IVF medications: what each drug costs and does
A protocol arrives as a list of brand names and injection days with no explanation of what any of it is for or what it will cost. This is that list, decoded: what each medication does, when in the cycle it is given, and what it costs at the pharmacies that post a cash price, beside what pharmacies pay for it, each figure cited to its source.
A standard IVF cycle uses injectable gonadotropins to grow multiple follicles, a GnRH antagonist or agonist to prevent early ovulation, a single hCG trigger shot before the retrieval, and progesterone afterwards to support the lining. Together those medications typically cost $3,000–$7,000 per cycle, on top of the clinic's base fee.
IVF medication prices, compared
The lowest and highest cash price posted for each medication by the fertility pharmacies, cash pharmacies, TrumpRx.gov and manufacturer programs we checked (read Oct 4, 2026), per one comparable unit. Every price, with its seller and conditions, is on the drug's own page.
| Medication | Per | Lowest posted | Highest posted | Retail guide |
|---|---|---|---|---|
| Letrozole | 2.5 mg tablet | $0.25 Mark Cuban Cost Plus Drugs | one seller | $0.40 |
| Clomid | 50 mg tablet | $4.08 Mark Cuban Cost Plus Drugs | $10.91 Amazon Pharmacy | $4.50 |
| Gonal-f | 75 IU | $42 TrumpRx.gov | $42 Mandell's Clinical Pharmacy | $236.57 |
| Follistim | 75 IU | none posted | $213.11 | |
| Menopur | 75 IU vial | $95 Mandell's Clinical Pharmacy | one seller | $258.05 |
| Ganirelix | 250 mcg syringe | $45.25 Mark Cuban Cost Plus Drugs | $49.90 Mandell's Clinical Pharmacy | $37.38 |
| Cetrotide | 0.25 mg dose | $22.50 TrumpRx.gov | $59.88 Mark Cuban Cost Plus Drugs | $316.68 |
| Lupron | 14-day kit | $64.02 Mark Cuban Cost Plus Drugs | one seller | $133.80 |
| Ovidrel | 250 mcg syringe | $84 TrumpRx.gov | $84 Mandell's Clinical Pharmacy | $253.90 |
| hCG | 10,000 units | $149.90 Mandell's Clinical Pharmacy | one seller | $182.10 |
| Progesterone Progesterone in oil | 10 mL vial (50 mg/mL) | none posted | $22.25 | |
| Progesterone Endometrin | 100 mg insert | none posted | $15.60 | |
| Progesterone Crinone 8% | applicator | none posted | $32.71 | |
| Progesterone Progesterone capsules | 200 mg capsule | $0.40 Mark Cuban Cost Plus Drugs | one seller | |
| Estradiol | 2 mg tablet | $0.23 Mark Cuban Cost Plus Drugs | one seller | $0.19 |
Cash prices only, each the seller's own published figure; insurance, quantity and eligibility for a program change what you pay. "Retail guide" is a drug-price guide's figure for an ordinary retail pharmacy, for context. What a standard cycle's drugs cost, and what TrumpRx changed.
Ovulation induction
Oral tablets that prompt the ovary to release an egg. The first thing tried for many people, and the whole of a timed-intercourse or IUI cycle.
Ovarian stimulation
The daily injections that grow many follicles at once instead of the single one a natural cycle produces. This is the expensive part of an IVF drug bill.
- Gonal-f (follitropin alfa)Injectable
Controlled ovarian stimulation for IVF
from$42per 75 IU, lowest posted cash price - Follistim AQ (follitropin beta)Injectable
Controlled ovarian stimulation for IVF
$213.11per 75 IU at a retail pharmacy (price guide); no seller posts a price - Menopur (menotropins)Injectable
Combined FSH and LH activity during stimulation
from$95per 75 IU vial, lowest posted cash price
Preventing early ovulation
Injections that stop the body releasing the eggs before the retrieval can collect them. Without one, a stimulated cycle can be lost.
- Ganirelix (Fyremadel)Injectable
GnRH antagonist that blocks a premature LH surge
from$45.25per 250 mcg syringe, lowest posted cash price - Cetrotide (cetrorelix)Injectable
GnRH antagonist that blocks a premature LH surge
from$22.50per 0.25 mg dose, lowest posted cash price - Lupron (leuprolide acetate)Injectable
GnRH agonist used to down-regulate, or as an alternative trigger
from$64.02per 14-day kit, lowest posted cash price
Trigger
The single, precisely timed shot that finishes egg maturation and sets the retrieval clock running.
- Ovidrel (choriogonadotropin alfa)Injectable
The trigger shot that finishes egg maturation before retrieval
from$84per 250 mcg syringe, lowest posted cash price - Novarel, Pregnyl and generic hCGInjectable
The trigger shot that finishes egg maturation before retrieval
from$149.90per 10,000 units, lowest posted cash price
Luteal support and transfer prep
The hormones that prepare and hold the uterine lining, before a frozen transfer and through the two-week wait after it.
- Progesterone (PIO shots, Endometrin, Crinone)Vaginal / injectable
Luteal-phase support after IUI, retrieval, or embryo transfer
from$0.40per 200 mg capsule, lowest posted cash price - Estradiol (Estrace)Oral
Builds the uterine lining before a frozen embryo transfer
from$0.23per 2 mg tablet, lowest posted cash price
Where the medication bill sits in a cycle
Medications are the volatile line in an IVF budget: dosed to your own response, billed by a specialty pharmacy, and usually excluded from the base price a clinic quotes.
A clinic's posted base fee almost never includes the drugs. Budget $3,000–$7,000 per cycle for stimulation medication, more if you respond slowly and need a longer stimulation, less in a mini-IVF or oral-only protocol. The full cost breakdown shows how that fits against the base fee, anesthesia, genetic testing and storage, and paying for IVF covers grants, HSA and FSA money, and financing when the total is out of reach.
What people ask about fertility medications
What medications are used in an IVF cycle?
A standard US IVF cycle uses four kinds of medication in sequence: injectable FSH (Gonal-f or Follistim, often with Menopur) to stimulate the ovaries, a GnRH antagonist (ganirelix or Cetrotide) or agonist (Lupron) to stop the body ovulating early, a single trigger shot (Ovidrel, Novarel or Pregnyl, or Lupron) to finish egg maturation before the retrieval, and progesterone (progesterone-in-oil shots, Endometrin or Crinone, with estradiol before a frozen transfer) to support the uterine lining. Oral letrozole or Clomid are used for ovulation induction rather than IVF itself.
How much do IVF medications cost?
Medications for one IVF cycle typically run $3,000 to $7,000, roughly a fifth of an all-in cycle, because the injectable FSH is dosed to how your body responds. Per unit, at the pharmacies and programs that post a cash price: Gonal-f $42 per 75 IU; Menopur $95 per 75 IU vial; Ganirelix $45.25 to $49.90 per 250 mcg syringe; Cetrotide $22.50 to $59.88 per 0.25 mg dose; Lupron $64.02 per 14-day kit. The same drug can cost several times more at an ordinary retail pharmacy than at a fertility pharmacy, so it pays to compare.
Why does CMS publish no acquisition cost for Gonal-f or Follistim?
CMS's NADAC survey records what retail pharmacies pay, and Gonal-f and Follistim are filled almost entirely by specialty fertility pharmacies, so the survey has no row for them. Menopur, Cetrotide, Ovidrel, Novarel and Pregnyl do have NADAC rows, listed under their brand names. For Gonal-f and Follistim the posted cash prices on this page are the published figures.
Are letrozole and clomiphene the same thing?
No. Both are oral drugs that induce ovulation, but letrozole is an aromatase inhibitor and clomiphene is a selective estrogen-receptor modulator. Letrozole is FDA-approved for breast cancer and used off-label in fertility care, where it is commonly preferred for ovulation induction in PCOS; clomiphene is the longer-established fertility drug.
Does insurance cover IVF medications?
Sometimes separately from the cycle itself: a plan with no IVF benefit can still carry a prescription benefit that covers part of the drugs, and some plans cover medication but not the procedure. It is worth checking the pharmacy benefit specifically, not just the medical one.