Strong evidence · Grade A
HMG
HMG (Human Menopausal Gonadotropin)
Score
80 / 100
Class
Gonadotropin (FSH+LH)
Approved
Ovulation / IVF
Status
FDA-approved (prescription)
TL;DR
01
Human menopausal gonadotropin is a purified preparation with both FSH and LH activity, an FDA-approved fertility medicine (e.g., Menopur).
02
It is used to stimulate the ovaries for IVF and ovulation induction, and its efficacy is well established.
03
A large Cochrane review found it produces live-birth rates equivalent to the newer recombinant FSH, so the choice usually comes down to cost and convenience.
04
It is a fertility drug that requires medical monitoring — ovarian hyperstimulation (OHSS) is a real risk.
05
Off-label use in men (for fertility/testosterone) is less well evidenced than its established fertility indication in women.
Approved use
Ovulation / IVF
well established
vs recombinant FSH
Equivalent
live birth, Cochrane 42 trials
Live birth rate
No difference
vs rFSH
OHSS
Monitored risk
requires supervision
Type
FSH + LH activity
urinary-derived / purified
Part 01 · How it works
Mechanism.
HMG supplies both of the pituitary hormones that drive the ovaries — FSH (which grows follicles) and LH (which supports maturation). Given by injection in a fertility cycle, it stimulates the ovaries to develop multiple eggs for IVF or to induce ovulation. It's a long-established, effective fertility drug: a big Cochrane review found it gives the same live-birth rates as the newer, lab-made recombinant FSH. Because it makes the ovaries work hard, it needs careful monitoring to avoid overstimulation.
A two-in-one ovary-stimulating signal (FSH + LH) for fertility treatment — as effective as the pricier recombinant version, and needing the same careful oversight.
FSH + LH activity
Purified gonadotropin preparation providing both follicle-stimulating and luteinizing activity.
Ovarian stimulation
Drives multi-follicular development for IVF or monofollicular ovulation induction.
Equivalence to rFSH
Cochrane meta-analysis (42 trials, ~9,600 couples): no difference in live birth or OHSS vs recombinant FSH.
Monitoring
Requires ultrasound/hormone monitoring to titrate dose and limit OHSS.
Part 02 · Dosing & administration
How it's taken.
Clinical · trial-validatedValues below describe how HMG has been administered in human clinical trials and/or approved labeling. Provided for educational purposes only — this is not medical advice and not instructions for self-administration. Consult your healthcare provider before making any health decision.
Fertility cycle
Individualized (IU)
Titrated to ovarian response under monitoring; not a fixed regimen.
·
Doses below are from fertility protocols, not instructions.
·
Dosing is individualized to ovarian response with ultrasound/hormone monitoring.
·
Requires specialist supervision to manage OHSS and multiple-pregnancy risk.
Need help with reconstitution?
Use the free peptide calculator for dilution, unit conversion, and injection volume.
Part 03 · Safety
Side effects, rare serious events, who shouldn't.
Common
Injection-site reactions
Generally mild.
Common
Bloating / pelvic discomfort
From ovarian stimulation.
Common
Headache / mood changes
Hormonal effect.
Occasional
Serious · rare
Ovarian hyperstimulation syndrome (OHSS)
Can be serious; the key reason for supervised use.
Monitored
Multiple pregnancy
A recognized risk of ovarian stimulation.
Increased
Thromboembolism
Associated with severe OHSS.
Rare
Absolute · do not use
×
Hormone-sensitive cancers
×
Pregnancy (except under specific fertility protocols)
×
Known hypersensitivity to HMG, urinary-derived gonadotropins, or any component
×
Undiagnosed uterine bleeding
×
Ovarian cysts or enlargement not due to PCOS
×
Primary ovarian failure or primary testicular failure
×
Adrenal or thyroid dysfunction (must be corrected first)
Relative · discuss first
!
Use outside a monitored fertility program — OHSS/multiple-pregnancy risk
!
Hormone-sensitive tumors — contraindicated
!
Uncontrolled thyroid/adrenal dysfunction — address first
!
Off-label male/optimization use — weaker evidence, clinician-directed only
Interactions
Clomiphene citrate
Often used in combination for fertility but increases risk of ovarian hyperstimulation syndrome (OHSS)
Moderate
GnRH agonists/antagonists
Used together in controlled ovarian stimulation protocols; requires careful timing and monitoring
Moderate
Anticoagulants
OHSS risk includes thromboembolic events; anticoagulation management may need adjustment
Moderate
Labs to monitor
Estradiol (E2)
Baseline and during stimulation cycles
HMG contains FSH and LH activity — stimulates estrogen production
Total and Free Testosterone
Baseline and per protocol
LH component stimulates testosterone
FSH and LH
Baseline
Baseline gonadotropin levels and response monitoring
Semen Analysis
Baseline and at 3-6 months
If used for male fertility
Pelvic Ultrasound
Per fertility protocol
Monitor follicular development in women (if applicable)
CMP (Comprehensive Metabolic Panel)
Baseline
General metabolic safety
Part 04 · Evidence
How strong is the evidence?
80
Grade A
Grade A for its approved fertility use — a long-established, effective gonadotropin with high-quality meta-analytic evidence of equivalence to recombinant FSH. Limits: it's fertility-specific and monitoring-dependent, and male/off-label uses are less well evidenced.
Mechanistic plausibility
Directly supplies the FSH/LH drive for folliculogenesis.
86
Human evidence
Large Cochrane meta-analysis; decades of fertility use.
85
Safety & tolerability
Well characterized; OHSS and multiple-pregnancy risks require monitoring.
76
Durability
Cycle-based use; outcomes are event (pregnancy) based.
74
Independence
Independent Cochrane synthesis; broad clinical use.
76
Part 05 · Research log
Every study we cite.
We list each study with its methodology, funding source, and our quality grade. Flagged studies aren't dismissed — they're tagged so you can weigh them.
01
2011
Cochrane Database Syst Rev Flagged
Recombinant vs urinary gonadotrophin (incl. HMG) for ovarian stimulation — Cochrane review
No statistically significant difference in live birth rate (OR 0.97) or OHSS between recombinant FSH and urinary gonadotrophins including HMG; choice should depend on availability, convenience, and cost.
Meta-analysis of 42 RCTs · n = 9,606 · Independent Cochrane synthesis of a large trial base.
PMID 21328276 ↗
High (independent)
Evidence against
What didn't work, and where the evidence is thin.
Every publication is incentivized to tell you a peptide works. We catalogue the null results, failed trials, and mechanism limits we found in the same literature — so you can weigh them against the upside, with your provider.
01
Fertility-specific and monitoring-dependent
Mechanism limit Cochrane Database Syst Rev · 2011
HMG's strong evidence is confined to ovarian stimulation for fertility, and it requires monitoring (OHSS, multiple-pregnancy risk). It is not a general hormonal-optimization tool.
What this means: Its Grade-A evidence does not transfer to non-fertility uses; it belongs in a supervised fertility program.
PMID 21328276 ↗
02
Male/off-label use is less evidenced
Mechanism limit off-label context · 2011
Using HMG in men (for fertility or testosterone) or for other off-label goals rests on much thinner evidence than its established female fertility indication.
What this means: Off-label gonadotropin use should be clinician-directed and not assumed to carry the same evidence weight as the approved indication.
Part 06 · Cost & access
Where it's available, at what price.
United States
FDA-approved
Rx for ovulation induction/IVF (e.g., Menopur) within fertility care.
Fertility-clinic pricing
European Union
Approved
Approved fertility use; prescription-only.
Varies
United Kingdom
Approved
Fertility use via specialist services.
NHS/private
Canada
Approved
Approved fertility use.
Varies
The Peptide Column takes no affiliate commission from any source. HMG is a prescription fertility medicine used under specialist monitoring; off-label uses are less evidenced. We link only to clinician-directed care, never to sellers.
Part 07 · Your appointment
Questions to bring.
01
Is HMG or recombinant FSH more appropriate for my fertility treatment?
02
What monitoring (ultrasound, estradiol levels) is needed during HMG treatment?
03
What is my risk of ovarian hyperstimulation syndrome with HMG?
04
How does HMG compare to HCG for male fertility purposes?
05
What is the expected timeline for spermatogenesis recovery with HMG?
06
Are there risks of multiple pregnancies with HMG-based protocols?
References
Every citation, numbered.
Citation list. For our editorial read of each study — including bias flags and quality grades — see the Research log above.
- 01. Recombinant vs urinary gonadotrophin (incl. HMG) for ovarian stimulation — Cochrane review · Cochrane Database Syst Rev, 2011 · PMID 21328276 ↗
- 02.