Female:

Male:

Sterility in men with hypo‑ or normogonadotropic hypogonadism (in combination with HCG to stimulate spermatogenesis)

Pharmacodynamics: HMG acts directly on ovaries and testes.
- In ovaries: FSH component increases follicle growth and estradiol production; LH component stimulates theca cells.
- In testes: FSH promotes maturation of seminiferous tubules and spermatogenesis (requires prior HCG treatment for adequate androgen levels).
Pharmacokinetics:
- IM injection: peak FSH serum level in 6–10 hours; half‑life ~50 hours.
- SC injection: peak in 6–8 hours; half‑life ~51 hours.
- Excreted mainly renally.

Female sterility: Start 75–150 IU FSH daily IM/SC. Adjust based on ovarian response (ultrasound, estradiol). Continue until pre‑ovulatory estradiol level achieved. Ovulation induced with 5000–10,000 IU HCG 1–2 days after last HMG dose.
Male sterility: Initially HCG 5000 IU twice weekly until testosterone normalizes. Then add HMG (5 × 75–150 IU FSH + 75–150 IU LH weekly) for several months.

IM or SC injection.
Patient selection requires thorough gynecological/endocrinological evaluation in women; pituitary function assessment in men.

Female:

Male:

Risk of miscarriage, multiple births, ectopic pregnancy after ovulation induction.
Monitor ovarian activity (ultrasound, estradiol) every 1–2 days.
Discontinue immediately if unintended hyperstimulation occurs.
Severe OHSS may be life‑threatening (large cysts, ascites, hydrothorax, thromboembolism).