Do You Know the Risks of Fertility Drugs? (2022)

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.

Know the Risks and Side Effects of Clomid

(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.

Letrozole Use in Infertility

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.

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) What You Need to Know About Fertility Medications

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) Fertility Treatment: Any Long Term Health Risks?

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.

Questions to Ask Before You Hire Your Fertility Doctor

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.


What are the risks of taking fertility drugs? ›

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).

What are the advantages of taking fertility drugs? ›

These medications can help increase sperm count and motility. Women can benefit from using fertility drugs to regular their menstrual cycle. By being able to more accurately chart and predict a woman's cycle, the exact time of ovulation can increase the likelihood of a natural pregnancy.

When Should fertility drugs be taken? ›

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.

Do fertility drugs affect the baby? ›

Even if you get pregnant with just one baby, some fertility treatments make your baby more likely to have problems than a baby born without fertility treatment. These include premature birth, low birthweight and birth defects.

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

Complications of these drugs include ovarian hyper-stimulation syndrome, osteoporosis, and adverse pregnancy outcomes (6, 7). In recent years, there have been many debates about the relationship between ovulation-inducing drugs, infertility treatment, and cancer (8–10).

How do I know if I am fertile enough to get pregnant? ›

If your menstrual cycle lasts 28 days and your period arrives like clockwork, it's likely that you'll ovulate on day 14. That's halfway through your cycle. Your fertile window begins on day 10. You're more likely to get pregnant if you have sex at least every other day between days 10 and 14 of a 28-day cycle.

What is the success rate of fertility drugs? ›

Success rates: Successful pregnancy rates with fertility medications depend on the drug. For hormone shots it's 32 percent, for letrozole it's 28 percent, for Clomid it's 23 percent and for Femara it's 18 percent.

What is the best fertility drug? ›

Clomiphene (Clomid): This drug can trigger ovulation. Many doctors recommend it as the first treatment option for a woman with ovulation problems. Letrozole (Femara): Like clomiphene, letrozole can trigger ovulation. Among women with PCOS, especially those with obesity, letrozole may work better.

What can I use to clean my womb to get pregnant? ›

10 Detox Tips for Women Trying to Get Pregnant
  • Drink Lemon Water Daily. ...
  • Clean Up Your Diet. ...
  • Move Your Body. ...
  • Try Dry Brushing. ...
  • Fertility Cleansing. ...
  • Boost Regular, Daily Detoxification with Specific Herbs. ...
  • Utilize Castor Oil Therapy. ...
  • Fertility Massage.
Aug 2, 2021

How do I know if I'm fertile female? ›

8 Signs of Fertility to Look for Each Month
  1. Sign #1: A Positive Result from Your Ovulation Predictor. ...
  2. Sign #2: A Change in Your Cervical Mucus. ...
  3. Sign #3: Increased Sex Drive. ...
  4. Sign #4: Increased Sense of Smell. ...
  5. Sign #5: Lower Abdominal Pain. ...
  6. Sign #6: Change in Your Cervical Position. ...
  7. Sign #7: Breast Tenderness.

How long does fertility treatment take to work? ›

IVF involves several steps — ovarian stimulation, egg retrieval, sperm retrieval, fertilization and embryo transfer. One cycle of IVF can take about two to three weeks. More than one cycle may be needed.

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.

Can fertility drugs cause liver problems? ›

Hormonal Meds Come with Side Effects

Ovary-stimulating medications up the estrogen in your body. This will tell your liver to bump up its production of compounds that can lead to blood clots, so you do have a slightly higher risk of those during IVF treatment, Chang says.

Does fertility drugs delay period? ›

Progesterone Support

Progesterone can delay your period, so a pregnancy test must be performed. If pregnancy occurs, the medications will continue until around the 10th week of pregnancy. If the pregnancy test is negative, the medication is stopped, and a period will occur in 2–7 days.

Can fertility drugs cause blood clots? ›

Health professionals treating pregnant women need to be even more alert to signs of pulmonary embolism and venous thromboembolism if their patient conceived using in vitro fertilization.

What fertility drugs can I take to conceive twins? ›

Clomiphene and gonadotropins are commonly used fertility drugs that can increase your chances of having twins. Clomiphene is a medication available only through prescription. In the United States, the brand names for the drug are Clomid and Serophene.

Can fertility drugs cause diabetes? ›

Conclusion(s): No association between fertility treatment and childhood type 1 diabetes mellitus was found. Ovulation induction or intrauterine insemination with follicle-stimulating hormone may be associated with an increased risk of childhood type 1 diabetes mellitus.

How can a woman become more fertile? ›

How to get pregnant: Step-by-step instructions
  1. Record menstrual cycle frequency. ...
  2. Monitor ovulation. ...
  3. Have sex every other day during the fertile window. ...
  4. Strive for a healthy body weight. ...
  5. Take a prenatal vitamin. ...
  6. Eat healthy foods. ...
  7. Cut back on strenuous workouts. ...
  8. Be aware of age-related fertility declines.
Dec 10, 2021

How do you know if you have fertility problems? ›

The main symptom of infertility is the inability to get pregnant. A menstrual cycle that's too long (35 days or more), too short (less than 21 days), irregular or absent can mean that you're not ovulating. There might be no other signs or symptoms.

What are the chances of getting pregnant with fertility treatment? ›

If you're considering a fertility treatment, it's normal to wonder, "What are my chances of getting pregnant?" It's also smart to ask about success rates of any treatment or clinic you're thinking about. Overall, the success rate of fertility treatment is about 50%.

What are the 3 main types of fertility treatments? ›

There are 3 main types of fertility treatment:
  • medicines.
  • surgical procedures.
  • assisted conception – including intrauterine insemination (IUI) and in vitro fertilisation (IVF)

What fertility treatment has the highest success rate? ›

IVF is the most successful fertility treatment, and often helps couples get pregnant when other infertility treatment options have failed. It can be especially successful when combined with other procedures.

What are names of fertility drugs? ›

The following are some of the infertility medications available in the U.S.:
  • Bravelle (follicle stimulating hormone)
  • Cetrotide (gonadotropin-releasing hormone antagonist)
  • Clomid (clomiphene citrate)
  • Crinone (progesterone)
  • Dostinex (prolactin reducing)
  • Factrel (gonadotropin-releasing hormone)
  • Femara (Letrozole)
Feb 4, 2021

Do fertility drugs make you gain weight? ›

Researchers have consistently proved that fertility treatment does not lead to true weight gain. If you're undergoing infertility treatment, it's worth noting that the process in general — and the drugs in particular — may leave you feeling moody and blue.

Can you get pregnant while pregnant? ›

A double pregnancy, or superfetation, is extremely rare — in fact, there aren't even stats on how often it happens — but it's scientifically possible. We're not saying you should worry about it happening to you, just that you can't say that it's impossible. Here's why.

Is lemon water good for fertility? ›

Adding half of a fresh squeezed lemon to your water can really up the game. Lemon is loaded with vitamin C and potassium and both are fantastic for supporting fertile health.

What should I do before fertility treatment? ›

Before you start your IVF journey, we recommend that you prepare your body for treatment in the following ways:
  1. Eat a healthy, well balanced diet.
  2. Start taking prenatal vitamins.
  3. Maintain a healthy weight.
  4. Stop smoking, drinking alcohol and recreational drugs.
Nov 10, 2020

What is the first step to fertility treatment? ›

The First Step: Accurate Infertility Testing and Diagnosis
  1. A complete review of your personal and family medical/reproductive history.
  2. Semen analysis ad male factor infertility testing (we prefer to repeat a semen analysis even if you received the “green light” from your GP.
Jul 7, 2020

How many eggs does a woman have? ›

At birth, there are approximately 1 million eggs; and by the time of puberty, only about 300,000 remain. Of these, only 300 to 400 will be ovulated during a woman's reproductive lifetime. Fertility can drop as a woman ages due to decreasing number and quality of the remaining eggs.

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 drugs affect female fertility? ›

Some of the most common medicines that affect fertility in women are:
  • Meloxicam, diclofenac or other non-steroidal anti-inflammatories (NSAIDs). ...
  • Anti-epileptic drugs (AEDs). ...
  • Antipsychotics (neuroleptic medicines). ...
  • Thyroid medication. ...
  • Spironolactone, a diuretic used to treat swelling (oedema).

How can I make myself more fertile? ›

How to Increase Fertility Naturally: 9 Ways to Improve Fertility
  1. Stick to a fertility diet. ...
  2. Maintain a healthy weight. ...
  3. Eliminate alcohol and tobacco. ...
  4. Take prenatal vitamins. ...
  5. Stay hydrated. ...
  6. Manage stress. ...
  7. Monitor your ovulation. ...
  8. Get busy in the bedroom.
Apr 24, 2020

What are signs of not being able to have a baby? ›

What Are the Signs of Not Being Able to Have a Baby?
  • How Common Is Infertility? While some people seem to have an easy time having a baby, others struggle. ...
  • Trying to Get Pregnant for 12 Months Without Results. ...
  • Heavy Periods. ...
  • Irregular Periods. ...
  • Ejaculation Problems. ...
  • Pain During Sex. ...
  • Trouble Keeping an Erection. ...
  • A Woman's Age.
Sep 30, 2021


1. Prioritising Patient Safety: How to Minimise Risk in Fertility Treatment
(Progress Educational Trust)
2. How Can We Reduce the Risk of Multiples while Using Fertility Drugs?
3. The Truth About Fertility Drugs
(Egg Whisperer Show)
4. What Is the Risk of Multiples — Twins, Triplets — with Fertility Drugs and IVF?
5. OHSS is the biggest risk of IVF - What every woman needs to know
(Infertility TV)
6. About Fertility Drugs | Infertility

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