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Human Menopausal Gonadotropin
Human Menopausal Gonadotropin (hMG) is a hormonal substance containing a follicle-stimulating hormone (FSH) and a luteinizing hormone (LH).
HMG is a medication that is composed of FSH, with LH, and is used for stimulation of the egg development in women who do not ovulate spontaneously, ovulate extremely irregularly, or to increase the number of eggs developed in a single cycle within women who already ovulate.
FSH stimulates the growth and recruitment of immature ovarian follicles in the ovary. In early (small) antral follicles, FSH is the major survival factor that rescues the small antral follicles (2–5 mm in diameter for humans) from apoptosis (programmed death of the somatic cells of the follicle and oocyte). In the luteal-follicle phase transition period the serum levels of progesterone and Oestrogen (primarily Estradiol) decrease and no longer suppress the release of FSH, consequently FSH peaks at about day three (day one is the first day of menstrual flow). The cohort of small antral follicles is normally sufficiently in number to produce enough Inhibin B to lower FSH serum levels.
Follicle-stimulating hormone (FSH) is a gonadotropin, a glycoprotein polypeptide hormone. FSH is synthesized and secreted by the gonadotropic cells of the anterior pituitary gland, and regulates the development, growth, pubertal maturation, and reproductive processes of the body. FSH and luteinizing hormone (LH) work together within the reproductive system.
FSH is used commonly in infertility therapy, mainly for ovarian hyperstimulation as part of IVF. In some cases, it is used for reversal of anovulation as well.
In addition, there is evidence that gonadotrophin surge-attenuating factor produced by small follicles during the first half of the follicle phase, also exerts a negative feedback on pulsatile luteinizing hormone (LH) secretion amplitude, thus allowing a more favourable environment for follicle growth and preventing premature luteinisation.
Due to the variability in response from patient to patient no fixed dosage regimen can be recommended. Each patient and cycle must be individualized, however, it is generally thought to be a stronger superovulation agent than other oral medications.