A Patient-Friendly Guide to Common Fertility Medication Symptoms
Fertility medications play a vital role in helping many individuals and couples grow their families. These medicines support ovulation, egg development, hormone balance, and overall treatment success. But as your body responds, it’s completely normal to experience side effects—some expected, some surprising, and some worth reaching out about.
This guide breaks down what’s typical, why these symptoms happen, and when to contact your care team at Tennessee Fertility Institute (TFI), so you can feel informed and prepared at every step of your treatment.
Why Fertility Medications Cause Symptoms
Most fertility medications work by stimulating your ovaries or adjusting hormone signals in your brain. Because hormones influence many systems in the body, changes during treatment can lead to:
-
Mood fluctuations
-
Fluid shifts and bloating
-
Headaches
-
Breast tenderness
-
Mild discomfort near the ovaries
Everyone’s body responds differently—so it’s important to try not to compare your experience with someone else’s. “Typical” looks different for each patient.
1. Oral Ovulation Medications
Letrozole (Femara)
Letrozole is frequently used as a first‑line ovulation induction medication, especially for patients with polycystic ovary syndrome (PCOS) or irregular cycles, either for timed intercourse or intrauterine insemination (IUI) cycles. It helps the body release a mature egg when natural ovulation is not happening regularly.
Common Symptoms:
Headaches, hot flashes, fatigue, dizziness, mood changes
Why it causes symptoms:
Letrozole temporarily lowers estrogen levels, and low estrogen can affect temperature regulation, blood vessels, and mood‑related neurotransmitters — leading to hot flashes, headaches, and fatigue.
Clomiphene Citrate (Clomid)
Clomid is a long‑established option for patients who need help triggering ovulation. It’s often used for those with ovulatory dysfunction who don’t ovulate regularly on their own. It is also used during the ovulation induction stage, often for timed intercourse or IUI.
Common Symptoms:
Hot flashes, mood swings, headaches, bloating, breast tenderness, rare visual disturbances
Why it causes symptoms:
Clomid blocks estrogen receptors in the brain, tricking it into increasing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) release. This estrogen‑blocking effect also disrupts the body’s temperature control and emotional regulation, causing common PMS‑like symptoms.
2. Injectable Stimulation Medications
FSH Injections (Follistim®, Gonal‑F®)
FSH injections help the ovaries grow multiple follicles in preparation for egg retrieval in in vitro fertilization (IVF) or to support a more robust ovulatory response in IUI. They are used during the ovarian stimulation phase of IVF and sometimes in medicated IUI cycles.
Common Symptoms:
Bloating, pelvic pressure, injection‑site irritation, mood shifts
Why they cause symptoms:
FSH directly stimulates the ovaries to grow follicles. As follicles enlarge, the ovaries become temporarily bigger than usual, causing pelvic pressure and bloating. Hormonal surges may also influence mood.
FSH + LH Combination (Menopur®)
Menopur is used for patients who benefit from both FSH and LH support to optimize follicle development and estrogen production during IVF. It is used during IVF stimulation, often in protocols tailored for patients with lower ovarian reserve or previous suboptimal response.
Common Symptoms:
Stinging during injection, bloating, headaches, breast tenderness
Why it causes symptoms:
The medication’s formulation creates a distinctive stinging sensation. The combined hormonal stimulation increases estrogen levels and follicle growth, causing fluid shifts and breast tenderness.
3. Antagonists (Cetrotide®, Ganirelix®)
Antagonists prevent a premature LH surge, ensuring follicles don’t release eggs before retrieval — this is critical for a successful IVF cycle. Antagonists are added mid‑stimulation during IVF cycles, once the follicles have reached a certain size.
Common Symptoms:
Redness or itching at injection site, headaches, fatigue, mild abdominal discomfort
Why they cause symptoms:
These medications suppress LH quickly, which can temporarily alter the body’s hormone rhythm, leading to headaches or fatigue. Skin welts can occur because some people react to the antagonist formulation locally.
4. Trigger Shots (hCG Trigger or Lupron® Trigger)
Trigger shots induce final egg maturation, preparing eggs for retrieval (IVF) or ovulation timing (IUI).
Common Symptoms:
Bloating, breast tenderness, pelvic heaviness, mood changes
Why they cause symptoms:
Triggers create a strong hormone surge that mirrors the body’s natural LH spike. This sudden hormonal shift produces symptoms similar to PMS or early pregnancy.
5. Progesterone Supplements (PIO injections, vaginal suppositories or gels)
Progesterone supports the luteal phase and helps prepare the uterine lining for implantation after ovulation or embryo transfer. Progesterone supplements are used after IUI, after timed intercourse cycles, and routinely after embryo transfer in IVF.
Common Symptoms:
Breast tenderness, bloating, fatigue, cramping, mood changes, discharge (vaginal forms)
Why they cause symptoms:
Progesterone creates a pregnancy‑like hormonal environment, which naturally leads to symptoms that closely resemble early pregnancy.
When Symptoms Are Normal vs. Concerning
Please contact your care team right away if you notice any of the following symptoms:
-
Severe or sudden bloating
-
Significant abdominal pain
-
Rapid weight gain
-
Shortness of breath
-
Persistent nausea or vomiting
-
Vision changes
-
Heavy bleeding
-
Signs of an allergic reaction
These may indicate ovarian hyperstimulation syndrome (OHSS) or another complication requiring care.
Quick Tips for Managing Common Symptoms
-
Hydrate well (electrolyte drinks can help reduce bloating).
-
Use heat packs for abdominal discomfort (unless instructed otherwise).
-
Rotate injection sites to reduce skin irritation.
-
Eat small, balanced meals if nausea or bloating occurs.
-
Move gently—short walks can relieve pelvic pressure.
-
Lean on your support system—emotional changes are normal.
Remember: Every Patient Responds Differently
Not experiencing many symptoms? That’s okay. Experiencing more than expected? Also okay. What matters most is keeping open communication with your TFI care team—we’re here to guide you through every question, every symptom, and every milestone of your treatment.