Over-The-Counter Medications To Avoid While Trying To Conceive

Most people know going in to it that pregnancy may come with limitations — no drinking, not much coffee, taking a break from some prescription medications, and avoiding some over-the-counter (OTC) medications, too. But what about when you’re trying to conceive? Is it safe to take over-the-counter medications like Tylenol when you’re trying to get pregnant? Or is it possible that common OTC drugs interfere with fertility or pose a risk in very early pregnancy? We posed these questions to Dr. Liz Rubin, an OB-GYN and fertility specialist at Oregon Health & Science University.

What medications should you avoid while trying to conceive?

While there are a few OTC medication to avoid when you’re trying to conceive, the list is relatively short. When you’re trying to become pregnancy, you should avoid:

• Nonsteroidal anti-inflammatory drug (NSAIDs), like ibuprofen or naproxen (Aleve and Midol, for example)
• Retinoids, both oral forms and topical

NSAIDs are the only OTC drug that Rubin says has associated with changes in ovulation, so they may interfere with your ability to conceive. However, this doesn't mean you shouldn't take it when you do get your period for relief from menstrual cramps if you need it, but if you're not sure if you're pregnant — perhaps you’re in the so-called “two-week wait” between ovulation and taking your first pregnancy test — she recommends staying away from NSAIDs.

Retinoids, on the other hand, should be completely avoided when you’re trying to get pregnant because, as Rubin explains, “the oral version is associated with pretty significant potentials for congenital malformations.” The topical versions of retinoid medications aren’t recommended in early pregnancy out of an abundance of caution, she adds. Other than these two OTC medications, “most of the medications that really impact your ability to conceive are prescription,” Rubin says.

What medications should be avoided during IVF?

“IVF is such an intense process. It's resource-intense, it's emotionally intense, and I think it's always reasonable to double check your medication list with your provider,” Rubin shares. You’ll likely be working closely with a physician or nurse practitioner or physician assistant who's helping coordinate your IVF process and managing your treatment plan, and they’ll know your particular case best. You should feel free to ask questions about any medications or supplements you’re taking. “I always ask my patients the full medication list — including over-the-counter and supplements — just to make sure there isn't anything that I have any concerns about,” Rubin explains, adding that it is much more likely that you’ll need to change prescription medications rather than OTC ones.

What OTC medications can affect fertility?

Non-steroidal anti-inflammatory medications (NSAIDs) are known to temporarily interfere with ovulation, so Rubin says that people who are hoping to conceive should avoid them completely. “When somebody is going through fertility treatment — whether that's ovulation induction for insemination or if that's IVF, or even egg freezing, we want to tightly control ovulation,” Rubin says. Because NSAIDs impact the signal that comes from your brain that tells your body to ovulate, it’s best to stay away from them if you’re trying to become pregnant.

Can I take Tylenol while trying to conceive?

In short, yes, Tylenol is considered safe to take both when you’re trying to become pregnant and during pregnancy. “Generally speaking, I say that Tylenol is safe while trying to conceive and even if you’re pregnant,” Rubin says. Occasionally, some OB practices will tell patients to avoid all OTC pain medications, she adds, “because they don't want you to take ibuprofen, naproxen or aspirin, and it's just easier to say ‘no over-the-counter pain medications,’” but Rubin says that Tylenol is something that she considered to be very safe both for people who are trying and who are currently pregnant.

Common prescription medications that can affect fertility

People who are hoping to become pregnant should carefully go over any prescription medications with their healthcare provider, Rubin says. But, there are a few very common prescription medications that Rubin encounters regularly in her work as a fertility specialist. She especially recommends that people consider the following prescription drugs when trying to conceive:

• Anyone taking a thyroid medication, like levothyroxine, should see a physician to make sure that their thyroid medications are very tightly regulated while trying to conceive, Rubin urges.
• Anyone taking a psychiatric medication, but most specifically an anti-psychotic medication or mood stabilizer (like risperidone) because Rubin says those ones can actually prevent you from getting pregnant.
• Anyone taking anti-epileptic medications, “because they can impact ovulation, and they can have very significant early pregnancy impacts.”
• Anyone taking spironolactone, which some people take to help them regulate acne that’s associated with their cycles, but which Rubin says can really impact your fertility and early pregnancy.

In short, if you’re ready to begin trying to conceive, you avoid NSAIDs like ibuprofen and should ask a trusted healthcare provider for guidance about any prescription medications you’re taking that may interfere with your ability to get pregnant.

Studies Cited:

Mendonça, L., Khamashta, M., Nelson‐Piercy, C., (2000) Non‐steroidal anti‐inflammatory drugs as a possible cause for reversible infertility. Rheumatology, https://academic.oup.com/rheumatology/article/39/8/880/1784112

Experts:

Dr. Liz Rubin, M.D., Oregon Health & Science University