You've been trying for what feels like forever to get pregnant. You've met with doctors and specialists, probably argued with your insurance company at least once, and are on a first name basis with the gals in the blood lab. You've been told you have infertility. You've tried your luck with oral medications and still- not pregnant. Your doctor says the next course of action would be to try injectable medications and if that doesn't work, an intrauterine insemination, or IUI. You figure you've come this far, why stop now. Here's what you need to know about taking the next steps down the fertility treatment rabbit hole.
Do I need to do anything to prepare for taking the injectable medications?
Just the facts
Your doctor or a nurse will show you how to inject the medications, from filling the syringe to how and where to give the injection. Some medications need to be refrigerated. Like oral fertility medications, the timing can be particular so bear your work schedule and possible traffic in mind when deciding what time of day to do your injections. You may decide to have your partner or someone else perform the injection for you. When discussing the medication, be sure to ask your doctor if the office accepts discarded needles for disposal. If not, the pharmacy may have needle receptacles available for purchase.
The real deal
Before you even schedule the appointment to learn how to administer your injections, take time to grieve and be frustrated with this process. Maybe you need to take a couple months off from treatment or perhaps, like me, you need to have one really sad and bad night of ugly crying to come to terms with your situation. Whatever you have to do to wrap your head around it, do it and don't feel bad about it. Your feelings of it being unfair, being jealous, or even feeling rage when you read or hear about kids being abused when you are trying so hard to have a baby- all of these feelings are common, and more importantly, they are valid.
If you are reading this in order to support someone you know going through infertility treatments, here's the best way I know to describe what it's like: most medical issues, you get the diagnosis like an earthquake. Total devastation all at once, and then you try to pick up the pieces. With infertility, its more like standing in the surf. Each wave is a separate month, and every time a month goes by without a pregnancy is like getting hit with the pain all over again.
As for the injections, most couples dealing with infertility love their doctors, but if you ever want to see a doctor squirm, or perhaps put a stuck-up med student in their place, ask them to show you exactly where on your body the injection goes and enjoy the blank look of horror when they can't answer you. Nurses administer injections far more often than doctors and will have better pointers for you- like pinching the skin of your stomach before the injection to reduce pain.
My fertility clinic didn't offer a service for disposal of used needles and with the cost of my medications, there was no way I was shelling out money for a plastic sharps container. I ended up using an empty laundry detergent container that we sealed with duct tape and took to the hazardous waste dump when full. Be forewarned that it can be tricky to find a place that will take used sharps and there may be a fee to dispose of them- like you haven't spent enough already.
How are injections different from oral medications?
Besides the obvious- that injectable fertility medications are taken using a needle rather then swallowing a pill, the overall purpose and side effects are basically the same.
One of the most common injectable fertility medications is gonadotropin, also know as FSH. FSH will stimulate the growth of egg follicles in your ovaries. If you are having an IUI as well you may be ordered to give yourself an injection of Human Chorionic Gonadotropin or HCG, at a certain time, which works to trigger ovulation and produce an egg for fertilization. This is why the HCG shot is commonly referred to as the "trigger shot".
Because the timing is so specific, in addition to the injections you may need to visit the doctor for multiple rounds of bloodwork, ultrasounds or both before getting the go ahead to take the HCG injection. While most FSH medications are injected into the fat of your stomach, the HCG is an intramuscular shot, most commonly given in the upper butt/lower back fat area of the body. I've seen videos of women giving these injections by themselves like rockstars, but a lot of women can't bend like that and prefer to have a helper. As your nurse for pointers because the placement of that shot can be tricky due to a nerve that runs down the back of your leg.
Do the injections hurt?
It's just a small pinch.
For the belly shots- it's a small thin needle and really is just a small pinch because the injection is going into your fat. The trigger shot goes into your muscle and that needle is much longer and scarier. Many a woman I know had to be coaxed, bribed and in some cases chased for that shot. It's not horribly painful, but it does go into the muscle so you make be sore or have a welt for a few days afterwards.
What is Intrauterine Insemination (IUI)?
IUI is an in-office procedure that is fairly quick. Your partner will produce a sperm sample and active sperm will be taken from the sample. Your doctor will time the procedure in conjunction with your injection medications to increase the likelihood that you will be ovulating at the time of the procedure. The doctor will insert a catheter into your uterus and then introduce the sperm. The hope is that with proper timing and reducing how far the sperm has to travel, your Eggo will get preggo.
I sat down for a virtual cup of coffee with Mommyish's own Aimee Ogden to get the scoop on having an IUI. According to her, it's not so bad. She says "The procedure was uncomfortable, but for me, way less uncomfortable than getting my IUD placed or getting a hysterosalpingogram (HSG)."
As for the experience itself, Aimee notes," I remember being surprised by how fast the appointment was: drop in, the doctor took a gander at my eggs, a few moments of intense discomfort, then you lay around for 15 minutes so you don't spill all that perfectly good sperm everywhere. Which for me meant 15 minutes of thinking about how I might never have kids if this didn't work. FUN."
Next week: In vitro fertilization (IVF), as explained by your best friend