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Fertility Injections: Resources, Techniques, and Tips

February 17, 2023
Jessica Joseph, RN, BSN, MHA
Women Self-Injecting Fertility Hormone
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Women who have undergone IVF treatment often have mixed feelings about hormone injections. While some appreciate the potential benefits and see them as a necessary part of the process, others may find the experience physically and emotionally challenging.   Part of overcoming the hurdles of hormone injections is understanding how they work and having valuable resources that can provide guidance and support to women throughout their fertility journeys. 

 

Hormone injections, also known as gonadotropins, are purified versions of natural hormones involved in the reproductive process. These injections are designed to stimulate the ovaries or testes to produce eggs or sperm, respectively, and improve the chances of conception.   Injectable hormones are commonly prescribed for women experiencing infertility due to conditions such as polycystic ovary syndrome (PCOS), ovulation disorders, tubal disorders, endometriosis, diminished ovarian reserve (DOI), premature ovarian failure (POF), or unexplained infertility. Gonadotripins can help promote ovulation, increase the number of mature eggs, and enhance the chances of pregnancy.  In cases of male infertility caused by low sperm count or poor sperm motility, hormone injections may be recommended to stimulate sperm production. This can improve the chances of successful fertilization.

 

Types of Hormone Injections

Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) Injections

FSH and LH injections are the most commonly prescribed hormone injections for fertility treatment. They work by directly stimulating the ovaries to produce multiple mature eggs, increasing the chances of successful fertilization.  Common brand names for FSH/LH injections are Follistim, Gonal-F, and Menopur.

Human Chorionic Gonadotropin (hCG) Injections

hCG injections are often used in conjunction with FSH injections to trigger ovulation. This hormone mimics the hormone naturally produced by the body after ovulation, preparing the uterus for implantation and supporting early pregnancy.  Common brand names for hcG are Pregnyl, Novarel, and Ovidrel.

 

Ganirelix

Ganirelix is a medication that belongs to a class of drugs known as gonadotropin-releasing hormone (GnRH) antagonists. It is primarily used in fertility treatments to prevent premature ovulation during assisted reproductive techniques such as in vitro fertilization (IVF). Ganirelix works by stopping luteinizing hormone (LH) surges in women undergoing controlled ovarian stimulation for assisted reproductive technologies (ART) like IVF. It is used to help regulate the timing of egg retrieval during IVF to optimize the success of fertility treatments.

 

Leuprolide

Leuprolide is a medication that belongs to a class of drugs known as gonadotropin-releasing hormone (GnRH) agonists. It is commonly used in fertility treatments to suppress the natural hormone production in the body, allowing for controlled ovarian stimulation. It is used to suppress the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), thereby enhancing the success of IVF or other assisted reproductive techniques.

 

Hormone Injection Tips

Patients considering fertility treatment fear hormone injections will be the most challenging parts of their IVF cycles.  For many, there is a psychological component based on fear of getting it wrong and physical pain.

 

Rest assured that:

 

  1. After the first injection, it gets much easier, and the anxiety surrounding injections is usually alleviated.

  2. Most women state that the injections are not painful, mainly mild discomfort that quickly subsides after the injection. 

 

 

Below are resources, techniques, and tips to make fertility injections smoother:

 

Resources

  1. Freedom Fertility website offers video tutorials on common injectable fertility medications.

  2. Some fertility centers offer injection training classes for patients.  If offered, it is advisable to sign up for it.

  3. If training classes are not provided, most nurses can do one-to-one demonstrations.

  4. Some fertility nurses may offer home injection services; you can confirm with the clinical team if this is provided.

 

Techniques

  1. Confirm dosage, timing, injection type (subcutaneous or intramuscular), and injection site (abdomen, thigh, arm, or gluteal muscle) and with the clinical team.

  2. Wash hands thoroughly.

  3. Prepare a clean and decluttered surface area to layout out supplies.

  4. Have supplies prepared on the surface area before injecting (alcohol wipes, gauze, needles, medication, syringes, sharps container).

  5. Prep medications according to instructions: one-time dose, multidose vial, prefilled syringe, or pen device.

  6. Clean the injection site with alcohol, and allow it to dry for a few seconds.

  7. For subcutaneous injections, pinch the skin to create a fold. For intramuscular injections, hold the skin taut.

  8. With your opposite hand, insert the needle straight at a 90-degree angle.

  9. Push down on the plunger to release the medication.

  10. Withdraw the needle, and gently press the site with gauze.

 

Tips

  1. Confirm with the clinical team how many days your prescription will last, and if you need refills.

  2. Besides needles, syringes, and medications, verify that the pharmacy dispenses alcohol wipes, gauze, and a sharps container with your medication order.

 

 

Side Effects

Common side effects of hormone injections may include injection site reactions, abdominal discomfort, bloating, breast tenderness, mood swings, and temporary fluid retention. These side effects are usually temporary and resolve once the treatment is complete.  Rare but more serious side effects may include ovarian hyperstimulation syndrome (OHSS), multiple pregnancies (due to the stimulation of multiple egg production), and allergic reactions to the medication. It is important to discuss potential risks and side effects with your healthcare provider.

 

It is crucial to undergo hormone injections under the supervision of a qualified healthcare professional who specializes in fertility treatment. Regular monitoring through blood tests and ultrasound examinations is necessary to ensure the safety and efficacy of the treatment.

Sources

Cunha A, Póvoa AM. Infertility management in women with polycystic ovary syndrome: a review. Porto Biomed Journal. 2021 Jan 26;6(1):e116. doi: 10.1097/j.pbj.0000000000000116. PMID: 33532657; PMCID: PMC7846416.

 

Dabaja AA, Schlegel PN. Medical treatment of male infertility. Translational Andrology and Urology. 2014 Mar;3(1):9-16. doi: 10.3978/j.issn.2223-4683.2014.01.06. PMID: 26816749; PMCID: PMC4708300.

 

Freedom Med Teach

https://www.freedommedteach.com/eng/

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