Subcutaneous injections are commonly required for hormonal fertility drugs. Subcutaneous means just below the skin, into the fatty tissue that lies between your skin and the muscle underneath. Some fertility treatments, including IVF treatment and IUI treatment, often require subcutaneous injections of fertility drugs.
Giving yourself a subcutaneous injection is much easier than you think it is. The first time I gave myself an injection, I was really nervous. The second time I gave myself an injection, I hardly hesitated. I was a pro, and you'll be one, too. You'll see.
If your medication is stored in the refrigerator, you'll want to take it out about a half hour before you do the injection. You want the medication to be at room temperature when you give yourself the injection.
Gather everything you need before you start on a clean, flat surface. If you want, you can use an alcohol swab to wipe the surface you'll be working on. You'll need your medication vials and/or syringe (some medications come in a prefilled syringe, others you need to mix), the needle for mixing the medication and the needle for administering the shot, alcohol swabs, and a bit of gauze.
Wash your hands thoroughly to prevent infection.
If your medication requires mixing, follow the mixing instructions given to you by your doctor or nurse, and draw the dosage prescribed by your doctor into the syringe. Usually, the needle you'll use for mixing the medication and drawing it into the syringe will be different than the needle used for injecting yourself. (A larger needle can be used to mix the medications, so the mixing goes quickly.)
Once your medication is mixed, place the needle for injection on the syringe. Remove the cap cover from the needle. If your syringe is pre-filled with a pre-attached needle, you'll just need to remove the cover of the needle.
Hold the syringe upright, the needle point up, and gently tap on the side of the syringe to get any air bubbles moving to the top. It's normal if a few bubbles remain, but most of them should move on up to the top.
Next, carefully press on the syringe, pushing out the air bubbles, until a small drop of the medication appears at the tip of the needle. Once you've done this, you may want to put the needle cap back on until you're ready to do the injection. Whatever you do, don't let the needle tip touch any surface.
Next, choose your injection site. Your nurse or doctor will tell you where they want you to do the injection, but the most common place is around and just below the belly button, but at least one inch away from the belly button itself. (Most medication information sheets include an illustration of where the best place for injection is. Take a look if you're unsure.)
You should do the injection in a slightly different spot each time, to avoid skin irritation. You also shouldn't do the injection where there is a scar or bump.
Wipe the area with an alcohol swab, and let air dry. If you don't let it dry, the alcohol will give you a little sting when you do the injection. However, don't blow or wave your hand to make the alcohol dry quicker. That'll just reintroduce germs into the area.
If you're afraid of the pain, you can numb the area with an ice cube. Be sure to swipe with alcohol afterward. (But honestly, I didn't feel much more than a quick poke. You probably won't need to numb it.)
You might want to double check that you've measured out the correct dose. Then, remove the cap from the needle, if you had put it back on after tapping out the bubbles. At your chosen injection site, pinch up about an inch worth of the skin, which helps move the fatty tissue up away from the muscle (which we don't want to hit.) See the photo above for an example.
Take the needle in your other hand, holding the syringe like a dart. You might want to take a few deep breaths. Then, on an exhale, gently but firmly push the needle through the skin at an upward 90 degree, or if you're very thin, 45 degree angle. Once the full length of the needle is in, you can let go of the pinched skin.
Next, carefully depress the syringe until all the medication is administered. Don't feel like you need to rush, take your time.
Once you've injected all the medication, carefully remove the needle, and cover the injection site with a gauze pad. You may want to hold the gauze pad against your skin and just next to the needle before you pull the needle out, to prevent the skin getting pulled up as you remove the needle (which can be uncomfortable.) Usually, the injection site won't bleed, but if you've accidentally nicked a blood vessel, a little bleeding is normal. It should stop soon. If not, you can use a Band-aid to cover it.
Dispose of the needle or syringe in a puncture-proof container. Your pharmacy may have provided you with a special needle container, but if not, any puncture proof container can work. An empty plastic milk carton, an empty coffee can, or other kind of similar container works fine.
Put whatever remaining medication vials you have back in the refrigerator (if that is where they are stored) until next time. You're done! If it's your first time, go get yourself an ice cream sundae, or some yummy fruit, maybe strawberries (for the dieting among you). You deserve it!
Your fertility clinic may hold classes on how to do injections, or be more than happy to show you how to do the first injection. Be sure to ask!
If you just can't get yourself to give yourself an injection, see if your partner will do it. If that's not an option, some fertility clinics will do the injections for you, for a small fee. Though if you're doing daily injections, unless you live nearby your clinic, this might not be practical.
It's normal for some bruising and redness to appear by injection sites, especially if you nick a blood vessel. Just try to avoid that area next time you give yourself an injection to avoid further irritation.
Many medication manufactures have how-to videos on their websites. It can help to watch these videos, to feel more confident. For example, you can watch a video how-to instructional video for injecting the medication Ovidrel here. How-to instruction videos are also available for Follistim and Gonal-F.
Breath, don't rush and remember - the first time is the most difficult! You don't know what to expect, and it can feel crazy to be aiming a needle at your tummy. Trust me, though, after the first time, it'll be much easier.
Giving a Subcutaneous Injection. Warren Grant Magnuson Clinical Center. National Institute of Health. Accessed September 24, 2008. http://www.cc.nih.gov/ccc/patient_education/pepubs/subq.pdf
Injection techniques and medications. Society for Assisted Reproductive Technologies. Accessed September 24, 2008. http://www.sart.org/Guide_InjectionTechniquesAndMedications.html
What You Need
- clean hands
- alcohol swabs
- your medication, along with any needles or syringes
- a clean, dry surface to work on