Details about the intramuscular injections used for infertility and in vitro fertilization
MEDICATION MIXING INSTRUCTIONS
PREPARING INTRAMUSCULAR (IM) INJECTIONS USING VIALS
- Remove the syringe and needle from the wrapper, making sure needle is secure. Set aside.
- Remove plastic caps from prescribed # of vials of medication and diluent.
- Wipe tops of vials with alcohol to sterilize them. Don't touch the tops after they have been cleansed.
- Uncap needle by pulling cap straight out. Do not twist.
- Draw up 2cc of air into syringe and inject into each powdered vial.
- Draw up 2cc of air and inject into the diluent vial. Tip the diluent vial and, with the needle in the fluid, withdraw fluid to the 2cc mark. Remove needle from vial.
- Inject the diluent fluid into the vial of powder, gently aiming the fluid at the side of the vial.
- The powder will dissolve quickly-do not shake the vial. This will create bubbles.
After the powder has dissolved, draw the reconstituted solution into the syringe. This can be done in 2 ways:
- Leave the vial on the counter, tilting the vial at the end, to withdraw the full solution.
- After inserting the needle, raise the vial upside down to withdraw the medication. Slowly lower the needle as you withdraw the full solution.
If you are instructed to reconstitute 2-4 vials, simply take your filled syringe, insert the needle into the rubber stopper of the second vial, and inject the reconstituted mixture. Withdraw the fluid as described previously. Repeat this procedure for each vial up to 4. If you are taking more than 4 vials at a time, they must be divided up into 2 shots.
After drawing up the last vial of medication, carefully recap the needle. Change the needle to the blue 25G 1 1/2 inch needle.
If the uncapped needle ever comes into contact with anything but the medication or diluent in the vial, such as your finger or countertop, immediately remove the needle and replace it with a new one.
Next, hold the syringe straight up and tap it so that any air bubbles rise to the top. To get rid of the bubbles, slowly press the plunger just a little, until a drop of liquid forms at the tip of the needle.
You are now ready to give your injection.
ADMINISTRATION OF INTRAMUSCULAR INJECTIONS
Injection Instructions: General Comments
- Bravelle, Menopur, Repronex, and HCG can be given either subcutaneously or intramuscular
- Progesterone in oil needs to be administered intramuscularly into the large muscle of the buttock
- To locate the correct area for intramuscular injections, divide the buttock into four parts. The injections should be given in the upper, outer portion of the buttock.
- The needle should go into the skin on a 90 degree angle, and should go into the skin the entire 1½ inches (entire length of needle)
- A consistent even motion should be used when an injection is administered
- The woman getting the injection should lay face down on a bed, or lean over a bed, table, etc.
- Wash hands
- Cleanse injection site with an alcohol pad in a circular fashion
- Check correct area for injection
- Remove cap from needle
- Hold syringe like a pencil or dart on a 90 degree angle to the skin
- Use a single consistent motion when breaking the skin. A slow dragging motion will increase the discomfort of the injection.
- The entire 1 ½" needle must enter the muscle
- When the needle is in the muscle, steady the syringe with one hand, pull back on the plunger to look for possible blood in the syringe ( this would indicate that the needle is not in the correct area). Should this occur, simply remove the needle and find a new site for the injection. You may use the same medication. Attach a new needle.
- If after pulling back on the plunger no blood was noted, (remains clear) slowly push on the plunger to administer the entire contents of medication in the syringe.
- Pull the needle straight out quickly.
- Some blood may appear at the surface of the skin.
- Place a Band-Aid at the injection site.
- Dispose of all needles in a safe manner by using a special container (glass bottle or empty pop can).
- Gently massage the area.
Ultrasound of multiple follicles (black circles) in a stimulated ovary
When the woman's follicles are mature, an egg aspiration (retrieval) procedure is performed to remove the eggs from her ovaries.
4 cell embryo from IVF