Guide to IVF Injections - Tips & Tricks
Written By: Mackenzie Naert, MD
Preparation:
Work with your nurse and pharmacy to ensure that you have your medications a few days ahead of time. Unpack the box and confirm the contents with the list of medications you need for the cycle. Pay attention to which medications needs to be refrigerated and which should be room temperature.
It can be helpful to dedicate a space to your supplies. This could be on a bathroom or kitchen counter or a table. Good organization is key to minimizing stress during the cycle.
Keep track of cycle instructions and injections via a calendar, journal, or note on your phone. You can also use this to keep track of the amount of medication you have left in order to time refills. You can also set alarms on your phone, so you do not miss any dosing.
Watch videos from your fertility clinic or the fertility pharmacies to learn how to give injections. Think about whether you will do them yourself or have someone help you.
Freedom Fertility Pharmacy: www.Freedommedteach.com
Village Fertility Pharmacy: https://www.vfppharmacygroup.com/education/medication-instructional-videos/
Determine your daily injection schedule, with guidance from your clinic which will usually suggest possible windows, such as 5am-7am and 6pm-8pm. Keep in mind what time you will have to be in clinic for morning monitoring (labs and/or ultrasound) and do the injections at the same time every day, or on the days you do injections.
Some patients have needle phobias. If you fall into this category, discuss it openly with your doctor to help identify solutions, which could include cognitive behavior therapy or having friends/family do injections.
Administration:
Prepare the injections in a clean, well-lit space. If you need to give multiple injections during one sitting, get them all ready ahead of time so you can inject them in succession.
As much as possible, create a relaxing environment to do the injections. This may mean playing music in the background or laying on your couch. Allow adequate time so that you do not feel rushed.
Most IVF medications are subcutaneous, which means that you are injecting the fat right under (“sub”) your skin (“cutaneous”). Most people inject into their abdomen, avoiding the belly button area. Try different areas to see which areas are less sensitive and to avoid injecting the same spot each time. Consider your whole abdomen to be an open field for injections.
Most people find that pinching the skin or pulling it tight is helpful for subcutaneous injections. You can also try icing the area prior to injection to numb the skin.
Other IVF medications are injected intramuscularly (IM) – into the muscle. These injections go in different locations- primarily the upper outer corner of the buttocks. You can have your nurse show you and even mark where to inject.
One commonly used IM injection is progesterone in oil. This should not be stored in the refrigerator. It helps to warm up the vial prior to injection using your hands, warm water, or a heat pack.
Many patients find IM injections more painful. Instead of using ice, which can actually cause the muscles to tense up, try using a heating pad for 10 minutes prior to relax the muscles. After injecting, massage the area.
Additional tips:
In preparing for your stimulation cycle, think about ways that you can adjust your daily life to facilitate the process. This is particularly important for people who have other early morning commitments.
Consider creating a list of things that you will do to make your life less stressful. These might include ordering healthy take-out, doing gentle stretching before bed, getting your nails done, or having a movie night. Also consider things you might be able to cut out, including taking on new projects at work, volunteering, or hosting a social gathering.
Prioritize self-care during the cycle to help you stay relaxed and positive. Know that while IVF can be intimidating, many women have gone through it and had successful pregnancies –the ultimate reward!
