Even as the conversation around in vitro fertilization (IVF) grows increasingly more public, there’s still a huge part of the experience that remains generally undiscussed. Notably, while people are quick to talk about the children they’ve added to their families through IVF, there’s little public discussion about the process of IVF itself. While even that is shifting, many people who go through IVF feel that they weren’t quite prepared for the ups and downs of the process.
And it’s easy to understand why — from medication side effects to relationship stress and daily injections, it isn’t typically a glamorous process. As a registered fertility nurse who has spent over a decade working in some of the top clinics in the U.S., I’ve supported many patients through one of the most painful parts of the fertility care process: having to self-administer injections.
Many are terrified of needles, so the idea of consistently injecting needles into your body over a period of time can be particularly daunting. But if you’re prepared and know what to expect, these injections can become manageable. While everyone’s prescriptions for IVF are different, the process for administering these medications is similar.
Get ready and make your space comfortable. This might look like playing music, putting on your favorite TV show, or calling a friend. Place everything you need (alcohol swabs, gauze, medication vials, needles, syringes, etc.) on a clean surface.
Wash your hands to prevent infection.
Medications vary. Some require mixing, while others are pre-mixed. Follow any instructions provided by your doctor.
Place your needle in the vial. With the needle still in the vial, flip the vial upside down. Gently pull back on the plunger of the syringe to draw your prescribed dose.
Hold your syringe upright with the needle pointed to the ceiling. Any air bubbles will float to the top and can be removed by gently tapping on the side of the syringe or by pushing up on the plunger to release the air bubbles through the needle.
Your doctor or nurse may recommend where to place your injection. But most IVF medications require a subcutaneous injection, meaning a shot beneath your skin. The best place for these types of injections is an area with fatty tissue, such as your lower abdomen — typically about 2 inches below the belly button on either the left or right side. Once you select your injection site, you can place an ice pack on your injection site for 15-30 seconds to numb the area. For future injections, consider alternating sides or areas for each injection to give your body a break.
Clean your injection site with an alcohol swab. Allow the area to completely dry to prevent stinging.
Aim the needle at your injection site at a 90-degree angle. Squeeze the injection site with your other hand and in a single motion push the needle through your skin. Inject the medication until all of the medication is fully released. Count to five and breathe.
Remove the needle slowly so all of the medication is fully released into the body. With a gauze, gently rub the injection site in small circular motions to help your body absorb the medicine. Depending on your medication regimen, some medications may need to be done at night. For these medications, move your body a bit after each injection before going to sleep.
Cap and remove the needle. Place the needle into a puncture-proof container. Your clinic or pharmacy should be able to provide you this.
If you have any questions about your dosage, timing, or administration, call your clinic.
Injections typically have a specific schedule to follow, so that might mean needing to self-administer injections outside the comfort of your home. Here are some tips for self-injections and how to make them less intimidating on the go.
While you most likely will be injecting medications in the evening, you may have to administer the injections during work hours. Many offices have mother’s rooms for nursing; consider asking your employer if these spaces can be used for injection administration, as well. And employers can even take a more proactive approach — make it known to your employees that these spaces can be used for that purpose in advance of your employees coming and asking.
Hormone injections can have a number of side effects ranging from hot flashes and headaches to bloating and nausea. Make sure to familiarize yourself with your company’s flexible work offerings in advance to know what’s available if you find yourself dealing with a rough day. And for employers, the best thing is to be understanding: make sure to be clear that it’s okay to use sick time or work from home when dealing with the worst of IVF side effects.
There are a number of resources available for people going through IVF treatment. At Carrot, we offer our members unlimited virtual chats with fertility nurses, medication ordering support through Carrot Rx, and a library of resources to help guide people through their fertility journey. Videos like the one below can help with questions, and members can book a chat with a fertility nurse or medication expert if they’re still uncertain about what to do. If you’re an employer, make sure any fertility benefits you’re offering are there for your employees when they need them the most.
In these videos, we demonstrate how to self-inject five of the most common IVF medications: Follistim, Gonal-F, Menopur, progesterone, and a trigger shot.
By offering Carrot, employers give their employees access to a premium suite of care navigation features including live video appointments with fertility nurses while doing injections. They can also access these videos as part of a comprehensive library of content to support learning and understanding.
We’re making these videos publicly available because we know that so many people who may not have Carrot as an employer benefit are struggling through this experience — sometimes alone, sometimes with a partner — but almost always nervous and anxious. We want to help make a scary experience more comfortable for everyone.
Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical advice, diagnosis, or treatment. Carrot Fertility makes no representations or warranties and expressly disclaims any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app.
