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Prescription hormoneHuman trialsFDA approved

HMG

Human menopausal gonadotropin (menotropins)

Last reviewed October 27, 2026 · 17 sources · Written for general readers · Compare with another compound →

The bottom line

HMG is an FDA approved fertility medicine, sold in the United States as Menopur, that helps the ovaries grow several eggs during IVF. Large trials and reviews show it works about as well as lab made FSH, and possibly slightly better for live births. It must be used under a fertility specialist because it can overstimulate the ovaries and cause blood clots or multiple pregnancy, and there is no evidence for its use in bodybuilding.

Where the evidence stands

What it is

HMG is a hormone mix purified from the urine of women after menopause. It contains two pituitary hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH) activity. Small amounts of HCG are also found in it. Because it is a mixture of large proteins, there is no single formula or sequence.[1]

In the United States the approved product is Menopur. Its label lists 1975 as the first U.S. approval of menotropins. It is used to grow several egg follicles in women going through assisted reproduction such as IVF.[1]

In March 2020, FDA moved Menopur from a drug approval to a biologics license, the category used for large protein medicines.[2]

Outside the U.S. label, specialists also use HMG with HCG to start sperm production in men whose brain or pituitary does not make enough of these hormones.[3][4]

Name
HMG (Human menopausal gonadotropin (menotropins))
Other names
menotropins, menotrophin, Menopur
Type
Prescription hormone

What it does in the body

HMG is purified from the urine of women after menopause and carries FSH and LH activity, the two pituitary hormones that signal the ovaries and testes. It works by doing what the brain's own fertility hormones do, but more strongly.[1]

This is the biology, area by area. A change measured in the body, like a higher blood level, does not always mean a person feels a benefit. The claims check below covers that.

Ovaries and egg follicles

Well established

The FSH and LH activity push follicles, the small fluid sacs that hold eggs, to grow and mature in ovaries that still work. This lets doctors collect several eggs in one IVF cycle instead of one.[1]

Ovulation

Well established

HMG alone usually does not release the egg. A separate HCG shot is given to trigger ovulation once the follicles are ready.[1]

Egg and embryo results

Measured in people

In IVF trials, HMG gave pregnancy rates at least as good as lab made FSH, and in the 731 woman MERIT trial top quality embryos from the HMG group led to more live births.[5][6] In women with a large egg reserve, ovary overstimulation was about half as common with HMG (about 10% versus 21%).[7]

Fluid balance and blood clotting

Well established

Strong ovary stimulation can cause ovarian hyperstimulation syndrome, with fluid building up in the belly, chest and around the heart. In women expected to overrespond, HMG may cause it about half as often as lab made FSH.[8] Serious lung problems and blood clots, including stroke, have been reported with gonadotropins, and some cases were fatal.[1][9]

Testes and sperm production

Measured in people

In men whose pituitary makes too little FSH and LH, HMG supplies FSH, which drives the sperm making cells, while HCG drives testosterone. In 10 such men, HMG plus HCG brought normal sperm, while FSH plus testosterone did not.[10] Across 41 studies, adding FSH to HCG gave more sperm than HCG alone.[4]

Testosterone

Measured in people

In 17 Chinese men with pituitary hormone loss, testosterone rose into the normal range mainly through the HCG part of treatment.[11] A 2024 analysis found testosterone and testicle size rose about the same whether or not FSH was added.[4]

How it works

HMG works by doing what the brain's own fertility hormones do, but more strongly.[1]

  • The FSH and LH activity push follicles (small fluid sacs that hold eggs) in working ovaries to grow and mature.[1]
  • HMG alone usually does not release the egg. A separate HCG shot is given to trigger ovulation once follicles are ready.[1]
  • In men, its FSH part supports the cells that make sperm, which is why it is often added to HCG.[10][4]

This mechanism is well understood and is described on the FDA approved label.

What the research shows

We keep animal and human evidence apart. A result in animals is a reason to study something in people, not proof that it works in people.

Animal and lab studies

Not the main evidence for this drug

  • HMG is a human derived fertility drug that was approved based on human trials, so animal studies are not the main evidence.[1]

Limit: Animal data add little beyond the human trials and decades of clinical use.

Human studies

Large trials and reviews in IVF, smaller series in men

  • Label trial: in an open label trial in Europe and Israel, 373 women having IVF were given Menopur shots and compared with women given lab made FSH. About 23% had a continuing pregnancy and 26% a clinical pregnancy after one cycle, and Menopur was judged no worse than lab made FSH.[9]
  • MERIT trial: 731 women having IVF were assigned to highly purified HMG or lab made FSH, with embryo assessors blinded. Ongoing pregnancy was 27% versus 22%, a difference that was not statistically clear. Top quality embryos from the HMG group led to more live births.[5]
  • MEGASET trial: 749 women having IVF with single blastocyst transfer were assigned to highly purified HMG or lab made FSH. Ongoing pregnancy was about 29% versus 27%, and live births over a year, including frozen embryos, were 40% versus 38%. HMG was judged at least as effective.[6]
  • Women expected to overrespond: a trial of 620 women with high egg reserve found ongoing pregnancy of about 36% with HMG versus 31% with lab made FSH. Ovarian hyperstimulation was less common with HMG (about 10% versus 21%), and total live births were about the same, near 51%.[7]
  • A 2026 Cochrane review (a careful summary of all good trials) pooled 17 trials with 5,639 women comparing lab made FSH with HMG. Live births were probably a bit lower with lab made FSH than with HMG. It found no clear difference between lab made FSH and other urine based FSH products.[12]
  • Women with polycystic ovary syndrome: a 2025 Cochrane review of 15 trials with 2,348 women found little or no difference in live births or multiple pregnancies between urine based gonadotropins and lab made FSH. Only a few small trials tested HMG itself, and those results were very uncertain.[14]
  • Big picture: a 2025 Cochrane network review of 338 trials with 59,086 women found that, in women expected to overrespond, HMG may cut ovary overstimulation by about half compared with lab made FSH, but may raise the chance a cycle is cancelled. The evidence was low certainty.[8]
  • Against a lab made FSH and LH mix: a 2026 analysis of 6 studies covering 5,287 IVF cycles, most of them observational, found about one and a half more eggs per cycle and somewhat more clinical pregnancies with the lab made mix than with highly purified HMG. Live birth data were too thin to judge.[13]
  • Men with brain or pituitary hormone loss: a 2024 analysis of 41 studies with 1,673 men found 78% made some sperm after a median of 18 months of gonadotropins, and HCG plus FSH, the role HMG often fills, gave more sperm than HCG alone.[4]
  • In a German clinic series of 42 such men, HMG plus HCG (or a hormone pump) brought sperm in 54 of 57 treatment courses and pregnancy in 26 of 36 courses aimed at it.[3]
  • In 10 men with the same problem, two years of HMG plus HCG shots into a muscle brought normal sperm in all of them, while FSH plus testosterone failed to start or keep sperm production.[10]
  • In 17 Chinese men treated with HCG, with HMG added for most, sperm first appeared after an average of 13 months, and 12 men fathered a pregnancy after an average of 20 months. Two men never made sperm.[11]

Limit: IVF differences between fertility drugs are small and depend on the clinic and patient. Studies in men are small treatment series without placebo groups, and men's use is not on the U.S. label.

Claims check

The most common claims about this compound, and what studies actually found. Verdicts rate the evidence, not whether you should use it.

Grows more eggs for IVF

Shown in people

In a label trial where 373 women received HMG, in the 731 woman MERIT trial and in the 749 woman MEGASET trial, pregnancy rates with HMG were at least as good as with lab made FSH, which is the standard comparison drug.[9][5][6] Growing multiple follicles for assisted reproduction is its FDA approved use.[1]

Gives better IVF results than other fertility drugs

Mixed results

A 2026 Cochrane review of 17 trials with 5,639 women found HMG probably gives slightly more live births than lab made FSH.[12] But single trials often show no clear difference: in 620 high responders, total live births were about 51% with either drug, and in MEGASET cumulative live births were 40% versus 38%.[7][6] A 2026 analysis of 6 mostly observational studies found a lab made FSH and LH mix gave slightly more eggs and clinical pregnancies than highly purified HMG.[13]

Restores sperm in men with low pituitary hormones

Mixed results

Clinic series consistently report sperm in most treated men, for example 54 of 57 courses in 42 German men and all 10 men in another study.[3][10] A 2024 analysis of 41 studies found 78% of men made some sperm, but only 15% reached higher counts.[4] These were mostly uncontrolled series, it can take a year or more, and some men never respond.[11]

Keeps testicles working during testosterone or steroid use

Not tested

We found no study testing HMG in men taking testosterone or steroids. In men with pituitary problems, FSH combined with testosterone failed to start or keep sperm production, while HMG plus HCG worked.[10]

Boosts testosterone and muscle

Not tested

No study has tested HMG for muscle or performance in healthy men. In men with pituitary hormone loss, testosterone rose into the normal range mainly through the HCG part of treatment.[11]

Known risks and side effects

  • Ovary overstimulation. Ovarian hyperstimulation syndrome affected about 6 to 7% of women in the IVF trial behind the label. It can develop fast, cause fluid buildup in the belly, chest and around the heart, and happen even after treatment stops.[9][1]
  • Common side effects. In the label's IVF group, abdominal pain occurred in about 7%, headache in 6% and injection site pain or reaction in about 4% of women.[9]
  • Blood clots and lung problems. Serious lung problems and blood clots, including stroke, have been reported with gonadotropins, and some cases were fatal. Vein inflammation with clots was seen in under 1% in the trial.[1][9]
  • Multiple pregnancy and other risks. Twins or more are a known risk with all gonadotropin treatments. Ovarian torsion (a twisted ovary), ectopic pregnancy and miscarriage are also listed on the label.[1]
  • Outside a fertility clinic. Since March 2020, menotropins no longer qualify for the compounding exemptions that let pharmacies make their own versions of a drug, so the licensed product is the legal source.[15] Products sold online for bodybuilding are outside any approved use.

Regulatory status

Today: HMG is FDA approved as Menopur for growing multiple follicles in assisted reproduction and is regulated as a licensed biological product.[1][2] HMG is not named on the 2026 WADA list or the 2027 list that starts January 1, 2027, but both ban chorionic gonadotrophin and LH in males and say their examples are not complete.[16][17]

  1. Initial U.S. approval of menotropins, as listed on the Menopur label.[1]
  2. Menopur was moved to a biologics license, and menotropins stopped qualifying for compounding pharmacy exemptions.[2][15]
  3. An updated Cochrane review found urine based gonadotropins and lab made FSH give similar live birth rates in women with polycystic ovary syndrome.[14]
  4. An updated Cochrane review found HMG probably gives slightly more live births than lab made FSH in IVF.[12]

Sources

  1. Ferring Pharmaceuticals. Menopur (menotropins for injection) prescribing information. U.S. Food and Drug Administration. 2014. FDA label
  2. U.S. Food and Drug Administration. List of Approved NDAs for Biological Products That Were Deemed to be BLAs on March 23, 2020. FDA list
  3. Büchter D, Behre HM, Kliesch S, Nieschlag E. Pulsatile GnRH or human chorionic gonadotropin/human menopausal gonadotropin as effective treatment for men with hypogonadotropic hypogonadism: a review of 42 cases. Eur J Endocrinol. 1998;139(3):298-303. PMID 9758439
  4. Muir CA, Zhang T, Jayadev V, Conway AJ, et al. Efficacy of Gonadotropin Treatment for Induction of Spermatogenesis in Men With Pathologic Gonadotropin Deficiency: A Meta-Analysis. Clin Endocrinol (Oxf). 2025;102(2):167-177. PMID 39445789
  5. Ziebe S, Lundin K, Janssens R, Helmgaard L, Arce JC; MERIT Group. Influence of ovarian stimulation with HP-hMG or recombinant FSH on embryo quality parameters in patients undergoing IVF. Hum Reprod. 2007;22(9):2404-2413. PMID 17640944
  6. Devroey P, Pellicer A, Nyboe Andersen A, Arce JC, et al. A randomized assessor-blind trial comparing highly purified hMG and recombinant FSH in a GnRH antagonist cycle with compulsory single-blastocyst transfer. Fertil Steril. 2012;97(3):561-571. PMID 22244781
  7. Witz CA, Daftary GS, Doody KJ, Park JK, Seifu Y, Yankov VI, Heiser PW; MEGASET-HR Trial Group. Randomized, assessor-blinded trial comparing highly purified human menotropin and recombinant follicle-stimulating hormone in high responders undergoing intracytoplasmic sperm injection. Fertil Steril. 2020;114(2):321-330. PMID 32416978
  8. Melo P, Eapen A, Chung Y, Jeve Y, et al. Controlled ovarian stimulation protocols for assisted reproduction: a network meta-analysis. Cochrane Database Syst Rev. 2025;7(7):CD012586. PMID 40590303
  9. Ferring Pharmaceuticals Inc. Menopur (menotropins) kit prescribing information. DailyMed, U.S. National Library of Medicine. Label revised May 2018. DailyMed
  10. Schaison G, Young J, Pholsena M, Nahoul K, Couzinet B. Failure of combined follicle-stimulating hormone-testosterone administration to initiate and/or maintain spermatogenesis in men with hypogonadotropic hypogonadism. J Clin Endocrinol Metab. 1993;77(6):1545-1549. PMID 8263139
  11. Kung AW, Zhong YY, Lam KS, Wang C. Induction of spermatogenesis with gonadotrophins in Chinese men with hypogonadotrophic hypogonadism. Int J Androl. 1994;17(5):241-247. PMID 7698849
  12. Berkhout RP, Kostova EB, van Wely M. Recombinant follicle stimulating hormone (rFSH) versus other recombinant or urinary gonadotropins for ovarian stimulation in assisted reproductive technology cycles. Cochrane Database Syst Rev. 2026;(7):CD005354.pub3. Cochrane CD005354
  13. Dahan MH, Schwarze JE, Gupta SS, Hayward B, et al. Comparative Effectiveness of Recombinant Human FSH:Recombinant Human LH in a 2:1 Ratio versus Highly Purified Human Menopausal Gonadotropin Alone in Ovarian Stimulation for Medically Assisted Reproduction Treatment Using in vitro Fertilization/Intracytoplasmic Sperm Injection: A Systematic Review and Meta-Analysis. Gynecol Obstet Invest. 2026;91(5):608-621. PMID 41729769
  14. Weiss NS, Kostova EB, Mol BWJ, van Wely M. Gonadotropins for ovulation induction in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2025;4(4):CD010290. PMID 40193219
  15. U.S. Food and Drug Administration. Notice to Compounders: Changes that affect compounding as of March 23, 2020. FDA
  16. World Anti-Doping Agency. The 2026 Prohibited List, section S2.2.1. WADA 2026
  17. World Anti-Doping Agency. The 2027 Prohibited List, section S2.2.1. In force January 1, 2027. WADA 2027
Medical disclaimer

This page is educational information only. It is not medical advice and does not replace care from a licensed medical provider. Do not use this page to decide whether to take any substance. Talk to a licensed medical provider first.

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