HCG vs. Gonadorelin

[Puff88]

a TRT clinic I am looking into provides test c, anastrozole, and gonadorelin. Anyone have any feedback or insight on gonadorelin compared to traditional HCG?

[Deacon]

bump!

[liftsiron]

Comparison of hCG versus GnRH analog for releasing oocytes following ultra low-dose gonadotropin stimulation
J H Check 1 , B H Vetter, W Weiss
Affiliations

PMID: 8213225 DOI: 10.3109/09513599309152490

Abstract

Previous data have suggested there is a higher incidence of luteinized unruptured follicle (LUF) syndrome (defined as failure to release any oocyte as determined by sonography) in gonadotropin-treated patients following human chorionic gonadotropin (hCG) versus the gonadotropin releasing hormone agonist (GnRH-a) leuprolide acetate. The present study was designed to determine if an ultra low-dose gonadotropin regimen, designed not to raise the serum estradiol level much above normal for non-stimulated cycles, might result in a decrease in LUF following hCG treatment, and even reduce the rate to that seen following leuprolide acetate. The hypothesis tested was that the higher estradiol levels might suppress the pre-ovulatory follicle stimulating hormone (FSH) surge which, in turn, would inhibit plasmin production, thus preventing detachment of the oocyte from the follicle. The data did show a reduced rate of LUF incidence with either hCG or leuprolide acetate in ultra low-dose human menopausal gonadotropin-(hMG-) treated patients compared to data from previous studies with conventional hMG/hCG therapy. Pregnancy rates were also similar following hCG or leuprolide acetate for release in low-dose hMG-treated patients. Preliminary data show that leuprolide acetate is superior to hCG for causing oocyte release when stimulation is with low-dose purified FSH, and possibly also that low-dose hMG is superior to low-dose purified FSH for producing superior pregnancy rates.

[liftsiron]

The efficacy of short-term gonadotrophin-releasing hormone agonists versus human chorionic gonadotrophin to enable oocyte release in gonadotrophin stimulated cycles
J H Check 1 , A Nazari, E R Barnea, W Weiss, B H Vetter
Affiliations

PMID: 8501187 DOI: 10.1093/oxfordjournals.humrep.a138097

Abstract

One of the reasons for failure to conceive following human menopausal gonadotrophin (HMG) therapy may be due to non-release of oocytes from the follicles. We hypothesized that by using a gonadotrophin-releasing hormone agonist (GnRHa) for a short duration, endogenous release of luteinizing hormone and follicle stimulating hormone may enable oocyte release to occur, similar or superior to the effect of human chorionic gonadotrophin (HCG). This study attempted to compare the efficacy of HCG versus the GnRHa leuprolide acetate to release oocytes and achieve pregnancies and to compare the effectiveness of leuprolide acetate versus a combination of HCG with HMG to release oocytes. Unfortunately due to lack of prior data, many patients preferred to reject leuprolide acetate in favour of HCG, resulting in three times as many patients being treated with HCG in cycle 1; 78.2% of oocytes were released following leuprolide acetate versus only 55.7% with HCG. Interestingly, 87.5% of those females in whom oocyte release failed in cycle 1 with HCG did indeed release with leuprolide acetate in cycle 2, but none of these previous failures released with HCG in cycle 2. Pregnancy rates were equal in those women releasing oocytes, whether treated with HCG or leuprolide acetate. These preliminary data justify a larger randomized study.

[liftsiron]

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Research Article: Clinical Trial/Experimental Study
Optimal treatment for spermatogenesis in male patients with hypogonadotropic hypogonadism

Lin, Jianli MDa,b; Mao, Jiangfeng MDa; Wang, Xi MDa; Ma, Wanlu MDa; Hao, Ming MDa; Wu, Xueyan MD, PhDa,∗

Section Editor(s): Liu., Jian Author Information
Medicine: August 2019 - Volume 98 - Issue 31 - p e16616
doi: 10.1097/MD.0000000000016616

Open

Abstract
Background:

To compare the efficacies of gonadotropin-releasing hormone (GnRH) pulse subcutaneous infusion with combined human chorionic gonadotropin and human menopausal gonadotropin (HCG/HMG) intramuscular injection have been performed to treat male hypogonadotropic hypogonadism (HH) spermatogenesis.
Methods:

In total, 220 idiopathic/isolated HH patients were divided into the GnRH pulse therapy and HCG/HMG combined treatment groups (n = 103 and n = 117, respectively). The luteinizing hormone and follicle-stimulating hormone levels were monitored in the groups for the 1st week and monthly, as were the serum total testosterone level, testicular volume and spermatogenesis rate in monthly follow-up sessions.
Results:

In the GnRH group and HCG/HMG group, the testosterone level and testicular volume at the 6-month follow-up session were significantly higher than were those before treatment. There were 62 patients (62/117, 52.99%) in the GnRH group and 26 patients in the HCG/HMG (26/103, 25.24%) group who produced sperm following treatment. The GnRH group (6.2 ± 3.8 months) had a shorter sperm initial time than did the HCG/HMG group (10.9 ± 3.5 months). The testosterone levels in the GnRH and HCG/HMG groups were 9.8 ± 3.3 nmol/L and 14.8 ± 8.8 nmol/L, respectively.
Conclusion:

The GnRH pulse subcutaneous infusion successfully treated male patients with HH, leading to earlier sperm production than that in the HCG/HMG-treated patients. GnRH pulse subcutaneous infusion is a preferred method.

[liftsiron]

Pulsatile gonadotropin-releasing hormone therapy is associated with earlier spermatogenesis compared to combined gonadotropin therapy in patients with congenital hypogonadotropic hypogonadism
Jiang-Feng Mao,1,* Zhao-Xiang Liu,1,* Min Nie,1 Xi Wang,1 Hong-Li Xu,1 Bing-Kun Huang,1 Jun-Jie Zheng,1 Le Min,2 Ursula Brigitte Kaiser,2 and Xue-Yan Wu1
Author information Article notes Copyright and License information Disclaimer
This article has been cited by other articles in PMC.
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Abstract

Both pulsatile gonadotropin-releasing hormone (GnRH) infusion and combined gonadotropin therapy (human chorionic gonadotropin and human menopausal gonadotropin [HCG/HMG]) are effective to induce spermatogenesis in male patients with congenital hypogonadotropic hypogonadism (CHH). However, evidence is lacking as to which treatment strategy is better. This retrospective cohort study included 202 patients with CHH: twenty had received pulsatile GnRH and 182 had received HCG/HMG. Patients had received therapy for at least 12 months. The total follow-up time was 15.6 ± 5.0 months (range: 12–27 months) for the GnRH group and 28.7 ± 13.0 months (range: 12–66 months) for the HCG/HMG group. The median time to first sperm appearance was 6 months (95% confidence interval [CI]: 1.6–10.4) in the GnRH group versus 18 months (95% CI: 16.4–20.0) in the HCG/HMG group (P < 0.001). The median time to achieve sperm concentrations ≥5 × 106 ml−1 was 14 months (95% CI: 5.8–22.2) in the GnRH group versus 27 months (95% CI: 18.9–35.1) in the HCG/HMG group (P < 0.001), and the median time to concentrations ≥10 × 106 ml−1 was 18 months (95% CI: 10.0–26.0) in the GnRH group versus 39 months (95% CI unknown) in the HCG/HMG group. Compared to the GnRH group, the HCG/HMG group required longer treatment periods to achieve testicular sizes of ≥4 ml, ≥8 ml, ≥12 ml, and ≥16 ml. Sperm motility (a + b + c percentage) evaluated in semen samples with concentrations >1 × 106 ml−1 was 43.7% ± 20.4% (16 samples) in the GnRH group versus 43.2% ± 18.1% (153 samples) in the HCG/HMG group (P = 0.921). Notably, during follow-up, the GnRH group had lower serum testosterone levels than the HCG/HMG group (8.3 ± 4.6 vs 16.2 ± 8.2 nmol l−1, P < 0.001). Our study found that pulsatile GnRH therapy was associated with earlier spermatogenesis and larger testicular size compared to combined gonadotropin therapy. Additional prospective randomized studies would be required to confirm these findings.

[liftsiron]

a TRT clinic I am looking into provides test c, anastrozole, and gonadorelin. Anyone have any feedback or insight on gonadorelin compared to traditional HCG?

Ok the above studies seem to indicate that gonadorelin is a bit more effective in helping women to conceive than traditional hcg.
In men it seems that gonadorelin is faster and more effective than hcg in restoring testicle volume and sperm production.

[Puff88]

Good info, thanks lifts. Now to try and find out ideal dosing

[liftsiron]

Good info, thanks lifts. Now to try and find out ideal dosing

I think i'll stick with hcg. This is typical of what I found with dosing.
Application and dosage of Gonadorelin

In order to prevent complications the peptide is administered in courses. The following scheme is acceptable: 100-200 mcg every four hours. Gonadorelin course lasts for four weeks and consists of 4 injection per day. Then the pause must be made in order to recover normal operation of organism’s own endocrine organs.



Side effects and contraindications

The course of the gonadorelin may cause several side effects such as strong headache, alteration in bowel habits, allergic reactions, as well as local reactions in the form of congestion. In case of intake process violation there is a possibility of thrombosis.



Gonadorelin 2mg is hardly absorbed into the digestive tract that is why it is recommended to use the injectable form of the peptide. A linear intake of the preparation will cause the decrease of the pituitary gland function, which leads to the testosterone production stopping. That is why the experts recommend to buy Gonadorelin 2mg for the pulse administration, i.e. high dosage for 3-4 months followed by a break. During the break the work of the internal body organs is normalized and the organism starts to produce its own hormone again. It is also important to note that prolonged use of the peptide lowers organism’s sensibility to a preparation, significantly reducing its effectiveness.



Application information is posted for the informational purposes only.

[Puff88]

I haven't had a detailed conversation with the "medical professional" at the clinic yet about a tailored program, but their generic email shows two .5ml subQ shots of gonadorelin per week.

[Puff88]

Ok the above studies seem to indicate that gonadorelin is a bit more effective in helping women to conceive than traditional hcg.
In men it seems that gonadorelin is faster and more effective than hcg in restoring testicle volume and sperm production.

Hey lifts - So in what you read here in your articles, it would lead one to believe the Gonadorelin would be effective, in comparison to HCG, in keeping the testes working enough to produce sperm? Asking in the sense of using in place of HCG for fertility reasons.

[Deacon]

i think i would stay with HCG also

[A.B]

Like the others I would stick with Hcg. No experience with gonadorelin

[steelpreacher]

If you do roll with the gonadorelin. Post the dosages and results! Ive only used HCG and would be curious.

[Puff88]

What's up bros- so I started my TRT on 9/30 and was going to give it a good month or 2 before introducing any other compounds as I wanted to be able to tell how I responded to the test alone first. Was prescribed the gonadorelin but also purchased some HCG as well as I wasn't sure which I wanted to use (never ran either before). I was going to be using one for the pure purpose of keeping my fertility.

Well, about 3 weeks ago we found out the wife is pregnant, shes now 8 weeks in. So lucky me, I dont have to run either! Ha.

For the time being I am deciding to not use the gonadorelin or hcg. Not 100% sure if we will be done after this child or not, but will definitely be some time before we try for a 3rd, thats for sure. So if the time comes, ill start working in an HCG protocol down the road but for now I am content without it. Also to add, so far my testi size has not really suffered, so I guess they are still working to some degree.