The Most Common IVF Medications and What They Do
A fertility nurse’s guide to how they work, how they feel, and what’s normal vs not.
IVF meds can look like alphabet soup, and most patients only get a quick run-through at their appointment before being sent home with a giant box of needles. This guide breaks down the most common medications, what they actually do in your body, and what you can expect to feel along the way.
1. Gonadotropins
Examples: Gonal-f, Follistim, Menopur
When you take them: Early in your cycle, usually for 8 to 12 days
What they do: They stimulate your ovaries to grow multiple follicles instead of the usual single dominant follicle. More follicles means more eggs to work with at retrieval.
What they feel like: Most people feel full, tight, a little crampy, and sometimes genuinely bloated by day 5 or 6. It’s not subtle. You may also feel tired, weepy, or short-fused. Mood swings are common.
Normal side effects:
Abdominal bloating
Cramping
Breast tenderness
Mood changes
Mild headaches
Bruising at injection sites
Not normal:
Sudden or extreme abdominal pain
Rapid weight gain in 24 hours
Difficulty breathing
These can be signs of OHSS, which your clinic wants to catch early.
2. Menopur (specifically)
When it comes into play: Usually added around day 3 to 5 of stims
What it does: It gives your follicles a “maturity boost” and helps with egg quality.
What it feels like: Not gonna sugar coat or lie besties, it can burn. Ice your skin for a minute before mixing and keep the needle shallow.
Normal side effects:
Redness or stinging at the injection site
Bloating
Moodiness
Not normal:
Severe rash and trouble breathing - these can signal an allergic reaction and you should call your clinic and/or 911 if it’s an emergency.
3. Ganirelix / Cetrotide
When you take them: Mid-stims, usually once your lead follicles reach 12 to 14 mm
What they do: They prevent your body from ovulating early. Think of them as the “stop sign” that keeps your follicles growing without releasing the eggs prematurely. Gotta keep ‘em baking!
What they feel like: A quick, sometimes itchy injection. These meds are subcutaneous, so the needle is tiny, but the medication can be irritating to the skin.
Normal side effects:
Redness or welts
Slight itching
Twinges in the ovaries
Not normal:
Persistent hives
Severe abdominal pain
Anything that feels like sudden swelling or systemic allergic reaction deserves a call.
4. Trigger Shot (hCG or Lupron)
Examples: Pregnyl, Novarel, Ovidrel, Lupron
When you take it: Exactly 34 to 36 hours before retrieval - the timing REALLY matters here
What it does: It pushes the eggs through their final maturation step so they’re ready to be collected during retrieval.
What it feels like: Most people don’t feel much right away, but within 24 hours you may feel heavy and extra bloated. Some people get mild nausea or feel super emotional - #completelyfair
Normal side effects:
Abdominal pressure
Mild nausea
Fatigue
Mood swings
Not normal:
Sharp, worsening pain
Severe nausea or vomiting
These can show early OHSS risk.
5. Progesterone (PIO or vaginal inserts)
When you take it: Usually starts the night of retrieval or a few days before transfer in an FET
What it does: It thickens and stabilizes the uterine lining, making it receptive for an embryo.
What it feels like: PIO injections can leave your butt sore, lumpy, or bruised. Vaginal inserts can feel messy and can cause discharge.
Normal side effects:
Sore breasts
Fatigue
Moodiness
Low-level cramping
Constipation
Not normal:
Calf pain (blood clot risk)
Shortness of breath
Fever
All of these need medical evaluation.
6. Estradiol (pills, patches, or injections)
When you take it: In medicated FET cycles or to prep your lining after retrieval
What it does: It thickens the lining so it’s ready for implantation.
What it feels like: A lot like PMS. It can also make you bloated or mildly nauseous. Ginger ale is a good thing to have on hand.
Normal side effects:
Slight headaches
Breast tenderness
Nausea
Bloating
Not normal:
Severe migraines with visual changes
Leg swelling
These could indicate vascular complications and are worth a call.
7. Doxycycline or Other Antibiotics
When you take it: Around retrieval or transfer
What they do: Prevent infection and reduce inflammation.
What they feel like: Most people tolerate them well, but they can upset your stomach.
Normal side effects:
Nausea
Sun sensitivity
Mild GI upset
Not normal:
Severe diarrhea
Full body rash
These can indicate an allergic reaction
8. Medrol / Steroids
When you take it: Sometimes given around transfer
What it does: Can reduce inflammation and help modulate the immune system, particularly if you have an existing inflammatory autoimmune condition
What it feels like: Some people get a little wired, hungry, or irritable.
Normal side effects:
Increased appetite
Trouble sleeping
Moodiness
Not normal:
Severe insomnia
Heart palpitations
Your Potential IVF Medication Timeline at a Glance
Stimulation (days 1–12): Gonal-f, Follistim, Menopur, Ganirelix/Cetrotide
Trigger (one dose): hCG, Lupron, or dual trigger
Post-Retrieval: Progesterone, estradiol, antibiotics
FET Prep (if applicable): Estradiol followed by progesterone