Comprehensive medication guide to Follitropin Alfa including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$200 copay per fill for patients with fertility benefits and approved prior authorization; coverage varies significantly by plan. Many commercial plans with fertility benefits cover Gonal-F as a specialty medication after prior authorization. Medicare and Medicaid generally do not cover fertility medications.
Estimated Cash Pricing
$500–$800 per 450 IU Redi-ject pen and $900–$1,500 per 900 IU Redi-ject pen at cash price; a typical IVF cycle may require $1,800–$6,000+ in Gonal-F. No generic or biosimilar is available in the US as of 2026.
Medfinder Findability Score
42/100
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Follitropin alfa is a recombinant (laboratory-made) form of follicle-stimulating hormone (FSH), sold under the brand name Gonal-F by EMD Serono. First FDA-approved in 1997, it is one of the most widely prescribed injectable fertility medications in the world.
It is used in women to induce ovulation, to stimulate the development of multiple follicles for IVF (in vitro fertilization) and other assisted reproductive technologies (ART), and in men to stimulate sperm production in cases of hypogonadotropic hypogonadism. Follitropin alfa is classified as a gonadotropin — a class of hormones that regulate the function of the ovaries and testes.
Gonal-F is available as pre-filled injection pens (Redi-ject) in 300 IU, 450 IU, and 900 IU strengths, as well as multi-dose lyophilized powder vials (450 IU and 1050 IU) and single-dose vials (75 IU). All formulations are administered by subcutaneous injection.
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Follitropin alfa is a recombinant human FSH produced in Chinese Hamster Ovary (CHO) cells. After subcutaneous injection, it is absorbed into the bloodstream (peak levels around 15.5 hours post-dose, half-life approximately 53 hours) and travels to the ovaries or testes.
In women, it binds to FSH receptors (FSHR) on ovarian granulosa cells, activating cAMP production and downstream PI3K-AKT and ERK1/ERK2 signaling pathways. This drives follicle growth, estrogen production, and the expression of LH receptors. Unlike the body's natural FSH — which is regulated by an estrogen feedback loop — Gonal-F bypasses this regulation, allowing multiple follicles to develop simultaneously when doses are maintained.
In men with hypogonadotropic hypogonadism, follitropin alfa acts on Sertoli cells in the testes to activate the protein production required for sperm development (spermatogenesis). It is used in combination with hCG, which provides the LH-like stimulus needed for testosterone production.
75 IU — single-dose vial (lyophilized powder)
Gonal-F RFF; reconstitute with 1 mL sterile water; use immediately after mixing
300 IU / 0.5 mL — pre-filled injection pen (Redi-ject)
Gonal-F RFF Redi-ject; no reconstitution needed; subcutaneous injection
450 IU / 0.75 mL — pre-filled injection pen (Redi-ject)
Gonal-F RFF Redi-ject; no reconstitution needed; subcutaneous injection
900 IU / 1.5 mL — pre-filled injection pen (Redi-ject)
Gonal-F RFF Redi-ject; most commonly prescribed format; subcutaneous injection
450 IU — multi-dose vial (lyophilized powder)
Gonal-F multi-dose vial; reconstitute with 1 mL Bacteriostatic Water; 600 IU/mL; delivers six 75 IU doses; discard after 28 days
1050 IU — multi-dose vial (lyophilized powder)
Gonal-F multi-dose vial; reconstitute with 2 mL Bacteriostatic Water; 600 IU/mL; delivers fourteen 75 IU doses; discard after 28 days
Follitropin alfa is rated a 42/100 on medfinder's findability scale — indicating frequent localized shortages and inconsistent availability. Gonal-F is not always on the FDA's official shortage list, but real-world access is tight in 2026, especially for the 900 IU Redi-ject pen. Stock varies by region and can change daily.
The main drivers of limited availability: Gonal-F is a specialty biologic with no US generic or biosimilar competitor (as of 2026), requiring cold-chain distribution through specialty pharmacy channels. Growing demand for IVF driven by expanded insurance mandates and demographic trends outpaces manufacturing capacity.
To find Gonal-F in stock near you, use medfinder — enter your medication, dosage, and location and medfinder contacts specialty pharmacies near you on your behalf. Start your search at least 1–2 weeks before your planned injection start date.
Follitropin alfa is not a controlled substance, so no special DEA license is required to prescribe it. However, the FDA labeling states that only physicians experienced in infertility treatment should prescribe it — given the monitoring requirements (ultrasound and blood tests) necessary to manage ovarian stimulation safely.
Providers who commonly prescribe follitropin alfa:
Reproductive Endocrinologists (REIs) — the primary specialists for IVF and complex infertility cases
OB-GYNs with fertility training — may manage less complex ovulation induction cases
Urologists / Urologic Andrologists — for male infertility requiring spermatogenesis induction
Nurse Practitioners and Physician Assistants — may prescribe under physician supervision in fertility practices
Fertility treatment with Gonal-F requires close in-person monitoring — frequent blood tests and ultrasounds to track follicular development. Fully remote telehealth is not appropriate for managing injectable gonadotropin treatment. Many fertility clinics offer hybrid models with telehealth for some consultations and in-person visits for monitoring.
No. Follitropin alfa (Gonal-F) is not a controlled substance and has no DEA schedule. It does not have the prescription restrictions, refill limitations, or documentation requirements that apply to Schedule II–V controlled substances.
Gonal-F does require a prescription from a licensed provider. The FDA labeling recommends that it be prescribed only by physicians experienced in infertility treatment, due to the monitoring requirements (ultrasound and blood tests) needed to safely manage stimulation and prevent complications like ovarian hyperstimulation syndrome (OHSS).
Most patients tolerate Gonal-F well. Commonly reported side effects include:
Headache
Nausea
Abdominal pain or bloating
Injection site reactions (redness, soreness, bruising)
Pelvic pain or discomfort
Breast tenderness
Serious side effects requiring immediate medical attention:
Ovarian Hyperstimulation Syndrome (OHSS) — severe pelvic pain, rapid weight gain, abdominal distension, shortness of breath, decreased urination
Ovarian torsion — sudden severe one-sided pelvic pain; surgical emergency
Multiple gestation — twins, triplets, or more
Anaphylaxis / serious allergic reactions — facial swelling, difficulty breathing
Thromboembolic events (blood clots)
Increased risk of miscarriage (ectopic pregnancy, spontaneous abortion)
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Follistim AQ (follitropin beta)
The most direct alternative — also a recombinant FSH product (Organon). Functionally interchangeable for most fertility protocols with comparable clinical outcomes. Uses a cartridge-and-pen delivery system. No US generic available.
Menopur (menotropins)
Urinary-derived gonadotropin with both FSH and LH activity (Ferring). Used in ovulation induction and IVF protocols. Not a 1:1 swap — the addition of LH changes the hormonal profile. Approximately $90–$130 per 75 IU vial.
Letrozole (Femara)
Oral aromatase inhibitor used off-label for ovulation induction. Not for IVF. Inexpensive (often under $20/cycle with generic). Especially effective for PCOS-related anovulation. First-line option before escalating to injectables.
Clomiphene citrate (Clomid)
Oral SERM for ovulation induction in timed intercourse or IUI cycles. Not a substitute for Gonal-F in IVF. Very inexpensive ($10–$30/cycle generic). Decades of safety data.
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GnRH agonists (leuprolide/Lupron)
minorUsed intentionally in combination with Gonal-F in long-protocol IVF cycles to suppress pituitary FSH before controlled ovarian stimulation begins.
GnRH antagonists (ganirelix/Cetrotide)
minorUsed intentionally alongside Gonal-F in antagonist IVF protocols to prevent premature LH surge during stimulation.
hCG (Ovidrel, Pregnyl, Novarel)
minorUsed after Gonal-F stimulation as a trigger shot to induce final oocyte maturation. Also co-administered with Gonal-F for male hypogonadotropic hypogonadism treatment.
Alcohol
moderateAlcohol consumption may reduce egg quality and quantity during IVF cycles and may affect sperm count in men. Not a pharmacokinetic interaction but clinically significant — avoidance during treatment is strongly recommended.
Thyroid medications (levothyroxine)
moderateUncontrolled thyroid disease is a contraindication to Gonal-F use. Thyroid levels should be optimized before starting fertility treatment.
Follitropin alfa (Gonal-F) is a cornerstone of modern fertility treatment, with nearly three decades of clinical use supporting its safety and efficacy for ovulation induction, IVF stimulation, and male spermatogenesis induction. For the vast majority of patients who receive it, Gonal-F is well-tolerated and highly effective — but the realities of cost and availability in the US make planning ahead essential.
With no FDA-approved generic or biosimilar available, Gonal-F remains an expensive brand-name specialty medication. Patients should explore the EMD Serono Compassionate Care Program, insurance coverage options, specialty pharmacy price comparisons, and fertility grant programs to manage costs. Supply constraints in 2026 mean starting the sourcing process early — at least 1–2 weeks before your injection start date — is essential.
If you're having trouble locating Gonal-F at a pharmacy near you, medfinder contacts pharmacies on your behalf so you don't have to. Enter your medication, dosage, and location to get started.
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