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In vitro fertilization (IVF) has made parenthood a reality for many individuals and couples who once struggled to conceive, but that doesn’t mean it is an easy process. Not only is it challenging on both an emotional and financial level, the fertility medications used in a cycle can affect the body in many ways.

How to Navigate Common IVF Side Effects

Knowing what to anticipate can make the experience easier to navigate. To help you prepare as much as possible for your IVF cycle, we’ve put together a guide to medication side effects and management strategies.

This post is a deep dive into medication side effects. For a closer look at the IVF process and medication sequencing, read:

IVF and Egg Freezing: What to Expect and How to Prepare

IVF Medications: Schedule and Side Effects Explained

Below are the main categories of IVF medications and associated side effects. While individual medication protocols vary, you can generally anticipate the types of medications your doctor will prescribe.

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

These medications are typically taken as nightly injections, with the exception of Clomid/Letrozole, which is an oral medication.

Known side effects of these medications include:

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

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

Ovulation suppression medications prevent premature ovulation — the body’s natural release of eggs from the ovaries — so that your doctor can retrieve as many eggs as possible for fertilization. These are some of the medications you may take at this stage:

Cetrotide/Fyramedel™ (ganirelix acetate)

These medications also bring the risk of ovarian hyperstimulation syndrome (OHSS). This condition is characterized by swelling and pain in the ovaries as the result of over stimulation or an excessive hormonal response to fertility medications. Many mild cases don’t require treatment, but doctors often recommend the following medications for moderate to severe symptoms. (These medications may also be prescribed to prevent OHSS.)

Cabergoline is an oral medication, sometimes used vaginally, that can reduce OHSS symptoms

Gonadotropin-releasing hormone (Gn-RH) antagonists or letrozole suppress ovarian activity

In some cases, your doctor may recommend canceling treatment and starting a new cycle in the future after OHSS symptoms have resolved.

Once your eggs have sufficiently developed, your doctor will schedule 1-3 trigger shots to give your eggs a final growth spurt and trigger release.

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

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 progesterone injections

Vaginal itching or burning and yeast infection, if taking vaginally

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

Redness or irritation in the skin covered by the patch, if taking topically

Increased vaginal discharge, if taking vaginally

Constipation, bloating, or stomach cramps  

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.

Below are effective and safe ways to treat common side effects during IVF. Many over-the-counter products can be added to the next delivery of your fertility medications through Essentials From Alto.

This is one of the most common side effects during IVF, and you should expect to experience some soreness, redness, or bruising at the site of injection. You don’t need to do anything to treat the reaction; it will typically resolve itself within a few days.

Icing your skin beforehand can help keep this side effect to a minimum for intramuscular injections — the deeper of the two injection techniques used during IVF. Be sure to massage your skin afterwards, both to help the medication spread and to prevent soreness in your muscles.

Icing isn’t necessary for subcutaneous injections, the other injection technique.

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 one week between patch applications.

Acetaminophen (Tylenol®) is the best way to treat pain during IVF. Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin®, Advil®) during IVF. Their anti-inflammatory properties prevent the ovaries from expanding and growing, essentially canceling out treatment.

Shop acetaminophen through Essentials From Alto.

Eating smaller meals can help reduce bloating. Some individuals also take simethicone (Gas-X®). If you develop acid reflux from bloating, Tums® is safe to take.

Order digestive health products through Essentials From Alto.

Stool softeners like Colace® and the fiber supplement Metamucil® are often used to alleviate constipation. In addition, stay hydrated — drinking more water helps stool softeners work better — and opt for fiber-rich foods.

Heating pads and acetaminophen (Tylenol) are commonly used to alleviate abdominal cramping during IVF. NSAIDs should be avoided.

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

Over-the-counter nausea relief options include ginger chews, peppermints, and nausea bracelets. You can also speak with your doctor about your options for prescription nausea medication if symptoms persist.

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

Some OTC antifungals like Monistat® are helpful for vaginal itching or burning and yeast infections. However, always check with your doctor before using these medications to make sure they’re appropriate for you. You can also ask your doctor about prescription medication options like fluconazole (Diflucan®).

Traveling during fertility treatment may feel overwhelming, but it’s definitely doable. While the fertility journey involves many moving parts, careful planning and coordination with your care team can help you take a trip without impacting your treatment. Use the suggestions below to prepare for your travels. 

A Guide to Traveling During Fertility Treatment

Advanced preparation is important when traveling with any medication. Given the complex and time-sensitive nature of fertility treatment, the planning process involves a few more steps.

First, consult your doctor about your plans and make sure your intended travel dates don’t conflict with your treatment. In vitro fertilization (IVF) requires very thorough travel planning, since it entails multiple in-person doctor’s appointments and a very carefully timed egg retrieval. Other treatments such as intrauterine insemination (IUI) may leave more room for flexibility.

Regardless of your specific treatment plan, make sure you are up to date on vaccines and be sure to monitor health-related travel alerts. The CDC advises that women who intend to conceive consult their physician before traveling to a destination with potential exposure to the Zika virus.

Lastly, make sure that you have more than enough of your fertility medication(s) and supplies on hand. Aim for several additional days’ worth. Needles used to inject medications require a prescription in some states, so bring extra to avoid unnecessary hassle.

If you are traveling near an Alto location, same-day delivery of fertility medications and supplies may be available.

Pack your medications and supplies in a carry-on

When traveling by plane, it’s always best to pack important medications and supplies in your carry-on rather than in a checked bag. Bring everything you need to safely administer your medications, including syringes, needles, alcohol swabs, hand sanitizer, gauze, and a sharps disposal container.

While the U.S. Transportation Security Administration (TSA)’s current limit on liquids, gels, and creams in a carry-on is 3.4 ounces (100 milliliters), there are exceptions for medications. Bringing needles onto a plane is acceptable when accompanied by injectable medications.

Give yourself extra time to allow for additional screening of these items. The following tips may help you get through security as efficiently as possible.

Inform the TSA officer that you are carrying more than 3.4 ounces of liquid medication before your screening process begins, if applicable.

Bring a copy of your prescription(s) with you.

Keep all medications and supplies in their original packaging.

Put your medications and supplies in a separate, clear bag, as they will need to be separated from the rest of your belongings.

Store your medications at the appropriate temperature

Refrigeration is essential with many fertility medications. (At Alto, we ensure that medications are held at the right temperature before you receive them and guide you on safe at-home storage.)

Many people use frozen gel packs and insulated medication bags to store fertility medications at an appropriate temperature while traveling. (This approach is particularly useful for air travel.) As you finalize your travel plans, verify that your hotel or other accommodation offers access to a refrigerator or mini fridge.

Choose a flexible and reliable pharmacy partner

Fertility treatment can be stressful, let alone traveling during the process, but we’ll be with you every step of the way. We offer free, same-day delivery of medication and supplies right to your doorstep, and our dedicated fertility team is here to answer any questions you may have before your trip.

Interested in learning more about how Alto can support your fertility treatment? 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.

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. It can cause significant pain in some cases and is often a factor in female infertility.

Various forms of pain relief and fertility treatment can help address endometriosis symptoms and related health complications. Here’s what to know about the condition’s causes, symptoms, and treatment options.

Endometriosis: A Leading and Treatable Cause of Female Infertility

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. It can cause significant pain in some cases and is often a factor in female infertility.

Various forms of pain relief and fertility treatment can help address endometriosis symptoms and related health complications. Here’s what to know about the condition’s causes, symptoms, and treatment options.

The endometrium is the tissue that typically lines the lining of the uterus. Endometriosis occurs when this type of tissue grows outside of the uterus, most commonly in the ovaries, fallopian tubes, and lining of the pelvic cavity. It may also grow in the intestines, rectum, bladder, vagina, cervix, or vulva. In extremely rare cases, it may be found outside of the pelvic area.

Just like endometrial tissue that grows normally in the uterine lining, the abnormal tissue that characterizes endometriosis thickens and bleeds during each menstrual cycle. However, whereas normal endometrial tissue is shed with the cycle, the abnormal tissue cannot leave the body. This can lead to inflammation and scarring of the surrounding tissue, as well as adhesions that bind the pelvic organs to one another.

In cases of endometriosis where tissue grows in the ovaries, the condition may lead to the development of cysts in the ovaries.

There is a spectrum of severity of endometriosis cases, defined by the amount of excess tissue and resulting cysts, scar tissue, or adhesions. The level of pain, which varies by individual, does not always correlate to the stage or severity of the condition. Pain typically peaks during a menstrual period.

The specific causes of endometriosis have not been identified, but the medical community believes that the following factors may contribute to its development:

Retrograde or reverse menstruation, in which endometrial tissue flows backwards through the fallopian tubes and into the abdomen during a menstrual cycle

Transformation of the cells that line the inside of the abdomen into endometrial-like tissue as the result of hormone or immune factors

Transformation of embryonic cells into endometrial-like tissue during puberty as the result of hormone factors

Attachment of endometrial cells to an incision during surgical procedures such as a hysterectomy or c-section

Transport of endometrial cells to other parts of the body via blood vessels or lymphatic fluid

Issues with the immune system that keep the body from destroying abnormal endometrial tissue

In addition, the following risk factors are often linked to endometriosis:

Getting your first menstrual cycle at an early age

Having an abnormally short menstrual cycle (e.g., less than 21 days)

Abnormally heavy menstrual periods lasting beyond seven days

Other health conditions that prevent the flow of menstrual blood during a menstrual period

There is also evidence that endometriosis may have a genetic component. You may have a higher risk of developing it if you have a mother, sister, or aunt with the condition.

Common symptoms of endometriosis include:

Pain, especially severe menstrual cramps in the abdomen or lower back

Painful urination or bowel movements during menstrual periods

Gastrointestinal issues including diarrhea, constipation, and nausea

Endometriosis can look very different from one individual to another, with varying experiences of symptoms. In some cases, the condition may not be accompanied by any noticeable symptoms.

How endometriosis affects female fertility

Endometriosis is a leading cause of female infertility, as abnormal growth of endometrial tissue can block the fallopian tubes, preventing the fertilization of an egg. It accounts for 24-50% of all female infertility cases, and one-third to one-half of individuals with the condition experience difficulty conceiving.

In mild or moderate cases of endometriosis, surgery to remove adhesions, cysts, and scar tissue is all that is needed to restore fertility. In other cases, additional procedures or fertility treatment may be required.

Getting an accurate diagnosis is critical to effectively treating the condition. However, the diagnosis process can be lengthy, with multiple steps, as symptoms frequently overlap with those of ovarian cysts, pelvic inflammatory disease, and irritable bowel syndrome (IBS).

An evaluation for endometriosis begins with a conversation about your health history. Several tests may be used during the diagnostic process, including the following.

A transvaginal or abdominal ultrasound, which provides images of your reproductive organs to help your doctor identify cysts potentially related to endometriosis

A laparoscopy, a procedure that inserts a small camera through the abdomen with the goal of directly identifying endometrial tissue outside of the uterus. This is the only procedure that can definitively confirm a diagnosis of endometriosis.

Severe pain from endometriosis can affect daily activities, and there are a variety of pain relief options, including both medications and surgery. Your doctor will likely try non-surgical interventions as a starting point and recommend procedures if the condition does not respond to initial treatment.

The following treatments may be used to treat discomfort caused by endometriosis or related health issues:

Over-the-counter pain medication such as ibuprofen

Supplemental hormones including the male hormone androgen, which can regulate hormonal production or minimize fluctuation to prevent abnormal tissue growth

Hormonal birth control including pills, patches, and vaginal rings, which prevent abnormal tissue growth by decreasing fertility

Gonadotropin-releasing hormone (GnRH) agonists, which block the production of estrogen to prevent menstruation

If symptoms do not improve after the treatments above, your doctor may recommend surgery. In addition to its usage during the diagnosis process, a laparoscopy can remove abnormal endometrial-like tissue. 

A hysterectomy, which removes the uterus and cervix, is typically reserved for severe cases. The procedure permanently affects your fertility, and you will not be able to become pregnant after the procedure. It’s important to consult your doctor about your options as well as your reproductive goals before moving forward.

In vitro fertilization (IVF) — a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy — can help individuals experiencing endometriosis-related infertility conceive.

In cases where fallopian tubes are blocked or severe scar tissue is present, your doctor may recommend proceeding directly to IVF before trying to conceive naturally.

Since 2016, Alto has supported more than 50,000 fertility journeys. We understand that fertility treatment is a significant investment — physically, emotionally, and financially — and we see ourselves as a partner in your health.

We offer free, same-day delivery seven days a week and temperature controlled packaging to ensure that your fertility medications always arrive in the right condition. And our fertility-trained pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to offer any support you need.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

While fertility treatments like in vitro fertilization (IVF) have become an increasingly common path to parenthood, helping millions of individuals conceive throughout the past four decades, they remain a significant financial investment.

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

Fertility medications used to support egg production, retrievals, and implantations frequently factor heavily into the overall cost of treatment. An average IVF cycle costs between $10,000 and $15,000, with medications an additional $5,000 or more depending on factors like a patient’s age and health history and a clinic’s treatment approach. Unfortunately, a portion of these medications often go unused, as many fertility treatment plans involve last-minute medication changes unsuited for the traditional retail pharmacy model.

As part of our commitment to your financial well-being, we offer a medication management experience that reduces fertility medication waste to lower the cost of treatment, developed in collaboration with Progyny. Take a closer look at our approach.

IVF is a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy. Multiple medications are used on a precisely timed schedule to grow follicles — fluid-filled sacs in the ovaries that potentially contain an egg — retrieve eggs, and, finally, implant a fertilized egg into the uterus. 

Here’s a snapshot of a typical IVF medication schedule:

Days 1-4: stimulation medications such as Gonal-f®, Follistim®, Menopur®, or Low-Dose hCG to stimulate egg production, so that you produce multiple follicles

Days 5-10: continuation of stimulation medications and introduction of antagonists such as Fyremadel™ (ganirelix acetate) and Cetrotide® to prevent premature ovulation

Days 10+: trigger shots of leuprolide acetate, Ovidrel®, and/or Novarel®/Pregnyl® to stimulate final growth spurt and ovulation

After transfer: estrogen and progesterone to support successful implantation of the embryo

Fertility medications are complex, with nightly dosages dependent upon hormone levels measured through bloodwork and ultrasounds. Not only do medication protocols vary from one individual to another, they are typically adjusted throughout the course of a cycle as hormones fluctuate.

Unused medication during fertility treatment

To prevent any missed doses, providers typically prescribe all medications that could be needed in bulk at the beginning of fertility treatment. However, dosages often decrease once a cycle is underway based on a provider’s discretion, ultrasounds, and bloodwork.

At traditional pharmacies, patients undergoing fertility treatment might end up paying for unused medication, as all potential medications are filled upfront. This contributes to the $5.4 billion epidemic of medication waste in the U.S. — one that is particularly acute in fertility, leading some individuals to buy and sell excess medication to each other on social media sites.

Our approach to fertility medication management

Alto has partnered with fertility benefits manager Progyny on an algorithm-powered, app-based medication management experience that reduces unneeded fertility medications while protecting the integrity of time-sensitive and personalized treatment plans.

First, we collect fertility cycle information through the Alto app and run the data through the Progyny algorithm to determine exactly what medication volumes are needed for the next phase of treatment. We then prepare a custom order for just the medications that are immediately needed, which are then delivered directly to your doorstep by our courier team. 

You will receive multiple deliveries throughout the course of your cycle, determined by your specific dosing, trigger schedule and other inputs from your clinical team. Carefully timed check-ins and local courier delivery make last-minute adjustments possible. This approach allows you to manage your medications as your IVF cycle progresses, giving you more control over the total amount of medication that you fill.

Additional financial resources for fertility medications

Alto is committed to helping you save as much as possible on your fertility medications. In addition to our personalized medication management approach, we’ll automatically search for savings and connect you with programs that require you to apply directly, including patient assistance programs from fertility medication manufacturers.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono or Ferring Pharmaceuticals. EMD has several programs that lower the cost of fertility treatment, including the Compassionate Care program, which offers income-based assistance for fertility medications that aren’t covered by insurance, and special opportunities for military veterans and cancer survivors.

Ferring Pharmaceuticals also offers financial assistance programs to offset the cost of fertility medications, including the HeartTomorrow program for individuals who elect to freeze their eggs, and special opportunities for military veterans and cancer patients.

Read Managing the Costs of Fertility Treatment for more on Alto’s financial support for fertility treatment and medications.

Fertility treatment can be challenging, but we’ll be with you every step of the way. To ensure that your treatment plan is followed correctly, we offer free same-day delivery of your medications and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

With many variables involved in an individual’s fertility, learning more about your reproductive health can help you manage expectations about your body’s response to fertility treatment. The anti-mullerian hormone (AMH) test, which measures your body’s levels of a hormone associated with ovarian reserve, is one potential source of information for those experiencing infertility.

AMH Testing in Fertility Treatment

While the AMH test can reveal certain factors related to your reproductive health, it is not relevant to all aspects of fertility, or all types of fertility issues. Here’s more about the AMH test, including what it can and can’t tell you.

Anti-mullerian hormone is a hormone that affects how a baby’s reproductive organs develop while in the womb. Male babies have higher levels of AMH than female babies.

AMH is also related to a woman’s ovarian reserve. Cells inside the ovarian follicles — fluid-filled sacs that release an egg during ovulation — produce AMH. An individual's levels of AMH correspond to their egg count, with higher levels of the hormone typically indicating a higher ovarian reserve.

Unlike many other hormones related to reproductive health, AMH levels remain steady throughout an individual’s menstrual cycle. This means that you can have your AMH levels measured at any time, unlike some other fertility-related blood tests.

An AMH test is a blood test that measures your levels of AMH, revealing the approximate number of eggs in your ovarian reserve that may be used for ovulation. It provides a snapshot into one aspect of your fertility, rather than a precise look at the whole picture.

The AMH test consists of a simple blood draw. It typically takes about a week for test results to arrive. There are at-home AMH tests available, however, it is important to discuss the results with a healthcare provider.

Below are general ranges of AMH levels, measured in nanograms per milliliter. Your provider can give you a clearer sense of what your AMH levels indicate.

An AMH test is an indication of the number of eggs remaining in your ovarian reserve. This is particularly relevant to in vitro fertilization (IVF), since one goal of IVF is to retrieve as many mature eggs for fertilization as possible. Your AMH test results may also inform your individual medication protocol for IVF, as they can help your provider anticipate your body’s response to ovarian stimulation medication.

The AMH test can also indicate the pace at which your ovaries are aging.

While AMH levels are helpful for determining egg quantity, they do not reveal anything about the quality of your eggs. Egg quantity factors into IVF success rates — the more eggs retrieved, the higher your chances are of producing multiple healthy embryos that may be placed into the uterus — but quality is also extremely important. It is possible to have a low ovarian reserve but a high percentage of viable eggs, in which case a successful IVF cycle would be more likely.

It is also possible to experience infertility despite having normal AMH levels. Other factors that may affect your ability to conceive include your age, lifestyle habits, ovulation disorders, uterine abnormalities, and endometriosis, among others. Sperm count and mobility also factor into a couple’s fertility. There are many diagnostic tests a reproductive specialist may use to evaluate your remaining egg supply and recommend the best treatment plan.

Read Infertility, Explained for a more comprehensive overview of common fertility issues.

A fertility pharmacy partner you can rely on

At Alto, we’re here for you at every step of your fertility journey. We offer free same-day delivery of your medications, with discreet packaging, fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists, and support with insurance and savings opportunities.

To learn more about how Alto can support your fertility treatment, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, Explained

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex, is a health condition that affects both men and women. Approximately one-third of infertility cases stem from a female reproductive factor, one-third stem from a male reproductive factor, and one-third stem from a combination of both or unknown causes.

These are some common causes of female infertility.

The majority of female infertility cases are caused by problems with ovulation, the release of a mature egg from the ovaries. There are several causes of ovulation disorders, including the following.

Polycystic ovary syndrome (PCOS), a condition characterized by a hormone imbalance that impacts ovulation. It is the leading cause of female infertility.

Excessive exercise, eating disorders, or stress, each of which can result in hormonal imbalances

Primary ovarian insufficiency, sometimes referred to as premature ovarian failure

Fallopian tube damage or blockage can prevent sperm from reaching an egg, or fertilized eggs from attaching to the uterus. Common causes of fallopian tube damage or blockage include pelvic inflammatory disease — an infection of the uterus and fallopian tubes from chlamydia, gonorrhea, or other sexually transmitted infections — or a prior surgery in the abdomen or pelvis, including surgery for ectopic pregnancy.

Uterine or cervical issues such as the following can disrupt the implantation of an egg into the uterus or increase a woman’s risk for miscarriage.

Benign polyps or fibroids may block fallopian tubes or interfere with the implantation of an embryo. However, many women with these growths are able to conceive.

Structural issues with the uterus that are present at birth

Cervical stenosis, a narrowing of the cervix

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. The abnormal tissue growth — as well as surgical procedures to remove it — can block the fallopian tubes, preventing the fertilization of an egg. In some cases, endometriosis may interfere with implantation of the fertilized egg, or embryo.

Male infertility is most often an issue of sperm production — including the quantity and quality of sperm produced — or of sperm mobility, which affects the sperm’s ability to find and fertilize an egg. A blockage in the testicle or damage to the reproductive organs can also contribute to male infertility.

Age is a factor in both male and female fertility issues. The quality and quantity of a woman’s eggs begin to decline as she enters her mid-thirties, and age factors into the success rates of in vitro fertilization (IVF).

Many individuals and couples first learn of a fertility issue after trying to conceive without success, and the primary symptom of infertility is the inability to get pregnant. There aren’t always noticeable symptoms, but the following may indicate an underlying fertility problem.

A menstrual cycle that’s irregular, absent, longer than 35 days, or less than 21 days

Unusually light or heavy bleeding during menstrual cycles

Erectile dysfunction or low sex drive in men

The timeline for seeking fertility treatment depends on your age. If you are under the age of 35, most health experts suggest consulting a reproductive specialist after a year of trying to conceive. If you are between 35 and 40, you may want to pursue testing or treatment after six months of trying to become pregnant. And if you are over 40, you may want to pursue testing or treatment before you start trying to conceive.

An evaluation for fertility issues and potential treatment begins with a conversation about your health history. Several tests may be used during the diagnostic process, including the following.

An hysterosalpingogram (HSG), an x-ray taken to examine issues within the uterus and fallopian tubes

Blood tests to measure hormone levels related to fertility and reproduction

Ovarian reserve testing, which evaluates the number of viable eggs in your ovarian reserve. These are typically used for women over 35 or those at risk of a low egg count for other reasons.

A semen test is used to diagnose most cases of male infertility. This identifies how many sperm you produce and whether the sperm are normal in shape and movement — healthy sperm have an oval head and long tail. In some cases, additional blood tests and/or genital ultrasounds may be used to rule out other health conditions.

Fertility problems do not mean that you won’t be able to have children biologically. There are many treatment options that can help increase your chances of conception. The most effective course of treatment depends on the underlying cause of your or your partner’s fertility issues. These are among the most common fertility treatments.

Forms of assisted reproductive technology (ART) including in vitro fertilization (IVF), a process in which eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. In addition to treating female infertility, IVF can also be used when male infertility is a factor.

Intrauterine insemination (IUI), a type of artificial insemination in which sperm that have been washed and concentrated are placed directly into a woman’s uterus during ovulation.

Injectable fertility medications including gonadotropins and oral fertility medications such as Clomid® and Femara® can treat fertility-related hormonal imbalances.

Your doctor may also recommend lifestyle changes or treating a related health condition.

Blog

How to Navigate Common IVF Side Effects

A Guide to Traveling During Fertility Treatment

Endometriosis: A Leading and Treatable Cause of Female Infertility

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

AMH Testing in Fertility Treatment

Infertility, Explained

A Guide to Ferring Pharmaceuticals’ Fertility Medication Savings Programs

Fertility Preservation Options After a Cancer Diagnosis

Top Questions to Ask Your Fertility Clinic

A Financial Planning Guide for Egg Freezing

Male Infertility: Causes, Symptoms, and Treatment

What to know about RESOLVE: The National Infertility Association

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