Infertility happens when you are not able to get pregnant after having regular, unprotected sex. Infertility can happen for many reasons, such as hormone problems, blocked fallopian tubes, or when a fertilized egg cannot attach to the uterus. Certain personal characteristics or health conditions can contribute to infertility, including smoking and being overweight. But sometimes, there is simply no clear explanation for infertility.
If you are having trouble getting pregnant, you can work with your health care provider to run tests to find out what may help and discuss possible treatment options. Some options may include using medicine to improve the chances of success with certain fertility treatments, such as in vitro fertilization (IVF).
Menopur (menotropins) is an injection that can be used with certain fertility treatments. Continue reading to learn more about how it works, who may benefit from using it, and information about possible side effects.
How Does Menopur Work for Infertility?
Menopur works by boosting the activity of two natural hormones, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones signal your ovaries to grow healthy eggs and get them ready for ovulation. Once the eggs have grown and matured, a different medicine is typically used to trigger ovulation, which is when the ovary releases an egg.
Is Menopur Right for Me?
Not everyone should use Menopur. Your health care provider will likely take a detailed medical history, do a physical exam, and order some blood tests to see whether Menopur is a good option for you.
Menopur is usually used to help you get pregnant. If you are already pregnant, you should not use Menopur. The increased activity of FSH and LH from Menopur could affect pregnancy hormones.
If you have certain problems with your ovaries, such as ovarian cysts not caused by polycystic ovary syndrome or enlarged ovaries with no known cause, you should not use Menopur, as its primary function is to affect the ovaries.
Your body must be able to make eggs for Menopur to work. If you have primary ovarian failure (you have ovaries, but they are not able to make eggs), Menopur should not be used. Your health care provider can test for this by checking certain hormone levels.
Menopur boosts the activity of certain sex hormones. If you have any tumors that rely on sex hormones (such as tumors in the ovaries, breasts, or uterus), Menopur should not be used. Using Menopur, which boosts the activity of certain sex hormones, can affect the growth of these tumors.
The relationship between the pituitary gland, hypothalamus, thyroid gland, and the hormones they produce or that affect them is quite complex. All of these are a part of the endocrine system. Menopur boosts the activity of FSH and LH, which are two of the hormones involved in this complex relationship. If you have thyroid, adrenal, or pituitary problems that are not controlled with medicine, or if you have certain brain tumors, such as tumors involving the pituitary gland or hypothalamus, Menopur should not be used.
How Do I Use Menopur?
Menopur is an injection given once a day, under the skin in your belly. You or a caregiver can be trained to give the injection at home. Be sure to read and follow the instructions for use to properly mix and inject Menopur.
Menopur is typically given starting on the second or third day of an IVF cycle, or as directed by your fertility specialist. It is often used once daily for several days in a row, but the exact number of days can vary from person to person and from cycle to cycle. Be sure to keep all of your appointments, including those for lab tests, when you are using Menopur. These help your health care provider track your progress and monitor for side effects. Follow your health care provider’s instructions on when and how much Menopur you should use. If you have any questions, talk to your health care provider.
How Was It Studied for Infertility?
To test how well Menopur works, a study was done involving a large group of women undergoing fertility treatment. In this study, women were using IVF or IVF with intracytoplasmic sperm injection (ICSI) to help them become pregnant. The study measured success by looking at how many women achieved a “continuing pregnancy.” A continuing pregnancy meant that an ultrasound showed a pregnancy with a fetal heartbeat at least 10 weeks after the embryo was transferred to the uterus. The goal of the study was to see if Menopur worked at least as well as another commonly used fertility hormone treatment (recombinant human FSH).
All people in the Menopur group got the same dose (225 units/day) for the first five days. After five days, Menopur doses were adjusted individually for each person, up to a prespecified maximum dose (450 units/day). Study participants could receive Menopur for up to 20 days.
What Benefits Were Seen?
A total of 373 study participants received Menopur as part of one cycle of IVF. Of those, 87 (23%) achieved a continuing pregnancy assessed by ultrasound at least 10 weeks after embryo transfer. The study found that Menopur seems to work at least as well as recombinant human FSH (another commonly used fertility hormone treatment).
Your results may differ from those seen in clinical studies.
How Can I Prevent and Manage Menopur Side Effects?
The most common side effects of Menopur include:
- Cramps, fullness, or pain in your belly
- Headache
- Pain, itching, swelling, or bruising near the injection site
- Ovarian hyperstimulation syndrome (OHSS)
To help with cramps, fullness, and pain in your belly, you can try using a heating pad or hot water bottle on your lower back or tummy. A warm bath may also give you some relief.
Getting plenty of rest and drinking enough water can help with headaches. You can also try over-the-counter (OTC) pain reliever medicines such as acetaminophen or ibuprofen for headaches.
You can apply a cold compress to the area where the medicine was injected to relieve any pain, itching, or swelling. Your health care provider or pharmacist may also recommend an OTC pain reliever for pain or an antihistamine for itching or swelling.
Your fertility team will monitor your hormone levels and adjust your dose to help prevent ovarian hyperstimulation syndrome (OHSS). To reduce your risk of OHSS, follow all instructions you get from your health care provider about getting blood tests done, changing your dose of Menopur, or using any medicines to reduce swelling or irritation of your ovaries.
These are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
Getting Your Medicine: Insurance and Cost
Infertility treatments can be very costly. Though Menopur may be covered by your insurance plan, coverage can vary from plan to plan. Your insurance may require approval for you to use this medicine. This is called a prior authorization. The insurance company reviews the prescription and other supporting information provided by your health care provider to make sure it is covered. Ask your fertility clinic or pharmacy if they can help you with insurance forms or patient assistance programs.
