Posted on October 5th, 2020by Melissa Bell, RNin Fertility Treatments

Fear of Needles? Fertility Medication Injection Help

If you have gone through infertility treatments, it is more than likely that you are familiar with the self-injections that are often necessary in order to grow your family. What you might not be familiar with (and may even be a little apprehensive about) is how to give yourself those injections. Fortunately, I can help alleviate your needle fears and even offer a few tricks and tips when giving yourself those injections. Here are some common questions I often receive from patients regarding medication injections.

1. What are strategies I can implement to reduce any pain that might be felt while giving themselves fertility medication injections?
For subcutaneous injections, I recommend injecting into the abdomen and the upper-outer thigh areas. When injecting in the abdomen, you should stay at least 1-2” away from the belly button. Rotating injection sites can also help reduce injection site pain. For intramuscular injections, aim for the upper-outer gluteal muscle. You should avoid the midsection of the buttocks since the sciatic nerve courses through there. Keep the muscle flaccid to reduce pain by standing on the leg opposite to the one in which you are injecting. For example, if you are injecting into the right gluteal muscle, stand and put all of your weight on your left leg. This will allow your right gluteal muscle to remain flaccid for the injection. Applying a warm pack to the injection site and a gentle massage will help disseminate the medication and reduce pain.

2. Can having a partner or someone to assist with the medications be helpful?
All of the injections are able to be self-administered. While the educational videos are usually adequate, our nursing team can also meet with you to demonstrate techniques. For those who cannot self-administer, there are nursing services that may be available to come to your house and help you get started or to teach a partner/friend to administer the injections for you. There is commonly a fee for this service which varies depending on location and travel time for the nurse.

3. Are there different types of needles that are easier to administer or less painful?
Needles are measured by gauge, or thickness, and length. Subcutaneous needles, most often used for injecting into fat, are shorter and often skinnier in diameter than intramuscular needles. Intramuscular needles are slightly larger in diameter because the medication to administer can be more viscous. In general, needles with smaller gauges tend to be less painful.

4. How can I learn to give myself injections? Is there a resource I can refer to as often as I may need?
RMA of New York has created videos with step-by-step mixing and injecting instructions to help you become proficient with self-administering prescribed medications. I recommend practicing injection technique prior to administration.

5. Is there a specific technique that works better when I am giving myself an injection?
Setting expectations can help to reduce anxiety. I recommend setting up a designated space for storing and administering the injection(s) so each day/night you are met with familiarity. Whether you use your bedroom, guestroom, bathroom – doesn’t matter, as long as you can claim this area as your “safe space.” I’ve even had patients choose to put on relaxing music for this process. These tips can help put the mind in a more relaxed state so “injection time” doesn’t create fear or anxiety. When injecting into the gluteal muscle I recommend watching yourself in a mirror to ensure proper injection placement.

6. What are some tips and tricks for remembering to administer the medications? Do they have to be administered at the same time every day?
You should inject within the same four hour window daily. For instance, if you injected at 7pm on Wednesday you can do the next injection between 5pm and 9pm Thursday, essentially, two hours before and two hours after the time injected the night before. I recommend setting a daily alarm on your phone alerting you to “injection time.”

7. Despite the use of additional needles, can acupuncture help reduce both pain that might be associated with taking fertility medications and anxiety surrounding using needles?
Acupuncture can trigger the nervous system which causes the release of endorphins. These endorphins can change the body’s natural response to pain. Some studies suggest acupuncture can help regulate serotonin levels which can decrease anxiety. Since anxiety and pain are subjective, what works for one person may not work for another.

8. What are some myths about administering fertility medications?
Myth: Fertility medications cause multiple births.
Fact: Fertility medications can cause multiple eggs to grow. However, not all of these eggs may fertilize. In fact, when doing IVF we want multiple eggs to grow so we can retrieve and inseminate the mature ones, hopefully resulting in normally fertilized embryos.

Myth: If the medications cause me to grow lots of eggs and the doctor retrieves them all, I will go into early menopause.
Fact: Each month you have a new cohort of follicles, fluid filled sacs which contain eggs, in each ovary. In the natural menses cycle, your body usually chooses one dominant follicle to mature and ovulate in hopes that it will be fertilized. The other follicles in the cohort die off. In an IVF cycle, the goal is to grow all of the follicles in the cohort and retrieve them. Neither of these scenarios will cause earlier menopause.

9. What side effects can I expect from taking fertility medications?
Side effects vary depending on the medication, but common ones are bloating, fatigue, breast tenderness and abdominal twinges. These are caused by the growth of follicles and increase in estrogen. Weight gain is another common side effects but it is usually minimal and temporary. This is also caused by the abdominal bloating from the medications. Injection site pain can be a temporary side effect, but rotating injection sites can prevent this from occurring. Not all patients will experience any or all of the above side effects. Drinking plenty of hydrating fluids and getting lots of rest can help to alleviate these symptoms.

10. Are there any tricks or insider secrets you’ve learned over the years?
Do not hesitate! The slower you go in with the needle, the more you will feel every millimeter of it. Inject swiftly and confidently. You are capable!

As always, if you have any questions, it is always best to reach out to your physician or their team. If you are interested in RMA of New York’s services or learning more about medication injection protocol, please contact the office at 212-756-5777.

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