Like most medical treatments, in vitro fertilization (IVF) can cause a range of side effects. Here’s what to expect throughout your journey and the best ways to manage discomfort.

Common IVF side effects

Fertility medications fall into several categories.

Stimulation medications

The first phase of IVF focuses on stimulating egg growth. These are some of the medications you may take during this stage:

• Clomid®

• Femara® (letrozole)

• Gonal-f® or Follistim®

• Menopur®

These medications are typically taken as nightly injections, with the exception of Clomid and Femara, which are oral medications.

Common side effects of these medications include:

• Injection site reaction (soreness, redness, or mild bruising)

• Bloating

• Cramping

• Headaches

• Nausea

• Mood changes including heightened sensitivity, irritability, euphoria, or depression - individual responses vary

• Breast tenderness (less common)

Ovulation suppression medications

Ovulation suppression medications prevent premature ovulation and help synchronize egg growth. These are some of the medications you may take at this stage:

• Cetrotide®/ganirelix

• Leuprolide

Common side effects of these medications include:

• Injection site reaction (soreness, redness, or mild bruising)

• Hot flashes

• Headaches

• Mood changes

Trigger medications

Once your eggs have sufficiently developed, your doctor will schedule 1-2 of the following trigger medications to give your eggs a final growth spurt and trigger release.

• Novarel®/Pregnyl®

• Ovidrel®

• Leuprolide

At this point in your cycle you may feel very full in your abdomen as your ovaries are enlarged from growing follicles.

Common side effects of these medications include:

• Injection site reaction (soreness, redness, or mild bruising)

• Bloating

• Cramping

• Headaches

• Nausea

• Mood changes

• Breast tenderness (less common)

Transfer medications

The final phase of IVF is the transfer of a fertilized egg into your uterus. Progesterone or estrogen supplements are often prescribed at this stage to support successful implantation of an embryo and sustain a healthy pregnancy.

Progesterone is taken as an intramuscular injection or vaginally in the form of suppositories and capsules. Known side effects include:

• Soreness or swelling at the site of injection, if taking injections

• Vaginal itching or burning and yeast infection, if taking vaginally

• Dizziness or fatigue

• Mood changes

• Bloating

• Nausea

• Cramps

Estrogen is typically taken as a topical patch but can also be taken orally, vaginally, or as an injection. Common side effects include:

• Headaches

• Breast pain or tenderness

• Nausea

• Skin irritation or redness (if taking as topical patch)

• Increased vaginal discharge, if taking vaginally

• Constipation, bloating, or stomach cramps  

• Mood changes

• Back, neck, or muscle pain

• Fluid retention 

Everyone has a different threshold for pain or discomfort. You know your body best. If anything feels unusual, it’s always worth speaking with your doctor.

How to manage side effects

These are safe and effective ways to treat side effects during IVF.

Injection site reaction

Most people experience some degree of soreness, redness, or bruising where the skin was injected. This will typically resolve on its own in a few days.

Ice your skin before intramuscular injections to minimize reaction symptoms. (Intramuscular injections are the deeper of the two injection techniques used during IVF.) Massage your skin after the injection to help the medication spread and to prevent sore muscles.

Icing isn’t necessary for subcutaneous injections.

Topical patch reaction

If you are prescribed estrogen as a topical patch during the final phase of IVF, rotating the location of your patch can help prevent skin irritation.

The patch should be applied to an area of your skin free of powder, lotions, hair, and cuts or other irritations. The most common application sites are the lower abdomen or buttocks.

It's important to let application sites heal as much as possible before reapplying a patch. Aim for at least a week between applications.

Back, neck, or muscle pain and headaches

Acetaminophen (Tylenol®) is safe to take for pain relief during IVF. Anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin®, Advil®) can directly interfere with the stimulation process. Never take NSAIDs during IVF without consulting your provider.

Bloating

Eat smaller meals or take simethicone (Gas-X®) to reduce bloating. Tums® is safe to take for acid reflux.

Constipation

Take stool softeners like Colace® or the fiber supplement Metamucil®. It’s also important to stay hydrated and eat foods high in fiber.

Cramping

Try a heating pad or take acetaminophen for relief, but avoid NSAIDs.

Increased vaginal discharge

Pantiliners can help absorb increased vaginal discharge caused by vaginal preparations of estrogen.

Nausea

For over-the-counter nausea relief, try ginger chews, peppermints, and nausea bracelets. You can speak with your doctor about prescription medication options if symptoms persist.

Mood changes

Some IVF side effects like mood swings and hot flashes occur as the result of hormonal changes, making them harder to treat.

However, if you find that mood changes are interfering with daily activities, speak with your doctor about medication. Many medications for mood disorders are safe to take during IVF. 

Vaginal itching or burning and yeast infection

Over-the-counter antifungals like Monistat® can alleviate vaginal itching, burning, and yeast infections, but check with your doctor before taking these medications. There are also prescription medication options like fluconazole (Diflucan®).

Reducing medication side effects

Most people experience some degree of side effects during an IVF cycle, but there are steps you can take to make them less severe.

Stay hydrated

You may become dehydrated more easily so consume plenty of water throughout your cycle.

Exercise in moderation

You may need to modify your workout routine during IVF. High-impact exercises such as running and interval training can increase the risk of ovarian torsion, a rare but serious complication in which an ovary twists around supporting ligaments.

Focus on low-impact exercises that place minimal stress on the body, like walking, yoga, and swimming. Always consult with your doctor about exercise precautions.

Take your medication as prescribed

Follow your doctor or pharmacist’s guidance about how to take your medication. Many IVF side effects are more manageable if medications are taken at night or with food.

Use your pharmacist as a resource

Practicing proper injection technique can increase your comfort during IVF. Our pharmacists can walk you through the process via in-app messaging or phone. We also have a library of injection guide videos for each medication in your protocol.

Exceptional pharmacy care for your fertility journey

Since 2016, we’ve helped more than 160,000 customers navigate the complexities of fertility treatment, with a seamless pharmacy experience and personalized support when it matters most.

Interested in learning how Alto can support your fertility journey? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

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