IVF and Injections, Your Questions Answered

Egg donor taking Lupron injections

The thought of injecting yourself with your fertility drugs can seem hugely overwhelming, especially for those who have a fear of needles. However, there really is no way around it, so the best thing to do is try and take charge of the matter. Understand why those horrid little needles are so necessary and focus on the end result.

Here we look at what the injections are for and how we can make the process that little less painful.

Dr Esther Marbán, Fertility Specialist at Clínica Tambre explains what the drugs are for.

What are the injections for during a course of IVF?

Your IVF medication is administered through “subcutaneous injections” which are inserted just underneath the skin, with a needle, into the fatty tissue that sits above the muscle.

There are injections that “switch off” your own natural cycle. These drugs are used to prevent premature ovulation and work by blocking the effects of gonadotropin-releasing hormone (GnRH).

Following that, you will administer injections that will stimulate the ovaries—this means making the follicles (a follicle is a sac filled with fluid in which an immature egg develops) grow to obtain a good number of eggs for egg retrieval. These drugs are the follicle-stimulating hormone, FSH or HMG.

The medication is usually taken for 7-12 days.

The last injection you will take is the trigger shot. The trigger shot is the name given to an injection of hCG (human Chorionic Gonadotrophin). This kick starts a cycle of development that enables the egg to mature and loosen from the follicle wall so it can be collected.

Where do you have the injections? 

We suggest our patients inject the medication in the belly, around the belly button as it is less painful (because the fatty tissue behind the belly skin is quite easy to go through) but it also can be injected in the thighs.

Are the injections painful?

The injections are really not too painful at all. In fact, we would say that they can cause discomfort rather than pain.

The needles are relatively thin and short—it is just the fact that you have to take them every day that can lead to a feeling of soreness.

Easing the discomfort

There are several things you can do to ease the discomfort. We can’t promise that these suggestions will ease your discomfort, but we tried them while we (Sara & Tracey) were going through IVF and they did offer some relief for us:

Pinch the area. Pinching the skin during the injection or inserting the needle at 90 degrees to the skin can reduce the pain of the initial needle insertion.

Ice the area. Applying ice to the area where you are going to inject, about 15 minutes beforehand, will numb the skin will temporarily.

Do not always inject in the same place

Visualization. As you take a long deep breath, focus on why you are doing this to yourself. Picture yourself holding your baby and tell yourself that the discomfort will all be worth it in the end.

Ask for help. Get your partner, or good friend to administer your injections, then find distractions for yourself whilst you are being injected – TV, music, a magazine.

Will I be given a schedule with what medication to take and when?

All patients are given a treatment plan, recommended by their doctors, that they should follow. In their plan, they will find the medication to take, the dosage, and when they need to go back to the clinic for vaginal ultrasounds during the ovarian stimulation.

Do IVF injections have side effects? (Will they affect my mood?)

Some patients feel a slight swelling or bloating in their belly, or some pain at the end of the treatment, but these symptoms are normally mild and do not require any additional measures.

With regards to your mood, some women do feel emotional changes, such as a tendency to cry, sadness, or anxiety. Fortunately, these situations are not severe and ease after the treatment.

The cost of IVF medication

IVF drugs are expensive. Medication costs change in each country. Furthermore, depending on the dose to use and the medication itself, the price may be different but to have an idea, it may cost between $900 and $2500 dollars (900 and 1500 Euros).

Can you buy medication from other patients who no longer need it?

It is not recommended to buy any medication from other patients as you never know how it was preserved (some medication needs to be put in the fridge) and who injected it (risk of infectious diseases).

How long do I have to take progesterone shots after IVF?

Progesterone has to be used from the day after the egg retrieval to the day when the pregnancy test is done.

The pregnancy test is commonly performed 11 days after the embryo transfer, if the embryo transferred was on blastocyst stage (embryo on day 5 or day 6 of development). If the pregnancy test is positive, the progesterone must be kept on until week 10 of pregnancy approximately.
The progesterone can be used vaginally (vaginal pessaries) or injected in the belly.

Source: This post originally appeared in IVFBabble: https://www.ivfbabble.com/2020/05/ivf-injections-questions-answered/

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