In vitro fertilization and the egg/embryo freezing processes require a few different medications, taken at different times throughout the cycle, that have different functions within your body. Below, we’ve provided a glossary of fertility medications: what they contain, what they do, and anything else you need to know.
Remember, your specific medication plan will depend on your biology, so always follow the instructions provided by your healthcare team—and don’t hesitate to contact us with any medication questions.
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Purchasing your medication
All of the medications listed below will be purchased through a specialty pharmacy, and our healthcare team can provide pharmacy recommendations. Patients are free to purchase from any online or brick-and-mortar pharmacy they wish, and may choose a specific pharmacy based on a lower price, insurance coverage, easy delivery, or fast turnaround. We urge anyone purchasing their medication online or from out of the country to be very certain that they’re getting quality medication produced by a legitimate pharmaceutical manufacturer. If you have any questions, our team is happy to help.
Most IVF and egg/embryo freezing medications are injectables
You’ll receive training, during the logistics class, on how to inject your medications—and it’s not as bad as you might think. Most patients find the injections easy once they receive hands-on instruction from a nurse. As for the discomfort level, that’ll depend on how sensitive you are, but because the injections are made subcutaneously (under the skin, not into the muscle like a flu shot) and with short, thin needles, it’s generally more of a pain than it is painful.
Need a refresher? See medication instruction videos here.
You’ll be closely monitored throughout the process
The doctor will check in on your progress with 5–7 short office visits, known as “monitoring” visits. These visits, typically scheduled in the morning before work, usually take under 30 minutes, and may include a blood test and/or an ultrasound to assess how your body is responding to the medication. Because each body is different, the doctor can use the information gained at these visits to adjust your medication or your cycle schedule, if necessary.
Glossary of IVF and egg/embryo freezing medications
Follicle-stimulating hormone (FSH)
Brand names: Gonal-F, Follistim
Follicle-stimulating hormone, a naturally occurring hormone in the body, promotes the growth of the ovarian follicles that contain eggs. During IVF and egg/embryo freezing, the goal is to produce as many eggs as you healthfully can, increasing the chances of finding healthy eggs later. The FSH injections used get your ovaries working overtime to mature multiple eggs, instead of the single egg typically ovulated in a menstrual cycle.
Though Gonal-F and Follistim are made by different manufacturers (kind of like Coke and Pepsi), they’re completely interchangeable, even within the same cycle. Follistim comes in medication cartridges that are inserted into a pen for injection, and Gonal-F comes as a prefilled pen. FSH medication is normally started on the first or second day of your period, and is injected once or twice daily for 8–11 days, depending on your body’s response to the medication.
Learn more about egg freezing side effects.
Menotropin or human menopausal gonadotropin (hMG)
Brand name: Menopur
Egg freezing patients are typically prescribed both FSH and menotropin. Menotropin is a combination hormonal medication that contains FSH and luteinizing hormone (LH); LH works with FSH to stimulate egg production in the follicles and to prompt ovulation. Like FSH, Menopur is typically begun on day one or two and continued for 8–11 days. Menopur requires mixing powder with sodium chloride fluid to reconstitute the medication, which is injected using a syringe.
About 1 in 4 patients taking FSH and menotropin (Menopur) report side effects that are similar to PMS symptoms: headaches, mood swings, insomnia, hot/cold flashes, breast tenderness, or bloating. These side effects are short-term, lasting only as long as the patient is taking the medication. Additionally, patients report that Menopur is a little more painful than other injections, and can sting or burn on the way in—this is normal, and will fade after you’ve completed the shot.
Rarely, fertility medications can result in “ovarian hyperstimulation syndrome” or OHSS, but this is generally preventable through careful monitoring, like we implement here at Extend Fertility.
Such as: Ganirelix, Cetrotide
GnRH-antagonists, or just “antagonists,” work to prevent you from ovulating early by blocking certain hormones in the pituitary gland. This helps time your cycle so your body will release mature eggs just before the egg retrieval—instead of releasing them prematurely. Antagonists are typically injected once daily, beginning about half or two-thirds of the way through your cycle.
Just like Gonal-F and Follistim, Ganirelix and Cetrotide is the same medication known by two different names. These medications come as pre-filled syringes. Some patients report that Ganirelix is a bit more difficult to inject than their other fertility medications, and they need to use more pressure when inserting the needle—this is normal!
Leuprolide acetate “trigger”
Brand name: Lupron
Taken exactly 36 hours before the egg retrieval, the “trigger” medication initiates the final egg maturation. Leuprolide is in a class of medications called gonadotropin-releasing hormone (GnRH) agonists (the opposite of the antagonists defined above). Essentially, it tells the pituitary gland to stop producing luteinizing hormone and stimulates the ovaries to release estrogen.
It’s really important for the success of your cycle that you inject this medication at the exact time instructed, and that you inject all of the medication. Lupron comes as a single pre-filled syringe.
Human chorionic gonadotropin (hCG) “trigger”
Brand names: Ovidrel, Novarel, Pregnyl
This is an alternative trigger medication which serves much the same function as the leuprolide trigger: to prompt your body to complete egg maturation. Your doctor will prescribe either a leuprolide acetate (Lupron) trigger or an hCG trigger, depending on your individual biology, your hormone levels, and the other medications you’ve been using throughout the cycle.
hCG comes in many brand names. Most of them come as a single pre-filled syringe, but if yours comes in a different form (because of your pharmacy or insurance specifications), contact your healthcare team so they can give you instructions specific to your medication. Like Lupron, it’s critical that the hCG trigger be taken at the exact time instructed—no earlier and no later.
Brand names: Zithromax, Z-Pak
This is the final medication involved in egg/embryo freezing, which you’ll take after the egg retrieval. Azithromycin is an antibiotic. During the egg retrieval, the doctor will be using an ultrasound-guided needle, inserted through the vaginal wall, to retrieve the eggs from your ovaries. While complications after egg retrieval are very rare (less than 1%), taking these antibiotics after the procedure reduces any chance of infection.
Like all antibiotics, it’s really important that you take the entire course of medication prescribed, even if you’re feeling fine after the procedure.