Provider Briefing: Menopur Supply in 2026

For reproductive endocrinologists, OB/GYNs, and fertility clinic staff, the ongoing Menopur (Menotropins) supply variability remains a real operational and clinical challenge. This briefing provides an up-to-date overview of the situation, practical prescribing guidance, and tools to help your practice and patients navigate the shortage.

Shortage Timeline

Menopur supply disruptions have followed a pattern since late 2023:

• Late 2023: Ferring Pharmaceuticals reported that demand for Menopur was exceeding manufacturing capacity, driven by year-over-year increases in IVF cycles across the U.S.
• 2024: Supply improved in Q1 before tightening again during spring and summer IVF season peaks. FDA intermittently listed menotropins on the drug shortage database.
• 2025: Ferring invested in expanded production, leading to partial recovery. However, continued demand growth (estimated 5-10% annually) kept supply under pressure. Regional variability persisted, with some markets experiencing more pronounced shortages.
• Early 2026: Supply remains inconsistent. Specialty fertility pharmacies generally maintain stock, while retail pharmacy availability is unreliable. No new entrants or biosimilars have reached the U.S. market.

Prescribing Implications

The clinical implications of the Menopur shortage fall into three areas:

Protocol Flexibility

Practices that have historically relied heavily on hMG-based protocols may need to maintain greater flexibility in their stimulation approaches. Consider establishing standard alternative protocols that can be deployed when Menopur is unavailable:

• Recombinant FSH monotherapy: Gonal-F (follitropin alfa) or Follistim AQ (follitropin beta) as primary stimulation agents
• Recombinant FSH + LH supplementation: Gonal-F or Follistim plus low-dose hCG (Pregnyl, Novarel) at 10-20 IU to provide LH activity
• Pergoveris: Recombinant FSH/LH combination that most closely mirrors Menopur's dual-hormone profile
• Mixed protocols: Initiating with Menopur (if partially available) and transitioning to recombinant FSH during the stimulation phase

Clinical evidence supports comparable outcomes across these approaches for most patient populations, though individual response variability should guide decisions.

Patient Communication

Proactive communication with patients about potential medication availability issues is essential. Consider:

• Discussing alternative protocols at the time of treatment planning, before cycle start
• Setting expectations about possible pharmacy challenges
• Providing patients with a backup protocol in writing, so switching can happen quickly if needed
• Directing patients to tools like Medfinder for Providers to help locate stock

Documentation and Prior Authorization

When switching gonadotropins mid-protocol or using non-preferred alternatives, ensure thorough documentation of medical necessity. Insurance plans that cover fertility medications may require updated prior authorization for substitute medications. Having templates ready for these situations can reduce administrative delays.

Current Availability Picture

Based on market conditions as of early 2026:

• Specialty fertility pharmacies (Freedom Fertility, Encompass, MDR, Village Fertility): Most reliable source. Generally maintaining stock with occasional 1-2 day gaps during peak periods.
• Retail chains (CVS, Walgreens, Rite Aid): Unreliable for Menopur. Most locations do not routinely stock fertility injectables and have difficulty obtaining them during shortages.
• Hospital/clinic pharmacies: Some larger fertility centers maintain on-site or partnership pharmacy stock. Worth exploring if your practice doesn't already have this arrangement.

Cost and Access Considerations

Provider awareness of cost barriers is critical during shortages, as patients may face limited pharmacy choices and reduced negotiating power:

• Menopur cash price: $90-$130 per 75 IU vial; $1,800-$5,200 per IVF cycle
• Insurance coverage: Varies by state mandate and plan. States with comprehensive fertility mandates (MA, IL, NY, CT, NJ, MD, RI) generally cover gonadotropins, though prior authorization and step therapy requirements are common.
• Ferring HEART Program: Offers 25-75% discounts for qualifying patients. Encourage patients to apply through ferringfertility.com
• Additional resources: Livestrong Fertility, Baby Quest Foundation, NeedyMeds (needymeds.org)

For detailed patient-facing cost guidance you can share, see our post on saving money on Menopur. For a provider-specific guide to helping patients with costs, see our provider cost guide.

Tools and Resources for Providers

• Medfinder for Providers: Search Menopur availability across pharmacies in real time. Useful for clinic staff helping patients locate medications quickly.
• FDA Drug Shortage Database: Check accessdata.fda.gov for official shortage status updates
• ASRM Clinical Guidance: The American Society for Reproductive Medicine has published practice advisories on managing gonadotropin shortages
• Ferring Medical Information: For product-specific clinical questions, contact Ferring's medical affairs team

Looking Ahead

Several factors may influence Menopur supply through the remainder of 2026 and beyond:

• Production expansion: Ferring has reported investments in increased manufacturing capacity, though biologically-derived products have long lead times for capacity expansion
• Demand trajectory: With continued expansion of state fertility mandates and growing patient awareness, demand for gonadotropins will likely continue to rise
• Pipeline: No biosimilar menotropins products are currently in late-stage development for the U.S. market, so competition relief is unlikely in the near term
• Recombinant shift: The trend toward recombinant gonadotropin protocols may gradually reduce dependence on urinary-derived hMG

Final Thoughts

The Menopur shortage requires ongoing vigilance and flexibility from fertility practices. By establishing backup protocols, communicating proactively with patients, leveraging specialty pharmacy networks, and using tools like Medfinder, providers can minimize disruptions to patient care. For patient-facing resources on this topic, direct your patients to our patient shortage update.