Constipation During Fertility Treatments

Undergoing fertility treatment usually includes a long list of tests, procedures, and medications. But what is not commonly discussed are symptoms like constipation and bloating. This guide explains why this happens and how to best manage fertility treatment and IVF constipation. 

By Dr. Kenosha Gleaton

Whether you’ve already started IVF or you’re preparing for your first fertility clinic appointment, you’re probably wondering what effects this journey will have on your body. In order to see the day when those two lines appear, you may have to endure some unpleasant aspects, including one very common symptom: constipation.

Do Fertility Drugs Cause Constipation?

Fertility drugs can sometimes cause constipation. During fertility treatments like IVF, you’re given hormones as well as sedatives. Many believe that progesterone can cause constipation by altering the regulation of g-proteins. [1] It’s also hypothesized that sedatives can have certain effects on the body, including constipation. [2] 

IVF Constipation

Not only are you taking added hormones, prenatal vitamins, and medications when going through fertility treatments, but your body is also experiencing a lot of changes. The removal of eggs, consumption of fertility drugs, and sedation for surgery can put a lot of stress on your GI tract.

What Treatments Can Lead to Constipation?

Egg retrieval, a key step in the IVF process, is a treatment commonly followed by constipation, bloating, and cramping. IUI can also lead to a change in bowel movements which can include constipation or diarrhea. Some research also explains that constipation may be tied to sex hormones seen during early pregnancy. [3] 

What Medications Cause Constipation?

There are a host of medications that can cause constipation, including common over-the-counter pain relievers like ibuprofen, iron supplements, and antidepressants. [4] The most common medications prescribed during fertility treatments that may result in constipation include [5-8]:

• Clomid: an ovulatory stimulant 
• Various gonadotropins: hormones that orchestrate the reproductive system
• Metformin: a common drug given to women with PCOS to regulate hormones
• Letrozole: an ovulatory stimulant

How to Manage Constipation

Fortunately, there are ways to manage constipation at home [9]: 

• Stay hydrated. Drinking more water can help loosen stool that’s preventing bowel movements. (Shop fertility and pregnancy-safe hydration packs)
• Keep moving. Exercise is a great way to keep your body running smoothly, so try going for a walk, doing yoga, riding a bike, or whatever will get you up and moving. Ask your doctor what type of exercise is safe during fertility treatments. 
• Take fiber or magnesium supplements. These supplements can help the digestive system work more efficiently and are pregnancy/TTC safe.
• Look into a squatty potty. The way we sit can have an impact on our bowel movements, and it can be much easier to poop with your feet elevated while on the toilet.

If you don’t have any luck with these methods, you should reach out to your healthcare provider. Always remember to speak to a provider before taking any new medications or supplements, as well. 

Benefits of Taking Fiber

Fiber is a useful gastrointestinal supplement for nutrient absorption and regulation of blood sugar levels. [9-10] You can find dietary fiber in fruits, vegetables, and grains, but there are also readily available psyllium husk fiber supplements on the market. One review found soluble fiber improves constipation and the average number of bowel movements per week. [10] Fiber can even help with preventing hemorrhoid formation. 

Support From Natalist During The Fertility Journey

Fertility treatments can be emotionally and physically exhausting. But it’s also a beautiful, humbling, and exciting journey to take. With a growing family comes a changing body, and it’s important you know how fertility treatments can impact your well-being. Constipation can sometimes arise when undergoing various treatments and medications, but it’s also manageable with fiber supplements and lots of water! As always, Natalist is here to help support you in this journey. Check out the fertility treatment blog, or shop for products like ovulation test kit, prenatal vitamins for women, and more.

References:

1. Xiao ZL, Pricolo V, Biancani P, Behar J. Role of progesterone signaling in the regulation of G-protein levels in female chronic constipation. Gastroenterology. 2005;128(3):667-675. doi:10.1053/j.gastro.2004.12.001
2. Zielmann S, Grote R. Auswirkungen der Langzeitsedierung auf die intestinale Funktion [The effects of long-term sedation on intestinal function]. Anaesthesist. 1995;44 Suppl 3:S549-S558.
3. Gomes CF, Sousa M, Lourenço I, Martins D, Torres J. Gastrointestinal diseases during pregnancy: what does the gastroenterologist need to know?. Ann Gastroenterol. 2018;31(4):385-394. doi:10.20524/aog.2018.0264
4. Fragakis A, Zhou J, Mannan H, Ho V. Association between Drug Usage and Constipation in the Elderly Population of Greater Western Sydney Australia. Int J Environ Res Public Health. 2018;15(2):226. Published 2018 Jan 29. doi:10.3390/ijerph15020226
5. CLOMID- clomiphene citrate tablet. A-S Medication Solutions. May 2023. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=f15e9918-6001-4150-bd54-1364a6febcb8&type=display
6. Ohlsson B. Gonadotropin-Releasing Hormone and Its Role in the Enteric Nervous System. Front Endocrinol (Lausanne). 2017;8:110. Published 2017 Jun 7. doi:10.3389/fendo.2017.00110
7. Fatima, Madiha & Sadeeqa, Saleha & Nazir, Saeed. (2018). Metformin and its gastrointestinal problems: A review. Biomedical Research. 29. 10.4066/biomedicalresearch.40-18-526. 
8. Letrozole (Oral Route). Mayo Clinic. January 2024. https://www.mayoclinic.org/drugs-supplements/letrozole-oral-route/side-effects/drg-20067579?p=1
9. Treatment for Constipation. NIH- National Institute of Diabetes and Digestive and Kidney Diseases. May 2018. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/treatment
10. Suares NC, Ford AC. Systematic review: the effects of fibre in the management of chronic idiopathic constipation. Aliment Pharmacol Ther. 2011;33(8):895-901. doi:10.1111/j.1365-2036.2011.04602.x

Originally published November 5, 2020. Updated for accuracy and relevancy on January 5, 2024. 

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.