Meriofert Set (Menotropin)
Human menopausal gonadotropin (hMG) for ovulation induction and assisted reproduction
Meriofert Set is a prescription gonadotropin medication containing highly purified menotropin (human menopausal gonadotropin, hMG). It provides both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activity to stimulate ovarian follicular development. Used under medical supervision for ovulation induction and controlled ovarian stimulation in assisted reproductive technology (ART) procedures such as IVF.
Quick Facts
Key Takeaways
- Meriofert Set contains menotropin, providing both FSH and LH activity to stimulate ovarian follicular growth in women undergoing fertility treatment.
- It is used for ovulation induction in anovulatory women who have not responded to clomifene citrate, and for controlled ovarian stimulation prior to IVF or other ART procedures.
- The medication must be reconstituted before injection and can be administered subcutaneously (self-injection after training) or intramuscularly (by a healthcare professional).
- Ovarian hyperstimulation syndrome (OHSS) is the most important risk; treatment requires close monitoring with ultrasound and hormone levels throughout stimulation.
- Store unopened vials at or below 25°C protected from light; once reconstituted, use immediately and discard any unused solution.
What Is Meriofert Set and What Is It Used For?
Quick Answer: Meriofert Set is a gonadotropin injection containing menotropin (human menopausal gonadotropin, hMG) that stimulates the ovaries to develop follicles and produce mature eggs. It is prescribed for women who do not ovulate naturally and for those undergoing assisted reproductive technology such as IVF.
Meriofert Set belongs to a class of medications known as gonadotropins, which are hormones that directly stimulate the ovaries. Each vial contains highly purified menotropin, which provides two essential hormonal activities: follicle-stimulating hormone (FSH) activity and luteinizing hormone (LH) activity. The FSH component drives the growth and maturation of ovarian follicles, while the LH component supports the theca cells of the ovary in producing androgens that are converted to estrogens, which are essential for normal folliculogenesis.
The menotropin in Meriofert Set is extracted from the urine of postmenopausal women, who naturally produce high levels of gonadotropins. Human chorionic gonadotropin (hCG), derived from the urine of pregnant women, is added to contribute to the complete LH activity of the product. This combination closely mimics the body's natural hormonal profile needed for proper egg development.
Meriofert Set is available in two strengths: a 75 IU vial (containing 75 IU FSH and 75 IU LH activity) and a 150 IU vial (containing 150 IU FSH and 150 IU LH activity). The medication is supplied as a freeze-dried powder that must be reconstituted with the provided solvent before injection. Each set includes a vial of powder, a pre-filled syringe of solvent (sodium chloride 9 mg/mL), a reconstitution needle (long), and a subcutaneous injection needle (short).
Approved Indications
Meriofert Set is approved for two primary indications in women of reproductive age:
- Ovulation induction: For women who do not ovulate (anovulation) and have not responded to initial treatment with clomifene citrate. In this setting, Meriofert Set stimulates the development of one or a few mature follicles, followed by administration of hCG to trigger ovulation and enable natural conception.
- Controlled ovarian stimulation (COS): For women undergoing assisted reproductive technology (ART) procedures such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Here, the goal is to produce multiple mature follicles simultaneously for egg retrieval, increasing the chances of successful fertilization and embryo transfer.
Meriofert Set must only be used under the direct supervision of a physician experienced in fertility treatment. Regular monitoring with transvaginal ultrasound and serum estradiol measurements is required throughout treatment to assess ovarian response and minimize the risk of complications such as ovarian hyperstimulation syndrome (OHSS).
What Should You Know Before Taking Meriofert Set?
Quick Answer: Before starting Meriofert Set, your physician will evaluate your fertility status and that of your partner. You should not use this medication if you have ovarian cysts, unexplained vaginal bleeding, cancer of the reproductive organs or breast, certain brain tumors, or premature ovarian failure.
A thorough medical evaluation is essential before beginning treatment with Meriofert Set. Your healthcare provider will assess your overall health, reproductive history, and fertility status. This typically includes a gynecological examination, blood tests for hormone levels, ultrasound evaluation of the ovaries and uterus, and assessment of your partner's sperm quality. The goal is to ensure that gonadotropin therapy is appropriate and that there are no contraindications that could make treatment unsafe.
Contraindications
You must not use Meriofert Set if you have any of the following conditions:
- Enlarged ovaries or ovarian cysts not caused by polycystic ovarian disease
- Unexplained vaginal bleeding of unknown origin
- Cancer of the ovaries, uterus, or breasts
- Tumors of the pituitary gland or hypothalamus
- Hypersensitivity (allergy) to menotropin or any of the excipients
- Primary ovarian failure (premature menopause)
- Malformations of the reproductive organs incompatible with pregnancy
- Uterine fibroids that are incompatible with a normal pregnancy
Warnings and Precautions
Treatment with gonadotropins carries a risk of ovarian hyperstimulation syndrome. Early signs include lower abdominal pain, nausea, vomiting, and weight gain. If these symptoms occur, contact your doctor immediately. In severe cases, the ovaries may enlarge significantly and fluid may accumulate in the abdomen or chest cavity. If overstimulation occurs, treatment will be stopped and pregnancy should be avoided. You should not have intercourse for at least four days, even when using barrier contraception.
Several important warnings and precautions should be considered before and during treatment with Meriofert Set:
- Multiple pregnancy: The risk of multiple pregnancies (twins, triplets, or higher-order multiples) is significantly higher with gonadotropin-stimulated cycles compared to natural conception. This risk can be minimized by using the recommended doses and by careful monitoring of ovarian response. Multiple pregnancies carry increased risks for both mother and babies, including preterm delivery and other complications.
- Miscarriage: Women with fertility problems have a higher rate of miscarriage compared to the general population, regardless of the treatment method used.
- Ectopic pregnancy: Women with tubal damage have a slightly increased risk of ectopic pregnancy (pregnancy outside the uterus), whether conception occurs naturally or through assisted reproduction.
- Congenital abnormalities: Multiple pregnancies and certain parental characteristics associated with infertility (such as maternal age and sperm quality) may be associated with a slightly increased risk of congenital abnormalities.
- Thromboembolism: As with pregnancy itself, gonadotropin treatment may increase the risk of blood clots (thrombosis), particularly in the leg veins and lungs. Discuss this risk with your doctor before starting treatment, especially if you have a personal or family history of thrombosis, are significantly overweight, or have other risk factors for blood clots.
Although allergic reactions to Meriofert Set have not been reported to date, you should inform your doctor if you have experienced allergic reactions to similar medications in the past.
Pregnancy and Breastfeeding
Meriofert Set must not be used during pregnancy or while breastfeeding. The medication is specifically designed for use prior to conception and is discontinued once adequate follicular development has been achieved. If you suspect you may be pregnant, inform your doctor immediately before any further injections.
Driving and Operating Machinery
Meriofert Set has no or negligible effect on the ability to drive and use machines. However, you should be aware that some patients may experience side effects such as dizziness or fatigue during treatment, which could affect your ability to drive or operate machinery safely. Use your own judgment and exercise caution if you experience these effects.
Sodium Content
This medicine contains less than 1 mmol (23 mg) of sodium per reconstituted solution, meaning it is essentially sodium-free. This is relevant for patients on controlled sodium diets.
How Does Meriofert Set Interact with Other Drugs?
Quick Answer: No specific drug interaction studies have been conducted with Meriofert Set. However, inform your doctor about all medications you are currently taking, as some drugs may affect fertility treatment outcomes. Clomifene citrate is often used sequentially (not simultaneously) with gonadotropins in certain treatment protocols.
While formal drug interaction studies for Meriofert Set have not been performed, it is important to inform your healthcare provider about all prescription medications, over-the-counter drugs, herbal supplements, and vitamins you are taking. Certain medications may influence ovarian response to gonadotropin stimulation or interact with the hormonal environment during fertility treatment.
In clinical practice, Meriofert Set is frequently used as part of multi-drug fertility protocols. GnRH agonists (such as leuprolide) or GnRH antagonists (such as cetrorelix or ganirelix) are commonly administered alongside gonadotropins to prevent premature ovulation during controlled ovarian stimulation. These combinations are well-established and considered safe when used under proper medical supervision.
| Drug / Class | Interaction Type | Clinical Significance | Recommendation |
|---|---|---|---|
| Clomifene citrate | Sequential use | May enhance ovarian response | Used in some protocols; monitor ovarian response carefully |
| GnRH agonists (e.g., leuprolide) | Planned co-administration | Prevents premature LH surge | Standard ART protocol; dose adjustment may be needed |
| GnRH antagonists (e.g., cetrorelix) | Planned co-administration | Prevents premature ovulation | Standard ART protocol; timing is critical |
| hCG (human chorionic gonadotropin) | Sequential use | Triggers final oocyte maturation | Administered after adequate follicular development; withheld if OHSS risk is high |
| NSAIDs (e.g., ibuprofen) | Potential interference | May inhibit ovulation | Avoid around time of expected ovulation |
What Is the Correct Dosage of Meriofert Set?
Quick Answer: Dosage is individualized by your doctor based on ovarian response. For ovulation induction, treatment typically starts with 75 IU daily. For IVF/ART, the starting dose is usually 150–300 IU daily. Doses are adjusted based on ultrasound monitoring and estradiol levels.
Meriofert Set dosing is highly individualized and must be determined by your fertility specialist based on your specific clinical situation, ovarian reserve, previous treatment response, and the treatment goal (ovulation induction versus controlled ovarian stimulation for ART). Always use this medication exactly as prescribed by your doctor.
Ovulation Induction
Women with Anovulation (No Ovulation)
For women who do not ovulate and have irregular or absent menstruation:
- Starting dose: 75 IU (one vial of Meriofert Set 75 IU) daily, given as a single injection
- Timing: Treatment is typically started during the first week of the menstrual cycle, after spontaneous or induced menstruation
- Dose adjustments: Your doctor will adjust the dose based on ovarian response, assessed by ultrasound examination and estradiol levels. The aim is to develop one (or at most two) mature follicles
- Duration: Treatment continues until one or more mature follicles have developed (typically 7–14 days)
- Ovulation trigger: Once a follicle reaches the required stage of development, Meriofert Set is discontinued and a single injection of hCG is administered to trigger ovulation
- Ovulation timing: Ovulation generally occurs 32–48 hours after hCG administration
- Intercourse: You will be advised to have intercourse daily, starting from the day before hCG is given
Controlled Ovarian Stimulation for IVF/ART
Women Undergoing Assisted Reproductive Technology
For multiple follicular development prior to IVF or ICSI:
- Starting dose: 150–300 IU daily (1–2 vials of Meriofert Set 150 IU)
- Timing: Treatment begins on day 2 or 3 of the menstrual cycle
- Dose adjustments: Your doctor may increase the dose if needed, based on ultrasound monitoring. Higher doses are used in ART than in ovulation induction protocols
- Duration: Individual, typically 8–12 days, determined by the physician
- Ovulation trigger: Once a sufficient number of follicles have developed, treatment is stopped and hCG is administered to trigger final oocyte maturation
- Egg retrieval: Performed approximately 34–36 hours after hCG administration
Reconstitution and Mixing Multiple Vials
When more than one vial of Meriofert Set is required per dose, the contents of the first vial should be reconstituted with the solvent, drawn up into the syringe, and then slowly injected into the second vial. This process can be repeated for a third vial if necessary. The following table shows the total menotropin content when using multiple vials:
| Number of Vials (75 IU) | Total Menotropin (IU) | Number of Vials (150 IU) | Total Menotropin (IU) |
|---|---|---|---|
| 1 | 75 IU | 1 | 150 IU |
| 2 | 150 IU | 2 | 300 IU |
| 3 | 225 IU | 3 | 450 IU |
| 4 | 300 IU | — | — |
| 5 | 375 IU | — | — |
| 6 | 450 IU | — | — |
How to Prepare and Administer the Injection
Meriofert Set is administered by subcutaneous injection (under the skin) or intramuscular injection (into a muscle). After receiving proper instruction and training from your healthcare provider, subcutaneous injections may be self-administered at home. Intramuscular injections should be given by a healthcare professional.
Follow these steps for subcutaneous self-injection:
- Prepare a clean surface and wash your hands thoroughly. Lay out the vial, pre-filled syringe, reconstitution needle (long), subcutaneous needle (short), and alcohol swabs.
- Attach the reconstitution needle to the pre-filled syringe. Do not remove the white backstop collar from the syringe, as it prevents accidental plunger withdrawal.
- Remove the colored cap from the vial (light green for 75 IU, dark green for 150 IU). Clean the rubber stopper with an alcohol swab and let it dry.
- Inject the solvent through the center of the rubber stopper into the vial. Press the plunger firmly to empty all the solvent onto the powder. Do not shake. Gently swirl until the solution is clear and transparent.
- Draw up the solution: Invert the vial while keeping the needle inserted. Ensure the needle tip is below the liquid level. Slowly pull back the plunger to draw up all the solution.
- Switch needles: Replace the reconstitution needle with the short subcutaneous needle. With the needle pointing up, tap the syringe gently to move air bubbles to the top, then press the plunger until a drop of liquid appears at the tip.
- Inject: Clean the injection site (thigh or lower abdomen, below the navel) with an alcohol swab. Pinch the skin firmly and insert the needle at a 45–90 degree angle. Push the plunger slowly and steadily. Remove the needle and apply gentle pressure with an alcohol swab.
- Dispose safely: Place all needles, empty vials, and syringes in an appropriate sharps container.
Missed Dose
If you forget to administer Meriofert Set, give the injection at the next scheduled time. Do not take a double dose to make up for a missed dose. Contact your doctor for advice if you are unsure about what to do.
Overdose
The effects of an overdose of Meriofert Set are not fully characterized, but it is expected that ovarian hyperstimulation syndrome (OHSS) would occur. If you suspect an overdose, contact your healthcare provider or local poison control center immediately for assessment and guidance. Treatment would be supportive, with close monitoring of ovarian size and hormone levels.
Do not stop using Meriofert Set on your own initiative. Always consult your doctor before discontinuing this medication, as premature cessation may compromise your fertility treatment cycle.
What Are the Side Effects of Meriofert Set?
Quick Answer: Common side effects include headache, abdominal bloating, pelvic pain, nausea, and injection site reactions. The most significant risk is ovarian hyperstimulation syndrome (OHSS), which requires immediate medical attention. Rare but serious side effects include ovarian torsion and thromboembolism.
Like all medicines, Meriofert Set can cause side effects, although not everyone experiences them. The side effects are generally related to the pharmacological action of the medication (ovarian stimulation) and are usually mild to moderate in severity. Most side effects resolve on their own once treatment is completed.
If you experience severe lower abdominal pain, significant abdominal swelling, nausea with vomiting, reduced urination, rapid weight gain, or difficulty breathing during treatment with Meriofert Set, stop taking the medication and contact your doctor or go to the nearest emergency department immediately. These may be signs of ovarian hyperstimulation syndrome (OHSS).
Very Common
May affect more than 1 in 10 users
- Headache
- Abdominal swelling or bloating
Common
May affect up to 1 in 10 users
- Ovarian hyperstimulation syndrome (OHSS)
- Abdominal pain or discomfort
- Pelvic pain
- Back pain
- Feeling of heaviness
- Breast discomfort or tenderness
- Dizziness
- Hot flushes
- Thirst
- Nausea
- Fatigue
- General malaise (feeling unwell)
- Injection site reactions (pain, inflammation) — more frequent with intramuscular than subcutaneous injections
Rare
May affect up to 1 in 1,000 users
- Ovarian torsion (twisting of the ovary, causing severe lower abdominal pain)
- Thromboembolism (blood clot formation in a blood vessel, with a piece potentially breaking off and blocking another vessel)
Understanding Ovarian Hyperstimulation Syndrome (OHSS)
OHSS is the most significant complication associated with gonadotropin therapy. It occurs when the ovaries over-respond to stimulation, leading to a cascade of effects throughout the body. The condition is classified by severity:
- Mild OHSS: Abdominal bloating, mild abdominal pain, ovarian enlargement up to 8 cm. This is relatively common and usually resolves without treatment.
- Moderate OHSS: More pronounced abdominal pain, nausea, vomiting, ultrasound evidence of ascites (fluid in the abdomen), ovarian enlargement 8–12 cm. Requires medical monitoring and may need hospitalization.
- Severe OHSS: Significant ascites, pleural effusion (fluid around the lungs), hemoconcentration, oliguria (decreased urination), liver dysfunction, thromboembolic events. This is a medical emergency requiring hospitalization and intensive management.
The risk of OHSS is higher in women with polycystic ovarian syndrome (PCOS), young women, those with a high antral follicle count, and those who develop a large number of follicles or have rapidly rising estradiol levels during stimulation. The administration of hCG to trigger ovulation further increases OHSS risk in susceptible patients. For this reason, your doctor may withhold the hCG trigger if overstimulation is suspected.
Reporting Side Effects
It is important to report suspected side effects after the medicine has been authorized. This enables continuous monitoring of the medicine's benefit-risk balance. You can report suspected side effects to your national medicines regulatory authority or through the reporting system applicable in your country (such as the FDA MedWatch program in the United States, the Yellow Card Scheme in the United Kingdom, or the EMA's EudraVigilance system in the European Union).
How Should You Store Meriofert Set?
Quick Answer: Store Meriofert Set at or below 25°C (77°F) in the original outer carton to protect from light. Once reconstituted, use immediately. Do not use if the solution is cloudy or contains particles.
Proper storage of Meriofert Set is essential to maintain the medication's potency and safety. Follow these storage guidelines carefully:
- Temperature: Store at or below 25°C (77°F). Do not freeze.
- Light protection: Keep the vial and pre-filled syringe in the outer carton at all times. The powder is light-sensitive and should not be exposed to direct sunlight or bright artificial light.
- Keep out of reach of children: Store in a location that is out of sight and reach of children.
- Expiry date: Do not use after the expiry date printed on the outer carton, vial, and pre-filled syringe after "EXP." If the expiry date is shown as month/year, the expiry date is the last day of that month.
- After reconstitution: Use the medication immediately after reconstitution. Do not store the reconstituted solution.
- Visual inspection: The reconstituted solution must be clear and colorless. Do not use if the solution appears cloudy, discolored, or contains visible particles.
- Disposal: Do not dispose of the medicine via household waste or down the drain. Ask your pharmacist about proper disposal methods for unused medications. These measures help protect the environment.
What Does Meriofert Set Contain?
Quick Answer: The active substance is menotropin, providing FSH and LH activity. Each vial contains either 75 IU or 150 IU of each hormone. The powder also contains lactose monohydrate, and the solvent is a sterile sodium chloride (0.9%) solution.
Active Substance
The active substance in Meriofert Set is menotropin (human menopausal gonadotropin, hMG). Menotropin is extracted from the urine of postmenopausal women and provides two hormonal activities:
- 75 IU vial: Contains 75 IU of human follicle-stimulating hormone (FSH) activity and 75 IU of human luteinizing hormone (LH) activity
- 150 IU vial: Contains 150 IU of human FSH activity and 150 IU of human LH activity
Human chorionic gonadotropin (hCG), extracted from the urine of pregnant women, is added to the formulation to contribute to the complete LH activity. The hMG is highly purified to minimize impurities while retaining the biologically active hormone components.
Other Ingredients (Excipients)
- Powder: Lactose monohydrate (a sugar used as a stabilizer and bulking agent for the freeze-dried cake)
- Solvent: Sodium chloride 9 mg/mL solution (0.9% sterile saline in water for injection)
Appearance and Pack Sizes
Meriofert Set is supplied as a powder and solvent for solution for injection. The powder appears as a white freeze-dried cake or powder in a glass vial. The solvent is a colorless and clear solution in a pre-filled glass syringe (1 mL).
Each set contains:
- One vial containing the freeze-dried powder
- One pre-filled syringe (1 mL) containing the solvent
- One reconstitution/intramuscular injection needle (long needle)
- One subcutaneous injection needle (short needle)
Available in pack sizes of 1, 5, or 10 sets. Not all pack sizes may be marketed in all countries.
Frequently Asked Questions About Meriofert Set
Meriofert Set is used to stimulate ovulation in women who do not ovulate and have not responded to clomifene citrate. It is also used for controlled ovarian stimulation in women undergoing assisted reproductive technology (ART) procedures such as IVF or ICSI. The medication contains menotropin, which provides both FSH and LH hormonal activity to stimulate the growth and maturation of ovarian follicles.
Meriofert Set contains menotropin (hMG), which provides both FSH and LH activity, unlike recombinant FSH products (such as follitropin alfa or beta) that contain only FSH. Some clinical evidence suggests that the addition of LH activity may be beneficial for certain patient groups, particularly older women or those with low LH levels. The choice between hMG and recombinant FSH depends on the individual patient's profile and the treating physician's preference.
Yes, subcutaneous (under-the-skin) injections can be self-administered at home after receiving proper training from your healthcare provider. Your doctor or nurse will demonstrate the correct technique, show you suitable injection sites (typically the thigh or lower abdomen), and teach you how to reconstitute the powder. Intramuscular injections should be given by a healthcare professional. Each vial is for single use only, and the injection should be given immediately after reconstitution.
If you experience symptoms of ovarian hyperstimulation syndrome (OHSS) such as severe abdominal pain, abdominal bloating, nausea, vomiting, decreased urination, or rapid weight gain, stop taking Meriofert Set and contact your doctor immediately. In severe cases, go to the nearest emergency department. Do not have sexual intercourse, and do not take the hCG trigger injection unless directed by your doctor. Early recognition and medical management are crucial for preventing severe complications.
Store Meriofert Set at or below 25°C (77°F) in the original outer carton to protect from light. Do not freeze. Once reconstituted with the solvent, use the solution immediately and discard any unused portion. Do not use the medication if the reconstituted solution is cloudy, discolored, or contains particles. Always check the expiry date before use.
Yes, treatment with gonadotropins like Meriofert Set significantly increases the risk of multiple pregnancies compared to natural conception. This risk is inherent to ovarian stimulation, as multiple follicles may develop simultaneously. Your doctor will use the lowest effective dose and monitor your response closely with ultrasound and hormone measurements to minimize this risk. In IVF cycles, the number of embryos transferred can also be limited to reduce the chance of multiples.
References
This article is based on the following evidence-based medical sources and international guidelines:
- European Medicines Agency (EMA). "Menotropin – Summary of Product Characteristics." EMA, 2024. Available at: www.ema.europa.eu
- ESHRE Guideline Group on Ovarian Stimulation. "Ovarian Stimulation for IVF/ICSI – ESHRE Guideline 2023." Human Reproduction Update, 2023. doi: 10.1093/humupd/dmad002
- National Institute for Health and Care Excellence (NICE). "Fertility problems: assessment and treatment." Clinical guideline CG156, updated 2024. Available at: www.nice.org.uk/guidance/cg156
- World Health Organization (WHO). "WHO Model List of Essential Medicines – 23rd List, 2023." Geneva: World Health Organization, 2023.
- Lehert P, Kolibianakis EM, Fatemi HM, et al. "Recombinant human follicle-stimulating hormone (r-hFSH) plus recombinant luteinizing hormone versus human menopausal gonadotropin (hMG) for ovarian stimulation during assisted reproductive technology (ART) cycles: a systematic review and meta-analysis." Reproductive Biology and Endocrinology, 2014; 12:17. doi: 10.1186/1477-7827-12-17
- Practice Committee of the American Society for Reproductive Medicine (ASRM). "Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline." Fertility and Sterility, 2024; 121(2):230-245.
- British National Formulary (BNF). "Menotropins (human menopausal gonadotrophins)." NICE, 2024. Available at: bnf.nice.org.uk
Editorial Team
This article was prepared by the iMedic Medical Editorial Team and reviewed by specialists in reproductive medicine and clinical pharmacology.
All medical content is reviewed by board-certified physicians with expertise in reproductive medicine and fertility treatment, following international guidelines from ESHRE, NICE, EMA, and WHO.
This article follows the GRADE evidence framework. All clinical claims are supported by systematic reviews, randomized controlled trials, and international medical guidelines (Evidence Level 1A).
iMedic receives no pharmaceutical company funding or advertising revenue. All content is produced independently by medical professionals with no conflicts of interest. Our editorial standards are published at Editorial Standards.