What Medications Do I Need To Stop Before Freezing My Eggs?

If you're taking any prescription medications, you may be wondering how they might affect your egg freezing journey. It's a common concern, and an important one to address. Whether you're on birth control, managing a chronic condition, or taking medication for mental health, it's crucial to understand how these drugs might interact with the egg freezing process.

First and foremost, we want to emphasize a critical point: Do not stop taking any of your medications without explicit instructions from your fertility doctor. This is absolutely vital for your health and safety. Abruptly discontinuing certain medications can have serious consequences, and your overall well-being is the top priority throughout this process.

Your fertility doctor will work closely with you to create a personalized plan that takes into account all aspects of your health, including any medications you're currently taking. They have the expertise to determine which medications may need to be adjusted, which can be continued as usual, and which might need to be temporarily paused during your egg freezing cycle.

Remember, egg freezing is a medical procedure that involves carefully controlled hormonal stimulation. Your doctor's goal is to optimize your chances of success while ensuring your safety. This means carefully considering how your current medications might interact with the fertility drugs used in the egg freezing process.

In this article, we'll discuss some common medications that people often ask about when considering egg freezing. However, it's important to understand that this information is general and may not apply to your specific situation. Your individual health profile, the specific medications you're taking, and their dosages all play a role in determining the best approach for you.

Let's explore some of the medications that might need to be adjusted during the egg freezing process, always keeping in mind that any changes should only be made under the guidance of your healthcare team.

Birth control and egg freezing

Most fertility clinics will ask you to stop taking hormonal birth control pills, patches, or rings at least one month before starting your egg freezing cycle (IUDs can remain in place). This allows your natural menstrual cycle to resume and helps your doctor accurately assess your ovarian function. It’s counter-intuitive, but some clinics might prescribe you birth control pills to time your cycle as part of their treatment protocol. This will all be discussed with your fertility doctor before your cycle begins.

Read more in: Egg Freezing and Birth Control: An Overview

GLP-1 medications (e.g., Ozempic, Wegovy)

If you're taking GLP-1 medications for weight management or diabetes, discuss this with your fertility doctor as well as your PCP (or whomever wrote the prescription). 

Many doctors recommend pausing GLP-1 medications for a few weeks before procedures involving sedation or anesthesia, including an egg retrieval, to reduce potential risk

The reason is, that there have been some reports that the delay in stomach emptying due to the GLP-1 medication could be associated with an increased risk of regurgitation and aspiration of food into the airways and lungs. And, because you are unconscious during the egg retrieval, you can’t clear your lungs or eliminate the obstruction on your own. Unfortunately, there is currently a lack of scientific data on how GLP-1 medications affect patients having procedures like egg freezing, so most doctors like to play it safe. 

Bipolar, depression, and anxiety medications

Most women can continue their psychiatric medications during egg freezing. However, some medications may need dose adjustments. It's important to involve both your psychiatrist and fertility doctor in this decision to ensure your mental health is properly managed throughout the process.

Read more in: Do I Need to Stop Taking My Antidepressant to Freeze My Eggs?

Spironolactone

Spironolactone is often used for acne or hormonal issues. Recent research has shown that there was no significant difference in the number of mature eggs retrieved between patients who continued spironolactone, those who discontinued it prior to cycle initiation, and patients with no prior use of spironolactone.

This research suggests that patients may be able to continue taking spironolactone while undergoing egg freezing. As with all medications, transparency with your healthcare team is key. Be sure to inform your fertility doctor about your use of spironolactone, including dosage and duration of use, so they can provide the most appropriate guidance for your situation.

Acne and skin care medications

Your doctor may suggest stopping some acne medications, like Isotretinoin (Accutane®), well in advance of egg freezing due to unknown risks to the eggs. Topical acne treatments like Retinol or Tretinoin may be safe to continue, but always check with your doctor.

Allergy medications

Generally, allergy shots don't interfere with egg freezing. However, inform your fertility doctor about any allergy treatments you're receiving to ensure they don't conflict with your fertility medications.

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs like ibuprofen and naproxen may need to be avoided during your egg freezing cycle as they can interfere with ovulation. Your doctor may recommend alternative pain relief options, like acetaminophen (Tylenol), if needed.

Blood thinners

If you're taking blood thinners such as warfarin (Coumadin), heparin, or newer anticoagulants like apixaban (Eliquis) or rivaroxaban, it's important to discuss this with your fertility doctor. Blood thinners can potentially affect the egg retrieval procedure, which involves passing a needle through the vaginal wall into the ovaries.

Your doctor will need to carefully balance the risks of stopping or adjusting your blood thinner regimen against the risks associated with the egg retrieval procedure. In some cases, they might recommend adjusting the timing of your medication around the retrieval procedure.

Do not stop or adjust your blood thinner medication without explicit instructions from your healthcare team. Your fertility doctor may consult with your prescribing physician to create a safe plan for managing your anticoagulation therapy during the egg freezing process.

Steroids

Steroids, such as prednisone or dexamethasone, are used to treat a variety of conditions, from autoimmune disorders to asthma. If you're taking steroids, it's important to inform your fertility doctor. In many cases, patients can continue their steroid medication during the egg freezing process. 

However, the impact of steroids on fertility treatments can depend on the specific medication, dosage, and reason for use. Your fertility doctor will consider these factors when determining whether any adjustments are necessary for your egg freezing cycle.

As with all medications, never adjust or stop your steroid regimen without guidance from your healthcare providers. Abrupt discontinuation of steroids can have serious health consequences. Your fertility doctor will work with your prescribing physician to ensure your condition is properly managed throughout the egg freezing process.

Hormone replacement therapy

If you're a transgender man undergoing hormone replacement therapy as part of your gender-affirming care, it's crucial to have an in-depth discussion with your fertility doctor about your options for egg freezing. If you have already started hormone therapy, such as testosterone (T) therapy, your doctor will likely recommend discontinuing testosterone before you proceed with the egg freezing process. 

Read more in Egg Freezing for Transgender Men: What You Need to Know

Summing it up

Preparing for egg freezing involves a careful review of your current medications and potential adjustments. Always be transparent with your fertility doctor about all substances you're taking, and follow their guidance closely. Remember, the goal is to create the optimal conditions for retrieving and freezing high-quality eggs, giving you the best chances for future fertility success.

Every person's medical history is unique, so what applies to one individual may not apply to another. Your fertility doctor will work with you to create a personalized plan that takes into account your specific health needs and medications. 

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