For many patients, IVF injections feel like one of the most intimidating parts of fertility treatment and questions may arise about what medications they might be prescribed, how often they will have to be administered, and how your doctor might adjust your medication based on how your body responds.
Your fertility care team will create an individualized medication plan based on factors such as your age, ovarian reserve, hormone levels, health history and response to previous treatments.
Understanding why you take each medication can make the process feel more manageable. Let’s look at the most common IVF injections, when you may take them, and how they support each stage of treatment.
Why Are Injections Used During IVF?
Before we dive into the specific medications, let’s look at why you may be prescribed injections in the first place.
During a typical menstrual cycle, the ovaries usually develop and release one mature egg. During an IVF cycle, fertility medications encourage the ovaries to develop multiple follicles because the goal is to ovulate with multiple eggs. Retrieving multiple eggs can create more opportunities for fertilization and embryo development.
IVF medications also help your fertility specialist control the timing of ovulation, complete the eggs’ final maturation, and support the uterine lining after egg retrieval.
Most patients take some medications as subcutaneous injections, which go into the fatty tissue beneath the skin, like in the abdomen or thigh. Other medications, including some forms of progesterone, require an intramuscular injection that reaches the muscle.
Your care team will show you how to prepare and administer each medication before treatment begins.
What Medications Are Used During IVF?
An IVF medication protocol commonly includes four main categories:
- Ovarian stimulation medications
- Medications that prevent premature ovulation
- A trigger injection
- Progesterone or other medications that support implantation
Here’s an explanation of each of the four stages and the medications associated with each stage.
Stage 1: Ovarian Stimulation Injections
Stimulation medications contain hormones called gonadotropins, which supply follicle-stimulating hormone (FSH), luteinizing hormone (LH), or a combination of both.
FSH encourages multiple ovarian follicles to grow at the same time. LH can also support follicle development and hormone production. The goal is to help several eggs mature rather than the single egg that typically develops during an unmedicated cycle.
Common gonadotropin medications include Gonal-f® or Follistim®, which contain FSH, and Menopur®, which provides both FSH and LH activity.
These brand names represent common examples, but your clinic may prescribe different medications or equivalent products.
Stage 2: Medications That Prevent Premature Ovulation
As the follicles grow, the body may try to release the eggs before the scheduled retrieval. The next step, then, is to use medications called gonadotropin-releasing hormone, or GnRH, agonists or antagonists to help prevent premature ovulation.
Patients typically start these injections several days after beginning ovarian stimulation, once the follicles reach a certain stage of development. Your ultrasound and bloodwork results will help your care team determine when you should start.
By preventing the body’s natural luteinizing hormone surge, a GnRH antagonist helps keep the eggs inside the follicles until they’re ready.
Stage 3: The Trigger Injection
Once your follicles reach an appropriate size, you may be ready to take a trigger injection. This medication helps the eggs complete their final stage of maturation before retrieval.
The trigger shot may contain human chorionic gonadotropin, or hCG. Common hCG trigger medications include Ovidrel®, Novarel® and Pregnyl®. Some patients receive a GnRH agonist trigger, such as leuprolide, instead, or even a combination of the two.
Timing matters more for the trigger injection than for almost any other IVF medication. Egg retrieval usually takes place before ovulation occurs, often approximately 34 to 36 hours after an hCG trigger.
Stage 4: Progesterone After Egg Retrieval
After ovulation, the ovaries naturally produce progesterone to prepare the uterine lining for implantation. IVF treatment can affect the body’s progesterone production, so many patients receive progesterone support after egg retrieval.
Progesterone comes in several forms, including:
- Intramuscular injections, often called progesterone in oil
- Vaginal suppositories, inserts or gels
- Oral capsules
Will You Take Other Medications During IVF?
Some IVF treatment plans include additional medications before, during or after the injection phase. For example, a doctor may prescribe birth control pills or estrogen to help coordinate your cycle and control when stimulation begins. Other patients may receive antibiotics, low-dose aspirin, or medications that address a specific medical need.
Every IVF process looks a little different and your fertility specialist will explain which medications are right for your body and your needs.
Common Side Effects of IVF Injections
IVF medication side effects vary by medication and patient. Common effects may include:
- Bruising, redness or tenderness at injection sites
- Abdominal bloating or pressure
- Headaches
- Fatigue
- Breast tenderness
- Mood changes
- Pelvic discomfort as the ovaries enlarge
Tips for Managing IVF Injections
A little preparation can make daily IVF injections feel less overwhelming.
- Create a medication schedule that lists each drug, dosage and injection time.
- Keep supplies organized, review storage instructions and check that you have enough medication before weekends or holidays. Some medications require refrigeration, while others should remain at room temperature.
- Rotate injection sites to reduce irritation, and use a new needle and syringe as directed for every injection. Place used needles immediately in an FDA-cleared sharps container rather than throwing them loose into household trash.
- Don’t be afraid to ask questions. Contact your clinic if you feel uncertain about mixing a medication, measuring a dose, or administering an injection. If you miss a dose, take a medication at the wrong time, or spill part of it, call the clinic for help.
RRFC Specializes in Personalized IVF Medication Plans
Looking at all the IVF injections that you may have to take can be overwhelming, but you’re not in it alone. We’re here to help you through your treatment plan, teach you how to administer each medication, and monitor your response throughout the cycle.
At Red Rock Fertility Center, we create personalized treatment plans based on each patient’s health, fertility goals and response to medication. We support you through every stage, from your first injection and monitoring appointment to egg retrieval and embryo transfer.
If you are considering IVF or want to discuss what your treatment plan might look like, contact Red Rock Fertility Center to schedule a consultation.
