Injection Training

Some fertility patients need to receive medications via injection, which they usually do in their home. Some people find this to be a difficult part of their treatment.

Injections can be subcutaneous (into the fat under the skin) or intramuscular (into the muscle).

Redi-ject Injection 

1. Before you start, examine the pen and the medication. The medication in the pen should be clear. There should be no cracks in the plastic window, and there should be liquid in the reservoir. Check the dose display in the Redi-ject Pen. If there is any number other than ‘0’ on the dose display, set the dose display to ‘0’. 
2. Remove the Pen cap and swab the tip of the pen with an alcohol swab. Remove the peel-off seal from the outer needle cap. Hold the outer needle cap in one hand and the Pen in your other hand. Place the needle on the end of the pen where you see the threads and screw the needle onto the pen until the needle is securely tightened. Be careful not to overtighten the needle. Gently remove the outer needle cap and place on a clean, flat surface to use later. Leave the inner needle shield on the needle.
3. Turn the dose knob until your prescribed dose shows in the dose display. Do not push or pull the dose knob while you turn it. If you pass your dose, simply turn the dose knob back to the correct dose. Confirm you have selected the correct dose.
4. Your healthcare provider should show you the injection sites to use around your abdominal area. You should change injection sites each time to reduce the chance of a skin reaction.
5. Clean the injection site with an alcohol swab and allow it to air dry.
6. Make sure the dose on the dose display matches your prescribed dose. If the dose does not match your prescribed dose, adjust to the correct dose. Carefully remove the needle shield and throw it away. Do not recap the needle with the needle shield. Hold the pen at a 90-degree angle and insert the needle into your skin.
7. Press down on the dose knob with your thumb and hold the dose knob as far as it will go to complete the full injection. Keep the needle in your skin for at least 5 seconds to make sure you receive your full dose. Remove the needle from your skin and place the pen on the table. Apply pressure using a gauze pad. The dose display should indicate ‘0’. This confirms you have received the full dose. If the display does not indicate ‘0’, please confirm that the dose knob has been depressed completely.

Needle Disposal

1. Place all sharp objects in a puncture-resistant, hard plastic or metal container. An empty detergent bottle with a screw-on cap or an empty coffee can will work.
2. Close the container with its original lid and secure with heavy-duty tape. 
3. Place the tightly sealed container in a paper bag and discard it with your household trash. 
4. Place non-sharp home health care waste in a doubled, securely fastened opaque plastic trash bag before putting them into your garbage can with other waste. 
    

Points to note during ovarian stimulation

• Follow timing and dosage strictly
• Normal to have mild abdominal bloating, breast tenderness and increased vaginal discharge when the oestrogen level is increasing
• Ice packing for injection site discomfort
• Talk to your doctor/nurse if there is any problem with injections
• How to dispose of your sharps container
• Preparation of EC/ET (fasting / full bladder) before and after
• Use of progesterone 

If you are pregnant after an IVF cycle, your fertility specialist may recommend that you continue progesterone supplementation for a period of time to support the developing pregnancy. Progesterone is a hormone that is naturally produced by the ovaries and plays a critical role in preparing the uterus for implantation and supporting early pregnancy.

After the embryo transfer, progesterone supplementation can help support the growth and development of the embryo, as well as help prepare the uterine lining for implantation. Progesterone supplementation may be given in the form of vaginal suppositories, injections, or oral medications, depending on the patient's individual circumstances.

The length and dosage of progesterone supplementation may vary depending on the patient's individual circumstances and the fertility specialist's recommendations. In general, most patients will continue progesterone supplementation until a pregnancy test is performed, and may continue for several weeks or months after a successful pregnancy is confirmed.

Supplements

 If you are pregnant after an IVF cycle, your fertility specialist may recommend additional supplements to support a healthy pregnancy. Some of the most common supplements recommended during pregnancy include:

1. Prenatal vitamins: Taking a daily prenatal vitamin that contains folic acid, iron, and other essential vitamins and minerals can help support a healthy pregnancy and reduce the risk of birth defects.
2. Omega-3 fatty acids: Omega-3 fatty acids, found in foods such as fatty fish, nuts, and seeds, can help support fetal brain and eye development.
3. Vitamin D: Vitamin D plays a critical role in fetal bone development and can help support a healthy pregnancy. Your fertility specialist may recommend a vitamin D supplement if your levels are low.
4.  Iron: Iron is essential for fetal growth and development, and can help prevent anaemia during pregnancy. Your fertility specialist may recommend an iron supplement if your levels are low.
5.  Calcium: Calcium is important for fetal bone and teeth development, and can also help prevent bone loss in the mother. Your fertility specialist may recommend a calcium supplement if your diet is low in calcium.

It is important to discuss any concerns or questions you may have about additional supplements with your fertility specialist and nurses, and to follow their guidance regarding prenatal care and supplementation during your pregnancy. They can provide you with personalized guidance and support, and help ensure that you and your baby are healthy and well throughout your pregnancy and beyond.

Reminders

• Semen collection (2-7 days, collection time, delivery to lab within one hour)
• Special condom (sperm-friendly) available if necessary