It can be overwhelming when going through in vitro fertilization (IVF). Understanding the process, the medications, and possible side effects and accepting that you will need the assistance of a surrogate to build your family can be a lot to process. This blog will provide an overview of IVF, what purpose the medication serves, some tips for taking the medicines needed for your surrogacy journey, and any concerns you may want to discuss with your doctor.
An Overview of the IVF Process
A typical female produces a follicle that contains an egg every month. These follicles grow on your ovary, and when the egg is released, it’s known as ovulation. However, if you’re pursuing IVF, you have been prescribed injectable medications that aim to increase the number of follicles that will develop over a single cycle. More eggs mean a greater chance of having more embryos to have.
You will be monitored through ultrasounds and blood work when taking fertility drugs. Observing how big your follicles are and watching When your Reproductive Endocrinologist determines that your follicle is at a certain size, which indicates that your eggs are mature, they will recommend you take a trigger shot in preparation for egg retrieval.
Using ultrasound, a very thin needle is inserted into each follicle to retrieve the egg. Every patient can respond differently to the IVF stimulation process, so the number of eggs retrieved can vary. Any eggs retrieved that are mature would then be fertilized with the partner’s (or a donor’s) sperm.
After the day of the egg retrieval, you are contacted with the fertilization results (the number of eggs that became an embryo). Then, depending on your treatment protocol (if you’re doing a fresh or frozen transfer), the embryo(s) would be transferred to your surrogate’s uterus when your physician feels the time is ideal.
The Injectables Used for IVF
Bravelle, Follistim, Gonal-F, Menopur, and Repronex are injectable medications’ most commonly used brand names. These are known as gonadotropins. This term means “Any of a group of hormones secreted by the pituitary which stimulate the activity of the gonads.” All these medications are administered to stimulate the ovaries to produce multiple follicles. Your doctor will prescribe the ones they feel you will best respond to, increasing your chances of a positive outcome.
Every patient is responsible for administering these medications, but do not worry. Your fertility clinic will teach you how to give detailed instructions and will continue to be available for any questions you may have. Some commonly reported side effects of gonadotropins are the following:
- Feeling tired
- Feeling moody
- Possible discomfort at where you have given yourself an injection
- Ovarian hypersensitivity is another possibility, but you will also be monitored for any signs of this when seeing your doctor
Advice for Administering Injectable Fertility Medications
Once you have been informed of your IVF protocol and what fertility medications it will entail, below is a list of some items you may want to have handy:
- Antibacterial soap
- Cotton balls and alcohol; or alcohol swabs
- Vials of medication
- Vials of a diluent such as
- The correct size of the needles or syringes recommended by your doctor
- A container specifically used to dispose of needles
Ways to prepare yourself and the area you will be injecting:
- Find a flat surface to set up everything
- Clean the surface with alcohol and let air-dry
- Wash your hands with the antibacterial soap
- Then, set up your medication and supplies on the flat surface
The following tips are often recommended to minimize any pain or discomfort:
- Applying ice 30 to 60 seconds before the injection site to help numb the area
- If progesterone is in oil IM injection, do not use ice (it’s oil). But instead, warm the bottle in your hand and heat the injection site with a heating pad post-injection.
- Double-check that air bubbles are removed from the syringe before injecting
- Wait until alcohol on the skin has evaporated
- Mixing up the sites where you inject your medication to prevent one area from getting sore
- Inject the medications when they seem to be at room temperature (this is especially when using progesterone in oil)
- Use a quick, almost dart-like motion when putting in the needle
- Do not change the direction of the needle once it’s in
- Apply warm compresses can help soreness of injection afterward
While all of the advice and tips above can be incredibly helpful, nothing can replace the instructions or insight of your doctor and their medical team. In short, if you have any concerns or questions, you should feel comfortable asking them directly.
Once the necessary shots are done, dispose of any needles, syringes, and vials you used into your designated container, categorized as “medical waste.” This is to ensure that it can be disposed of properly. Once the container is full, talk to your fertility clinic about how best to discard it.
Additional notes around injectable fertility medications:
- Any and all needles used for your injections must be sterile
- It’s vital not to reuse any needles
- Please do not leave any needs lying around or dispose of them in your regular trash
- Injections usually are done for approximately ten days.
As mentioned above, under the IVF overview section, your reproductive endocrinologist will determine when you are ready to receive the next injection called human chorionic Gonadotropin (hCG), which induces ovulation for your egg retrieval.
If you have any questions, it’s best to speak with your reproductive endocrinologist or your medical team. And as always, we’re happy to help!