Menotropin

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Menotropin
Secondary to quaternary structure Mixture of substances
Identifier
External IDs
Drug information
ATC code G03 GA02
DrugBank DB00032
Drug class Gonadotropins

Menotropin (human Meno pausengonado atropine , hMG) is a drug used to treat fertility problems in women. It is obtained from human urine from postmenopausal women e.g. B. obtained from China and South America and contains the two gonadotropins LH and FSH . It was used as early as the 1980s to directly stimulate the ovaries (for egg production and egg maturation).

Although human menopausal gonadotropin (hMG) is highly purified, the risk of transmission of pathogens of known and unknown nature cannot be completely ruled out. Complete traceability of the urine donors is not possible.

Menotropin leads to multiple pregnancies in around 20% of the women treated.

Biotechnologically produced recombinant FSH (rFSH) and LH (rLH) can also be used for fertility disorders . The study results, which compare the effectiveness of menopausal gonadotropins (hMG) with recombinant FSH (rFSH), are contradicting and depend on the various questions and study groups examined. An evaluation of some relevant studies showed that in vitro fertilization (IVF) with human menopausal gonadotropin (hMG) leads to higher live birth rates than treatments with recombinant follicle-stimulating hormone (rFSH). In these studies, the majority of courses of treatment were performed with hMG. The pooled analysis from two large randomized, controlled studies showed that hMG leads to significantly higher pregnancy rates than rFSH in IVF cycles.

Regarding the number of oocytes obtained and the pregnancy rate, however, better results for urinary products were obtained in some studies and better results for recombinant products in other studies. A large-scale meta-analysis, which takes into account the various studies, therefore comes to the conclusion that there is no significant difference between urinary and recombinant products with regard to the pregnancy rate.

Finished medicinal products

Menogon ® ( D ), Merional ® ( A , CH ), Menopur ® ( A , CH , USA and others), Fostimon ® ( A , CH ) Repronex ® ( CND )

Web links

Individual evidence

  1. ↑ a b Documed AG: compendium.ch. March 11, 2011, accessed July 20, 2015 .
  2. ↑ Lois Jovanovic, Genell J. Subak-Sharpe: Hormones. The medical manual for women. (Original edition: Hormones. The Woman's Answerbook. Atheneum, New York 1987) From the American by Margaret Auer, Kabel, Hamburg 1989, ISBN 3-8225-0100-X , p. 142 f. and 383 (to Pergonal ).
  3. ^ A b A. Van Dorsselaer, C. Carapito, F. Delalande, C. Schaeffer-Reiss, D. Thierse, H. Diemer, DS McNair, D. Krewski, NR Cashman: Detection of prion protein in urine-derived injectable fertility products by a targeted proteomic approach. In: PloS one. Volume 6, number 3, 2011, p. E17815, doi: 10.1371 / journal.pone.0017815 . PMID 21448279 , PMC 3063168 (free full text).
  4. ^ A b A. Coomarasamy, M. Afnan, D. Cheema, F. van der Veen, PM Bossuyt, M. van Wely: Urinary hMG versus recombinant FSH for controlled ovarian hyperstimulation following an agonist long down-regulation protocol in IVF or ICSI treatment: a systematic review and meta-analysis. In: Hum Reprod. 23 (2), Feb 2008, pp. 310-315. PMID 18056719 .
  5. ↑ a b H. G. Al-Inany, AM Abou-Setta, MA Aboulghar, RT Mansour, GI Serour: Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a meta-analysis. In: Reprod Biomed Online. 16 (1), Jan 2008, pp. 81-88. PMID 18252052 .
  6. ↑ a b P. Platteau, A. Nyboe Andersen, A. Loft, J. Smitz, P. Danglas, P. Devroey: Highly purified HMG versus recombinant FSH for ovarian stimulation in IVF cycles. In: Reprod Biomed Online. 17 (2), Aug 2008, pp. 190-198. PMID 18681992 .
  7. ↑ A. Demirol, T. Gurgan: Comparison of different gonadotrophin preparations in intrauterine insemination cycles for the treatment of unexplained infertility: a prospective, rand. In: humrep.oxfordjournals.org. Retrieved July 20, 2015 .
  8. ↑ M. Ludwig: Efficacy of recombinant human FSH compared to urinary hMG after downregulation in the long protocol - An analysis of 24,764 ART cycles in Deut. In: researchgate.net. December 31, 2002, accessed July 20, 2015 .
  9. ↑ a b P. Lehert, JC Schertz, D. Ezcurra: Recombinant human follicle-stimulating hormone produces more oocytes with a lower total dose per cycle in assisted reproductive technologies compared with highly purified human menopausal gonadotrophin: a meta-analysis. In: Reproductive biology and endocrinology: RB&E. Volume 8, 2010, p. 112, doi: 10.1186 / 1477-7827-8-112 . PMID 20846363 , PMC 2954883 (free full text) (review).