Causes & Treatment

5 Days of fertility meds, uncovered

Kristina Lopez, in partnership with SMP Pharmacy  |   19 Apr 2023

Fertility treatments are an incredibly personal journey that’s as challenging in its process as it is emotional in the result. There are so many different fertility tests and medications, but it can be confusing to know how it all works. Always speak with your OBGYN/fertility doctor about what treatments work best for you, but it’s equally important to be informed on what you can do beyond more well known options as each has its own timeline, effectiveness levels, and potential side effects that can affect your fertility during your IVF (in-vitro fertilization) journey.

Whatever your personal needs, the right tools and resources can make the process a little less daunting and help you make informed decisions about your fertility treatment options. SMP Pharmacy can help you take the stress out of the equation as they understand your fertility treatments need support through medication access and beyond. Read on to learn more about different fertility treatment methods and how to use certain medications to support your next steps.

1. Suppositories

If you’ve been prescribed a suppository, chances are its supplemental progesterone or PVS. This one is given through vaginal suppositories to create a receptive environment for the embryo to implant and grow. Progesterone is a hormone that plays a vital role in preparing the uterus lining for embryo implantation during the luteal phase of an IVF cycle. The essential hormone supplement balances healthy menstruation between ovulation day and the onset of your period about two weeks later and supports the earliest stages of implementation.

Typically started a few days before the embryo transfer and continued for several weeks after, PVS is inserted into the vagina one to three times per day to release the hormone gradually. Once the embryo implants, the placenta takes over the job of naturally producing progesterone which can start as early as 6 to 7 weeks into pregnancy. The timing in this shift between using PVS to placental progesterone production differs based on individual body chemistry but usually happens around 10 to 12 weeks into pregnancy and has proven successful in improving clinical pregnancy by up to 39% when using IVF.

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2. Intramuscular

Intramuscular injections are a common form of medication delivery in fertility treatments, specifically in the implantation process. Intramuscular injections are administered directly into the muscle tissue like the glutes or thigh, whereas subcutaneous injections are given into the fatty tissue layer just beneath the skin. Intramuscular injections have been used for decades, but they also carry more risks including infection, bleeding, and nerve damage.

Bacteria and fungi can infect the muscle tissue, leading to irritation and deeper complications, but your fertility doctor can reduce the risk of contamination by rotating the injection sites and sterilizing the area with alcohol swabs prior to injection. The success rate of intramuscular injections can vary depending on the medication and a patient’s individual situation, but they remain a vital component of fertility treatment plans overall.

3. Subcutaneous

Subcutaneous injections are commonly used to administer certain medications—like FSH and hCG—into the abdomen or thigh as a safe and effective fertility treatment. Your OBGYN can provide specific safe injection instructions and it’s important to remember that, like any medical procedure, there are risks. Newer drugs administered via subcutaneous injection offers benefits such as reduced side effects and more convenience for patients.

To minimize bruising when using subcutaneous injections, it’s best to rotate injection sites to let the skin heal, only use slow and gentle pressure to the site, and use smaller gauge needles when injecting.

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4. Transdermal

Transdermal administration refers to a method of delivering medication through the skin using a self-adhesive patch or cream, which is a relatively new method of fertility treatment. It can be applied directly to the skin and its active principle is estradiol, a female steroid hormone that causes the maturation and release of the egg to allow a fertilized egg to implant on the uterine lining.

5. Oral

Oral fertility treatments are medications that are small, often inexpensive pills taken by mouth to improve fertility probability by stimulating ovulation, regulating menstrual cycles, and increasing the chances of conception. While they can be effective in helping achieve pregnancy, they can also come with specific risks like multiple births and ovarian hyperstimulation syndrome.

Your fertility doctor’s guidance is vital when considering oral fertility treatments as it lowers estrogen levels, which stimulate the ovary and increases the production of the follicle-stimulating hormone (FSH). The goal is to improve the likelihood that sperm will meet the egg by helping release an egg during the ovulation cycle. It’s a balancing act of the right medication that is both safe and effective for your body.

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Which fertility pill?

Oral fertility pills may be taken between five to twelve days from the onset of your menstrual cycle to balance your hormones and increase the chances of pregnancy. Here’s a breakdown of the pros and cons of three oral fertility medications you can use and how you and your doctor might choose the one best for your lifestyle.


Considered the first line of fertility treatment, clomiphene citrate — known as Clomid — is an FDA-approved prescribed oral medication used to coax the body into regular ovulation and treat a range of infertility factors related to irregular cycles by helping your hormones perceive a decrease in estrogen levels.

The process causes the body to increase FSH (follicle-stimulating hormone) and LH (luteinizing hormone) which stimulates follicle development and then ovulation. Reports show that it works to stimulate ovulation for about 80% of women who use it; however, only about 13% of those who use it will get pregnant during its cycle. It won’t help you get pregnant if you have other infertility factors like blocked tubes, uterine abnormalities, ovarian failure, or pelvic lesions, but it’s worth consideration with your OBGYN.


If you’re experiencing issues with ovulation and you haven’t responded to treatments like Clomid,  Femara — also known as letrozole — could be a viable option for you as it has been more effective for those who haven’t responded well to other oral fertility treatments, which is especially helpful for women with polycystic ovary syndrome or anovulation.

It works by suppressing estrogen levels and increasing the follicular stimulating hormones (FSH) and can help with ovulation induction. The success rate of Femara is similar to Clomid, but be sure to discuss factors such as age, current health concerns, reproductive health, and sperm quality with your fertility doctor.


Used mainly as an off-label insulin-sensitizing drug, Metformin has also been used to balance insulin levels and resume the ovulation process in women diagnosed with PCOS. It is sometimes prescribed along with other fertility drugs like Clomid and Follicle Stimulating Hormones (FSH) for inducing ovulation. Metformin may not increase the odds of ovulation in everyone, which is why it’s often clinically combined with treatments like Clomid for a better chance of pregnancy.

Our go-to 24/7 fertility and IVF pharmacy

Now that you have a baseline to understand your different fertility treatment options, you can feel even more comfortable knowing that SMP Pharmacy Solutions is here to help you walk through your fertility journey with the fertility pharmacy care you need. This woman-led modern online pharmacy understands the unique challenges families face when it comes to fertility. They want every patient to have access to fertility medications, comprehensive reproductive health education, and top-notch 24/7 pharmacy customer support.

With resources like MedReady modern injection training, intuitive unpack it resources and a patient app, SMP empowers you to be a part of your care throughout the process and is there to support you every step of the way.

Medication access and affordability shouldn’t be a barrier to starting or growing your family, so take that first step to safely embrace your fertility journey today with SMP Pharmacy Solutions.

Plus, FHH readers get a special discount with SMP Pharmacy Solutions, helping you get the meds you need at a better price point. Use code TRB200 for $200 off all qualifying orders.

Limited to one coupon per patient per order. Valid for self-pay patients. Not valid on previous orders. Minimum order 2,100 units.

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