From the Research
Menopur, Ganirelix, and Gonal-F are not typically associated with causing macrocytosis, and other causes should be investigated if a patient undergoing fertility treatment develops this condition. Macrocytosis, a condition characterized by abnormally large red blood cells, is not a known side effect of these fertility medications. Menopur (menotropins) contains follicle stimulating hormone and luteinizing hormone, Ganirelix is a gonadotropin-releasing hormone antagonist, and Gonal-F (follitropin alfa) is a recombinant follicle stimulating hormone - all of these medications primarily affect the reproductive system rather than red blood cell production or metabolism.
Common Causes of Macrocytosis
- Vitamin B12 or folate deficiency, as supported by a recent study 1
- Alcoholism
- Liver disease
- Certain medications (like methotrexate, phenytoin, or some chemotherapy drugs)
- Myelodysplastic syndromes If a patient undergoing fertility treatment develops macrocytosis, other causes should be investigated rather than attributing it to these fertility medications. Regular blood monitoring during fertility treatment is important, but clinicians should look for alternative explanations if macrocytosis is detected, as suggested by studies on the evaluation of macrocytosis 2. The use of Ganirelix, a gonadotropin-releasing hormone antagonist, has been studied in the context of follicle maturation 3, and its effects on the reproductive system are well understood 4, but its association with macrocytosis is not established. Similarly, Menopur, a highly purified human menopausal gonadotropin, has been profiled for its use in infertility 5, without any indication of causing macrocytosis.