Fertility medications can help with a lot of issues, including improving the odds of getting pregnant and carrying a pregnancy to full term. These medications treat certain conditions, so it is important to only take them when recommended by a doctor. However, fertility drugs impact natural biological functions, and thus patients often experience various side effects while undergoing a treatment regime.
Note: using fertility medications without a diagnosis won’t automatically improve your chances of conceiving. According to the US Center for Disease Control and Prevention (CDC), approximately 12% of American women aged 15 to 44 have difficulty becoming and staying pregnant. Infertility can be due to different problems in men and women.
It is recommended that a woman seek fertility treatment if she is unable to conceive or keeps having miscarriages after 12 months of trying.
For women older than 25, doctors advise pursuing treatment if they fail to become pregnant after 6 months of actively trying to do so.
Women with irregular menstrual periods and those suffering from conditions that can impact pregnancy need to consult a physician before trying to conceive.
The Importance of Fertility Medications
Fertility medications are an essential part of the fertility treatment process, be it IVF (in vitro fertilization), IUI (intrauterine insemination), or other medical procedures. These drugs are taken to encourage the production of some hormones and help balance the levels of certain chemicals in the body.
There are different kinds of fertility drugs patients will have to use as part of their treatment. Some of the common ones include:
- Clomid
- Antagon
- Lupron
- Doxycycline
- Synarel
- Cetrolide
- Profasi
- Novarel
- Gonadotropin
- Pregnyl
- Medrol
Side Effects of Fertility Drugs
Fertility drugs used in IVF, IUI, or ICSI are generally considered to be safe but depending on multiple factors, they may have minor side effects, curable adverse effects (i.e., ovarian hyperstimulation syndrome), and severe long-term effects. There are certain concepts to bear in mind when discussing the side effects of fertility medication. Side effects refer to those symptoms (often mild) that a lot of patients experienced when taking a medication. Examples are nausea or headaches.
Fertility medications can also have some “adverse effects.” Although they rarely occur, these events are usually more severe and often hard to predict, i.e., a heart attack or stroke. Ovarian hyperstimulation syndrome is an example of a mild adverse effect of injectable fertility drugs.
If a medication is found to pose a significant risk of severe adverse effects, it is unlikely to get FDA approval. If the adverse effect is very rare, it might not be detected until many people have used the drug. In this case, the medication will be withdrawn from the market even after it has been approved, for example, Bextra.
There are also “long-term effects,” which are different from side effects and effects. These are severe adverse effects that are not detected until after the medication therapy has been completed. A good example of this is the negative effect on the wombs of daughters of women who used the drug DES when they are pregnant.
Fortunately, these side effects are not severe, temporary, and easy to treat. In most cases, patients will be able to bear these mild effects, although they may be an inconvenience.
Here are common side effects that patients experience with various types of fertility drugs:
Clomid Side Effects and Risks
Clomid tricks the body into thinking there isn’t enough circulating estrogen. It blocks the receptors in the body that react to the estrogen hormone. Most Clomid side effects are caused by the body’s perception of low estrogen levels. Common side effects are:
- Hot flashes
- Bloating and abdominal discomfort
- Weight gain
- Headaches
- Mood swings
- Nausea
- Dizziness
- Breast tenderness
- Abnormal menstrual bleeding/spotting
- Vaginal dryness
A rare but serious risk of using Clomid is blurred vision that occurs in less than 1.5% of women. This side effect involves blurred vision, flashing lights, or floaters. If you are experiencing any of these, tell your doctor right away.
Letrozole Side Effects and Risks
Letrozole (also known as Femara) is actually intended to be used in breast cancer treatment. Letrozole works similar to Clomid (by blocking estrogen receptors). Studies found that women with PCOS and women who are Clomid resistant (don’t ovulate with Clomid) may have better success with letrozole.
Possible side effects associated with letrozole are:
- Fatigue
- Dizziness
- Headache
- Bloating/abdominal discomfort
- Hot flashes
- Blurred vision (much less common than with Clomid)
- Trouble sleeping
- Abnormal menstrual bleeding/spotting
- Breast pain
Just as with Clomid, there is an increased risk of conceiving twins on letrozole.
Gonadotropins Side Effects and Risks
Gonadotropin fertility drugs are actually injectable hormones. The gonadotropin medication family includes drugs like Gonal-F (FSH), Follistim, and Ovidrel (hCG). Injectables can be used alone, or in combination with other drugs during an IVF cycle.
Possible side effects of gonadotropins include:
- Bloating/abdominal tenderness
- Absentmindedness/feeling “foggy”
- Headaches
- Nausea/upset stomach
- Upper respiratory tract infection
- Mood swings
- Acne
- Weight gain
- Abnormal menstrual bleeding/spotting
- Injection site soreness and redness
- Dizziness
When compared to Clomid and letrozole, the risk of twins is significantly higher with gonadotropins. Up to 30% may result in multiples, which is why many clinics do not prescribe gonadotropins for timed intercourse or intrauterine insemination.
GnRH Agonist Side Effects and Risks
GnRH agonists (including Lupron) are most commonly used during IVF treatment. They hinder the body’s natural reproductive system so that your doctor can control ovarian stimulation and maturation timing. A low estrogen level is the main responsible factor for many of the side effects of GnRH agonists.
Some common side effects of GnRH agonists include:
- Hot flashes
- Headache
- Mood swings/depression/anxiety
- Vaginal dryness
- Acne
- General body aches/joint pain
- Nausea
- Fluid retention
- Upset stomach
- Weight gain
- Decreased sex drive
- Dizziness
- Injection site soreness
GnRH Antagonist Side Effects and Risks
Similar to GnRH agonists, GnRH antagonists are used to shutting down the body’s reproductive system during IVF treatment. GnRH antagonists have significantly fewer side effects than GnRH agonists. Some side effects of GnRH antagonists include:
- Abdominal tenderness
- Headache
- Nausea/upset stomach
- Abnormal menstrual bleeding/spotting
- Injection site soreness
Minimizing Side Effects and Risks of Fertility Medications
While you cannot avoid all the side effects of fertility drugs, there are certain things you or your physician can do to mitigate the risks.
For example, you can avoid or reduce certain side effects by using the medication at bedtime or by taking it together with food. Consult your doctor regarding the best time and ways to use your fertility drugs.
Your physician should prescribe you the lowest effective dose of the fertility drug. Instead of starting with a high dose, it is always better to begin with a lower dose and gradually raise the dosage if it fails to work.
Closing monitoring of your menstrual cycle is essential to minimize the risk of having a multiples pregnancy (twins or more). When Clomiphene or gonadotropin is used, ultrasound can be conducted to know the number of potential follicles (oocytes) that are growing. Each follicle can result in a baby if you get pregnant.
If your physician finds that you have a very high risk of multiples, your treatment cycle may be canceled and you may be advised to abstain from sexual intercourse.
It is very important to follow your doctor’s advice.
Bear in mind that a multiples pregnancy can pose great danger to your and your baby’s health and may even be life-threatening.
A single embryo transfer (SET) can help reduce your risk of multiples when undergoing an IVF treatment. However, this is not suitable for all couples. Speak with your physician to know more about the options available for you.
Be careful of fertility clinics that are too aggressive in their infertility treatments. While it may feel great to have a physician guaranteeing you success and beginning with the “most effective” treatments first, climbing up the ladder too fast can make you fall prematurely.
Maintain contact with your fertility expert
It’s crucial to keep in touch with your fertility specialist throughout your treatment. This will give you the chance to voice out your worries and address issues that you may be going through, whether they have to do with the medications you are using or the symptoms you are experiencing.
By maintaining contact, these issues can be resolved quickly, and any severe side effects can be treated as soon as possible. Besides, this also helps ensure a smooth and successful fertility treatment.
Below are some questions to ask your fertility doctor:
- What’s the success rate for this treatment among patients with my condition?
- What is the overall cost of this treatment?
- Are there less costly treatment options?
- What are my chances of conception if I don’t take fertility medications?
- Are there other things I can do to improve my chances of getting pregnant?
- What is the average length of fertility treatment before a healthy pregnancy?
Conclusion
Fertility drugs have enabled many hopeful parents to experience the joy of parenthood. However, the side effects can pose minor inconveniences along the way.
Do not worry too much! Most of these symptoms go away on their own, so just consider them part of your journey.
Note that not all causes of infertility can be treated with medications. For example, blocked fallopian tubes are a common cause of infertility, and it is often treated using a surgical procedure known as hysteroscopy.
If you are still concerned regarding the fertility drug risks, it is best to talk to our reproductive endocrinologists directly. Schedule a consultation today using the link below.
