Several common medications can impair fertility or harm a developing baby. NSAIDs (ibuprofen, naproxen) around ovulation may temporarily suppress it. Isotretinoin (Accutane) causes severe birth defects. Some antidepressants, blood pressure meds, and seizure drugs need to be switched. Never stop a prescription medication without talking to your doctor first — unmanaged conditions carry their own risks.
Medications to Discuss With Your Doctor
| Medication | Risk | What to Do |
|---|---|---|
| NSAIDs (ibuprofen, naproxen) | May temporarily suppress ovulation if used around mid-cycle | Use acetaminophen (Tylenol) instead during the fertile window; occasional NSAID use is likely fine |
| Isotretinoin (Accutane) | Severe birth defects (category X) | Stop at least 1 month before TTC; confirm clearance with your dermatologist |
| Tretinoin / Retinoids (topical) | Potential teratogen | Switch to azelaic acid or pregnancy-safe skincare |
| SSRIs / SNRIs | Most are relatively safe; paroxetine (Paxil) has higher risk | Do NOT stop without medical guidance — untreated depression is also a risk. Doctor may switch to sertraline (Zoloft, better pregnancy data) |
| ACE inhibitors / ARBs | Kidney damage in fetus; especially risky in 2nd/3rd trimester | Switch to labetalol, nifedipine, or methyldopa before conception |
| Valproic acid (Depakote) | High neural tube defect risk | Switch to a safer anticonvulsant (levetiracetam, lamotrigine) |
| Methotrexate | Potent teratogen; also affects sperm | Stop 3+ months before TTC (both partners); must be fully cleared |
| Finasteride (Propecia) | Affects fetal genital development; reduces male sperm count | Stop at least 3 months before TTC (for him) |
| Testosterone supplementation | Suppresses sperm production; can cause azoospermia | Stop under urological supervision; recovery takes 3–12 months |
| Statins (Lipitor, Crestor) | Category X; contraindicated in pregnancy | Stop before TTC; discuss alternatives with your cardiologist |
The critical rule
Never stop a prescription medication cold turkey because you're trying to conceive. Unmanaged epilepsy, severe depression, uncontrolled blood pressure, and uncontrolled diabetes all carry significant pregnancy risks. The goal is to switch to a safer option, not to stop treatment entirely. Your doctor can help you find the right balance.
Plan Your Preconception Visit
Our checklist covers everything to discuss with your doctor before TTC.
Read the Checkup Guide