Fertility drug facts
Fertility drugs play a large role in many different types of infertility treatment options, and the majority are self-administered at home by the patient.
- Some medications used during in vitro fertilization (IVF), intrauterine insemination (IUI) or ovulation induction are self-administered injections.
- Though daunting for some, we offer instructions and advice that help make the process clear and as stress-free as possible.
About fertility drugs (medications), including IVF injections
Fertility medications are highly individualized, calling for combinations and dosing specific to the patient’s fertility treatment plan. Taking fertility medication as instructed, whether orally, by vaginal insertion or by injection, is critical to treatment success.
Fertility medication injections
Injections, either under the skin (subcutaneous) or into a muscle (intramuscular), are often preferred to get the highest percentage of medication into the system, most often through the bloodstream. Certain oral medications lose a good bit of their strength going through the digestive process.
The process of self-administering injectable medications in preparation for some treatments can seem daunting to someone who has no experience with an injection treatment process. This page addresses at-home injections to help patients feel more comfortable with the routine.
The Dallas IVF staff also helps alleviate the stress by properly managing and administering fertility treatment medication in the clinic setting. During those visits our staff members teach patients the best way to self-inject so they can do it on their own at home. Through personalized instruction, patients learn to self-administer properly, consistently and safely.
We also encourage patients to call us from home if they have any questions in administering the injections. One of our IVF nurses will assist and review any elements of the process if needed.
Instructions for administering fertility medication
Dr. Mucowski demonstrates fertility injections
Dr. Mucowski froze her eggs. In this video she shows how she self-administered fertility injections during the process. Scroll to the 2:12 video mark to see her instructions on self administering.
Additional fertility injection training from Freedom Fertility
How fertility drugs aid infertility treatments
About follicle-stimulating hormones, gonadotropins & human chorionic gonadotropins
Several types of injectable medication can be used during fertility treatments such as IVF, IUI, egg freezing for fertility preservation, ovulation induction and others. There are several different brand names for these medications. The dose and use of fertility drugs are generally different for each individual, based on her and her partner’s infertility evaluation. The primary categories of injectable drugs follow.
- Gonadotropins are injectable hormones that increase the number of follicles prior to ovulation and/or IVF egg retrieval. These are administered early in the menstrual cycle.
- Follicle-stimulating hormone (FSH), which may be given along with luteinizing hormone, stimulates the growth and maturation of multiple ovary follicles, which contain eggs.
- Human chorionic gonadotropin (hCG) signals the woman’s body to release eggs once they are mature. This is generally administered when the eggs are mature and is time-specific.
- Gonadotropin releasing hormone (GnRH) antagonists are hormones that prevent premature ovulation in order to time the egg retrieval.
Gonadotropin releasing hormone (GnRH) agonists like Synarel and Lupron induce a larger surge in LH and FSH, which triggers ovulation. GnRH may also help reduce the risk of ovarian hyperstimulation syndrome (see below on risks) when a GnHR antagonist is used.
Tips for self-injecting infertility medications
Due to the number of injections and timing necessary for treatment, infertility medication injections often need to occur at home and/or outside the fertility clinic. Injections are done either under the skin (subcutaneous) or into muscle (intramuscular). The method depends on the type of drug being used.
In addition to advice and instruction we give patients during clinical visits, the following tips can help women and their partners safely and competently self-administer medication. Refer to the video instructions (above) for specifics on needle placement and handling medications and equipment.
Tips to create a positive experience when injecting fertility drugs
- Work self-injections into your daily routine and consider setting up a regular reminder on your phone to keep track of timing.
- Find a process that works best for you. Sometimes it helps to have a loved one with you. Or you may discover that self-administering alone is more comfortable.
- Store medications properly to ensure effectiveness.
- Follow the provided instructions carefully, making sure all the items are included, to ensure safety and receive the full benefit of the medication.
- Make sure to choose a clean and sanitized location to administer injections. Thoroughly wash your hands.
- Choose the site for the injection, which can be the buttock, stomach or upper thigh. Clean the site with an alcohol swab.
- You can try ice on the area to numb it a little before the injection; you can use lidocaine patches to numb the area, but make sure to wipe it off with alcohol afterward.
- Practice deep breathing before penetrating the skin with the needle, which helps your body relax and lessens the pain.
- Try different injection sites, particularly if one is getting very sore.
- When finished, store the medication as directed and be sure to properly dispose of needles.
- Give yourself a reward! Having something to look forward to after the injection helps people face them with less dread. You can change these up, such as your favorite sweet one day or a massage from your partner the next.
Possible fertility medication side effects, such as OHSS
Our fertility specialists thoroughly discuss risks, considerations and side effects with each patient before beginning injections. The injections themselves may cause pain and soreness as well as bleeding at the site occasionally. Bruising at the injection site is also common. Gonadotropins can cause some women to have headaches, mood swings and tenderness in the breasts. Other side effects include the following.
Ovarian hyperstimulation syndrome (OHSS)
OHSS is soreness of enlarged ovaries due to fluid accumulation after ovulation and gonadotropin stimulation. The American Society for Reproductive Medicine reports mild OHSS in about 10% to 20% of cases. It usually resolves on its own, and rarely requires medical attention.
OHSS symptoms include abdominal pain and bloating, tenderness of the ovaries, nausea, diarrhea and vomiting.
A multiple pregnancy
A multiple pregnancy, which is twins or more, occurs in about 30% of implantations when using gonadotropins alone or with IUI. The natural occurrence is 1%-2%. Multiple pregnancy carries health risks for the mother and the resulting child.
Risk for an ectopic pregnancy
Ectopic pregnancy is an unsustainable pregnancy that occurs when the embryo implants outside the uterus (typically in the fallopian tube). The risk of ectopic pregnancy increases slightly with gonadotropin use.
This occurs in about 2% of gonadotropin cycles. This is when the ovary twists over on itself, and can require surgery to correct it.