What is the difference between Gynogen (human menopausal gonadotropin (hMG)) and Menapur (human menopausal gonadotropin (hMG)) injections?

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Gynogen HP vs. Menopur: Key Differences

Both Gynogen HP and Menopur are highly purified human menopausal gonadotropin (hMG) preparations that are therapeutically equivalent and interchangeable for controlled ovarian stimulation in IVF, with the primary difference being that Menopur causes significantly more injection site reactions when administered subcutaneously. 1, 2

Composition and Formulation

Both medications contain the same active components:

  • Follicle-stimulating hormone (FSH) activity 3
  • Luteinizing hormone (LH) activity 3
  • Both are urine-derived, highly purified hMG preparations 1, 3

The formulations are bioequivalent in terms of hormonal content and mechanism of action. 1

Clinical Efficacy: No Meaningful Differences

A 2025 multicenter randomized controlled trial directly comparing these medications demonstrated therapeutic equivalence: 1

  • Oocyte retrieval: Gynogen HP yielded 6.3 ± 3.39 oocytes vs. Menopur 6.7 ± 4.52 oocytes (not statistically or clinically significant) 1
  • Total hMG dose required: No significant difference 1
  • Days of stimulation: No significant difference 1
  • Fertilization rates: Comparable between groups 1
  • Implantation rates: Comparable between groups 1
  • Clinical pregnancy rates: Comparable between groups 1

The study conclusively demonstrated non-inferiority, with the lower limit of the 95% CI above the pre-specified non-inferiority threshold, confirming therapeutic equivalence. 1

Safety Profile: The Critical Distinction

The most important practical difference between these medications is tolerability:

Injection Site Reactions

  • Menopur causes significantly more injection site reactions (P < 0.001) when administered subcutaneously compared to Gynogen HP 2
  • This difference was statistically significant and clinically meaningful in a randomized controlled trial 2
  • Overall adverse event rates are otherwise comparable between the two preparations 1, 2

Clinical Implications

For patients who experience injection site reactions with Menopur, switching to Gynogen HP is a reasonable strategy without compromising efficacy. 1, 2

Use in Clinical Practice

Both medications are appropriate for: 3

  • Controlled ovarian stimulation (COS) in IVF/ICSI protocols
  • Ovulation induction (OI) in anovulatory infertility

Treatment Context from Guidelines

When using hMG preparations for male factor infertility with hypogonadotropic hypogonadism, hCG injections are typically initiated first to normalize testosterone, followed by addition of FSH or FSH analogues (like these hMG preparations) to optimize sperm production. 4

Common Pitfalls to Avoid

  • Do not assume brand interchangeability affects outcomes: The 2025 head-to-head trial confirms these are therapeutically equivalent 1
  • Do not ignore injection site reactions: If a patient reports significant local reactions with Menopur, switching to Gynogen HP is evidence-based 2
  • Do not use these as monotherapy in male HH: Always start with hCG to normalize testosterone before adding hMG preparations 4

Bottom Line

Gynogen HP and Menopur are clinically equivalent hMG preparations with identical efficacy for oocyte retrieval, fertilization, and pregnancy outcomes in IVF. 1 The only clinically significant difference is that Gynogen HP causes fewer injection site reactions, making it the preferred choice for patients sensitive to subcutaneous injections. 2 Either medication can be confidently prescribed based on availability, cost, and patient tolerance considerations. 1

References

4
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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