Gonadorelin

Gonadotropin-releasing hormone analog · Also known as GnRH, LHRH, Factrel, Lutrepulse

What is gonadorelin?

A synthetic version of the body's natural gonadotropin-releasing hormone (GnRH). It stimulates the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential for reproductive function.

Gonadorelin was previously FDA-approved under the brand names Factrel (for diagnostic use) and Lutrepulse (for pulsatile infusion therapy). It was discontinued in the US for commercial reasons, not safety concerns. It is now commonly used off-label in hormone optimization and TRT clinics as an alternative to hCG for preserving fertility and testicular function.

Key takeaway: Gonadorelin is a bioidentical GnRH peptide that stimulates natural LH and FSH production, but its very short half-life (2-4 minutes) limits its practical effectiveness compared to hCG.

Benefits & evidence

LH and FSH stimulation High confidence
Testosterone production support Moderate confidence
Fertility preservation during TRT Moderate confidence
Pituitary function assessment High confidence

How it works

Gonadorelin binds to GnRH receptors on gonadotroph cells in the anterior pituitary gland. When administered in a pulsatile fashion (mimicking the body's natural release pattern), it triggers the release of both LH and FSH. LH then stimulates testosterone production in the testes (Leydig cells), while FSH supports sperm production (Sertoli cells).

The critical challenge with gonadorelin is its extremely short half-life of 2-4 minutes. Natural GnRH is released in pulses every 60-120 minutes by the hypothalamus. True physiological replacement requires a pulsatile infusion pump, which is impractical outside clinical settings. Standard subcutaneous injections 2-3 times per week do produce acute LH surges, but the sustained stimulation seen with hCG (which has a 36-hour half-life) is difficult to replicate.

Dosing information

Typical dosing protocol
Starting dose

100 mcg 2-3x/week

Ongoing
Maintenance dose

100-200 mcg 2-3x/week

Duration of TRT or as prescribed

For pulsatile pump therapy (clinical setting): 5-20 mcg every 90-120 minutes. For TRT fertility support, subcutaneous injections are given 2-3 times per week. Gonadorelin's 2-4 minute half-life makes it much less practical than hCG for sustained gonadal stimulation. Consult your prescriber.

Side effects

Most side effects tend to improve as your body adjusts.

Headache Common
Nausea Common
Injection site reactions Common
Abdominal discomfort Uncommon
Flushing Uncommon
Hypersensitivity reaction Rare

Research (10 studies)

Successful live birth following fertility preservation in a breast cancer patient. Taiwanese journal of obstetrics & gynecology · 2026
De novo rare EMX2 variants lead to idiopathic hypogonadotropic hypogonadism. Genetics in medicine : official journal of the American College of Medical Genetics · 2026