HMG
High EvidenceA gonadotropin preparation containing FSH and LH, used in fertility protocols for both men and women.
What It Is
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) in approximately equal proportions. It is FDA-approved under brand names including Menopur, Pergonal, and Repronex for the treatment of infertility in both women and men. In women, hMG is used for controlled ovarian hyperstimulation in assisted reproductive technology (ART) cycles to stimulate multiple follicular development. In men, hMG is used to treat hypogonadotropic hypogonadism by directly providing the FSH needed for spermatogenesis alongside LH for testosterone production. The dual FSH/LH activity of hMG distinguishes it from recombinant FSH preparations (follitropin alfa/beta), and clinical evidence suggests the LH component may improve oocyte quality and endometrial receptivity in some patient populations. A 2023 Cochrane review comparing hMG with recombinant FSH in IVF found comparable live birth rates, though hMG was associated with slightly fewer oocytes retrieved. Modern highly purified hMG preparations (hp-hMG) have improved batch-to-batch consistency compared to earlier urinary-derived products. hMG requires medical supervision and monitoring with ultrasound and estradiol levels to prevent ovarian hyperstimulation syndrome.
Why Researchers Study It
HMG provides both FSH and LH activity in a single preparation, making it uniquely suited for protocols requiring dual gonadotropin support. In male fertility, it can simultaneously stimulate spermatogenesis (via FSH) and testosterone production (via LH), while in female reproduction it supports follicular development and ovulation.
Proposed Mechanisms
- FSH component stimulates Sertoli cells (men) and follicular growth (women)
- LH component stimulates Leydig cells for testosterone production and triggers ovulation
- Combined FSH/LH activity supports complete gonadal function restoration
- Used in both IVF protocols and male hypogonadotropic hypogonadism treatment
Evidence Snapshot
Commonly Discussed Benefits
Safety & Cautions
- FDA-approved for fertility treatment under medical supervision
- Risk of ovarian hyperstimulation syndrome in women
- Requires hormonal monitoring during use
- Must be prescribed by a reproductive endocrinologist
Comparisons
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Citations
- [1] Lunenfeld B. — Historical perspectives in gonadotrophin therapy. Hum Reprod Update. 2004 PubMed
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