Because in vitro fertilization (IVF) involves the use of hormone medications, the side effects you may experience are similar to those you may usually have during a menstrual period, only more intense. That said, it’s important to know the side effects associated with the medications and know when you may want to contact your fertility clinic or seek medical care.

Stimulation injection side effects

During ovarian stimulation, you will use injectable hormone medications to encourage more follicles to develop in your ovaries, and to control ovulation. The most commonly experienced side effects of these medications include headache, nausea, abdominal pain, bloating, and injection site tenderness.

Below are some frequently used ovarian stimulation medications and the side effects you may experience in addition to the ones above. Please note that though these are the most commonly reported side effects, you may not experience all or any of these:

• Follistim (follitropin) or Gonal-F side effects - vomiting, breast tenderness
• Menopur side effects (menotropins) - drowsiness, breast tenderness, dizziness, vomiting, diarrhea, fever, chills, muscle aches, rash
• Cetrotide side effects (cetrorelix) - vomiting
• Lupron side effects (leuprolide) - hot flashes, mood swings, joint pain, anxiety, dizziness, vaginal dryness/irritation
• hCG side effects - fatigue, tiredness, breast tenderness

A more serious result of ovarian stimulation medications may be the development of ovarian hyperstimulation syndrome (OHSS). OHSS is an uncomfortable and potentially dangerous condition that may develop after ovarian stimulation if you developed a large number of follicles (more than 20) and/or had high estrogen levels before the trigger shot was administered. Mild cases involve bloating, constipation, reduced urinary output, and abdominal pain. While rare, more severe symptoms include rapid weight gain (more than 2.2 pounds in one day), nausea and/or vomiting, severe abdominal pain, and/or shortness of breath. If you suspect that you are experiencing OHSS, you may consider contacting your fertility clinic.

Trigger shot side effects

At the end of ovarian stimulation, you will self-administer a “trigger” shot, which gives the signal to your follicles to mature so they can be collected during an egg retrieval procedure. Common side effects of these medications include headache, abdominal pain, bloating, and injection site tenderness. Below are some of the frequently used trigger shot medications and their potential side effects:

• Novarel/Pregnyl side effects - stomach/pelvic pain, restlessness, irritability
• Ovidrel side effects - confusion, dizziness, headache, vomiting, irritability, restlessness, breast tenderness
• Lupron side effects (leuprolide) - hot flashes, headaches, mood swings, joint pain, anxiety, dizziness, vaginal dryness/irritation

Embryo transfer injection side effects

Before and after embryo transfer, you may self-administer injectable medications to help prepare your uterus for transfer and support an early pregnancy. The most commonly experienced side effects of these medications include headaches, injection site tenderness, breast tenderness, bloating, and or swelling of hands and feet. Medication-specific side effects that you might experience are below:

• Progesterone side effects - dizziness, constipation, diarrhea, joint pain, hot flashes, vaginal discharge
• Estrace side effects (estrogen) - light vaginal bleeding, nausea, vomiting, vaginal itching and/or discharge

Serious side effects of IVF medications

Most patients complete their IVF cycle without serious side effects. However, if any of the above side effects persist or get worse, you may consider contacting your fertility clinic, clinician, or other medical care. This is particularly the case if you experience eye symptoms (vision loss, blurring, halos around light, eye pain), heart symptoms (fast, irregular, or pounding heart, shortness of breath, lightheadedness), headache, confusion, slurred speech, fever, and/or stiff muscles after taking any of these medications.