**Answer:**

In vitro fertilization (IVF) is an assisted reproductive technology that involves retrieving eggs and sperm from the body, fertilizing them in a laboratory, and then transferring the embryo into the uterus. To maximize success rates and minimize risks, stable hormone levels and a healthy metabolism are essential.

Acne medications, ranging from topical creams to systemic oral treatments, can directly or indirectly affect hormone levels, liver and kidney function, and egg production. This is why fertility specialists thoroughly review a patient's acne treatment history before deciding when to begin an IVF cycle.

For topical acne treatments such as benzoyl peroxide, azelaic acid, or local antibiotics, absorption into the bloodstream is usually low, with minimal systemic effects. However, some topical retinoid medications are classified as requiring caution during pregnancy due to their potential teratogenic effects with prolonged or widespread use. Therefore, even with a low risk, women preparing for IVF are advised to stop these medications for at least a few weeks to one month to allow the body to stabilize completely before ovarian stimulation.

Doctor Le Quang Do is consulting a couple. Photo: IVF Tam Anh

The risk of oral acne medications affecting the IVF process is clearer. Tetracycline antibiotics, often prescribed for moderate to severe inflammatory acne, can affect fetal bone and tooth development and are generally contraindicated during pregnancy. This group of drugs can also impact the microbiome, liver function, and metabolism. Therefore, it is necessary to stop them for at least one to two months before IVF to ensure the medication is fully eliminated and the body has time to recover.

Isotretinoin, specifically, is an oral retinoid used for severe, resistant acne. It carries a very high risk of teratogenicity, linked to craniofacial, cardiovascular, and central nervous system abnormalities in the fetus. Beyond directly affecting pregnancy, the medication can also impact egg quality during follicular development. Doctors recommend that women practice strict contraception while taking this medication and wait at least six months before attempting pregnancy or IVF.

Men treating acne with isotretinoin may also experience a temporary impact on sperm quality. Many specialists recommend that men discontinue isotretinoin for approximately one to three months before sperm retrieval for IVF.

Many acne medications also indirectly affect the liver and blood lipids. The ovarian stimulation process in IVF demands intense hormone metabolism from the body. If the liver has not fully recovered, women may face a higher risk of side effects during the IVF process.

Persistent acne in adult women sometimes indicates a hormonal imbalance, such as polycystic ovary syndrome (PCOS). This condition is a cause of acne and a common reason for infertility. In such cases, beyond waiting the necessary time after acne treatment, patients need a comprehensive assessment and adjustment of their hormonal status, weight, and insulin resistance before starting IVF to improve success rates.

Technology-based acne treatments like laser, intense pulsed light (IPL), chemical peels, or professional skincare generally do not directly affect fertility. However, chemical peels using high-concentration acids or the use of retinoid active ingredients before and after procedures should still be considered. Doctors often advise patients to complete their skin treatment regimen and allow their skin to stabilize for at least one to two months before IVF, to avoid dermatitis, infection, and the need for unsuitable medications during pregnancy preparation.

You should consult a doctor to review your acne treatment history, including the types of medications used, dosage, and duration of use. In addition to assessing the overall reproductive health of both partners, the doctor will need to check liver function, blood lipids (if isotretinoin was used), hormonal status, and ovarian reserve. Based on this, the doctor will select an appropriate treatment protocol for you, ensuring a safe IVF journey and increasing the chances of a healthy baby.

Master of Science, Doctor Le Quang Do

Center for Reproductive Assistance,

Tam Anh General Hospital Hanoi