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Injections
Most of the medications used in the treatment of infertility are given by injection. Individuals will receive injection instructions in our clinic as they are prepared to start treatment. Written instructions and diagrams are included in our information packets.
The individual giving your injections should be available during your entire treatment cycle. Individuals who may be available to give injections include friends who are registered nurses, husbands (who can receive instruction from our nurse clinicians), local physicians, as well as staff at urgent care centers and emergency rooms.
This individual must be identified prior to proceeding with the controlled ovarian hyperstimulation (COH) therapy. The cost of this service will vary among locations. It is advisable to ask about their fees in advance.
If the individuals or the facility at which you are receiving your injections require a prescription, please make us aware of this and we will give you the appropriate instructions.
Read instructions for mixing fertility medications
Subcutaneous Injections
We recommend that all subcutaneous injections (SQ) be given in either the thigh or abdomen. Once the medication has been prepared in the syringe, place the 27-gauge needle on the syringe for the actual injection.
Choose a location for injection according to the diagram below, and clean the skin using an alcohol pad. Pinch the skin gently to help decrease the sensation of the needle. Holding the needle like a dart, insert the 27-gauge needle just below the surface of the skin. Inject the medication and remove the needle.
You may notice a raised area (like with Tb tests) that will go away shortly. Itching, burning, and redness are not uncommon. You should rotate the sites of injection to prevent repeated irritation to the skin.
Medications that will be given by the SQ route include Lupron, Follistim, and Gonal-F.
Intramuscular Injections
Intramuscular injections (IM) should be given in the hip. See the diagram below.
After mixing the medication you will need to place the 1.5-inch, 25-gauge needle on the syringe.
Choose a spot for injection and clean the skin with an alcohol pad. Gently pinch the skin. Holding the needle like a dart, inject the needle through the skin and into the muscle. You do not need to go all the way to the hub of the needle and should not go all the way to the bone.
Pull back on the plunger to make sure no blood is seen in the syringe. Inject the medication and withdraw the needle. If you notice blood when you draw back on the syringe, remove the needle and reattempt the injection.
You may notice a small amount of bleeding at the injection site. Direct pressure will stop the bleeding and help prevent bruising. You may also notice slight swelling, redness, burning, or itching. These are transient effects and should subside shortly.
As multiple injections are given, it is recommended that you rotate the sites of the injections.
Medications given by IM injection include progesterone and HCG.
Tips
- Pinching the skin can often provide enough distraction that you do not feel the needle. Some people prefer a quick motion with the needle while others have suggested resting the needle on the pinched skin then pushing it through in a smooth motion.
- Applying ice to the site of injection may help numb the area.
- Rotate injection sites.
- Allow medications that have been refrigerated to warm to room temperature before injection.
Needle Disposal
Needles should be disposed of in a safe manner. Place used needles in a thick container such as a jar or plastic bottle, seal the lid, and discard in the trash.
Learn More
Learn more about fertility medications below.
