| It's a painful fact of
life that IVF treatment involves giving the woman lots
of infertility medications through injection. While most
people are naturally needle-phobic, learning how to take
these injections yourself can help simplify your life
considerably !
If you find the idea of giving yourself a shot more
than you can stomach, then you can get your husband
to give them to you. Trust me, no one will give them
with more love and care - and this way he can learn
a new skill as well !
There are basically 2 types of injections - intramuscular
( IM); and subcutaneous ( SC).
Lupron ( Buserelin) is usually given subcutaneously;
while Menogon ( HMG) is usually given intramuscularly.
Please remember that there is very little risk of your
harming yourself by giving yourself these injections.
It's a good idea to practise on an orange to increase
your confidence levels. You could also request a nurse
to supervise you the first time to give yourself a shot,
so she can confirm you are doing a good
job !
The steps are simple.
1. Assemble your equipment
2. Load the medication into the syringe
3. Prepare the injection site
4. Give the medication
5. Clean up
Find a clean, quiet and comfortable place where you will
not be disturbed. Many women find their bathroom or kitchen
to be a good spot. Clean a place on the countertop so
that you can lay your supplies down. Wash your hands well
and dry them thoroughly.
Gather your supplies. This includes your medications
, syringes, needles for mixing drugs (usually bigger)
and needles for injecting the drugs (usually smaller),
alcohol swabs and sharps container. If you are injecting
more than one drug (for example both Buserelin and Menogon
) you will want to separate the equipment for one drug
from the equipment for the other.
INTRAMUSCULAR INJECTIONS
This is an injection that you give into a muscle.
You first need to load the medication into the syringe.
You can use a 1 ml or 2 ml syringe. This is usually
a simple matter of dissolving the powder in the supplied
solvent .
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If your medication comes in rubber-stoppered ampoules,
you first need to draw up the solvent into a syringe.
You do this by sucking up the solvent into the syringe
by piercing the rubber stopper with a 20 gauge needle.
You then need to squirt this solvent into the ampoules
which contains the medication
( the active powder) by piercing the rubber stopper
with the same 20 gauge needle, and allow it to dissolve
completely. The powder will dissolve instantly and the
solution will become clear. Repeat this until you have
loaded the required dose into the syringe. Usually,
one 1 ml of solvent can dissolve upto 6 vials of the
powder. Keeping the solvent volume low will help to
reduce the pain of the injection.
If the medication comes in glass vials, you will need
to open the vials by breaking off the glass tops of
the vials , and following the above procedure. Open
all the vials at one time to make it easier for yourself.
Once the medication has been loaded into the syringe,
remove the 20 G needle, and replace it with a fine 23
G needle.
Lying down-or standing with your weight off of the
side to be injected-locate the upper outer quadrant
(or quarter) of your buttock. The injection is given
here. The other option is to give it in the outer aspect
of your thigh, along the middle third.
Take a deep pinch between your thumb and forefinger
and wipe with alcohol. Then let dry.
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Place the needle into this pinch of tissue and muscle
completely, leaving none of the needle exposed. This
ensures you are taking the injection deep into the muscle.
Draw back on the plunger. If you are accidentally in
a blood vessel ( incidentally, this is highly unlikely
! ) , blood will appear in the syringe. If so, pull
the needle out, replace it with a new, sterile needle,
and repeat the process.
Slowly push the plunger all the way to inject the medication,
and pull the needle straight out. The key to a comfortable
injection is swift needle entry followed by slow injection
of fluid. Therefore, slowly push the plunger down then
quickly withdraw the needle.
Alternate between your left and right sides, each time
you give yourself an injection. This will prevent the
muscles from becoming sore
Apply pressure and massage the injection site gently
for thirty seconds after you administer the shot.
Using ice cubes can help to relieve some of the discomfort.
Some patients find numbing the skin with ice cubes prior
to taking the injection is also helpful.
Never reuse needles and syringes.
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Dispose of the syringe in a biohazard container such
as a Sharps container-or in an unbreakable plastic container
such as a laundry detergent bottle that you can seal.
SUBCUTANEOUS INJECTIONS
A subcutaneous injection is one that is given just under
the skin.
You first need to load the medication into the syringe.
You usually use a disposable 1 ml insulin syringe. This
is usually a simple matter of piercing the rubber cap
of the ampoule with a 20 G needle, and sucking the required
volume of the medication into the syringe, upto the
required mark.
Once the medication has been loaded into the syringe,
remove the 20 G needle, and replace it with a fine 25
G needle.
The primary site for a subcutaneous injection in your
abdomen is 2 inches on either side of your navel, or
belly button.
Wash your hands thoroughly and make sure that the surface
you work on is clean.
Sterilize the injection area with an alcohol swab by
cleaning about two inches of skin around the injection
site. Let it dry for at least one minute.
Remove the needle cover.
Pinch the area of skin you have cleansed with alcohol.
The injection is given here.
Holding the needle like a pencil about 1 inch above
the injection site, quickly insert the needle.
Release the fold of skin.
Depress the plunger all the way, injecting all of the
medication, and pull the needle straight out.
Never reuse needles or syringes.
Dispose of the syringe in a biohazard container such
as a Sharps container-or in an unbreakable plastic container
such as a laundry detergent bottle that you can seal.
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