gonadotropin preparations gonadotropin preparations gonadotropin preparations are drugs that mimic the physiological effects of gonadotropins, used therapeutically mainly as fertility medication for ovarian hyperstimulation and ovulation induction. for example, the so-called menotropins consist of lh and fsh extracted from human urine from menopausal women. there are also recombinant variants. gonadotropin preparationsdrug classclass identifierssynonymsgonadotropins; lh; fsh; hcguseinfertility, hypogonadismatc codeg03gabiological targetgonadotropin receptors (lhcgr, fshr)chemical classglycoproteinsin wikidata fsh and lh preparations hmg (human menopausal gonadotrophins), fsh and lh prepared from human urine collected from postmenopausal women. first extracted in 1953. injected intra-muscularily (im) or subcutaneously (sc). generic menotropins for injections, usp brands menopur, 5 ml vials containing 75 iu fsh and 75 iu lh. repronex, vials containing either 75 iu fsh and 75 iu lh, or 150 iu fsh and 150 iu lh. common side effects of preparations containing fsh and lh are: mild bloating pain, swelling, or irritation injection site rash at injection site or other part of body stomach pain or pelvic pain fsh preparations preparations of follicle-stimulating hormone (fsh) mainly include those derived from the urine of menopausal women, as well as recombinant preparations. the recombinant preparations are more pure and more easily administered, but they are more expensive. the urinary preparations are equally effective and less expensive, but are not as convenient to administer as they are available in vials versus injection pens. one study reported that users of the purified urinary fsh preparation bravelle experienced less injection site pain compared to the recombinant preparation follistim. urinary preparations purified urinary fsh (75 iu fsh and ≤ 2 iu of lh) generic urofollitropin for injection, purified. brands bravelle, u.s., (≤ 2 iu lh) metrodin, u.s. and canada, (≤ 1 iu lh) fertinorm hp, (canada) highly purified urinary fsh (75 iu fsh and ≤ 0.1 iu lh/1000 iu fsh) generic urofollitropin for injection, (highly) purified. brands fertinex (≤ 0.1 iu lh/1000 iu fsh) recombinant preparations follitropin alfa generic follitropin alfa injection brands gonal-f cinnal-f fertilex ovaleap bemfola follitropin beta generic follitropin beta injection brands follistim aq puregon follitropin delta generic follitropin delta injection brands rekovelle the package insert for gonal-f states that based on physio-chemical tests and bioassays that follitropin beta and follitropin alfa are indistinguishable. two studies showed no difference. however, a more recent study showed there may be a slight clinical difference, with the alfa form tending towards a higher pregnancy rate and the beta form tending towards a lower pregnancy rate, but with significantly higher estradiol (e2) levels. the package insert for puregon states that structural analysis shows that the amino acid sequence of follitropin beta is identical to that of natural human follicle stimulating hormone (hfsh). further, the ogliosaccharide side chains are very similar, but not completely identical to that of natural hfsh. however, these small differences do not affect the bioactivity compared to natural hfsh. gonal-f was approved for medical use in the european union in october 1995. puregon was approved for medical use in the european union in february 1996. rekovelle was approved for medical use in the european union in december 2016. biosimilars