Many patients who undergo IVF or IUI are prescribed the shots. After taking the shots, some patients call my office complaining of side effects such as headaches. Today, I discuss the most common side effects that you may experience when taking medications such as Gonal-f® or Follistim® for infertility.
Patients undergoing in vitro fertilization (IVF) or intrauterine insemination (IUI) may be prescribed injectable fertility drugs. This may include medications such as follitropin alfa (Gonal-f®) or follitropin beta (Follistim®). Follitropin alpha and beta are human follicle stimulating hormone (FSH) preparations of recombinant DNA origin. Follitropin alpha and beta are indicated for the induction of ovulation and pregnancy in the oligo-anovulatory infertile patient in whom the cause of infertility is functional and not due to primary ovarian failure. Both of these medications are also indicated for the development of multiple follicles in the ovulatory patient participating in an Assisted Reproductive Technology (ART) program.
Although the risks from taking gonadotropin medications are low, one must be aware of the possible side effects. Fortunately, side effects are uncommon. The most common adverse reactions and their rates of occurrence are listed in the package inserts provided by the companies that make the follitropins (Serono for Gonal-f® and Merck for Follistim®).
For patients undergoing ovulation induction using follitropin alpha, here are the 9 most common side effects:
- Headache (26.5%)
- Abdominal pain (12.0%)
- Ovarian Hyperstimulation (7.2%)
- Pharyngitis (sore throat) (7.2%)
- Rhinitis (stuffy nose) (7.2%)
- Sinusitis (6.0%)
- Vaginal hemorrhage (6.0%)
- Breast pain (6.0%)
- Injection site pain (4.0%)
For patients undergoing assisted reproductive technologies using follitropin alpha, here are the 7 most common side effects:
- Abdominal pain (23.2%)
- Headache (18.6%)
- Abdomen enlarged (13.9%)
- Injection site bruising (9.7%)
- Nausea (8%)
- Injection site pain (5.5%)
- Ovarian Hyperstimulation (4.6%)
For patients undergoing ovulation induction using follitropin beta, here are the 3 most common side effects:
- Ovarian Hyperstimulation (7.6%)
- Ovarian cyst (2.9%)
- Abdominal pain and discomfort (2.9%)
For patients undergoing assisted reproductive technologies using follitropin beta, here are the 2 most common side effects:
- Ovarian Hyperstimulation (5.2%)
- Abdominal pain (2.2%)
There are also some rare but serious risks that patients must also be aware of when taking gonadotropins, including:
- Multiple gestations
- Ectopic pregnancy
- Ovarian Hyperstimulation syndrome
- Pulmonary and vascular complications (such as acute respiratory distress syndrome and/or pulmonary embolism)
- Ovarian enlargement
- Torsion of the ovary
For more information, please read the package insert that accompanies your prescription. If you are taking gonadotropins for infertility and experience side effects, alert your doctor immediately.
Source: Gonal-f® package insert by Serono and Follistim® package insert by Merck
Dr. Lowell T. Ku, M.D. is an award winning and leading Reproductive Endocrinology and Infertility specialist at Dallas IVF, one the nation’s premiere infertility centers. Dr. Ku clarifies the many confusing terms used in the world of Infertility using straightforward explanations.
