes.

Development and approval status

Menotropin is a long-established medicine rather than a substance under investigation. Research continues, but it compares hMG with laboratory-made FSH and examines patient subgroups, not the substance itself ^[7], ^[22].

After the pituitary product was withdrawn at the end of the 1980s, urinary hMG was for a while the only gonadotropin left on the market, and a preparation with a large share of unidentified urine proteins was therefore very hard to control for quality ^[20].

Three entries need a word. The German prescription rules list gonadotropin of human and horse serum without any exception, and hCG separately, so menotropin is caught twice over ^[33].

Australia names menotrophin in Schedule 4 and adds a catch-all entry for gonadotrophic hormones. There is no extra restriction on who may prescribe it ^[34]. Ireland uses the stricter European category, where a prescription may not be dispensed a second time ^[14].

No centrally approved European product exists, so there is no single European assessment report. Every European licence found here carries a national number ^[14], ^[5], ^[13].

One recall is on file. A class III recall beginning on 2 March 2021 covered the 75 IU kits of the American product, because the supplied saline failed its pH specification. The active ingredient was not affected, and the recall is closed ^[32].

The wider framework sits under are peptides legal and FDA-approved peptides. Every entry describes the position on 15 September 2026.

Anti-doping

Menotropin is prohibited for male athletes, and the word appears nowhere on the list. Section S2.2.1 of the 2026 prohibited list names testosterone-stimulating peptides in males including, but not limited to, chorionic gonadotrophin (CG) and luteinising hormone (LH). A check of the index finds entries for both and none for menotropin, hMG or human menopausal gonadotrophin ^[12].

The prohibition reaches hMG through its contents. Every product carries hCG as the bearer of the luteinising activity, and that hCG reaches the bloodstream. Mean levels of 2.5 and 2.9 IU/l were measured in treated women during stimulation ^[5], ^[11].

Class S2 is prohibited at all times, in and out of competition. Nothing in it counts as a specified substance ^[12].

Two limits matter. The list restricts the entry to men ^[12]. The reason is analytical: hCG occurs naturally in women, so it cannot mark anything there. The FSH half is not prohibited at all. A full-text check of the 2026 list for FSH, follicle and follitropin returns nothing, and German anti-doping law has no entry for follitropin either ^[12], ^[35].

What laboratories measure is hCG, not menotropin. Most accredited laboratories use automated immunoassays on urine, and only assays that detect the intact two-subunit hormone are acceptable. Confirmation needs a different intact-hCG assay or mass spectrometry ^[36].

A threshold of 1.0 IU/l for intact hCG in male urine has been proposed, giving a false positive rate below one in 10,000. In unexposed men the upper reference limit was 0.21 IU/l and the mean 0.04 IU/l, across 570 samples ^[36].

German anti-doping law names chorionic gonadotrophin and luteinising hormone. It closes with a sentence extending the list to salts, esters, ethers, isomers, mixtures of isomers, complexes and derivatives. Whether a urine extract that contains hCG falls under that sentence is a question of interpretation, and it is not settled here; the hCG inside it is a listed substance either way ^[35]. The wider picture is at peptides banned in sport.

Compared with related peptides

These neighbours line up along one chain of signals. Gonadorelin and kisspeptin act on the pituitary gland and above it, hMG and hCG act on the ovary and the testicle directly ^[12], ^[6].

The comparison that decides clinical choices is the one in the third row, between the purer laboratory product and the urinary mixture. Growth hormone belongs in a different chain of signals altogether and appears here only because it shares the prescription and anti-doping picture ^[7], ^[12].

Common misconceptions

• "HMG means the cholesterol enzyme." In lipid medicine HMG stands for 3-hydroxy-3-methylglutaryl, and HMG-CoA reductase inhibitors are the statins. In molecular biology HMG names the high mobility group chromatin proteins. Menotropin sits at G03GA02, statins at C10AA ^[21].
• "hMG and hCG are the same thing." hCG is a single hormone with LH-type action only, coded separately at G03GA01 and G03GA08. hMG is a mixture with both activities, whose LH activity is mostly hCG. So hMG contains hCG but is not hCG ^[5], ^[21].
• "hMG is harder to detect than hCG." The opposite holds. The test looks for intact hCG whatever product it came from, and the hCG in hMG reaches the bloodstream at measurable levels ^[11], ^[36], ^[12].
• "75 IU is a dose." It is the strength of one vial, an activity measured in animal assays against a World Health Organization standard, 75 IU of FSH and 75 IU of LH activity. What is given is set by prescription ^[6].
• "hMG beats recombinant FSH in everyone." The pooled evidence gives it a modest edge in assisted reproduction, at moderate confidence and with industry funding behind much of the underlying studies. For ovulation induction in polycystic ovary syndrome no difference is demonstrable, and MERiT, MEGASET and MEGASET-HR each showed non-inferiority only ^[7], ^[24], ^[8], ^[9], ^[10].
• "Every menotropin product is the same medicine." They all contain menotropin, but they come from different licence holders, in different forms, with different added ingredients and different licensed uses. One of the older American products has been discontinued there and cancelled in Canada ^[6], ^[13], ^[17], ^[18], ^[19].

Frequently asked questions

Is hMG a prescription-only medicine?

Yes, in every market examined here. Menotropin needs a prescription in the United States, in Germany, the United Kingdom, Ireland, Australia, Canada and Switzerland. Australia names it in Schedule 4 of its poisons standard, Canada adds it to Schedule D for biological medicines, and Ireland puts it in the stricter of the two European prescription categories, where a prescription may not be dispensed again.

What is hMG actually made from?

The urine of women after the menopause, put through further purification steps. Their urine carries both follicle-stimulating hormone and luteinising hormone. To reach the declared luteinising activity, manufacturers may add hCG obtained from the urine of pregnant women. The American product information states plainly that hCG is detected in the finished medicine.

Is hMG better than laboratory-made FSH?

For pregnancy in assisted reproduction the pooled evidence gives it a small edge. Across 4,793 women in 15 studies, live birth was probably lower with recombinant FSH, odds ratio 0.83 with a range of 0.73 to 0.95, at moderate confidence. The three large head-to-head trials, MERiT, MEGASET and MEGASET-HR, each showed only that hMG was not worse, never that it was better.

Is hMG banned in sport?

For men, yes, although the word menotropin appears nowhere on the 2026 prohibited list. The list bans chorionic gonadotrophin and luteinising hormone by name in section S2.2.1, and hMG contains the first of those two. The ban applies only to men, at all times, in and out of competition. The FSH half of the medicine is not prohibited.

Does hMG appear on the WADA prohibited list by name?

No. A full-text check of the 2026 list and its index finds no entry for menotropin, hMG or human menopausal gonadotrophin. The prohibition works through the contents instead, helped by the wording of section S2.2.1, which says including but not limited to. German anti-doping law likewise names the components rather than the mixture.

What is the main danger of hMG treatment?

Overstimulation of the ovaries. The syndrome makes blood vessels leak, so fluid gathers in the abdomen and chest, and it can turn severe quickly. It affected 7.2 percent of 373 women in the American approval study. Multiple pregnancy is the second risk, seen in 30 of 85 pregnancies in that study, or 35.3 percent.

Is hMG licensed for men anywhere?

In the United Kingdom, yes. The British product information names hypogonadotropic hypogonadism in men, together with hCG. The American label and the German product information cover female infertility only and contain no male indication at all. Using it in a man in Germany therefore falls outside the licence.

Is hMG a peptide?

No. The American regulator registers menotropins as a mixture rather than a single substance, under the identifier 5Y9QQM372Q, and no PubChem entry exists because there is no defined structure. What the vial holds is large sugar-coated protein hormones from human urine, alongside a substantial share of other urine proteins.

Can hMG be compounded by a pharmacy in the United States?

No longer. On 23 March 2020 menotropins became a biological product under section 351 of the Public Health Service Act, and the regulator states that transitioning products lose the exemptions for compounded medicines under sections 503A and 503B. The notice names menotropins alongside hCG, hyaluronidase and FSH.

Why does this page list no hMG doses?

Because menotropin is prescription-only in all seven markets covered here, and its licensed use needs ultrasound scans and hormone measurements to steer it. The figure 75 IU that appears on this page describes what a vial contains, not what anyone takes. Choosing an amount belongs in the approved product information and with the clinical team.

Cite this page

The facts on this page were checked on 15 September 2026, and the register searches behind the status table were run on that date. Licensed medicines gain new warnings over time, so the version and the date matter as much as the text. On that day the ClinicalTrials.gov registry listed 170 registered studies of this substance ^[22].

myPeptides Research & Editing. (2026). Menotropin (hMG): what the trials show, status and safety. Version 1.0, 15 September 2026. myPeptides Peptide Register. Retrieved from https://mypep.app/peptides/hmg

How pages in this register are compiled and graded is described under methodology; the full register is at peptides.

Last verified: 15 September 2026. Next review: on a labelling change in any covered market, on a new systematic review of the comparison with recombinant FSH, or on any change in the anti-doping classification.