If you are about to embark on an IVF journey, it’s natural to have concerns and questions, especially about the injections. “Do they hurt?”, “How will they make me feel?”, are among the most frequently asked questions that we get here at IVF babble.
We asked the nurses at the Lister Fertility Clinic to help us address these concerns to help put you at ease and prepare you for the exciting road ahead.
Key Takeaways
IVF medications are crucial for regulating the menstrual cycle, stimulating egg production, and supporting embryo implantation, all of which are essential for the success of the IVF process.
Administration of IVF medications typically involves daily self-injections or nasal sprays, with subcutaneous (into the fatty tissue just below the skin and above the muscle tissue) and intramuscular injections being the primary methods used; correct administration is essential for treatment efficacy.
Common side effects of IVF medications range from minor issues like headaches and bloating to more serious conditions like Ovarian Hyperstimulation Syndrome (OHSS); proper management and monitoring are important to mitigate these effects.
Before we talk you through the different types of medication, it’s important to note that each patient is different. Your doctor will create a personalized protocol (a plan) tailored specifically to your needs and circumstances.
It is also really important to remind you that although it might feel overwhelming and daunting, these IVF injections are crucial in helping you take that wonderful step forward towards your goal of becoming a parent. So, when it all gets a bit too much, take a deep breath and visualize your dream, knowing that each injection brings you closer to it.
Understanding IVF Medications
Navigating the world of IVF medications can feel overwhelming but understanding their purpose and function can make the process more manageable. IVF medications are designed to regulate the menstrual cycle, stimulate the ovaries to produce multiple eggs, and support embryo implantation. These fertility drugs are the backbone of the IVF process, helping to enhance the chances of a successful pregnancy.
Throughout the IVF cycle, a variety of medications are employed to halt the patient’s natural cycle, while encouraging the ovaries to generate mature eggs. This includes a range of fertility drugs such as:
Clomiphene citrate (Clomid)
Letrozole
GnRH agonists and antagonists
Each of these plays a vital role in ensuring that the in vitro fertilization (IVF) treatment progresses smoothly and effectively throughout the IVF treatment cycle.
Oral contraceptives
Oral contraceptives may be used as a first step in preparing for an IVF cycle. These birth control pills are used to regulate and control the menstrual cycle before starting the IVF treatment. By suppressing the natural cycle, oral contraceptives may help to create a more predictable environment for subsequent fertility treatments, increasing their effectiveness.
The use of oral contraceptives in IVF serves multiple purposes:
Birth control
Synchronizing the menstrual cycle with the treatment schedule
Ensuring that the ovaries are in the optimal state when stimulation drugs are introduced
Down regulation drugs
Down regulation drugs play a critical role in the IVF process by suppressing natural ovarian function, however, not every IVF patient will need to undergo down regulation. There are other protocols, such as the antagonist or mild stimulation protocols, which do not involve down regulation. The choice of protocol depends on individual factors and your doctor’s assessment of what will be most effective for you.
These medications, called GnRH agonists, are used to prevent premature ovulation during the stimulation phase, ensuring that the follicles can grow properly.
GnRH agonists, such as Synarel and Lucrin, have the following effects:
They initially over-stimulate the pituitary gland, leading to an increased hormone produced
They then shut down the pituitary gland to control the timing of ovulation
This meticulous regulation establishes a conducive environment for the ovaries to produce multiple mature eggs, which is a key factor in a successful IVF cycle.
How long does down regulation last?
During IVF down regulation, you typically take medications for 2 to 3 weeks. The exact duration can vary depending on your specific treatment plan and how your body responds to the medication. These medications may be administered as either an injection or a nasal spray. Your doctor will monitor your progress and adjust the timeline as needed. After 2 to 3 weeks of down-regulation, a scan confirms if it’s okay to start FSH injections.
Stimulation medications
Follicle stimulating hormone (FSH) is a crucial component of IVF treatment. This hormone stimulates the ovaries to produce multiple follicles, each containing an egg, ready for collection. Stimulation medications commonly used in IVF to mature eggs and improve the chances of a successful pregnancy include:
Follistim
Gonal-F
Menopur
Pergoveris
Some of these medications contain FSH alone, whereas some will also contain a hormone called Luteinsing hormone (LH). Your doctor will decide which drug would work best for your situation.
FSH drugs are otherwise known as gonadotrophins.
FSH injections are usually commenced early in your menstrual cycle, usually around day 2 or 3 of your period. This timing helps to stimulate your ovaries to produce multiple eggs in preparation for retrieval. Your doctor will provide specific instructions based on your personalized treatment plan.
How long do you inject FSH for?
You will have daily FSH injections for approximately 10 to 14 days, administered just under the skin on your thigh or tummy (this is called a subcutaneous injection).
The number and size of the follicles in your ovaries is monitored using internal scans. The first scan is usually performed after 5 injections, however your clinic may have different protocols. After this initial scan, your team will decide how regularly you will ned to be seen for further monitoring, but will likely be every 2-3 days until your follicles have reached an appropriate size.
The goal is to have at least 2 to 3 follicles measuring between18 to 20 millimeters in diameter before scheduling your egg collection.
Administration of IVF Medications
Correct administration of IVF medications is instrumental to the treatment’s success. These medications can be administered through daily self-injections or nasal sprays to suppress the natural menstrual cycle. Typically, patients are guided by experienced nurses who provide detailed instructions on how to self-administer these injections at home.
The two main types of injections used in IVF are subcutaneous and intramuscular injections.
Subcutaneous injections are given just under the skin, while intramuscular injections are administered deep into the muscle. Patients can choose to self-administer these injections or have a partner or relative assist them, with medical teams available for support throughout the process.
Subcutaneous injections
Subcutaneous injections are commonly used in IVF to stimulate the development of multiple eggs. Medications such as the ones listed below are administered this way. These injections involve a small needle inserted just under the skin, typically in the abdomen, front of the thigh, or back of the upper arm.
Gonal F
Menopur
Clexane
Lubion
The process of administering subcutaneous injections entails multiple steps:
Selecting an injection site
Cleaning the area with alcohol
Inserting the needle at a right angle
Checking for blood
Injecting the medication
Removing the needle
Disposing of the syringe properly
Rotating injection sites daily helps avoid tissue damage and improve medication absorption.
Intramuscular injections
Intramuscular injections are used for certain IVF medications that require deeper administration into the muscle. Common intramuscular medications include Lentogest and Prontogest. These injections are typically administered into the buttocks using longer needles to ensure the medication is delivered deep into the muscle.
To avoid bruising when injecting IVF medication, follow these tips:
Choose the Right Injection Site: Rotate injection sites to avoid using the same area repeatedly. Common sites are the abdomen and thigh.
Use a Cold Compress: Apply a cold compress to the injection site for a few minutes before injecting to numb the area and reduce blood flow.
Ensure Proper Technique: Inject at a 90-degree angle if using a subcutaneous needle, and ensure the needle is fully inserted.
Inject Slowly: Inject the medication slowly and steadily to minimize tissue damage.
Apply Pressure After Injection: After injecting, gently press on the site with a clean cotton ball or gauze for a minute to help prevent bruising.
Avoid Blood Vessels: Check the injection site for visible veins and avoid them to reduce the risk of hitting a blood vessel.
Stay Relaxed: Relax your muscles as much as possible during the injection to minimize tissue trauma.
By following these tips, you can help reduce the likelihood of bruising when injecting IVF medication.
How many times a day do you inject IVF drugs?
The number of times a day you inject IVF drugs can vary based on your specific treatment protocol. Typically, you will have to inject once or twice a day.
Is there a set time you have to take your ivf drugs?
It’s important to take your injections at the same time each day to maintain consistent hormone levels in your body. Your doctor will provide specific instructions on the timing of each medication to ensure the best possible outcome for your treatment. Always follow your doctor’s guidance closely regarding the schedule.
Proper storage of IVF medication is crucial to ensure its effectiveness. Here are some general guidelines:
Refrigeration: Some medications, such as certain gonadotropins and the trigger shot, need to be stored in the refrigerator. Check the packaging for specific instructions.
Room Temperature: Other medications may be stored at room temperature, typically between 20°C to 25°C (68°F to 77°F). Keep them in a cool, dry place away from direct sunlight and heat.
Check Expiry Dates: Always check the expiration dates on your medications and use them before they expire.
Original Packaging: Keep medications in their original packaging to protect them from light and moisture, and to ensure you have the correct information and instructions.
Out of Reach: Store medications out of reach of children and pets.
Always follow the storage instructions provided by your doctor or the medication manufacturer, and if you have any doubts, consult your healthcare provider.
Managing Your Fertility Medication When Traveling or Relocating
When traveling or relocating, it’s crucial to handle your fertility medication with care. A common mistake is hastily packing these medications in bathroom cabinets, which can expose them to unfavorable conditions. To ensure they remain effective, consult your healthcare team for proper transportation practices. Carry your medications in a temperature-controlled container instead of packing them with other items. This way, they stay in an optimal environment, ready to support your fertility journey. You may require a note from your doctor to state that you are travelling with needles.
Common Side Effects of IVF Medications
While IVF medications are essential for successful treatment, they can cause various side effects. Common side effects include:
Hot flushes
Irritability
Restlessness
Bloating
Headaches
Mood swings
Abdominal pain
Breast tenderness
It’s important to monitor these side effects and consult with a fertility clinic if they persist or become concerning.
Comprehending and managing these side effects can ease the course of the IVF journey. By staying informed and prepared, patients can better cope with the physical and emotional challenges that may arise during the treatment.
Ovarian Hyperstimulation Syndrome (OHSS)
Ovarian Hyperstimulation Syndrome (OHSS) is a complication of IVF treatment characterized by swollen and painful ovaries due to sensitivity to fertility medications. Symptoms of OHSS include pain and bloating in the lower abdomen, nausea, and shortness of breath. Severe cases may involve severe abdominal pain, nausea, vomiting, and rapid weight gain.
OHSS typically develops in the week following egg collection. Mild OHSS typically subsides on its own, whereas severe instances might necessitate hospitalization and expert care to manage symptoms and ward off complications.
Your doctor will discuss your individual risk and create a protocol for you to minimise your overall risk.
When are you ready for Egg Collection?
Your doctor decides you are ready for egg collection based on several factors observed during your IVF cycle, including:
Follicle Size and Number: Through ultrasound monitoring, your doctor will measure the size and number of developing follicles. Generally, follicles should be about 18 to 20 millimeters in diameter.
Estradiol Levels: Blood tests are used to measure your estradiol (estrogen) levels, which should correspond to the number and size of the follicles.
Endometrial Lining: The thickness and quality of your endometrial lining are also assessed to ensure it is optimal for implantation.
When these factors indicate that your follicles are mature and your body is ready, your doctor will schedule your trigger medication. This is either a Human chorionic gonadotropin (hCG) trigger injection or an GnRH agonist (injection or nasal spray). This medication induces final maturation of the eggs within the follicles. The egg retrieval procedure will be scheduled approximately 35-37 hours following the time of your trigger.
The Role of hCG in IVF
Human chorionic gonadotropin (hCG) plays a crucial role in the IVF process. The hCG hormone mimics the natural luteinizing hormone (LH) surge, signalling the final maturation of the eggs. The hCG injection, often referred to as the trigger shot, is administered once the follicles have reached an appropriate size to prepare the eggs for ovulation.
The timing of the hCG injection is crucial, as it ensures the eggs are mature and ready for collection. Medications such as Ovitrelle, and Zivafert are commonly used to trigger ovulation. This step is vital for the subsequent egg retrieval and embryo development stages of the IVF cycle.
Progesterone Support Post-Egg Collection
Progesterone is essential for preparing the womb lining for embryo implantation and supporting pregnancy after egg collection. This hormone ensures the uterus lining is receptive for an embryo to implant and develop. In an IVF cycle, progesterone supplementation is started on the day of egg retrieval and continues for 17 days or throughout the first trimester if pregnancy occurs.
Applying heat or using a heating pad on the injection site can help with the absorption of oily progesterone injections, improving their effectiveness. Adequate progesterone support is paramount for attaining a successful pregnancy and sustaining it during the initial stages.
Frequently Asked Questions
Why am I not responding to IVF medication?
Various factors can lead to an under-response to medication. Sometimes this may be predicted ahead of the start of treatment, for example in the case of low ovarian reserve or increasing female age. Occasionally, an under-response may be unexpected and may be related to underlying egg quality. In addition, inconsistent timing of medication administration or poor injection techniques could also be impacting your response. It’s important to address these factors with your healthcare provider to improve your chances of success.
Does ivf treatment bring on early menopause ?
No, IVF drugs do not bring on early menopause. IVF medications only stimulate the eggs in your antral follicles that are present during a single cycle. These eggs would all die at the end of a given cycle, and therefore stimulating and collecting them has no bearing on the time of menopause. Menopause is a natural biological process that occurs when the ovaries no longer produce eggs, and it typically happens between the ages of 45 and 55. While IVF drugs can temporarily alter hormone levels, they do not lead to early menopause.
Does ivf medication make you tired ?
Yes, IVF medication can make you feel tired. The hormonal changes and physical stress associated with the treatment can lead to fatigue. Additionally, the emotional strain of the IVF process can contribute to feelings of tiredness. If you experience significant fatigue, it’s important to discuss it with your doctor, as they can provide guidance and support to help manage this side effect.
Does ivf medication make you put on weight ?
Yes, IVF medication may cause weight gain. This weight gain is typically due to hormonal changes and fluid retention. The medications used in IVF, such as gonadotropins and progesterone, can lead to increased appetite and changes in metabolism, contributing to weight gain. Additionally, the body may retain more water during the treatment, leading to temporary weight increase. If you have concerns about weight gain during your IVF cycle, it’s best to discuss them with your doctor for personalized advice and support.
The post Top IVF Medication FAQs: Comprehensive Guide to Your Fertility Treatment appeared first on IVF Babble.
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