Human menopausal gonadotropins (hMG),
Human menopausal Gonadotopin (hMG), a mixture of FSH and LH (in various dosages) derived from the urine of postmenopausal women
Brand names: Pergonal, Repronex, Menogon, Merional, Menopur, Metrodin, Bravelle, Fertinex,
It is a freeze-dried powder available in packs of 1, 5 or 10 ampoules. Each ampoule contains 75 IU of human follicle-stimulating hormone (FSH) and various doses of human luteinising hormone (LH) depends on the specific drug.
The injection is taken usually as an intramuscular injections, (but can also be given subcutaneously, depends on the specific drug) once a day unless instructed otherwise.
Dosages can vary from woman to woman and from cycle to cycle, however, a typical dosage is between 75 and 450 IU/day. Since the half life of the drug is around 32 hours, there is no need to inject every day, exactly on the same time.
Human menopausal Gonadotopin (hMG),for injection should not be used by women who:
• Already have high levels of FSH (indicating another reason for infertility)
• Have uncontrolled thyroid and adrenal gland dysfunction
• Have any lesion inside the head such as a pituitary tumour
• Have undiagnosed abnormal vaginal bleeding
• Have ovarian cysts or enlargement
• Are pregnant
How to Store the Medicine
Drugs should be stored below 25°C in a dark place such as a cupboard. Once the medicine is reconstituted (made up with solvent) it should be used immediately.
It is important not to use the medicine after the date shown on the ampoule or carton label.
Side effects: In women, this medication may cause fever, breathing trouble, bloating, stomach pain, enlarged ovaries or a skin rash.
Instructions how to prepare the injection
Gonadotropins in ampules (Pergonal, and Fertinex)
1. To open ampule, hold the ampule with the dot facing away from you and wrap gauze around the neck of the ampule.
2. Grasp the top of the ampule between your thumb and index finger. Carefully snap the top off by pulling it back towards yourself.
3. Using a 22G, 1½" needle, withdraw 1cc of sterile water or diluent.
4. Squirt the water into the first amp of medication, aiming toward the side of the amp. Allow the powder to dissolve, swirling gently if needed.
5. Withdraw the entire mixture.
6. Squirt the water into the next amp, again aiming towards the side of the amp. Continue repeating steps 4 and 5 until all of the necessary ampules of medication have been mixed.
7. When you are finished mixing, you should have 1cc of mixture.
8. Remove any air bubbles.
9. Recap the needle and exchange for a 27G, ½" needle for subcutaneous injection or for 22G, 1½" needle for intramuscular injection.
Gonadotropins in vials (Repronex, and Bravelle)
1. Flip the plastic cap off the vials and wipe the top of each vial with rubbing alcohol.
2. Using a 22G, 1½" needle, pull back on the plunger to the 1cc mark. Insert the needle into the vial of water or diluent and inject the air.
3. Invert the bottle and withdraw 1cc of water or push the needle all the way into the vial and withdraw 1cc of water. Either method is acceptable, but please be sure that the needle tip is in the water.
4. Remove any air bubbles by tapping on the barrel of the syringe and pushing the air out once it reaches the top.
5. Inject the water into the first vial of medication, aiming toward the side of vial. Allow the powder to dissolve, swirling gently if needed.
6. Withdraw the entire mixture.
7. Squirt the water into the next vial, again aiming toward the side. Continue repeating steps 5 and 6 until all of the necessary vials of medication have been mixed.
8. Remove any air bubbles. You should have 1cc of mixture.
9. Recap the needle and exchange for a 27G, ½" needle for injection.
Instructions how to inject the drug
Intramuscular Injection Technique (IM)
1. Choose an injection site in the upper outer quadrant of the rear end, just behind the hip bone.
2. Wipe the injection site with an alcohol swab and allow to dry completely.
3. Using your non-dominant hand, pull the skin taut.
4. Holding the syringe in your dominant hand like you would hold a pen, inject at a 90-degree angle with one swift motion.
5. Withdraw slightly on the plunger to check for blood. (If blood appears, remove the syringe and apply pressure to the injection site. Choose a new site and begin again.)
6. Inject the fluid slowly.
7. Remove the syringe and apply pressure to the injection site.
Subcutaneous Injection Technique (SC)
1. Choose an injection site on the thigh, abdomen, or outer part of the arm. (Note: We recommend the abdomen.)
2. Wipe the injection site with an alcohol swab and allow to dry completely.
3. Using your non-dominant hand, squeeze an area of fatty tissue.
4. Holding the syringe in your dominant hand like you would hold a pen, inject the needle quickly at a 90-degree angle.
5. Withdraw the plunger slightly to check for blood. (If blood appears, remove the syringe and apply pressure to the injection site. Choose a new site and begin again.)
6. Inject the fluid slowly.
7. Remove the needle and apply pressure to the injection site.
