Hormone medications: what they do, side effects, costs
Gonal-F, Menopur, Follistim, trigger shots — a calm guide to your meds list.
The injectable gonadotropins
Gonal-F, Follistim, and Rekovelle are recombinant FSH — they recruit and grow follicles. Menopur is a urinary-derived mix of FSH and LH that some protocols add for additional LH activity. Doses range from 75 to 450 IU per day depending on age and response.
Suppression: antagonist vs agonist
To prevent your body from ovulating before the retrieval, clinics use either an antagonist (Cetrotide, Ganirelix, started mid-stim) or an agonist protocol (Lupron, started in the prior cycle). Antagonist protocols are shorter and simpler and have become the default in most US clinics.
The trigger shot
Either hCG (Pregnyl, Novarel) or a Lupron trigger gives the final push for eggs to complete maturation. Lupron triggers are preferred when there's a high risk of ovarian hyperstimulation syndrome (OHSS).
Side effects to expect
Bloating, mood swings, headaches, breast tenderness, and injection-site reactions are common. OHSS — fluid shifts, severe bloating, weight gain, shortness of breath — is the serious complication; with antagonist protocols and Lupron triggers, severe OHSS is now rare (<1% of cycles).
Medication costs and where to save
A typical IVF stim runs $3,000–$7,000 in medications. Specialty pharmacies (Freedom Fertility, MDR, Encompass, Walgreens Specialty) negotiate different prices — get quotes from at least two. Manufacturer programs (Compassionate Care from EMD Serono/Ferring, Heart) provide income-based discounts of 5–75%. Leftover medications from prior cycles can sometimes be donated through programs like Heart Beats.
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- American Society for Reproductive Medicine (ASRM)
- FertilityIQ — IVF & IUI cost data
- RESOLVE: The National Infertility Association
Cited figures (cycle counts, dollar ranges, mandate lists) reflect publicly available data as of early 2026. Always confirm specific numbers against the linked sources before relying on them — pricing, protocols, and laws change.
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