HMG info

[liftsiron]

Thanks rhinofight

Gonadotropin treatment for infertility
Examples
Brand Name Chemical Name
A.P.L., Pregnyl, Profasi
human chorionic gonadotropin (hCG)

Bravelle, Humegon, Metrodin, Pergonal, Repronex
human menopausal gonadotropin (hMG)

Follistim, Gonal-F
recombinant human follicle-stimulating hormone (rFSH)

The body produces two types of gonadotropins: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Once they are produced by the pituitary gland, gonadotropins trigger production of other sex hormones. Gonadotropins therefore play a part in egg and sperm production, as well as female and male physical traits such as voice, muscle, hair, and breast development.

Human menopausal gonadotropin (hMG) and recombinant human follicle-stimulating hormone (rFSH) are gonadotropin fertility drugs.

* hMG contains natural FSH and LH, purified from urine from postmenopausal women. (After menopause, women produce high levels of gonadotropins, which are excreted in their urine.)
* rFSH is genetically synthesized in the laboratory.

Human chorionic gonadotropin (hCG) is similar to LH; it contains equal amounts of LH and FSH. These hormones play a central role in egg production.
How It Works

In women. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are necessary for egg production (ovulation). Early in the menstrual cycle, a woman with low hormone levels who is not ovulating can have daily human menopausal gonadotropin (hMG) or recombinant human FSH (rFSH) injections for an average of 12 days. If this helps develop mature follicles, the ovary is ready to ovulate. One dose of human chorionic gonadotropin (hCG) is then used to stimulate ovulation.

In men with low testosterone and FSH. LH stimulates the production of testosterone, and FSH promotes the formation of sperm. If a semen analysis, LH, and FSH testing suggest that abnormal hormone levels are preventing sperm production, these gonadotropins may be prescribed to promote sperm formation together. hCG is injected 3 times weekly until blood testosterone level is within the normal range (this may take 4 to 6 months). Treatment continues with injections of hCG twice a week and hMG or FSH 3 times a week until the sperm count rises to normal levels.
Why It Is Used

Gonadotropins are given by injection to help the body make hormones needed for egg or sperm production.

In women. Gonadotropins may be used:1

* To stimulate ovulation related to low natural gonadotropin or estrogen levels. (This is most commonly seen in women with excessive exercise or eating disorders.)
* When clomiphene and metformin have been ineffective for correcting irregular or no ovulation caused by polycystic ovary syndrome (PCOS).
* For developing multiple egg follicles on the ovaries. Multiple eggs are harvested and used in assisted reproductive techniques such as in vitro fertilization or gamete intrafallopian transfer.
* In combination with intrauterine insemination for couples with unexplained infertility when clomiphene has not worked.

In men. Gonadotropin therapy can treat low sperm counts caused by low levels of natural gonadotropins.
How Well It Works

The combination human menopausal gonadotropin (hMG)/human chorionic gonadotropin (hCG) or recombinant human follicle-stimulating hormone (rFSH)/ hCG treatment can consistently stimulate ovulation. It results in pregnancy in 60% of women failing to ovulate. However, of those pregnancies, up to 35% end in miscarriage.2
Side Effects

Side effects are more common and more serious with gonadotropin treatment than with clomiphene (Clomid).

* Up to 35% of women who become pregnant after hMG/hCG or rFSH/hCG therapy have a miscarriage.2 This is higher than the risk of miscarriage in the general population.
* In 5% to 10% of treatment cycles, women develop detectable ovarian enlargement. Multiple follicles (cysts with eggs) make the ovaries larger and more tender.2
* There is a risk of ovarian hyperstimulation syndrome (OHSS), which (rarely) can be life-threatening. When closely monitored for side effects, however, a woman has less than a 1% risk of developing severe OHSS.2
* Ovarian stimulation increases the likelihood of multiple pregnancy (twins, triplets, or more). Multiple pregnancy is considered high-risk for both a mother and her fetuses.
* Other side effects include headache and abdominal pain.
* Men may experience temporary breast enlargement.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About

During gonadotropin treatment, frequent monitoring of egg follicle development is necessary.2 This is done with ultrasound and blood tests. Without careful monitoring, the ovaries may become hyperstimulated. Ovarian hyperstimulation syndrome can be a very serious condition. It usually goes away by itself in 2 to 4 weeks, but a woman may need bed rest or hospitalization and intravenous fluid therapy, or may need a procedure to remove fluid from the abdomen.

Gonadotropins should only be used by doctors who are specially trained in infertility and who are familiar with the management of possible complications.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.
References

Citations

1. Yao MWM, Schust DJ (2002). Treatment options section of Infertility. In JS Berek, ed., Novak''s Gynecology, 13th ed., pp. 1018–1036. Philadelphia: Lippincott Williams and Wilkins.
2. Mishell DR Jr (2001). Infertility. In MA Stenchever et al., eds., Comprehensive Gynecology, 4th ed., pp. 1169–1215. St. Louis: Mosby.
Author: Bets Davis, MFA Last Updated: April 7, 2006
Medical Review: Joy Melnikow, MD, MPH - Family Medicine
Kathleen Romito, MD - Family Medicine
Kirtly Jones, MD - Obstetrics and Gynecology

more info, different source:

Human Menopausal Gonadotropins (hMG)

If you're having difficulties getting pregnant because of menstrual irregularities, you may want to ask you're doctor about the fertility drug: Human menopausal gonadotropin (hMG). hMG is typically given to females undergoing fertility treatments like IFV and IUI to induce ovulation. hMG contains the luteinizing hormone (LH) and follicle-stimulating hormone (FSH)— the two crucial hormones needed to stimulate ovulation. hMG like the fertility drug Urofollitropin is extracted from the urine of post-menopausal women and then purified before use.

How hMG Works and Its Effectiveness

Human menopausal gonadotropins stimulate the pituitary gland to release the hormones: LH and FSH. These hormones released by hMG combine forces to aid in the development and release of the egg by a woman's follicles. Once the matured egg is released into the fallopian tubes, it is ready to be fertilized.

Help Treat

Human menopausal gonadotropins are most likely to increase the odds of conception, improving fertility in women who suffer from fertility problems including:

* Endometriosis
* Low levels of LH
* Low levels of FSH
* Ovary disorders like PCOS

Women who do not respond to the infertility drug Clomid can also use hMG.

Using HMG and Side Effects

Your doctor may recommend you to take human menopausal gonadotropins two to three days after your menstruation starts, for up seven to twelve days. Although, your dose of hMG will depend on your condition, the average dose of hMG recommended is between 75 and 600 IU per day. hMG are taken in the form of intramuscular injections.

A common side effect of hMG is hyperovarian stimulation. This occurs when the ovaries respond too well to the fertility drug. As a result the body releases multiple follicles into the ovaries. The release of multiple eggs can also increase the risk of multiple births by 40 percent while using hMG. Another side effect woman may notice while using this infertility drug to treat includes mood swings.

Here's some info about HCG so you can compare

What is Human Chorionic Gonadotropin?

Human Chorionic Gonadotropin (hCG) is a hormone that helps regulate the corpus lutem, a follicle that produces an egg for ovulation. hCG also stimulates the production of the two crucial hormones – estrogen and progesterone – needed to carry pregnancy to term. Normally, hCG is used in infertility treatments to trigger ovulation. hCG is extracted from the urine of pregnant women after being produced by the placenta.

How HCG Works

The HCG hormone works similar to the lutenizing hormone (LH) secreted by the pituitary gland. While the main function of LH is to the release the egg down the fallopian tube, hCG works to increase the number of eggs produced by the ovaries each month. With an increase number of eggs, the chance of fertilization increases.

Human Chorionic Gonadotropin Helps Treat

In women, human chorionic gonadotropin can help treat irregularities in ovulation, such as the following conditions:

* anovulation
* irregular menstruation
* polycystic ovary syndrome (PCOS)

In men, hCG can be used to increase the level of testosterones and sperm.

Taking hCG and Success Rates

hCG is taken in the form of an injection. Your fertility doctor will administer one dose of hCG during each cycle of your infertility treatment. Your fertility specialist may show you how and when to administer the injections yourself. But, either way your fertility doctor will need to monitor your progress, and will give you and your partner a guideline regarding timed intercourse, to increase chances of conception.

HCG has proven effective in inducing ovulation; in fact 90 percent of the women taking this fertility drug ovulate after receiving treatment. On average, hCG increases pregnancy rate by 15 percent per a cycle. But this percentage increases with the use of the artificial insemination procedure:IUI.

Side Effects and Risks of hCG

Like most fertility treatments, hCG may cause you to experience some side effects. Some common side effects and risks of hCG include:

* abdominal discomfort
* headaches
* mood changes
* nausea
* indigestion
* sore breasts
* tiredness
* water retention
* weight gain
* risk of multiple births

[Mr Incredible]

Good post, only thing id say was a little shakey in there was 4th para; hcg is like LH, it contains equal amounts of LH and FSH. That's not right in terms of fertility, if it was there would be no need for HMG. HCG mimmics LH period.

[liftsiron]

Good post, only thing id say was a little shakey in there was 4th para; hcg is like LH, it contains equal amounts of LH and FSH. That's not right in terms of fertility, if it was there would be no need for HMG. HCG mimmics LH period.

Good catch. Some hcg info:

From Wikipedia, the free encyclopedia

Chorionic gonadotropin, beta polypeptide




Human chorionic gonadotropin or human chorionic gonadotrophin (hCG) is a glycoprotein hormone produced in pregnancy that is made by the developing embryo after conception and later by the syncytiotrophoblast (part of the placenta).[1] Its role is to prevent the disintegration of the corpus luteum of the ovary and thereby maintain progesterone production that is critical for a pregnancy in humans. hCG may have additional functions; for instance, it is thought that hCG affects the immune tolerance of the pregnancy. Early pregnancy testing, in general, is based on the detection or measurement of hCG. Because hCG is produced also by some kinds of tumor, hCG is an important tumor marker especially (with clinical significance) in Gestational trophoblastic disease,[2] but it is not known whether this production is a contributing cause or an effect of tumorigenesis.
Contents


Human chorionic gonadotropin is a glycoprotein composed of 244 amino acids with a molecular mass of 36.7 kDa. Its total dimensions are 75×35×30 Ångströms (7.5×3.5×3 nanometers).

It is heterodimeric, ]] is 92 amino acids long and has dimensions 60×25×15 Ångströms (6×2.5×1.5 nm).

* The β-subunit of hCG gonadotropin contains 145 amino acids and has dimensions 6.5×2.5×2 nm, encoded by six highly-homologous genes that are arranged in tandem and inverted pairs on chromosome 19q13.3 - CGB (1, 2, 3, 5, 7, 8).

The two subunits create a small hydrophobic core surrounded by a high surface area-to-volume ratio: 2.8 times that of a sphere. The vast majority of the outer amino acids are hydrophilic.
[edit] Function

Human chorionic gonadotropin interacts with the LHCG receptor and promotes the maintenance of the corpus luteum during the beginning of pregnancy, causing it to secrete the hormone progesterone. Progesterone enriches the uterus with a thick lining of blood vessels and capillaries so that it can sustain the growing fetus. Due to its highly-negative charge, hCG may repel the immune cells of the mother, protecting the fetus during the first trimester. It has also been hypothesized that hCG may be a placental link for the development of local maternal immunotolerance. For example, hCG-treated endometrial cells induce an increase in T cell apoptosis (dissolution of T-cells). These results suggest that hCG may be a link in the development of peritrophoblastic immune tolerance, and may facilitate the trophoblast invasion, which is known to expedite fetal development in the endometrium.[3] It has also been suggested that hCG levels are linked to the severity of morning sickness in pregnant women.[4]

Because of its similarity to LH, hCG can also be used clinically to induce ovulation in the ovaries as well as testosterone production in the testes. As the most abundant biological source is women who are presently pregnant, some organizations collect urine from pregnant women to extract hCG for use in fertility treatment.

Human chorionic gonadotropin also plays a role in cellular differentiation/proliferation and may activate apoptosis.[5]


Like other gonadotropins, hCG can be extracted from urine or by genetic modification. Pregnyl, Follutein, Profasi, Choragon and Novarel use the former method, derived from the urine of pregnant women. Ovidrel, on the other hand, is a product of recombinant DNA.

[Mr Incredible]

Hmg is certainly an interesting one, its conceivable to use it place of hcg while on cycle, in fact its probably better because it causes much less estrogen stimulation. Problem is its very pricey and you would get more bang for your buck using hcg (for bbing purposes not fertility) along with a good AI and easier availability. Over time though I think hmg will become cheaper and replace hcg

[MR. BMJ]

Mr. I, I agree, with all accounts stated. If it were not so damn expensive, i think more people would use it more often. The HCG/HMG combo is very good for fertility issues. I've talked to a few that have been able to keep it at 32.5-75iu 3x/wk to EOD dosing, with HCG on the other days, and boom, they knock up their SO in no time.

BMJ