IVF Medications (Complete Guide 2025)

1. Gonadotropins

These medications stimulate the ovaries to produce multiple eggs in a single cycle, increasing the chances of retrieving viable eggs for fertilization.

• Gonal-F, Gonal-F RFF Redi-Ject, Rekovelle: Recombinant follicle-stimulating hormone (FSH) that helps stimulate egg production.

• Follistim AQ: Another recombinant follicle-stimulating hormone (FSH) option for controlled ovarian stimulation.

• Menopur: Combines follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to support both follicle development and ovulation.

• Bravelle: Purified follicle-stimulating hormone (FSH) extracted from urine for ovarian stimulation.

• Luveris: A purified LH medication used for women with severe LH deficiency.

• Pergoveris: A combination of follicle-stimulating hormone (FSH) and LH in one drug to stimulate ovarian response.

Related: Menopur Average Cost (Guide)

To get up to 80% off your IVF medications, please visit our resource here. DrugMart sells Gonal-f® RFF redi-ject pens for as low as $418.50, which is more than 80% off average prices ($3,200 in savings).

2. Gonadotropin-Releasing Hormone (GnRH) Antagonists

These prevent premature ovulation by suppressing natural luteinizing hormone (LH) surges during ovarian stimulation.

• Cetrotide: Blocks GnRH receptors to keep follicles from releasing eggs too early.

• Ganirelix: A prefilled injectable antagonist for ovulation suppression.

• Orgalutran: Similar to Ganirelix, used to maintain control over egg maturation timing.

3. GnRH Agonists

GnRH agonists are used to suppress natural hormone cycles and control ovulation timing.

• Lupron (Leuprolide): Temporarily suppresses the pituitary gland to prevent premature ovulation.

4. Progesterone Supplements

Progesterone helps prepare and maintain the uterine lining for embryo implantation after fertilization.

• Crinone: A vaginal gel providing sustained progesterone release.

• Endometrin: A vaginal insert delivering localized progesterone support.

• Prometrium: Oral progesterone capsules often used in luteal phase support.

• Progesterone in oil: An injectable form of progesterone for intensive luteal support.

Related: Gonal-F RFF Pen Price (Guide)

5. Human Chorionic Gonadotropin (hCG)

Used as a "trigger shot" to mature the eggs and prepare them for retrieval.

• Pregnyl, Novarel: Derived from human urine, these human chorionic gonadotropin (hCG) injections induce final egg maturation.

• Ovidrel: A recombinant human chorionic gonadotropin (hCG) trigger shot in a prefilled syringe for convenience.

6. Birth Control

Prescribed at the beginning of an in vitro fertilization (IVF) cycle to regulate the menstrual cycle and synchronize ovarian stimulation.

• Loestrin, Yasmin, Ortho-Novum: Common brands used to suppress natural ovulation before starting in vitro fertilization (IVF).

7. Antibiotics

Antibiotics are used to prevent or treat infections during invasive in vitro fertilization (IVF) procedures, like egg retrieval.

• Doryx, Vibramycin (Doxycycline): Often used to prevent pelvic infections.

• Amoxil (Amoxicillin): A broad-spectrum antibiotic.

• Zithromax (Azithromycin): Sometimes prescribed for specific bacterial infections.

8. Estrogen Supplements (Estradiol)

Estrogen supplements, such as Estrace (Estradiol tablets), Divigel, and Sandrena Gel, may also be used during in vitro fertilization (IVF) treatment to support the uterine lining and optimize the environment for embryo implantation. 

Estrogen helps maintain the endometrial thickness and quality, which is critical for successful implantation and pregnancy.

Physical symptoms

• Hot Flashes: Characterized by sudden and intense sensations of heat, often focused on the face, neck, and chest. These episodes may cause excessive sweating, flushing, and even an elevated heart rate. Hot flashes are commonly triggered by hormonal medications, such as GnRH agonists (for example: Lupron), which alter estrogen levels during the in vitro fertilization (IVF) cycle.

• Headaches: Hormonal fluctuations from fertility drugs can trigger headaches, particularly in women prone to migraines or those who experience headaches as part of their menstrual cycle. Stress and dehydration during treatment may further exacerbate this symptom.

• Bloating: Often caused by high levels of progesterone, bloating can result from slowed digestion and fluid retention. Additionally, ovarian stimulation can cause the ovaries to swell, contributing to a sensation of fullness or discomfort in the abdomen.

• Abdominal Pain: Discomfort or cramping in the abdominal region can range from mild to severe. This is sometimes linked to ovarian hyperstimulation syndrome (OHSS), a condition caused by an excessive response to fertility medications. Severe cases of ovarian hyperstimulation syndrome (OHSS) may require medical intervention.

• Breast Tenderness: Hormonal treatments, particularly those involving progesterone, can lead to swollen, sore, or tender breasts. This symptom may also occur as an early sign of pregnancy following a successful embryo transfer.

• Bruising and Soreness: Repeated injections, especially intramuscular ones (for example: progesterone in oil), can cause localized bruising, redness, or soreness at the injection site. Improper injection technique or using the same site repeatedly may worsen this issue.

• Vaginal Discharge: Changes in vaginal discharge, such as increased volume or a different consistency, may result from fertility medications like estrogen or progesterone. These changes are typically harmless but can sometimes cause discomfort or irritation.

Emotional symptoms

• Mood Swings: Hormonal fluctuations caused by fertility drugs, such as gonadotropins or progesterone, can lead to sudden and intense changes in mood. Patients may experience periods of extreme happiness, sadness, or irritability without clear triggers.

• Restlessness: The physical and emotional toll of fertility treatments, combined with side effects of medications like gonadotropins or GnRH agonists/antagonists, can cause restlessness. Anxiety and anticipation during the in vitro fertilization (IVF) process may further contribute to difficulty relaxing or sleeping.

• Irritability: Hormonal changes, coupled with the stress and pressure of undergoing in vitro fertilization (IVF, often result in heightened irritability. Patients may find themselves more easily frustrated or emotionally reactive due to both the medications and the taxing nature of the process.

• Fatigue: This is a common symptom linked to the use of fertility drugs (such as progesterone and hCG) and can also indicate a successful embryo transfer or early pregnancy. The physical and emotional exhaustion from repeated medical appointments, injections, and anticipation can exacerbate feelings of tiredness.

Allergic reactions 

• Skin Itching or Redness: A common side effect that can occur at the injection site during in vitro fertilization (IVF) treatments. This reaction is typically caused by the body’s response to the medication being administered or to the act of injecting itself. Fertility drugs, such as gonadotropins (for example: Gonal-F and Menopur) or progesterone in oil, often require subcutaneous or intramuscular injections, which can irritate the skin.

1. Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian hyperstimulation syndrome (OHSS) occurs when the ovaries become excessively stimulated due to fertility drugs, leading to swollen ovaries, fluid retention, and discomfort.

Mild OHSS occurs in approximately 30% of in vitro fertilization (IVF) cycles. While moderate to severe OHSS impacts about 3% to 8% of in vitro fertilization (IVF) cycles.

2. Multiple Pregnancies

Multiple pregnancies (twins, triplets, or more) are a common risk with in vitro fertilization (IVF), particularly when multiple embryos are transferred. The incidence of twin pregnancies after in vitro fertilization (IVF) is around 20% to 30%, depending on the number of embryos transferred. Triplet pregnancies or higher are less common but occur in about 2% to 3% of IVF pregnancies.

3. Ectopic Pregnancy

An ectopic pregnancy occurs when the embryo implants outside the uterus, usually in the fallopian tube. Ectopic pregnancies occur in about 2% to 5% of in vitro fertilization (IVF) pregnancies. The risk is slightly higher in women with a history of tubal issues or endometriosis.

4. Miscarriage

The overall risk of miscarriage after in vitro fertilization (IVF) is around 15% to 25%, similar to natural conception in women under 35. The risk increases with maternal age:

• Under 35 years old: 15% to 20%.

• 35-37 years old: 20% to 25%.

• 38-40 years old: 25% to 40%.

• Over 40 years old: 40% to 50%.

5. Complications from Egg Retrieval

Egg retrieval (aspiration) is a minor surgical procedure where eggs are collected from the ovaries. Infections occur in about 1% of egg retrieval procedures. Bleeding occurs in about 0.5% of cases. Ovarian torsion occurs in approximately 0.1% of cases.

6. Long-Term Risks

Ovarian cancer has become a larger long-term risk associated with in vitro fertilization (IVF). Some studies suggest a slight increased risk of ovarian cancer in women who undergo in vitro fertilization (IVF). The risk is estimated to be 1 in 5,000 to 1 in 10,000 women, and most studies suggest the risk is minimal. The risk of birth defects following IVF is estimated to be 1.5% to 2.5%, compared to a background risk of 2% in the general population.

7. Emotional and Psychological Risks

IVF can be emotionally taxing. Studies indicate that 30% to 40% of women undergoing in vitro fertilization (IVF) experience high levels of anxiety and stress during the process. Depression can also be quite common, particularly following failed in vitro fertilization (IVF) cycles. It's estimated that 15% to 25% of women undergoing in vitro fertilization (IVF) may experience depression during treatment.