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hMG (human Menopausal Gonadotropin, Follistim, Follitropin, Bravelle, Urofollitropin) is a fertility treatment medication containing a follicle-stimulating hormone (FSH) and a Luteinizing hormone (LH).
FSH is used commonly in infertility treatment therapy, mainly for ovarian hyperstimulation as part of IVF. In some cases, it is used for reversal of anovulation as well. 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 within 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 because of this, 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.
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 fertility medications. hMG is an important substance that needs to be taken in most, if not all IVF treatments and has shown to have some amazing effects on a female’s process to start ovulating. It has been shown that 75-150ui of hMG is a sufficient dose to begin the ovulation process, but as stated above, each individual will be different, you must check you have no underlying issues before consuming this medication and then start at a low dose and check your body’s own tolerance levels towards this drug.