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Injections. Shots. Jabs. No matter which word you use, the thought of anything requiring a syringe usually causes a shudder in most people, regardless of their age. According to the Center for Disease Control, as many as 1 in 4 adults have substantial fears around medically related needles. There’s even a scientific name for this condition: Trypanophobia.
Can you really blame anyone for not being keen on shots, though? Getting your body poked with a sharp object is hardly on anyone’s list of fun activities.
But, sometimes, you’ve got to grin and bear those jabs for the sake of your health, as in rolling up your sleeve for vaccinations. And if you’re trying to conceive through in-vitro fertilization (IVF), then you will need to prepare yourself for a number of injections in your future.
What injections are part of IVF treatment?
“The injections you take will vary based on your medication protocol,” says Stephanie Marshall Thompson, M.D., a reproductive endocrinologist and infertility specialist at the Institute for Reproductive Medicine and Science (IRMS), now part of CCRM Fertility, in New Jersey. “However, almost all protocols will include gonadotropins (follicle-stimulating hormone) to make the eggs grow, as well as an injection to prevent early ovulation prior to the egg retrieval.”
Dr. Thompson goes on to explain that, in addition to these injections, patients also typically receive “a ‘trigger’ shot of either human chorionic gonadotropin (hCG) or Lupron to induce the final maturation of the eggs prior to the egg retrieval.”
Finally, patients undergoing a fresh embryo transfer, which means “the embryo is transferred to the uterus days after an egg retrieval,” can expect yet another series of injections: “Progesterone in oil is given after the egg retrieval to help support implantation and growth of an embryo,” says Dr. Thompson.
How many injections are required during IVF?
It’s a substantial number: “Stimulation of the ovaries prior to an egg retrieval generally involves anywhere from 2-4 injections per day for approximately 8-10 days depending on the medication protocol,” says Dr. Thompson.
That could mean anywhere between 16 and 40 injections. Keep in mind that this doesn’t include the “trigger shot,” which, says Dr. Thompson, “is given on the last day of egg growth to prepare for an egg retrieval.”
Remember, these are just the injections to expect before any eggs are retrieved. If you’re doing a fresh embryo transfer, “patients should plan on continuing progesterone in oil injections until you are approximately 8 weeks pregnant,” says Dr. Thompson.
No matter how you do the Fertility Math, the IVF injection schedule is a substantial one, so it’s important that you’re mentally ready.
Okay, that’s a lot of injections – can I do them myself?
Yes and no. “Most injections during the egg stimulation portion of IVF are self-administered all at night, but they could be split into morning and night depending on what your doctor recommends,” says Dr. Thompson. “The injections are subcutaneous, meaning under the skin, so they are easy to give yourself.” But, if you’re not comfortable administering your own jab, that’s okay too. “Women who have difficulty with injections can have partners or friends help them with the injections,” assures Dr. Thompson.
The injections during the post-egg retrieval phase, for those doing a fresh embryo transfer, however, are a bit more difficult to do on your own. “Progesterone injections are given in the muscle,” says Dr. Thompson, “usually in your glutes, so most women will need assistance with these.”
Do IVF injections hurt? What about side effects?
These are reasonable questions given the number of injections required in an IVF cycle, but the good news is, the pain and side effects are minimal. “IVF injections may cause some discomfort but are overall not extremely painful,” says Dr. Thompson. “They feel like a small pinprick, similar to a diabetes needle, or may have a slight burn, but this feeling should go away quickly.” As for potential side effects, Dr. Thompson says the most common ones are bruising and soreness, and that “allergic reactions are extremely rare.”
Is there any way to make the IVF injection process stress-free?
Considering that 25% of people are frightened of shots in a healthcare setting, taking care of yourself throughout your IVF treatment isn’t just recommended, it’s vital. “My best advice to IVF patients is to try not to anticipate that it will be bad,” says Dr. Thompson. “Pick a time when you can be calm and relaxed, and, if possible, have someone with you for support at least for the first day.” Once you’re used to the procedure, she says, it’s very likely your fears will abate: “After the first day or two, you will be a pro!"
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.