Short answer: Follistim AQ (follitropin beta) and Gonal-f RFF Redi-ject (follitropin alfa) are both lab-made FSH injected daily under the skin to grow follicles.12 Follistim AQ is also approved to start sperm production in some men; the Gonal-f Redi-ject label covers women only. Their label starting doses differ, and both labels warn that switching products changes the dose.
| Follistim AQ (follitropin beta) | Gonal-f RFF Redi-ject (follitropin alfa) | |
|---|---|---|
| Form | Cartridge used in the Follistim Pen: 300, 600 or 900 IU1 | Prefilled pen: 300, 450 or 900 IU2 |
| Approved for | Ovulation induction; IVF or ICSI; sperm production in men with hypogonadotropic hypogonadism1 | Ovulation induction; multiple follicles for ART (IVF or ICSI)2 |
| Ovulation induction start | 50 IU a day for at least 7 days; up 25 or 50 IU weekly; max 250 IU a day1 | 75 IU a day for 14 days; up to 37.5 IU no more than every 7 days; max 300 IU a day2 |
| IVF / ART start | 200 IU a day for at least 7 days; max 500 IU a day1 | 150 IU a day from cycle day 2 or 3 (225 IU at 35 or older); max 450 IU a day, usually up to 10 days2 |
| OHSS in label trials | 7.6% (ovulation induction), 6.4% (IVF/ICSI)1 | 7.2% (ovulation induction), 4.6% (ART)2 |
| Most common in IVF trial | Pelvic discomfort 8.3%, headache 7.3%, OHSS 6.4% (751 women)1 | Belly pain 23.2%, headache 18.6%, belly enlargement 13.9% (237 women)2 |
| After first use | Kept at 2 to 25 C; thrown away after 28 days1 | Fridge or room temperature up to 28 days2 |
| Missed dose | Do not double; call your provider1 | Do not double; call your provider2 |
Both are recombinant FSH, made to act like the body's own follicle-stimulating hormone, and both are given daily under the skin with ultrasound monitoring.12 They are separate products with separate labels. The Follistim AQ label warns that switching between FSH products can change the dose needed.1 Neither label reports a trial against the other; each compared its product with another FSH, not placebo.12
The IVF trials were different. Follistim AQ's used a GnRH antagonist protocol in 751 women; Gonal-f RFF's used GnRH agonist down-regulation in 237 women.12 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison. Both labels list OHSS, twisted ovary, blood clots and multiple births among their main warnings. In the Gonal-f RFF trials, multiple births made up 20% of live births with ovulation induction and 35.1% with ART.2
Of these two labels, only Follistim AQ includes men: 450 IU a week with hCG, for at least 3 to 4 months, after hCG alone has brought testosterone to normal. In its open-label trial of 30 men, headache, acne and injection site reactions were each 6.7%.1 The Gonal-f RFF Redi-ject label covers women only.2
Dose and product choices belong to your fertility team. More detail: Follistim AQ side effects, Gonal-f side effects, and the Follistim AQ and Gonal-f dosing schedules.