IVF Medications & Side Effects — What to Expect During Your IVF Cycle

Understanding IVF Medications: An Overview

One of the most common sources of anxiety for patients starting IVF is the medication protocol. "What are all these injections? What do they do? Will I feel terrible?" These are completely valid questions — and the more you understand your medications, the more in control and confident you will feel throughout the process.

Dr. E. Prashanthi Reddy at Mother Hospitals & IVF Center, Boduppal, takes time to walk every patient through their specific medication protocol before they begin. Here is a comprehensive guide to what each IVF medication does and what to expect.

Phase 1: Ovarian Stimulation Medications (Days 1-12)

FSH Injections (Follicle-Stimulating Hormone)

FSH is the primary stimulation medication in IVF. It tells your ovaries to develop multiple follicles (fluid-filled sacs containing eggs) instead of the usual single egg per cycle. Common FSH medications used in India include Gonal-F, Folligraf, Ovitrop, and Recagon.

How given: Subcutaneous (under skin) injection, usually in the abdomen, once daily.
Duration: 10-14 days, with dose adjusted based on ultrasound monitoring.
Common side effects: Mild bloating, tender ovaries, mild mood changes, headache, injection site bruising.

GnRH Antagonist Injections (Cetrotide / Orgalutran)

These prevent your body from releasing the eggs prematurely before they are mature and ready for retrieval. They are added mid-stimulation (typically from day 5-6) and continued until the trigger shot.

Common side effects: Minimal — occasional injection site reaction, mild nausea.

GnRH Agonist (Lupron / Buserelin) — Alternative Protocol

Some patients use a GnRH agonist "long protocol" where the medication is started before stimulation to suppress the pituitary gland. This is often used for patients with endometriosis or previous cycle failures. Side effects include temporary menopause-like symptoms: hot flashes, mood changes, and vaginal dryness — these stop when stimulation begins.

Phase 2: The Trigger Shot — HCG or GnRH Agonist

Once follicles reach the ideal size (typically 17-20mm), a "trigger shot" is given to complete egg maturation. This is timed precisely — usually 36 hours before egg retrieval.

• HCG trigger (Ovitrelle, Pregnyl): The standard trigger. Mimics the LH surge that causes eggs to fully mature.
• GnRH agonist trigger: Preferred in patients at high risk for OHSS (especially PCOS patients). Causes a more natural LH surge with less OHSS risk.

Side effect: Mild bloating and pelvic pressure as follicles reach maximum size. This is normal.

Phase 3: Progesterone Support (After Egg Retrieval)

After the eggs are retrieved, the ovaries need support to produce progesterone for implantation. This is provided through:

• Progesterone vaginal pessaries (Crinone, Lutrogest, Endogest): The most common and well-tolerated form. Inserted vaginally twice daily.
• Progesterone injections: Intramuscular injections for patients who need higher levels. Can cause soreness at injection site.
• Oral progesterone (Duphaston): Often used in combination.

Progesterone support continues until the pregnancy test and, if positive, often until 10-12 weeks of pregnancy.

Understanding OHSS: Signs, Prevention, and Management

Ovarian Hyperstimulation Syndrome (OHSS) is the most significant potential complication of IVF stimulation. It occurs when the ovaries respond excessively to stimulation medications.

Warning Signs of OHSS

• Severe bloating and abdominal distension
• Significant weight gain (more than 1kg in 24 hours)
• Nausea, vomiting, or diarrhoea
• Difficulty breathing (in severe cases)
• Decreased urination

If you experience any of these symptoms during or after stimulation, contact Mother Hospitals immediately at 97059 93366.

Prevention at Mother Hospitals

For high-risk patients (especially those with PCOS), Dr. Prashanthi Reddy uses a tailored prevention strategy: careful dose management with daily monitoring, using GnRH antagonist protocol, triggering with GnRH agonist instead of HCG, and "freeze-all" strategy — freezing all embryos and doing a frozen embryo transfer in a subsequent, unstimulated cycle.

The Needleless IVF Alternative

For patients with needle anxiety, difficult veins, or who simply prefer a gentler approach, Mother Hospitals offers Needleless IVF — a protocol that replaces most injectable stimulation medications with oral tablets and transdermal (skin patch) delivery systems. This innovation is one of the unique services that sets Mother Hospitals apart as a patient-centred fertility clinic in Hyderabad.

Managing Side Effects During IVF

• Bloating: Wear loose clothing, stay hydrated, avoid heavy exercise
• Mood changes: These are hormone-driven and temporary — communicate with your partner and support system
• Headaches: Stay well hydrated; paracetamol is safe if needed (avoid NSAIDs)
• Injection site reactions: Apply ice before injection, rotate sites, use room-temperature medication
• Fatigue: Rest more during the stimulation phase — this is your body working hard

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Dr. E. Prashanthi Reddy

MBBS · DGO · PG Diploma in ART – Kiel University, Germany
Founder & Medical Director, Mother Hospitals & IVF Center
19+ Years Experience · ART Act 2021 Certified · TGMC Reg: 50624