HMG Reconstitution Calculator

Evidence level: randomized controlled trial (non-inferiority study)

Yes. Highly purified human menopausal gonadotropin (HP‑hMG; Menopur®) is FDA‑approved for ovarian stimulation in women undergoing infertility treatment. A 2026 trial confirmed that the pre‑filled pen formulation is non‑inferior to the US‑approved powder for the number of fertilized oocytes, and a ready‑to‑use liquid pen provides bioequivalent FSH exposure to powder.

Evidence level: community protocol

hMG is injected subcutaneously, either as a reconstituted powder or via a pre‑filled pen. The pen delivers the same efficacy as the powder with fewer injection‑site reactions and greater convenience (community protocol). Intramuscular administration is also possible but less common. Typical daily doses range from 75 IU to 450 IU depending on ovarian reserve and response, with stimulation usually lasting 9–13 days.

Evidence level: meta-analysis of RCTs and clinical guideline

A large 2026 meta‑analysis (56 RCTs, 14,034 women) showed that LH‑containing gonadotropins (including hMG) result in little to no difference in live birth rate or ongoing pregnancy rate compared with recombinant FSH (rFSH) alone. hMG retrieves a slightly lower number of oocytes (mean difference –0.50) but probably does not increase the risk of ovarian hyperstimulation syndrome (OHSS) (RR 0.80, 95% CI 0.61–1.03; moderate certainty). The ESHRE 2025 guideline acknowledges that hMG is a suitable alternative to rFSH, particularly when LH activity is clinically desirable.

Evidence level: cohort study and randomized controlled trial

Yes. In men with hypogonadotropic hypogonadism (HH) and non‑obstructive azoospermia, combined hCG/hMG therapy can induce spermatogenesis. A 2026 cohort of 35 HH‑related azoospermic men treated with hCG ± rFSH/hMG for a mean of 12 months reported sperm appearance in the ejaculate in 77%, and microTESE retrieved sperm in 88% of persistent azoospermia. In male adolescents with congenital HH, hCG/hMG was as effective as a GnRH pump in promoting puberty and testicular growth, with sustained spermatogenesis over 12 months.

Evidence level: meta-analysis of RCTs and guideline

hMG carries a lower risk of moderate/severe OHSS than rFSH‑only stimulation. In the meta‑analysis, the pooled RR for OHSS was 0.80 (95% CI 0.61–1.03; moderate certainty) favoring LH‑containing gonadotropins. ESHRE guidelines recommend considering LH activity (as provided by hMG) in predicted high responders as part of a freeze‑all strategy to reduce OHSS risk.

Evidence level: community protocol

Unreconstituted hMG powder should be stored at room temperature (20–25°C). After reconstitution, the solution must be used immediately; discard any unused portion (community protocol). The newer liquid‑formulation pre‑filled pen does not require refrigeration and remains stable at room temperature. Always check the specific product labeling for exact storage conditions.