In vitro fertilization (IVF) treatment relies on precise hormonal medications administered via injection over several weeks to stimulate the ovaries and prepare the uterus for pregnancy. While the prospect of self-injecting can cause apprehension, learning the proper technique is a necessary part of the process. Patients must always prioritize the specific, individualized instructions provided by their fertility clinic and medical team.
Preparation and Mixing Protocols
Meticulous preparation is necessary to ensure both sterility and accurate dosing of the medication. Gather all required supplies, including alcohol swabs, gauze, medication vials, syringes, needles, and a sharps container. Perform thorough handwashing and clean the preparation surface with an antiseptic wipe to establish a sterile workspace.
Carefully check all medication vials for the expiration date and confirm the correct storage conditions. Many IVF medications come as a powder that must be reconstituted with a sterile diluent or liquid, often supplied in a separate vial. To mix powdered medication, use the mixing syringe to draw up the diluent, inject it into the powder vial, and gently swirl the contents until the powder is fully dissolved.
Avoid shaking the vial, as this can create air bubbles. After mixing, draw the prescribed dosage into the syringe, measuring the liquid precisely. Hold the syringe upright and gently tap the barrel to move any air bubbles to the top. Push the plunger slightly to expel the air until a tiny drop of liquid appears at the needle tip.
Step-by-Step Injection Methods
The method for administering the injection varies significantly depending on whether the medication is meant for subcutaneous (SubQ) or intramuscular (IM) delivery. Subcutaneous injections are used for most stimulation medications and involve injecting into the fatty layer just beneath the skin. Preferred sites for SubQ injections are the lower abdomen, avoiding the two-inch area around the navel, or the front of the thigh.
To perform a SubQ injection, clean the chosen site with an alcohol swab, wiping outward from the center, and allow the skin to air-dry completely. Gently pinch a fold of skin and fat between your thumb and forefinger. Insert the small, short needle with a quick, dart-like motion at an angle of either 45 or 90 degrees, as instructed by your clinic.
Once the needle is fully inserted, release the pinched skin and slowly push the plunger down to administer the medication at a steady pace. After the medication is fully delivered, count to five before quickly and smoothly withdrawing the needle from the skin. Always rotate the injection site daily, moving slightly from the previous spot to minimize irritation, bruising, and the development of scar tissue.
Intramuscular injections, often used for Progesterone in Oil (PIO) or certain trigger shots, require a longer, thicker needle to deliver the medication deep into a large muscle. The most common site for IM injections is the upper outer quadrant of the gluteal area, which avoids major nerves and blood vessels.
The IM injection site should be cleaned with an alcohol swab and allowed to dry, and the skin should be stretched taut, rather than pinched. Insert the needle straight into the muscle at a 90-degree angle using a quick, firm motion. A crucial step for IM injections is aspiration, where you pull back slightly on the syringe plunger once the needle is inserted. If blood flows into the syringe, the needle is in a blood vessel and must be withdrawn, discarded, and a new injection prepared for a different site.
If no blood is aspirated, slowly and steadily push the plunger to inject the medication. After the medication is fully administered, quickly withdraw the needle and immediately dispose of the used syringe and needle. Due to the deep penetration, a partner often assists with IM injections to ensure the proper angle and site are used.
Post-Injection Care and Safety
Immediately after withdrawing the needle, apply gentle pressure to the injection site with a sterile gauze pad for about ten seconds to stop any minor bleeding. Avoid rubbing the area, especially after a SubQ injection, as this can push the medication out or increase bruising and irritation. Applying a warm compress or heating pad to an IM site can help the body absorb the medication and reduce post-injection soreness.
You should monitor the injection site for expected minor reactions like temporary redness, mild pain, or a small bruise. If you observe signs of a more severe reaction, such as a rash, persistent swelling, excessive bleeding, or pain that radiates down the leg, contact your fertility clinic immediately. These symptoms may indicate an allergic reaction or improper injection technique that requires medical guidance.
Proper disposal of all used needles and syringes is a safety mandate. These items must be placed immediately into a puncture-resistant sharps container. Never place used sharps directly into household trash or attempt to recap a used needle, which increases the risk of accidental needlestick injury. Once the container is three-quarters full, seal and dispose of it according to local regulations, such as drop-off locations or mail-back programs.
Maintaining a rigorous schedule is paramount, particularly for the trigger shot, which must be administered at the exact minute prescribed to ensure optimal timing for egg retrieval. Setting multiple alarms helps ensure consistency for all daily injections, which is important for maintaining stable hormone levels throughout the cycle.