The process leading up to an embryo transfer is different from that leading up to an egg retrieval. There is far less monitoring (yay for flexibility) and there are different medications to take. Our fourth retrieval was in September and we had two trips planned during October, so we weren’t sure if we’d have to take a month off or not. Luckily, with the timing of it all, our nurse was able to make it work as long as my body’s timing cooperated as well.
I started birth control right before our first trip, which was actually delayed because of Covid but it was our honeymoon. We went to the Dominican Republic and I had to take my meds with me. Halfway through our honeymoon is when I started the Lupron injections. Let me tell you, I tolerated all the medications quite well up until this point but I did not like the Lupron! I was taking 10 units daily and it made me feel dizzy and nauseated a majority of the time. I felt like when I moved my eyes, it took a while for my vision to catch up and readjust.
Because of this, I was not drinking any alcohol, despite being given clearance from my doctor for a drink a day. It was our honeymoon after all! Luckily, I still had my appetite and never actually got sick but I felt quite lousy for the second part of our honeymoon. We still managed to have a wonderful time though and kept in mind that it was all so that we could grow our family.
The birth control and Lupron’s purpose is to calm everything down so that the other medications can stimulate your hormones in a controlled way. The goal is to manage your hormone levels in a way that will most likely support the embryo implanting and your body maintaining the pregnancy.
After about 3 weeks, I stopped the birth control and lowered the dosage of Lupron, which luckily meant my side effects lessened. After another monitoring appointment, I started the Estradiol patches. These are little clear stickers that I had to wear on my lower abdomen and replace every two days. I started with one patch, then two, then three, and ultimately four. Since I have a mild adhesive allergy, my body didn’t respond very well to these patches being on 24/7. I rotated them around as instructed but I still had a rash/welts after a while. It was tolerable but not ideal.
Eventually I stopped the Lupron injections and switched to the PIO injections. That is, the big progesterone in oil injections 5 days before transfer. For that I used a 1 ½” 22g needle to dispense the medication in the upper outer quadrant of my butt/hip area. This was the scariest of them all. I got so used to (and quite comfortable with) the small subcutaneous injections but I was terrified of this injection.
I am on an IVF support group on Facebook and that’s where I learned about the auto injector by Union Medico. It takes the guesswork out of inserting the needle and quite frankly, I couldn’t imagine myself or my husband being able to shove that needle into my muscle without the assist. I was incredibly anxious before the first injection but again, it was more the anticipation than anything else.
I’ve never injected the PIO without the auto injector so I cannot compare the two processes, but I love the auto injector. While I still feel the injection, it’s just a momentary twinge and I can focus on keeping my muscle relaxed and breathing through it. I refuse to do that injection any other way.
Regardless of how a person chooses to inject, there is a process in order to prevent knots and pain that can build up over time with this injection. Since it’s in oil, it’s beneficial to warm the medication in the syringe before injecting so you thin it out. I used a microwavable heating pad to warm it up and to warm the area where I would inject. Many people advise never to use ice because of the oil. I can’t speak to that though as I’ve never tried. The heat has been perfectly fine for me though.
Once the syringe of medicine and the injection site are warmed up a little, I use my alcohol swab to clean the area and then load the syringe into the auto injector. I place it where I want to inject and then Ilan takes over. I’m usually standing up, leaning forward onto our dining room table, with the weight taken off the side I’m injecting on. He flips the safety, counts down and presses the button. It’s a lot like a piercing gun, honestly. It very quickly and smoothly inserts the needle and then you have to slowly inject the medication as you would normally. For me, the slower the better. I felt it more if Ilan would accidentally do it too fast and it just felt uncomfortable.
When he removed the needle, I’d hold gauze down to stop any bleeding or medication that was leaking out. That’s normal and nothing to panic about. Then I’d apply more heat for a little and we’d massage the area for about 5 minutes to prevent the buildup of knots. The process usually took me about 10-15 minutes once I got the hang of everything. So, I continued with the patches and these daily injections, as well as some antibiotics, until our first transfer. The entire embryo transfer preparation took two long months and I was beyond ready to move forward!
*** Little bonus story! My wonderful husband wanted to feel what I was feeling as best he could, so he asked me to use a spare needle and the Auto Injector on him. He hates needles so it was super sweet that he wanted to do this. If any partners out there are curious, this is one way that you can show your support and desire to understand your partner’s experience.