IVF Injections Guide

Key Takeaways

• IVF uses hormone therapy injections that are given over some time to prepare eggs for fertilization.
• Many of the injections used during an IVF treatment can be done at home by the patient.
• Subcutaneous injections are given in the area beneath the skin surface like the stomach or front thigh. 
• Intramuscular injections are delivered directly into the muscle usually in the top outer quadrant of the buttocks.

What is IVF?

In vitro fertilization or IVF is a fertility treatment where a female’s egg and male’s sperm are combined in a laboratory. The fertilized embryo is then allowed to develop before being transferred to the uterus to increase the likelihood of pregnancy.

IVF is recommended to an individual or couple when:

• One has blocked or damaged fallopian tubes
• There’s infertility relating to sperm quality or quantity
• One has endometriosis
• The woman has uterine fibroids
• One is suffering from polycystic ovarian syndrome (PCOS)
• The individual or couple is advanced in age
• Ovulation doesn't happen or doesn't occur often
• There’s unexplained infertility
• There are recurring miscarriages
• There are potential genetic issues that require embryo screening
• A woman has undergone tubal ligation

IVF treatment is customized depending on the individual’s needs. The process typically lasts between four and six weeks and one can choose to take the injections at a fertility specialist like Ivy Fertility or in the comfort of their home. Either way, healthcare professionals will monitor your health and adjust your dosage as you progress through the cycles. 

How to prepare for IVF

IVF can be a long and arduous journey. Before starting the cycle, it's important to prepare your mind and body for the journey ahead. 

• Find a reputable fertility clinic. One way is to check the clinic’s success rates or live birth rates. When you talk to the clinic, ask for detailed information about the process, including the costs.
• Ovarian reserve testing. Blood tests are done to find out how many eggs are available in the body. 
• Your partner will go through a semen analysis to check the amount of sperm, their shape, and movement. 
• Screen for infectious diseases like syphilis, hepatitis C, human papillomavirus, and HIV. 
• Test the depth of your uterus by practicing embryo transfer. This also helps to decide the technique that will work well during the process.
• Undergo a sonohysterography to test the lining of the uterus.  
• Plan ahead what you will do with any extra embryos you may have. 

IVF Medication Used

The medications used in IVF are used to stimulate the ovaries to produce many follicles (fluid-filled sacs in the ovaries) which contain eggs. Healthcare professionals start giving the medication at the beginning of the menstrual cycle. The medication is administered once or twice a day for about 7–14 days depending on the medication protocol. Here are some of the most common medications used during the IVF process.

Gonadotropins

Gonadotropin medications are used to stimulate the ovaries to produce several egg-containing follicles during an IVF cycle. These are shots injected under the skin and can contain FSH only. In many cases, the medication is given once per evening common gonadotropin medications include Gonal-f, cFollistim, Menopur, Pregnyl, Ovidrel, and Profasi. 

GnRH agonists

GnRH agonists are synthetic forms of gonadotropin-releasing hormone (GnRH), which stimulates the ovaries and at the same time suppresses the production of any new gonadotropins. In other words, GnRH agonists control the development and maturation of eggs during the IVF cycle and help prevent premature ovulation. Common forms include Lupron, Zoladex, and Synarel.

GnRH antagonists

GnRH antagonist medications prevent premature ovulation by preventing natural ovulation to ensure the maximum number of eggs can be retrieved during the IVF cycle. Common drugs include Antagon, Ganirelix, Orgalutran, and Cetrotide.

Progesterone

Progesterone prepares the uterine lining for implantation. Progesterone is given to support this process in preparation for embryo implantation. Popular types of progesterone include Endometrin, Crinone gel, and Prometrium tablets. 

Estrogen

Estrogen is given to help stimulate egg growth and increase the odds of embryo implantation. Estrogen comes as oral pills, vaginal suppositories, or skin patches. 

Antibiotics

Some healthcare professionals prescribe oral antibiotics like doxycycline to help control any bacteria that may negatively affect embryo implantation.‍

Clomid

Clomid is used to stimulate follicle and egg development in women with long menstrual cycles and infrequent periods by making the body secrete more FSH and LH, which can help stimulate follicle and egg growth.

IVF Stages

The IVF cycle involves 5 main stages. 

Downregulation

In this stage, fertility specialists suppress the natural menstrual cycle to prevent ovulation. This process is known as downregulation. When done before IVF, downregulation reduces premature ovulation.

Ovarian stimulation

This stage involves taking injections that increase the number of follicles and eggs produced. The more follicles produced the more the eggs can be retrieved. The healthcare provider will monitor your progress to ensure egg development is on track. 

Egg Retrieval

Once a trigger shot is given to mature the eggs, 36 hours later, the eggs are retrieved. Egg retrieval has to be timed perfectly to avoid egg loss during ovulation. The retrieved eggs are then put in a controlled environment in preparation for fertilization. 

Fertilization

In this stage, the retrieved eggs are fertilized with the sperm using traditional insemination, where healthy sperm is mixed with eggs in a petri dish in the laboratory or through intracytoplasmic sperm injection where sperm is injected into each egg separately. The combined mixture is given 20 hours to fertilize. 

Embryo Transfer

The fertilized eggs are allowed to grow before they are transferred. During transfer, the embryos are carefully injected into the uterus two to five days after egg retrieval. A blood pregnancy test is done 2 weeks later to confirm pregnancy. 

Taking Injections at Home

The IVF process isn’t a glamorous one and taking the injections at home can make the process easier for some. To take the injections at home:

1. Prepare your space and make it comfortable for you. 
2. Wash your hands to prevent infections.
3. Prepare your injections. Do any pre-mixing beforehand. Follow the instructions given by your fertility doctor. 
4. Place your needle in the vial, flip the vial upside down, and gently pull back on the plunger of the syringe. 
5. Choose your injection site and clean it with an alcohol swab.
6. Squeeze the injection site with your other hand and push the needle through your skin until all the medication is fully released. 
7. Remove the needle slowly so all of the medication is fully released into the body. 
8. Gently rub the injection site in small circular motions to help your body absorb the medicine.
9. Cap and throw away the needle.

The Bottom Line

Similar to any other fertility treatment, the length of time or number of doses of medication is determined by the individual and the type of required treatment. Based on these, the number of IVF shots can go up to 90 within one cycle of treatment. No matter where you take the injections, injections can be overwhelming, but the anxiety can be reduced when you’re adequately prepared.