IVF medicines do four main jobs: they help follicles (the small sacs that hold eggs) grow, prevent the eggs from being released too early, help the eggs mature before retrieval, and support the lining of the uterus. You will not take every medicine on this page. Your clinic picks the ones that fit your plan and sets each dose and time.
If you missed a dose or a plan changed, go to schedule changes. For symptoms that need help now, see when to get help.
Why IVF uses so many medicines
IVF works in steps, and each step needs a different medicine. Some are pills and some are shots. Others are patches you wear on your skin, or medicines placed in the vagina.
Your doctor picks the type, dose and timing based on your age, your health history, your hormone levels and how you responded to any earlier cycles. The same medicine can also do a different job at a different point. Estrogen, for example, may be used before stimulation to help time your cycle, and later to build up the lining of the uterus.
IVF medication list by stage
| Stage | Medicine type | What it does | How it is given |
|---|---|---|---|
| Before you start | Birth control pills or estrogen | Helps control the timing of your cycle | Pills or shots |
| Stimulation | Gonadotropins (FSH, LH, hMG) | Help many follicles grow at once | Shots |
| Stimulation | GnRH agonists (such as leuprolide) or antagonists (such as ganirelix or cetrorelix) | Prevent early egg release | Shots (leuprolide, ganirelix and cetrorelix) |
| Trigger | hCG, leuprolide, or both | Help eggs mature before retrieval | Shot, at an exact time |
| Lining support | Progesterone | Prepares and supports the lining | A shot into a muscle, or a vaginal gel, insert or suppository |
| Lining support | Estrogen (estradiol) | Builds up the lining | Pill, shot or skin patch |
Generic and brand-name examples
You may see brand names on your boxes. Here are some U.S. products, named as their FDA labels name them. This is a list of examples, not a recommendation. Your clinic chooses your products.
| Medicine type | Generic name | U.S. brand examples |
|---|---|---|
| FSH | follitropin alfa; follitropin beta | GONAL-f RFF Redi-ject; Follistim AQ Cartridge |
| FSH and LH (hMG) | menotropins | MENOPUR |
| GnRH antagonist | cetrorelix acetate; ganirelix acetate | Cetrotide; Fyremadel; ganirelix acetate injection (several makers sell it under this generic name) |
| GnRH agonist | leuprolide acetate | Your clinic or pharmacy names the product |
| hCG | choriogonadotropin alfa; chorionic gonadotropin | Ovidrel; Novarel, Pregnyl |
| Progesterone, vaginal | progesterone | ENDOMETRIN (insert); Crinone 8% (gel) |
The same medicine can come in more than one strength and form, so always check the full name and strength on the box against your plan.
Before stimulation: getting your cycle ready
Before IVF starts, your provider may prescribe birth control pills or estrogen. This helps stop ovarian cysts from forming and lets your clinic control the timing of your cycle, so your eggs start growing at the same time.
Stimulation shots: helping follicles grow
During stimulation, you take shots called gonadotropins. These hormones tell your ovaries to grow more than one follicle at a time. They contain FSH (follicle-stimulating hormone), LH (luteinizing hormone), or both. They are injected either into a muscle or just under the skin.
You can expect around 8 to 14 days of these shots. Your clinic will tell you how long yours last.
Medicines that prevent early egg release
While your follicles grow, your body could release the eggs too soon. Two kinds of medicine prevent that:
- GnRH antagonists, such as ganirelix and cetrorelix, block the signal for release right away.
- GnRH agonists, such as leuprolide, first cause a short rise in hormones and then a drop that prevents release.
Neither kind works when taken by mouth. Which one you take depends on your stimulation protocol.
The trigger
When your scans and blood tests show the eggs are nearly ready, your clinic gives you a trigger medicine plan and an exact time. The trigger helps the eggs mature before retrieval. It may be hCG or leuprolide.
Leuprolide can do two different jobs. Used steadily during stimulation, it prevents early egg release. Given as a trigger, it helps the eggs mature. Some plans combine hCG with a GnRH agonist such as leuprolide, which is called a dual trigger. Researchers are still studying who it helps. Your plan will say which medicines you take and when.
Egg retrieval is done 34 to 36 hours after the trigger, so the clock time matters. Write it down exactly as your clinic gives it, and set an alarm.
Progesterone and estrogen: supporting the lining
Progesterone prepares the lining of the uterus so an embryo can attach, and it supports an early pregnancy. In IVF it is given as a shot into a muscle, or placed in the vagina as a gel, insert or suppository. A progesterone pill taken by mouth does not work well here, because the stomach does not absorb enough.
The forms are different products, so do not switch from one to another without your clinic's instructions. Sources give different lengths of time for taking progesterone. Your clinic will tell you when to stop.
Estrogen helps thicken the lining. Most people take it before and after a transfer.
Medicines for a frozen embryo transfer
A frozen embryo transfer has its own plan. In a "programmed" cycle:
- You may first take a medicine to quiet your ovaries.
- Next you take estradiol, a form of estrogen, as a pill, shot or patch.
- An ultrasound checks if the lining is thick enough.
- Then you start progesterone, as a shot into a muscle or as a gel or tablet placed in the vagina.
The progesterone start time is very important, because it is tied to when your embryos will be thawed and transferred. Our guide to a medicated frozen embryo transfer explains these steps.
Why your schedule changes
During stimulation, your clinic checks you with blood tests and vaginal ultrasounds, sometimes as often as every day. After each visit, your nurse may keep your dose the same, change it, or add a medicine. To keep track, copy our blank IVF medication schedule, which has columns for strength, route, time and changes.
Schedule changes
If you missed a dose or are unsure about a change, call your clinic rather than guess. Your clinic makes every dosing decision, so it needs to hear quickly and clearly what happened.
If you missed a dose, or are not sure you took it right:
- Call your clinic as soon as you notice. Use the after-hours line if the office is closed.
- Do not take an extra dose or change the next one on your own. Take medicines exactly as your provider tells you.
- Have your medicine box and your schedule in front of you when you call.
What to write down before you call:
- The medicine name and strength, as printed on the box.
- The dose and time you were supposed to take.
- What actually happened, and when you noticed.
- Any symptoms you have.
How to check a change from your clinic:
- Write the new instructions down while you are on the phone.
- Read them back to the nurse: medicine, strength, dose, how it is given, time and start date.
- Ask if the change replaces your old plan or adds to it.
- Ask for the change in writing, such as in your patient portal, if your clinic offers that.
- Cross out the old line on your schedule and add the new one with the date.
Contact your provider whenever you have questions or feel confused about the directions for a medicine.
Side effects
Fertility medicines can cause bloating, belly pain, mood swings, headaches and bruising from shots. Our guide to IVF medication side effects covers each medicine type. For how to keep and carry your medicines, see storage and travel.
In rare cases, fertility medicines cause ovarian hyperstimulation syndrome (OHSS). The ovaries swell, and fluid can build up in the belly and chest.
When to get help
Call your clinic right away, day or night, if you have:
- A fever of 100.4°F (38°C) or higher.
- Heavy bleeding: soaking a full-size pad with bright red blood in less than an hour, or bleeding heavier than a period. Before a transfer, call for bleeding your clinic did not tell you to expect or a brown, watery discharge. After one, call for any bleeding.
- Belly or pelvic pain that is severe, gets worse, or isn't eased by the pain relief your clinic recommended.
- Pain and bloating in your belly, or bloating that is getting worse.
- Nausea and vomiting, nausea that won't go away, or you can't keep fluids down.
- Peeing less than usual, even if you are not thirsty.
- Fast weight gain. Your clinic will tell you its number, but do not wait to reach a weight threshold if you feel unwell.
- Before a transfer: sudden belly pain, dizziness, lightheadedness, or feeling faint.
- Pain, redness or warmth in an arm or leg.
- Blood in your urine, or pain when you pee or poop.
- Discharge from your vagina that smells bad, after a retrieval.
Tell your clinic at your next contact about other milder symptoms that are new, don't go away or slowly get worse.
Key takeaway
IVF medicines help follicles grow, prevent early egg release, help eggs mature and support the lining. Keep your clinic's latest plan written down, with each medicine's full name and strength, and call the clinic before you change, skip or make up any dose.