Most fertility medications are administered subcutaneously. This means that they are applied with a very small needle that only penetrates the skin, so they are painless.
Medications to stimulate egg production must be prescribed by a fertility specialist and their effects must be carefully monitored through transvaginal ultrasounds and blood tests every two to three days.
If you are about to undergo an assisted reproduction treatment such as In Vitro Fertilization (IVF), you must apply medications to stimulate your egg production and thus maximize your chances of pregnancy so that you have a baby.
It is normal to feel nervous before the first application. This is usually the first time that most women inject themselves and the fear of not doing it right adds to the emotions they face due to their struggle with infertility.
How to apply the medications?
The process of applying fertility medications consists of following simple steps:
- Gather all the necessary equipment.
- Wash your hands.
- Choose the site where you will inject and use an alcohol swab to clean the area from the center outward in circular motions. Wait for your skin to dry before the injection to avoid a burning sensation.
- Dissolve the medication with the indicated diluent and introduce it into the syringe.
- Hold the syringe like a pencil and place it at a 90-degree angle to the surface of your skin.
- Insert the needle quickly and gently into your abdomen, about 2 centimeters from your belly button in either direction. Remember that you should inject yourself at a different point each time to reduce discomfort.
- Detach the needle from the syringe with the help of the plastic protector. Be careful when handling the needle.
- Discard the syringe and needle in an appropriate container.
- Keep in mind that the idea of giving yourself an injection is much worse than the injection itself. Don't think about it too much.
- Make sure you are comfortable and relaxed.
- Give yourself the injection at the same time every day.
- When not in use, store your medications in a cool, dry place.
- If giving yourself the injection seems too difficult, ask your partner or a friend to help you. This is a good way to let your partner get involved in the process.
- Be sure to follow your doctor's instructions, follow the recommended dosage, and dispose of needles in special containers.
Normal effects of the medication.
During this process, you will have to undergo transvaginal ultrasounds and blood tests every two or three days. These allow you to monitor the development of the follicles (sacs that contain the eggs) and monitor your reaction to the medications.
The medications cause some effects that are considered normal, including mood changes, breast engorgement, and headaches in very rare cases.
For their part, if these medications are applied without the supervision of a specialist who monitors the patient's progress, they can cause ovarian hyperstimulation syndrome, which affects less than 1 percent of patients.
Ovarian hyperstimulation syndrome manifests itself with symptoms such as fever, nausea, fluid retention, and abdominal distention (which usually appear after egg retrieval or follicular aspiration). You should be treated by a specialist to avoid complications.
It is very important that you contact the fertility specialist if you present any of these symptoms, if you have doubts regarding the application of medications, or if you administer a higher dose than indicated.
Other symptoms that may occur are irritation in the application area or infection, in which case it is also important that you contact your doctor.
Most common medications
Your diagnosis and treatment plan will determine the combination of injectable medications you will require in each IVF cycle. Some of the most used are:
- Merapur - Used to stimulate the maturation of various follicles. It must be dissolved in a diluent and administered subcutaneously at the time indicated by the doctor, generally between 5 and 7 p.m. The daily dose should not be more than 450 units (each vial is 75 units).
- Cetrotide or Orgalutran - It is used to stimulate the maturation of several follicles from the moment the doctor indicates it until the end of the ovarian stimulation treatment. This medication must be administered subcutaneously at the time indicated by the doctor, generally in the morning between 7 and 9 a.m. The daily dose should be 0.25 milligrams (one syringe).
- Puregon - Used in some patients to stimulate the maturation of various follicles. It should be administered subcutaneously for 6 to 12 days and at the time indicated by the doctor. This medication comes in various presentations depending on the prescribed dosage.
- Choragon - This medication is used at the end of ovarian stimulation treatment and helps prevent the follicle from being damaged before the egg reaches the necessary maturity. A single dose of one or two ampoules is administered subcutaneously at the time indicated by the doctor.
- Lucrin Kit or Gonapeptyl Daily - Used in patients who must undergo long stimulation protocols. This medication is administered subcutaneously starting on day 17 of the menstrual cycle prior to the start of ovarian stimulation and at the time indicated by the doctor, generally between 7 and 9 a.m.
- Gonapeptyl Depot - Used in egg donation or frozen embryo transfer cycles to prepare the patient's endometrium to receive the embryo. A single dose of 3.75 milligrams (one vial) is administered on day 17 of the menstrual cycle prior to the start of ovarian stimulation of the donor.
- Evorel 50 (estrogen patches) - Used in egg donation or frozen embryo transfer cycles to prepare the patient's endometrium to receive the embryo. These can be placed below the navel, in the anterior and inner region of the thighs, or in the lower back and it is recommended that they be applied to a different place each time because the skin can become irritated. The use of patches should begin on the second day of menstruation and the dose varies according to what the doctor indicates (two to four patches every third day).
Remember that before administering any medication it is very important that you have a diagnosis from a specialist, since it is the one indicated to monitor the evolution of the medications and will be your guide during the process until you manage to have a baby at home.