Menopur (menotropins) is a fertility injection that supplies two hormones — FSH (follicle-stimulating hormone) and LH (luteinizing hormone).
These hormones help your ovaries grow multiple eggs at once during IVF stimulation. Most patients inject 75 to 300 IU daily for 8 to 14 days, depending on their age, ovarian reserve, and response. Menopur is one of the most widely used “add-on” or standalone stimulation drugs. A meta-analysis of 7 randomized trials (2,159 women) found that urinary hMG (human menopausal gonadotropin) was associated with a 4% absolute increase in live birth rate compared with recombinant FSH. The effect was seen in certain IVF-ICSI (intracytoplasmic sperm injection) protocols.
Data in this article is sourced from peer-reviewed medical literature (including Coomarasamy et al., Human Reproduction, 2008; Al-Inany et al., Gynecological Endocrinology, 2009), the Menopur prescribing information, public ASRM guidance, and the CDC National ART Surveillance System. The article was compiled by the ProIVF Medical Editorial Team and reviewed by the ProIVF Medical Advisory Board.
What Does Menopur Do?
Menopur contains menotropins, a purified extract of human menopausal gonadotropin (hMG) from the urine of postmenopausal women. The key ingredients are:
- FSH (follicle-stimulating hormone): the main driver of follicle growth — it tells the ovaries to recruit and mature multiple follicles.
- LH (luteinizing hormone): supports the cells around the egg (theca cells) that produce the hormones needed for final egg maturation.
Most fertility medications provide FSH alone. Menopur’s defining feature is that it also delivers LH activity. This matters for patients whose own LH is low — for example, after down-regulation with a GnRH (gonadotropin-releasing hormone) agonist, which suppresses natural LH production.
How Menopur Fits Into an IVF Protocol
Menopur is used during the stimulation phase — the 8–14 days of injections before egg retrieval. In agonist protocols, down-regulation happens first: a GnRH agonist temporarily switches off the pituitary’s own FSH and LH, so the clinic controls when follicles develop.
For a full overview of the medications used in an IVF cycle, see our guide to IVF medications.
| Protocol type | Typical Menopur role |
|---|---|
| Antagonist protocol | FSH-only drugs (like Gonal-F or Follistim) or Menopur alone, or a mix of both |
| Agonist (long Lupron) protocol | Often Menopur alone, because down-regulation suppresses LH and Menopur supplies it |
| PCOS (polycystic ovary syndrome) or high-responder | Lower doses (75–150 IU); may be combined with FSH-only drugs |
| Low ovarian reserve | Higher doses (300 IU or more); may be combined with FSH-only drugs |
| Egg freezing | Same stimulation drugs; Menopur may be used alone or combined |
Your clinic decides the dose and whether to combine Menopur with an rFSH (recombinant FSH) drug based on your age, AMH (anti-Müllerian hormone), antral follicle count, and previous response.
Typical Menopur Dosing and Injection Schedule
How much Menopur is used?
Menopur comes in vials of 75 IU and 150 IU, which are mixed with a diluent and injected subcutaneously (just under the skin). The usual sites are the abdomen or thigh.
| Patient profile | Typical daily dose |
|---|---|
| Young, normal reserve | 75–150 IU |
| Average response | 150–225 IU |
| Low AMH, older age, or previous poor response | 300 IU or higher |
| PCOS or high-responder risk | 75–150 IU, often with close monitoring |
Doses are almost always individualized. The exact number of days depends on ultrasound and blood test monitoring, which happens every 1–3 days during stimulation.
How to inject Menopur
- Mix the powder and diluent just before injection — do not prepare it in advance.
- Rotate injection sites in the abdomen and thigh to reduce soreness.
- Inject slowly and pinch the skin firmly while inserting the needle at a 45-degree angle.
- Follow the exact time your clinic recommends for the daily injection — usually in the evening, so that monitoring blood tests can be scheduled in the morning.
For a step-by-step guide to self-injection, see our IVF injections guide.
Menopur vs Gonal-F: What’s the Difference?
This is the most common question patients ask, and the answer comes down to one ingredient: LH.
| Feature | Menopur (hMG) | Gonal-F / Follistim (rFSH) |
|---|---|---|
| Hormones | FSH + LH | FSH only |
| Source | Purified from human menopausal urine | Recombinant (lab-made) |
| Injection | Subcutaneous | Subcutaneous |
| Typical dose | 75–300 IU daily | 150–450 IU daily |
| LH support | Yes — useful after down-regulation | No — relies on your own LH |
Does the LH in Menopur matter?
Research suggests it can. A meta-analysis of 7 randomized trials in 2,159 women found that urinary hMG was associated with a 4% absolute increase in live birth rate (RR 1.18, 95% CI 1.02–1.38) compared with recombinant FSH after a long down-regulation protocol.
In plain terms, an RR of 1.18 means live births were about 18% more likely with hMG than with rFSH; because the 95% confidence interval (1.02–1.38) stays above 1.0, the difference is statistically significant. Another systematic review found HP-hMG (highly purified human menopausal gonadotropin) achieved better pregnancy rates in IVF cycles — though not in ICSI cycles — compared with rFSH.
“For the populations in the randomized trials, hMG was associated with a pooled 4% increase in live birth rate when compared with rFSH in IVF-ICSI treatment following a long down-regulation protocol.” — Coomarasamy A. et al., Human Reproduction, 2008, PMID 18056719
These findings are not universal: many studies show equivalent outcomes, and the difference is small in absolute terms. For some patients — especially those whose LH is suppressed — Menopur’s LH activity may improve outcomes. For others, FSH-only drugs work just as well. There is no universal “best” — the right choice depends on your protocol and profile. Once your follicles are ready, the next step is the trigger shot to mature the eggs before retrieval.
Side Effects of Menopur
Menopur side effects are similar to other stimulation drugs and mostly predictable.
| Side effect | How common | What helps |
|---|---|---|
| Injection site redness or soreness | Very common | Rotate sites, cold compress, slow injection |
| Mild stinging during injection | Common | Inject slowly; it usually passes quickly |
| Bloating, pelvic fullness | Common | Mild activity, hydration; tell your clinic if severe |
| Headache, mood changes | Common | Rest; report if persistent |
| OHSS (ovarian hyperstimulation syndrome) | Uncommon but serious | Severe bloating, rapid weight gain, shortness of breath — contact your clinic immediately |
OHSS risk with Menopur
As with any gonadotropin, the main serious risk is OHSS — when the ovaries over-respond and fluid shifts into the abdomen. Risk is highest in PCOS, high AMH, or young patients.
Your clinic manages this by:
- using lower starting doses,
- monitoring estrogen levels and follicle counts closely,
- and choosing a Lupron trigger instead of hCG when risk is high.
How Much Does Menopur Cost?
Menopur is a significant part of IVF medication budgets.
| Item | Typical US cost |
|---|---|
| Menopur 75 IU vial (box of 5) | $400 – $700 |
| Menopur 150 IU vial (box of 5) | $700 – $1,200 |
| Full stimulation course (8–14 days) | $1,500 – $4,000 depending on dose |
| Injectable fertility meds overall | $3,000 – $7,000 per cycle |
Costs vary widely by pharmacy, insurance, and country. If Menopur is prescribed, ask your clinic about mail-order fertility pharmacies and generic hMG options, which can reduce the out-of-pocket cost.
Patient Stories: Real Menopur Experiences
The following patient stories are shared with consent. Names and identifying details have been changed to protect privacy.
Case 1: Menopur alone after down-regulation — age 36, Boston
Aisha, 36, stimulated with Menopur alone in a long Lupron protocol in Boston: 150 IU nightly for 11 days, 12 eggs retrieved, 9 mature, and a live birth from her first frozen transfer.
Aisha, 36, used a long Lupron protocol with Menopur as her only stimulation drug. “My nurse explained that because Lupron shuts down my own LH, Menopur’s LH was doing double duty. I injected 150 IU every evening for 11 days. The stinging at injection was real — more than I expected — but it faded in a minute,” Aisha said. She retrieved 12 eggs, 9 were mature, and her first frozen transfer resulted in a live birth. “I didn’t understand why I was on ‘the older drug’ at first. Now I tell people LH matters more than they think.”
Case 2: Combining Menopur with Gonal-F for low reserve — age 41, Miami
Nina, 41, in Miami took 300 IU Gonal-F plus 150 IU Menopur daily for 12 days; one euploid blastocyst from that cycle is now a healthy pregnancy.
Nina, 41, had an AMH of 0.6. “My doctor prescribed 300 IU Gonal-F plus 150 IU Menopur daily. The combination was my protocol’s backbone,” Nina recalled. She injected for 12 days, retrieved 5 eggs, and one made it to a euploid blastocyst. “The Menopur definitely stung more than the Gonal-F. I rotated sites religiously and used an ice pack afterward.” Her single frozen transfer is now a healthy pregnancy. “I was scared the numbers were too low, but the mix of both drugs was what finally worked.”
Case 3: Switching to Menopur after a poor first cycle — age 34, Austin
Priya, 34, in Austin added Menopur after a 4-egg FSH-only first cycle; the second cycle produced 11 eggs and 3 blastocysts, and her second frozen transfer led to a live birth.
Priya, 34, had a first cycle on FSH-only medication that produced only 4 eggs. Her clinic added Menopur for the second cycle. “The change felt small — same daily injections — but the second cycle gave me 11 eggs and 3 blasts. My doctor said the LH component was the likely difference, though he couldn’t promise it,” Priya told us. Her second frozen transfer resulted in a live birth. “I wish I had known about the option earlier. It cost more, but it changed my outcome.”
FAQ
Q: What is Menopur used for in IVF?
Menopur stimulates the ovaries to grow multiple follicles during IVF or egg freezing, typically at 75–300 IU per day. It provides both FSH and LH, which makes it especially useful after down-regulation protocols that suppress natural LH production.
Q: Is Menopur the same as Gonal-F?
No. Both stimulate follicle growth, but Menopur contains FSH plus LH (it’s an hMG product), while Gonal-F contains only recombinant FSH.
Menopur is injected subcutaneously in doses of 75–300 IU daily; Gonal-F is typically dosed at 150–450 IU daily.
Q: How long do you take Menopur during IVF?
Typically 8 to 14 days, depending on how your follicles respond. Your clinic monitors with ultrasound and blood tests every 1–3 days and adjusts the dose and duration accordingly.
The injection is usually scheduled in the evening so that monitoring blood tests can be drawn the next morning.
Q: Does Menopur hurt?
Many patients notice a mild stinging sensation during injection, more than with FSH-only drugs, which usually fades within 1 minute. Rotating sites, injecting slowly, and using an ice pack afterward reduce discomfort.
Q: Is Menopur better than Gonal-F?
The evidence is mixed: a meta-analysis of 7 randomized trials (2,159 women) found a 4% absolute live birth rate increase with hMG versus recombinant FSH (RR 1.18, 95% CI 1.02–1.38) in certain down-regulated IVF-ICSI protocols.
Many studies show equivalent outcomes. The best choice depends on your age, ovarian reserve, and protocol — not on one drug being universally “better.”
Q: What is the typical Menopur dose for IVF?
75 to 300 IU daily. Young patients with normal reserve often start at 75–150 IU; average responders typically take 150–225 IU; and patients with low AMH or previous poor response may use 300 IU or more.
Patients at high-responder risk, such as those with PCOS, usually stay at 75–150 IU with close monitoring. Doses are individualized based on monitoring.
Q: Can Menopur cause OHSS?
Like any gonadotropin, Menopur can contribute to ovarian hyperstimulation syndrome during the 8–14 day stimulation phase, especially in PCOS, high AMH, or young patients. Clinics manage the risk with lower doses, close monitoring, and Lupron triggers.
Contact your clinic immediately if you develop severe bloating, rapid weight gain, or shortness of breath.
Q: How much does Menopur cost?
A box of five 75 IU vials typically costs $400–$700; a box of five 150 IU vials runs $700–$1,200; and a full 8–14 day course comes to $1,500–$4,000 depending on dose. Mail-order fertility pharmacies and generic hMG can lower the cost.
How to Plan Your Menopur Cycle
Menopur is a well-studied, widely used stimulation drug, and its main job — supplying FSH plus LH to grow multiple follicles — fits into nearly every IVF protocol. Before you start, ask your clinic three questions.
Why is Menopur — alone or combined — the right choice for your profile? What target follicle count and monitoring schedule should you expect? What will the total medication cost be with your insurance?
If you are comparing clinics for your next cycle, browse our verified hospital profiles with real success-rate data and patient reviews, or talk to our team about which programs match your medical history and budget.
This article was written by the ProIVF Medical Editorial Team, reviewed by the ProIVF Medical Advisory Board, and is based on publicly available data from peer-reviewed meta-analyses (Coomarasamy et al., 2008; Al-Inany et al., 2009), the Menopur prescribing information, ASRM guidance, and CDC ART surveillance to provide objective, accurate information for patients. The Menopur prescribing information cited here comes from the manufacturer’s publicly disclosed materials; ProIVF has no commercial relationship with any of the companies or organizations mentioned in this article.
The information on this website is for educational purposes and is not a substitute for professional medical advice. Always consult a qualified fertility specialist about your individual situation.
Last updated: August 7, 2026
