Starting in vitro fertilization (IVF) injections can leave you feeling uncertain, hesitant, and even overwhelmed. This is especially true if you get a little squeamish with needles. You may wonder if you’re doing it correctly or if it will hurt.
However, IVF injections are manageable with the right preparation and knowledge. Most find the process easier than they expected. With practice, these daily injections simply become part of your routine.
At TRIO, we understand that self-administering injections is a big step in your fertility journey. Our team provides proper guidance and ongoing support to help you feel confident. We’re here to guide you through every aspect of your treatment. This article outlines everything you need to know about IVF injections at home. Remember that we’re always here to answer any questions you might have along the way.
How Do IVF Injections Work?
With IVF, self-injection is generally the norm. This means your team will instruct you on how to prepare and inject them.
These injections contain hormones that help control your reproductive cycle. They work by mimicking your body’s natural hormone production. However, they provide more precise timing and higher hormone levels than your body produces on its own.
There are 4 main types of IVF injections:
- stimulate your ovaries to produce multiple follicles;
- prevent early ovulation, ensuring eggs mature at the right time;
- trigger the ovulation so that eggs can be collected during the egg retrieval process; and
- maintenance of endometrial lining and support implantation and early pregnancy
During a typical IVF cycle, you’ll use different medications at specific stages. Your fertility team will create a personalized protocol based on your individual needs.
But why injections? Injections allow more direct and higher dosages of the medications to enter your bloodstream, and this bypasses the digestive system. In turn, it provides the most reliable and effective hormone delivery for your success.
IVF Injections Schedule
So, when do you start IVF injections? What should you expect? Below, we explore the timeline and frequency.
How Long Do You Take IVF Injections?
Most IVF injection cycles last between eight and 14 days. However, some patients may need injections for up to three weeks. The exact duration depends on how your body responds to the medications and your personal treatment plan.
Your fertility team monitors your progress through blood tests and ultrasounds. Based on these results, they may adjust your medication timing.
After egg retrieval, you may continue with different injections to support implantation. These post-retrieval medications typically continue for several weeks if pregnancy occurs.
What Day of Your Cycle Do You Start IVF Injections
The first day of IVF injections is usually day two or three of your menstrual cycle. Your fertility team will give you specific instructions about when to start based on your protocol. Some may also begin with birth control pills before starting injections.
In some cases, you might start injections on a different cycle day. This depends on your specific treatment plan and whether you use fresh or frozen embryo transfer protocols. Your care team will provide clear guidance about your start date.
Either way, it’s important to follow your prescribed schedule exactly. Starting too early or too late can affect your treatment outcome. Contact your fertility team immediately if you’re unsure about timing.
How Many IVF Injections Do You Take Each Day?
Most patients take one to three injections daily during their IVF cycle, but the exact number depends on their specific medication protocol.
Common daily injection combinations may include:
- One stimulation medication (like Gonal-F, Pergoveris, Menopur, or Rekovelle)
- One medication to prevent early ovulation (like Cetrotide, Orgalutran, Lurpon, Decapeptyl, Suprefact)
- Additional support medications as needed
Your injection schedule may change throughout your cycle. You might start with one daily injection and add others as treatment progresses. Your fertility team will clearly explain when to add or stop each medication.
IVF Injections Time of Day
Consistency in timing is of the utmost importance. Most patients find evening injections work best with their daily routine. Taking injections between 6 pm and 10 pm allows for monitoring appointments the next morning.
Set phone alarms or reminders to help you stay on schedule. Even being an hour late can affect your treatment outcomes. Thus, choose a time you can maintain every day, including weekends.
IVF Injection Sites
There are generally two injection sites: subcutaneous and intramuscular. Different medications require specific injection sites based on their absorption needs. Your fertility team will show you the proper locations and techniques during your training session.
Using the correct injection site ensures that your medication works as intended. It may also help prevent common side effects of IVF injections, such as bruising or irritation.
IVF Subcutaneous Injection Sites
Subcutaneous injections go into the fatty tissue just under your skin. Most IVF medications are given this way because it’s easier and less painful. These areas have good blood flow, allowing the medication to be absorbed effectively.
The best subcutaneous injection sites include:
- Abdomen: The most common area is your lower belly, about two inches from your belly button. Choose spots on either side, avoiding the area directly around your navel.
- Upper thigh: The front and outer parts of your upper thigh work well for subcutaneous injections. This area is especially helpful if your abdomen becomes tender from repeated injections.
- Upper arm: The back of your upper arm can be used. However, it’s harder to reach on your own.
It’s usually recommended to avoid areas with scars, moles, or skin irritation. Additionally, keep injection sites at least one inch apart from previous injection spots.
IVF Intramuscular Injection Sites
Intramuscular injections go deeper into muscle tissue. They are typically used for progesterone medications that support the uterine lining. The needle goes through the fatty tissue into the muscle below.
The main intramuscular injection site for IVF includes:
- Upper outer buttock: Divide your buttocks into four sections and use the upper outer quarter. This location has fewer nerves and blood vessels.
- Upper thigh: The vastus lateralis muscle on the outer part of your upper thigh can also be used. This site is easier to reach than your buttocks but may be more uncomfortable.
Intramuscular injections require longer needles and may cause more discomfort. Warming the medication to room temperature before injection can help reduce pain. A gentle massage after the injection may also help your body absorb it properly.
How to Administer IVF Injections at Home
Taking your time and following the proper steps can ensure everything is done correctly. This will also reduce stress throughout the process. After the first few injections, it’s likely you’ll begin to feel more comfortable, too.
Your TRIO fertility team will instruct you on proper administration. If you have any questions or concerns, don’t hesitate to ask. With that in mind, here’s what you should know.
Creating a Sterile Environment
A clean space prevents infection and ensures safe injection practices. Choose a quiet area where you won’t be interrupted. Good lighting also helps you see what you’re doing clearly.
Start by washing your hands thoroughly with soap and warm water for at least 20 seconds. Clean the space with an alcohol wipe or disinfectant. Lay out a clean towel or paper towels to place your supplies on.
Gather all your supplies before you begin:
- Your prescribed medication
- Appropriate syringes and needles
- Alcohol wipes
- Gauze pads
- Sharps disposal container
Keep pets and other people away from your injection area. It’s also a good idea to avoid doing this in your bathroom or kitchen; bacteria tend to be higher in these areas. A bedroom or living room table often works best for most people.
Getting Medication and Syringe Prepared
Some medications come in preloaded pens, making them simple to use—there’s no need to mix or draw up the drug yourself. However, if your medication does require preparation, don’t worry. Your medical team will give clear, step-by-step instructions to guide you. These instructions may include the following steps:
- Remove your medication from the refrigerator 15-30 minutes before injection time. Cold medication can be more painful and harder to inject. Never microwave or heat medications, as this can damage them.
- Check your medication label to ensure you have the correct drug and dosage. Look for any particles, cloudiness, or color changes indicating contamination. Contact your pharmacy immediately if anything looks unusual.
- Attach the needle to your syringe (if they come separately). Remove the cap from the needle carefully to avoid injury. Draw air into the syringe equal to your medication dose.
- Insert the needle into the medication vial and inject the air. This prevents a vacuum that makes drawing medication difficult. Turn the vial upside down and slowly draw your prescribed dose. Check for air bubbles and gently tap the syringe to remove them.
Prepping the Injection Site
- Clean your injection site with an alcohol wipe. Use a circular motion, starting from the center and working outward. Let the area air dry completely before injecting.
- Pinch the skin gently if giving a subcutaneous injection. This lifts the fatty tissue away from the muscle below. For intramuscular injections, stretch the skin taut instead of pinching.
- Take a deep breath and insert the needle quickly in one smooth motion. Going slowly often hurts more than a quick, confident insertion. Insert the needle as directed by your fertility team, usually at a 90 or 45-degree angle.
- Pull back slightly on the syringe plunger before injecting. If you see blood, remove the needle and choose a different site. If no blood appears, slowly inject your medication at a steady pace.
Post IVF Injection Care
- Remove the needle quickly after injecting all the medication. Apply gentle pressure with a gauze pad to prevent bleeding. Make sure to avoid rubbing the injection site, as this can cause irritation.
- Apply a small band-aid if there’s any bleeding or if it makes you feel more comfortable. Some bruising or tenderness at injection sites is normal. Contact your fertility team if you develop severe pain, excessive swelling, or signs of infection.
- Dispose of your needle and syringe in a proper sharps container immediately. Never reuse needles or leave them lying around. Most pharmacies accept full sharps containers for safe disposal.
- Record your injection in a medication log or app. Note the time, medication name, dosage, and injection site. This helps you track your progress and identify any patterns or concerns to discuss with your team.
Potential Side Effects of IVF Injections
Most side effects of IVF medication are mild and temporary. Your body usually adjusts to the medications within a few days of starting treatment.
It’s important to remember that experiencing side effects doesn’t mean your treatment isn’t working. Many patients have successful IVF cycles while managing various symptoms. If you have any concerns, make sure to bring them up with your fertility team.
Common side effects may include:
- Redness, swelling, or tenderness at injection sites
- Bloating and abdominal discomfort (often due to your ovaries growing larger than usual)
- Mood changes (such as feeling more irritable, anxious, or tearful)
- Fatigue
- Headaches
- Breast tenderness
While rare, more serious side effects that require immediate medical attention include:
- Severe abdominal pain or bloating
- Difficulty breathing or chest pain
- Rapid weight gain (more than two pounds per day)
- Nausea and vomiting
- Decreased urination
- Severe headaches with vision changes
These symptoms could indicate ovarian hyperstimulation syndrome (OHSS), which requires prompt medical care. While OHSS is uncommon, early treatment prevents complications.
IVF Injection Tips
These practical tips can make your injection experience smoother and more comfortable. So, let’s take a closer look.
Setting Yourself Up for the First Day of IVF Injections
Proper preparation may help reduce anxiety about your first injection. Set up your injection area the night before so everything is ready. Having all supplies organized makes the process feel less overwhelming.
- Practice the injection steps without medication first. Use a saline solution or practice on an orange to build confidence.
- Consider having your partner or a friend present for your first injection. Their support can provide comfort and reassurance. They can also help if you feel dizzy or need assistance.
- Ensure you also choose a relaxing environment for your first injection. Play calming music or light a candle to create a peaceful atmosphere.
- Additionally, you may want to plan something enjoyable after your first injection. This gives you something positive to look forward to. For instance, you could plan your favorite meal or an activity you love.
How to Make IVF Injections Less Painful
Here are a few techniques to help make these injections more comfortable:
- Allow the medication to come to room temperature before your injection. Do not use heat sources like microwaves. Simply let it sit out for 15 to 30 minutes.
- Ice the injection site for a few minutes before injecting. This numbs the area and reduces pain sensation. Remove the ice and clean with alcohol before proceeding with your injection.
- Insert the needle quickly and confidently. Slow, hesitant movements often hurt more than quick, decisive actions. Think of it like removing a Band-Aid; fast is usually better.
- Distract yourself during the injection by counting backward from 10, taking deep breaths, or focusing on something in the room.
- Relax your muscles at the injection site. Take deep breaths and consciously relax the area before injecting.
Changing IVF Injection Sites
Rotating injection sites helps prevent skin irritation and the formation of scar tissue. So, wait at least 24-48 hours before using the same spot again. This gives your skin time to heal between injections. It’s also important to stay at least one inch away from previous injection sites.
If one area becomes particularly sore or irritated, avoid using it until it has healed completely. Switch to alternative sites during this time. Lastly, watch for signs that indicate you need to change sites more frequently. These include persistent redness, hard lumps under the skin, or increased pain at injection sites.
What to Avoid During IVF Injections
Certain activities and substances can interfere with your treatment or increase side effects. Thus, keep these things in mind:
- Avoid alcohol during your IVF cycle, as it can affect hormone levels and egg quality.
- Don’t take hot baths, use saunas, or engage in intense exercise. High body temperatures can negatively impact egg development. Stick to warm showers and gentle activities, such as walking.
- Avoid taking medications not approved by your fertility team. This includes over-the-counter pain relievers, herbal supplements, and prescription drugs. Always check before taking anything new.
- Don’t massage injection sites vigorously after intramuscular injections. Gentle pressure is fine. However, aggressive rubbing can cause bruising or affect medication absorption.
- Avoid missing or delaying injections without consulting your team first. Consistent timing is crucial for treatment success. Set multiple alarms if necessary to stay on schedule.
Join an IVF Support Group
Support groups offer practical tips from people who understand your experience. They can also help you find others in similar situations, offering support when needed. If you feel this would help you, research groups in your local area.
Online communities can also provide 24/7 support when you need it most. Look for moderated groups with a positive and supportive environment. Avoid groups that focus primarily on negative experiences or medical advice.
Reach Out to Your Fertility Team
Your TRIO team is your best resource for injection-related questions and concerns. Don’t hesitate to contact us if any problems or concerns arise. Ultimately, we’re here to help and guide you toward success. Are you ready to start the IVF process? Curious to learn more? Book a consult with a TRIO Care Navigator today.
