hMG
Human Menopausal Gonadotropin (Menotropin) · HMG · Menotropin · Menotrophin · Menopur · Merional
Urine-derived FSH plus LH activity, added to hCG when sperm counts will not recover.
Typical dose
75 IU
3x per week
Range
75–150
IU
Half-life
—
see Dosing
Evidence
Human trials
Subcutaneous · Intramuscular
What it is
hMG is a purified gonadotropin preparation extracted from the urine of postmenopausal women. Each vial is standardised to contain equal FSH and LH bioactivity, usually 75 IU of each, with the LH side of the ledger topped up using hCG in most modern preparations. It is a licensed fertility drug, not a research chemical.
In men it exists to supply the half of the signal that hCG cannot. hCG replaces LH action at the Leydig cells, but Sertoli cells need FSH, and men whose spermatogenesis has not returned on hCG alone after several months are the population hMG is for. The standard approach is hCG first for three to six months, then hMG added at 75 to 150 IU three times a week.
This is a slow, expensive, blood-test-driven project rather than something to bolt onto a PCT. Spermatogenesis takes roughly 72 days per cycle, and the published male fertility protocols run 6 to 24 months before drawing conclusions. Recombinant FSH is the cleaner alternative where cost allows.
How it works
The FSH component binds Sertoli cell receptors in the seminiferous tubules, driving the support functions that developing germ cells depend on, including androgen-binding protein production and the maturation of spermatids. FSH alone does very little in a man whose intratesticular testosterone is on the floor, which is why hMG is essentially always run on top of hCG rather than by itself.
The LH activity in the preparation, largely contributed by added hCG in products like Menopur, provides some Leydig cell stimulation as well, but the amount is small relative to a normal hCG dose. Do not treat 75 IU of hMG as 75 IU of hCG: the bioassay units are matched for activity, not for the actual hormone content or duration of action.
Dosing
hMG is standardised by FSH and LH bioactivity, not by mass: vials are labelled 75 IU or 150 IU and the bulk of the powder is lactose, so there is no meaningful mg-per-vial or IU-per-mg figure; the vial strengths are carried in vialSizesIu instead. Dose entirely in IU.
Reconstitution calculator
Pre-loaded with hMG’s vial size, water volume and typical dose. Change anything.
Typical: 75 IU · range 75–150
Draw to
100 u
1 mL · 75 IU
Concentration
75 IU/mL
0.75 IU per unit
Doses per vial
1
Vial lasts
2.3 days
CheckThe draw fills more than 90% of the barrel. Workable, but there is no room for an air bubble or a correction.
Once mixed
Use immediately. The supplied diluent is unpreserved and the US label directs discarding any unused portion, though multi-dose EU presentations allow up to 28 days refrigerated once mixed.
A 75 IU vial is normally reconstituted with 1 mL of diluent, and several vials can be drawn up into the same 1 mL if a 150 IU dose is wanted. The supplied saline diluent contains no preservative, so a reconstituted vial is a single-use item; swirl gently until clear and never shake.
Storage
Before mixing
Store between 3 and 25 °C protected from light for the labelled shelf life; refrigeration is fine and preferable in a warm climate.
After mixing
Use immediately. The supplied diluent is unpreserved and the US label directs discarding any unused portion, though multi-dose EU presentations allow up to 28 days refrigerated once mixed.
Reported benefits
- ▪Supplies the FSH signal that hCG cannot, which is what stalled spermatogenesis usually lacks
- ▪Combined hCG plus FSH restores spermatogenesis in roughly 86 percent of hypogonadotropic men versus about 40 percent on hCG alone
- ▪Pharmaceutical-grade licensed product with real batch standardisation, unlike grey-market peptides
- ▪Also carries some LH activity, so it adds a small amount of Leydig cell stimulation
- ▪Three injections a week is a manageable schedule alongside existing hCG dosing
- ▪Progress is objectively measurable on semen analysis and FSH bloods
Side effects
- ▪Injection-site pain, redness and swelling, more common than with hCG
- ▪Gynecomastia and rising estradiol, driven mainly by the hCG and LH activity in the preparation
- ▪Acne, oily skin and mood changes
- ▪Headache, fatigue and abdominal discomfort
- ▪Rare hypersensitivity reactions, since this is a urine-derived protein preparation
- ▪Expensive, and the response takes many months to show up on a semen analysis
- ▪Serious pulmonary conditions and thromboembolic events, a labelled menotropin warning and the one serious risk on the label that is not specific to women
Do not use if
- ▪Androgen-dependent or gonadotropin-dependent tumours, including prostate cancer
- ▪Known hypersensitivity to menotropins or urine-derived protein preparations
- ▪Untreated thyroid, adrenal or pituitary disease
- ▪Primary testicular failure, where no amount of gonadotropin will produce a response
Evidence level — Human trials
Controlled human clinical data exists.
Prescription-only licensed fertility medicine in essentially every market. The current US Menopur label is approved only for development of multiple follicles and pregnancy in ovulatory women as part of an ART cycle — there is no US male indication, so use in men is off-label; a male spermatogenesis indication existed on older menotropin products such as Pergonal and survives on some European menotropin labels.
Commonly run with
hMG FAQ
Do I need hMG if I am already running hCG?+
Not usually. Most men maintaining testicular function on TRT or a cycle do fine on hCG alone. hMG becomes relevant when a semen analysis after several months of hCG still shows azoospermia or very low counts, which means the missing piece is FSH rather than LH signalling.
hMG or recombinant FSH?+
Recombinant FSH is purer, more consistent batch to batch and free of the added hCG that hMG preparations carry, but it costs considerably more. Comparative work in men with congenital hypogonadotropic hypogonadism has not shown a decisive advantage for either, so cost and availability usually decide it.
How long before I see anything?+
Months, not weeks. One spermatogenic cycle takes about 72 days, and published protocols in hypogonadotropic men typically run 6 to 24 months before a final verdict. Repeating a semen analysis at 6 weeks will tell you nothing useful.
Can I use hMG as a PCT drug?+
It is a poor fit. PCT is a matter of weeks and aims to restart the pituitary, whereas hMG bypasses the pituitary entirely and takes months to move a sperm count. It belongs in a supervised fertility protocol, not a post-cycle bridge.
References
- 1.Pulsatile GnRH or human chorionic gonadotropin/human menopausal gonadotropin as effective treatment for men with hypogonadotropic hypogonadism: a review of 42 cases — European Journal of Endocrinology (1998) PMID 9758439
- 2.Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis — European Journal of Endocrinology (2024) PMID 38128110
- 3.Efficacy of follitropin-alpha versus human menopausal gonadotropin for male patients with congenital hypogonadotropic hypogonadism — Turkish Journal of Urology (2020) PMID 31905120
- 4.MENOPUR (menotropins for injection) US prescribing information — FDA prescribing information (2018)
More hpta & fertility
Gonadorelin
Native GnRH decapeptide, now the usual compounded stand-in for hCG on TRT.
200 mcg · 1-2x daily
hCG
LH-mimic that keeps the testes producing while exogenous androgens shut the axis down.
500 IU · Every other day, or 2-3x per week
Kisspeptin-10
Upstream GnRH trigger — the switch that makes the hypothalamus fire and the pituitary release LH.
50 mcg · 3x weekly on non-consecutive days
Triptorelin
Long-acting GnRH agonist taken as one microdose to fire off a large LH and FSH surge.
100 mcg · Single one-off dose