Do You Know the Risks of Fertility Drugs? (2023)

Fertility drug side effects and risks depend on which medication you’re taking. Oral fertility drugs (like Clomid or letrozole) have milder side effects than injectable fertility drugs (like gonadotropins or GnRH agonists and antagonists.)

The most common fertility drug side effects are bloating, headache, breast tenderness, upset stomach, hot flashes, and mood swings. The most common fertility drug risks are conceiving a multiple pregnancy (like twins or triplets or more) and developing ovarian hyperstimulation syndrome (OHSS). These aren’t the only potential side effects and risks, just the most common ones.

Fertility drugs can create miracles and are generally effective. Still, it's important to know what can go wrong and how to possibly lower your chances of complications.

Side Effects

Side effects are unwanted and unintentional symptoms that result from a medication. Whether or not you’ll experience side effects will depend on…

  • the medication you take
  • the dosage of the medication (higher doses usually mean increased risk)
  • your particular body

Take, for example, the fertility drug Clomid. Some women take Clomid and feel fine. Others experience headaches or mood swings. It’s difficult to predict how you will react until you take a medication. Below are brief lists of common fertility drugs side effects.

If you are experiencing severe side effects, unusual symptoms, or are concerned for any reason, contact your doctor.


Reading about possible side effects can increase anxiety and may even increase the risk you’ll experience certain side effects. This is known as the nocebo effect. (It’s like the placebo effect, just negative.) Of course, you should always discuss with your doctor the risks of any medication before you take it.

However, if you tend towards anxiety, you might want to skip the detailed side effect/risk information and focus on the sections below on how to reduce and cope with the side effects.

Clomid Side Effects and Risks

Clomid works by tricking the body into thinking there isn't enough circulating estrogen. To do this, it blocks the receptors in the body that react to the estrogen hormone. Most side effects of Clomid are caused by these perceived low estrogen levels.

Possible side effects of Clomid include:

  • 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 Clomid is blurred vision. Occurring in less than 1.5% of women during the clinical trials, this side effect can involve blurred vision, flashing lights, or floaters. If this happens to you, tell your doctor right away.

Like most fertility drugs, Clomid can also lead to a twin pregnancy. About 7 in 100 Clomid-conceived pregnancies will result in twins.

Clomid Side Effects and Risks

(Video) What side effects do fertility drugs have?

Letrozole Side Effects and Risks

Letrozole is used off-label as a fertility drug. (Letrozole, also known as Femara, is actually intended for use in the treatment of breast cancer.) Letrozole works in a similar way as Clomid (blocking estrogen receptors). Studies have found that women with PCOS and women who are Clomid resistant (don't ovulate on Clomid) may have more success with letrozole.

Possible side effects of letrozole include:

  • Fatigue
  • Dizziness
  • Headache
  • Bloating/abdominal discomfort
  • Hot flashes
  • Blurred vision (much less common than with Clomid)
  • Trouble sleeping
  • Abnormal menstrual bleeding/spotting
  • Breast pain

There is an increased risk of conceiving twins on letrozole, just as with Clomid.

Gonadotropins Side Effects and Risks

Gonadotropin fertility drugs are injectable hormones. They include drugs like Gonal-F (FSH), Follistim, and Ovidrel (hCG). Injectables may 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.

If you're having IVF, a single embryo transfer is the recommended standard of care for most patients to reduce this risk of multiples. Transferring more than one embryo is reserved for a small number of special cases.

Gonadotropin Side Effects and Risks

GnRH Agonist Side Effects and Risks

GnRH agonists like Lupron are most commonly used during IVF treatment. They shut down the body's natural reproductive system so that your doctor can control ovarian stimulation and maturation. Low estrogen levels are responsible for many of the side effects of GnRH agonists.

Possible side effects of GnRH agonists (like Lupron) 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 Agonist Side Effects

(Video) Fertility Drugs-Side Effects, Risks & Right Way To Use #fertility - Dr.Shwetha Anand|Doctors' Circle

GnRH Antagonist Side Effects and Risks

Like GnRh agonists, GnRH antagonists are used to shutdown the body's reproductive system during IVF treatment. They have significantly fewer side effects than GnRH agonists.

Possible side effects of GnRH antagonists include:

  • Abdominal tenderness
  • Headache
  • Nausea/upset stomach
  • Abnormal menstrual bleeding/spotting
  • Injection site soreness

GnRH Antagonist Side Effects

Serious Risks of Fertility Drugs

In rare cases, fertility drugs can cause severe side effects. Your doctor should discuss these with you. Always tell your doctor if you’re experiencing worrisome symptoms, even if you’re not sure if they’re related to the medication. It’s better to call your doctor if you’re concerned and have him tell you everything is fine, than ignore a serious side effect that could lead to medical harm or danger.

Vision Changes

A very small percentage of women will experience vision disturbances when taking Clomid or letrozole. If this happens to you, you may see flashes of light, notice a sudden increase in “floaters,” or experience blurred vision.

The blurred vision may come along with a severe headache. Tell your doctor right away if this happens to you.

The vision problems should go away once you stop taking the medication. In very rare cases, long-term damage may occur.

Ectopic Pregnancy

Women taking gonadotropins have a slightly increased risk of ectopic pregnancy. Ectopic pregnancy can be life-threatening if ignored. If you experience severe pelvic pain, contact your doctor immediately.

Ovarian Hyperstimulation Syndrome (OHSS)

Fertility drugs intentionally stimulate the ovaries to produce more eggs than they usually would. With OHSS, the ovaries become dangerously overstimulated. This is more common during IVF treatment, but can also occur with Clomid and gonadotropin treatment.

Most cases of OHSS are mild, but severe OHSS can occur. In rare cases, OHSS can lead to blood clots and kidney failure. Severe OHSS can threaten your fertility and even your life. Catching the symptoms quickly and receiving early treatment is key.

Ovarian Torsion

Ovarian torsion is a possible complication of OHSS. Two percent of women taking gonadotropins will experience ovarian torsion, but with the proper precautions (including activity restrictions), this complication is very rare. Fertility drugs cause the ovaries to enlarge. Sometimes, the ovary can twist on itself, cutting off the blood supply. Surgery to untwist the ovary or even remove the ovary may be required.

Ovarian torsion may put your life and fertility at risk. If you experience severe pelvic pain, go to the nearest emergency room immediately.

(Video) The Truth About Fertility Drugs -- The Doctors

Allergic Reactions

Allergic reaction to fertility drugs is rare. However, as with any medication (or food), a reaction is possible.


You likely already know about the risk of multiples when using fertility drugs. Your risk of conceiving multiples will depend on what fertility treatment you are having and which medication you’re taking. For example, the risk of having twins when taking gonadotropins is three times as high as it is with Clomid.

Some people mistakenly think that multiples are only a risk withIVFtreatment. This isn't true. Your risk of multiples is much higher with IUI (insemination) treatment than with IVF.

Generally, withClomid, yourchance of having twinsis 10% Your chance of having triplets or more is less than 1%.

As many as 30% of pregnancies from gonadotropin fertility drugs are multiples. Two-thirds of those pregnancies are twin pregnancy, and a third are triplets or higher-order pregnancies.

Sometimes, a couple will hope that they do get pregnant with twins or triplets, or even ask their doctors to help. This isn't the best choice, for you or your baby.

Reducing Side Effects and Risks

It’s impossible to completely avoid all side effects. However, there are some things you or your doctor can do to reduce your risks.

Some side effects may be avoided or lessened by taking the medication at night or with food. Always talk to your doctor about the best time and way to take your medications.

Your doctor should also use the lowest effective dose. This is why it’s almost always better to start at a lower dose, and then increase the dosage if it doesn’t work, rather than start high.

Let your doctor know if your side effects are bad, even if they are mood-related side effects (which many people keep from their doctors). There may be an alternative drug.

To reduce your risk of conceiving twins or multiples, close monitoring of your cycle is important. With gonadotropins or Clomid, ultrasound can be used to determine how many potential follicles are developing. Every follicle is a potential baby, if you conceive.

Your doctor may cancel your cycle if she thinks your risk of multiples is high. You may be asked to avoid sexual intercourse. Listen to your doctor. Remember that a multiple pregnancy puts you and your future babies' health (and even life) at risk.

With IVF treatment, your risk of multiples can be reduced with single embryo transfer (SET). This isn’t appropriate for every couple, though. Talk to your doctor about your options.

(Video) What You Need to Know About Fertility Medications

Beware offertility clinicsthat are overly aggressive in theirtreatment of infertility. On the one hand, it may feel good to have a doctor promising you success and starting with the “best” or strongest treatments first. On the other hand, jumping up the ladder too quickly might lead to a premature fall.

How to Find the Best Fertility Clinic for You

Of course, even with careful monitoring and a responsible doctor, you still may develop OHSS or get pregnant with twins or more. In that case, the best thing to do is to follow your doctor's treatment advice and take care of yourself.

Good prenatal carecan lower the risks that comewith multiple pregnancies. With early detection and treatment, OHSS is rarely severe and usually can be dealt with at home.

Coping with Fertility Drug Side Effects

What can you do to relieve or reduce the discomfort of side effects? You should always talk to your doctor about this first. Let them know what you're experiencing. That said, here's some general advice.

Tylenol (or acetaminophen) is best for headaches or cramps. Talk to your doctor first, of course, but typically acetaminophen is the pain reliever of choice during fertility treatment. You should not take ibuprofen (Advil, Motrin) or naproxen (Aleve, Midol) because there is some concern these drugs can interfere with ovulation and embryo implantation.

Which Over-The-Counter Medications Are Safe When Trying to Conceive?

Dress in layers if you're experiencing hot flashes. You may also want to avoid drinking hot drinks, which might trigger a hot flash. If you dress in layers, and you're suddenly burning up, being able to strip (a bit) might help.

Take out your yoga pants. Or your sweatpants, or a long flowing summer dress—whatever will fit comfortably around your waist when you're bloated.

Stay hydrated. Drink a ton of water throughout any fertility treatment as the hormones can be very dehydrating and make you feel worse. Even though with the bloating it can seem counterproductive, make sure you are drinking extra water throughout your treatment.

Reach out for support and be forgiving of yourself. Infertility and fertility treatment alone are likely to have you feeling vulnerable and emotional. Add in some mood swings—thanks to the side effects of some hormones—and you'll likely be crying after a touching tire replacement commercial. Let your support circle know what you're going through and how they can help. You don't have to try to do this alone.

In Vitro Fertilization (IVF): What to Expect

(Video) #IVFfacts: Fertility drugs do not cause cancer | Esco Medical


What are the risks of taking fertility drugs? ›

having a multiple pregnancy or birth (twins, triplets or more) ovarian hyperstimulation syndrome (a severe reaction to fertility drugs) having an ectopic pregnancy. possible birth defects (these are rare and research is still ongoing).

Is it good to take fertility drugs? ›

Fertility drugs can treat many issues, increasing the chances of conceiving and carrying the baby to term. These drugs treat specific problems, so a person should take them only at a doctor's recommendation. Taking fertility drugs without a diagnosis will not necessarily increase the chances of getting pregnant.

What are the long term side effects of fertility drugs? ›

Infertility drugs may increase estrogen level during the follicular phase of ovulation stimulation cycles, and use of hCG and clomiphene for more than 6 months may increase the risk of uterine cancer (54).

Do fertility drugs affect the baby? ›

Tracking Birth Defects After Fertility Treatments

Overall, the study found that the risk of any birth defect in pregnancies involving assisted conception was 8% compared with 6% in babies conceived without assisted techniques. The risk of a birth defect after IVF was 7%.

Do fertility drugs affect egg quality? ›

High doses of drugs used to stimulate the ovaries of older women undergoing fertility treatment may be causing chromosomal abnormalities in their eggs, leading to failed pregnancies and even, potentially, babies with conditions such as Down's syndrome.

How long should I take fertility drugs? ›

You usually start taking them during your cycle, the second or third day after you see bright red blood, and continue taking them for 7 to 12 straight days. Sometimes, you may need to get injections along with Clomid that you take by mouth.

What is the best thing to take for fertility? ›

Antioxidants like folate and zinc may improve fertility for both men and women. They deactivate the free radicals in your body, which can damage both sperm and egg cells.

Can fertility drugs cause heart problems? ›

There were increased risks for women who underwent fertility treatments even when they had no preexisting symptoms of heart disease, the study also found. Women undergoing fertility treatments should work closely with their doctor to control their risk factors for heart disease.

Can fertility pills cause infertility? ›

What's the short answer? When it comes to birth control and fertility, there can be a lot of confusion. But hormonal contraceptives don't cause infertility , no matter which method you use or how long you've been using it. What they're designed to do, however, is temporarily delay your fertility and prevent pregnancy.

What is the most common fertility drug? ›

You've probably heard of Clomid before as it's the most common fertility drug. Clomid, or clomiphene citrate, is often the first drug tried when treating ovulatory dysfunction. 2 It may also be recommended in the early stages of treatment for couples diagnosed with unexplained infertility.

What are 5 factors that increase a woman's risk of infertility? ›

Certain factors may put you at higher risk of infertility, including:
  • Age. The quality and quantity of a woman's eggs begin to decline with age. ...
  • Smoking. Besides damaging your cervix and fallopian tubes, smoking increases your risk of miscarriage and ectopic pregnancy. ...
  • Weight. ...
  • Sexual history. ...
  • Alcohol.
Aug 27, 2021

What is the most common infertility problem for females admitted to IVF treatment? ›

Ovulatory disorders are the most common cause of female infertility. The failure to ovulate occurs in about 40% of women with infertility issues.

Are fertility hormones safe? ›

There are also risks to taking the drugs that are used in fertility treatments. Drug reactions can be mild, causing headaches or flushing. But they can also be dangerous, like Ovarian Hyper-Stimulation Syndrome (a reaction to certain drugs that stimulate egg production).

Do fertility drugs cause miscarriage? ›

Miscarriage. The risk of miscarriage after IVF is comparable to the risk commonly quoted for the general population. However there is variability in the numbers reported by different studies. According to recent Canadian statistics the risk of miscarriage following IVF is about 16%.

How common are twins with fertility drugs? ›

How likely is multiple gestation? Very possible. Depending on the type of fertility treatment used, if more than one follicle is produced, the risk of multiple gestation can be as much as 1 out of 3 women who become pregnant.

What are the pros and cons of Clomid? ›

Pros: Clomid can increase likelihood of ovulation and chance of conception for some women. Cons: Can cause ovarian cysts and increase risk of pregnancy with multiples. It can also cause hostile cervical mucus, vaginal dryness, headaches, fatigue, mood swings, hot flashes and abdominal discomfort.

How long do you take fertility drugs before egg retrieval? ›

Typically, you'll need one to two weeks of ovarian stimulation before your eggs are ready for retrieval.

What not to do when trying to get pregnant? ›

Things Not to Do If You Want to Get Pregnant
  1. Lose or Gain a Lot of Weight.
  2. Overdo the Exercise.
  3. Put Off Starting a Family Too Long.
  4. Wait Until You Miss Your Period to Stop Drinking.
  5. Smoke.
  6. Double Up on Your Vitamins.
  7. Amp Up on Energy Drinks or Espresso Shots.
  8. Skimp on Sex.
Feb 20, 2022

What vitamins should I take if trying to get pregnant? ›

Take a folic acid supplement

It's recommended that you should take a daily supplement of folic acid when you're pregnant, or there's a chance you might get pregnant. You should take a 400 microgram supplement of folic acid every day before you get pregnant, and every day afterwards, up until you're 12 weeks pregnant.

How can I get pregnant fast if I am infertile? ›

Two of the most common fertility treatments are:
  1. intrauterine insemination (IUI) Healthy sperm is collected and inserted directly into your uterus when you're ovulating.
  2. in vitro fertilization (IVF) Eggs are taken from your ovaries and fertilized by sperm in a lab, where they develop into embryos.

Can fertility drugs cause thyroid problems? ›

Increased thyroid cancer risk is associated with the use of fertility drugs, including the most commonly used fertility drug, clomiphene citrate.

Can fertility drugs cause leukemia? ›

However, people considering fertility drugs or IVF should know that the current research does not show a link between fertility drugs and an increased cancer risk.

Do fertility drugs cause anxiety? ›

Don't doubt for one moment that the hormonal changes some fertility drugs cause really can lead to mood swings. Some women experience few to no reactions, others report feeling very anxious and even depressed.

Do fertility pills cause twins? ›

Clomiphene and gonadotropins are commonly used fertility drugs that can increase your chances of having twins.

Do fertility vitamins help you get pregnant? ›

Fertility supplements provide micronutrients, or vitamins and minerals, that may help people increase their chances of pregnancy.

What is a good natural fertility drug? ›

Maca, a natural aphrodisiac, can help boost fertility! The first supplement to discuss is Maca (AKA maca-maca, maino, ayak chichira, macanoids and ayak willku). Maca is a commonly used fertility aid. In its natural form, it is a root plant that looks like a turnip; but has a chemical makeup similar to a grain.

What is a natural fertility drug? ›

Vitex and Maca – Nature's Clomid

For those wanting to use a more natural ovulation enhancer, Maca and Vitex may be the answer. Maca is used to regulate female hormones that aid in ovulation; increasing egg health and beefing up sperm production in men.

What drugs cause infertility in females? ›

Medications that raise prolactin hormone levels can affect ovulation and reduce fertility – chlorpromazine, prochlorperazine, haloperidol, risperidone, metoclopramide, methyldopa, cimetidine, some older antidepressants like amitriptyline, SSRI antidepressants like sertraline or fluoxetine, and many others.

What is the biggest risk factor for infertility? ›

Maternal age is probably the most significant factor related to a woman's ability to conceive. While many women today are waiting to become pregnant, the ovary's ability to produce normal, healthy eggs declines with age, increasing the risk of chromosomal abnormalities and unsuccessful implantation and pregnancy.

Who is most at risk for infertility? ›

Although advanced age plays a much more important role in predicting female infertility, couples in which the male partner is 40 years old or older are more likely to report difficulty conceiving. Being overweight or obese. Smoking. Excessive alcohol and drug use (opioids, marijuana).

Who are at risk of infertility? ›

Environmental and lifestyle factors such as smoking, excessive alcohol intake and obesity can affect fertility. In addition, exposure to environmental pollutants and toxins can be directly toxic to gametes (eggs and sperm), resulting in their decreased numbers and poor quality, leading to infertility.

Who is not a good candidate for IVF? ›

Not everyone is a good candidate for IVF

In vitro fertilization may not work for everyone. Conditions that may interfere with IVF success include fibroid tumors, ovarian dysfunction, abnormal hormone levels, and uterine abnormalities. Women with these issues may face lower rates of pregnancy with IVF.

Why is infertility so common now? ›

Couples are having children later

That number increases to 22% when the woman is 30 to 39. The main reason fertility decreases with age is because the quality of a woman's eggs declines as she gets older. And, as women are born with all the eggs they will ever have, older women have fewer eggs.

Which race has the highest sperm count? ›

Results: White men produced greater volumes of semen on average, however, Asian men had higher sperm concentrations and total sperm count.

Do fertility drugs cause weight gain? ›

It's not uncommon for women to gain a little weight during IVF treatments. Hormone injections can affect your weight and also your hunger levels (read # 4).

Can too much hormone cause infertility? ›

Hormonal imbalances are the leading cause of infertility in women, but are often treatable with lifestyle changes and medications. Hormonal imbalance can also cause infertility in men, but is a less common infertility factor in men than it is in women.

Can fertility drugs delay period? ›

So, does taking fertility drugs delay your period? If you are successful and get pregnant after using fertility drugs, your period will be delayed, otherwise, your period will be normal.

How long can you take fertility drugs? ›

Most studies of women using fertility drugs suggest that there are few if any long-term risks. However, a few studies suggest that women taking fertility drugs for 12 or more months without a successful pregnancy might be at increased risk of borderline ovarian tumors later in life.

What is the best fertility drug to get pregnant? ›

Human chorionic gonadotropin(hCG), such as Novarel, Ovidrel, Pregnyl, and Profasi. This medication is usually used along with other fertility drugs to trigger your ovaries to release an egg. Follicle-stimulating hormone (FSH), such as Bravelle, Fertinex, Follistim, and Gonal-F.

Do fertility drugs make you more likely to have twins? ›

Infertility treatments that cause multiple eggs to develop make it more likely that you will become pregnant with twins, triplets, or more.

When should you stop taking fertility treatments? ›

Signs that It May Be Time to Stop Fertility Treatment
  1. The fertility drugs are causing painful or adverse symptoms, ranging from physical pain to severe mood swings.
  2. You're already in debt and cannot afford another cycle.
  3. You cannot stand to be around anyone but your partner and your doctor.
Aug 20, 2021

When should I stop taking fertility pills? ›

Unless your provider tells you otherwise, stop taking any supplements or herbal products when you get pregnant, as most of these products have not been proven to be safe to take during pregnancy. Once you get pregnant, it will be time to switch to prenatal vitamins as recommended by your provider.

Do fertility drugs make you gain weight? ›

It's not uncommon for women to gain a little weight during IVF treatments. Hormone injections can affect your weight and also your hunger levels (read # 4).

What is the most likely to cause infertility? ›

Polycystic ovary syndrome (PCOS).

PCOS causes a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It's the most common cause of female infertility.

How fast can you get pregnant with fertility pills? ›

The majority of couples who get pregnant do so within 4-5 cycles, but it can take a longer or shorter period of time. When going through fertility drug cycles, it is important to understand the potential side effects that may occur.

What drugs affect female fertility? ›

For both men and women, taking cocaine, heroin, ecstasy, cannabis and other recreational drugs can reduce the chance of having a baby. Taken over a long period of time, recreational drugs can cause permanent problems with the reproductive system and infertility.

What not to do while taking Clomid? ›

Clomiphene for female fertility

Because Clomid can cause side effects like blurred vision or dizziness, it is safest to avoid any hazardous activity, like driving or using heavy machinery, until you know how the drug affects you.

Are Clomid babies normal? ›

Clomid (clomiphene), a pill taken by mouth to induce ovulation, causes twin pregnancies between 5% and 12% of the time. 1 That's fewer than one in 10 pregnancies. Your odds of conceiving triplets (or more) on Clomid is even lower: less than 1% (less than one in 100 pregnancies).


1. OHSS is the biggest risk of IVF - What every woman needs to know
(Infertility TV)
2. Types of Fertility Medications
(Mount Sinai Fertility Toronto)
3. The Truth About Fertility Drugs
(Egg Whisperer Show)
4. How long does it take for fertility drug to work? - Dr. Sangeeta Gomes
(Doctors' Circle World's Largest Health Platform)
5. Infertility Treatment for Women - Fertility Drugs - Infertility TV
(Infertility TV)
6. What Is the Risk of Multiples — Twins, Triplets — with Fertility Drugs and IVF?
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