Worried about IVF injections? Understand every type — stimulation, antagonist, trigger, progesterone — and discover the Needleless IVF option available at Mother Hospitals & IVF Center, Boduppal, Hyderabad. Dr. E. Prashanthi Reddy, 19+ years, 5,000+ cycles.
Each injection serves a different purpose in the IVF process. Here is exactly what each one does and when it is given.
The main injections of IVF. FSH (follicle-stimulating hormone) and sometimes LH (luteinising hormone) stimulate multiple follicles to develop simultaneously. Brand names: Gonal-F, Puregon, Menopur, Fostimon. Given subcutaneously (into abdominal fat) with a very fine pen-needle. Dose is personalised based on your AMH, antral follicle count, and prior response.
Cetrorelix (Cetrotide) or ganirelix (Orgalutran) — added from Days 5–7 to prevent the body from releasing eggs prematurely before retrieval. Given as a small subcutaneous injection. Usually one additional injection per day alongside FSH, ending when the trigger is given.
When follicles reach 18–20mm, a trigger injection matures the eggs and initiates final maturation. Two types: hCG trigger (Ovitrelle, Pregnyl) — the standard trigger. GnRH agonist trigger (Lupron, Decapeptyl) — used when OHSS risk is high. Given at a precisely timed hour (usually 10pm). Egg retrieval is scheduled exactly 36 hours later — timing is critical.
After egg retrieval, progesterone supplements support the uterine lining and early pregnancy. Given as vaginal pessaries (Utrogestan, Cyclogest), vaginal gel (Crinone), or occasionally as intramuscular injections. Continued for 2 weeks post-transfer; if pregnant, continued to 10–12 weeks. Most women prefer pessaries over injections for this phase.
| Day | Injection(s) | Route | Notes |
|---|---|---|---|
| Day 2 | FSH (± LH) | Subcutaneous — abdomen | Start stimulation; baseline scan done first |
| Days 3–4 | FSH (± LH) | Subcutaneous | Continue same time each day |
| Day 5 scan | FSH (± LH) | Subcutaneous | First monitoring scan; dose adjustment if needed |
| Days 5–7 | FSH + GnRH antagonist | Subcutaneous (two separate injections) | Antagonist starts based on follicle size/E2 level |
| Days 7–11 | FSH + GnRH antagonist | Subcutaneous | Scans every 1–2 days; dose adjusted per response |
| Day 10–13 (trigger day) | Trigger (hCG or agonist) | Subcutaneous | Given at exact prescribed time (e.g., 10pm); stop all other injections |
| Day 14 (egg retrieval) | None (sedation only) | IV sedation | 36 hours after trigger; no morning injections |
| Day 14 onwards | Progesterone support | Vaginal pessary/gel or IM injection | Start evening of retrieval or next morning |
| 14 days post-transfer | Progesterone (if positive: continue) | Vaginal | Beta-hCG test; continue progesterone if pregnant until 10–12 weeks |
Many women's biggest anxiety about IVF is the daily injections. Mother Hospitals offers a Needleless IVF protocol for suitable patients — replacing subcutaneous stimulation injections with alternative hormone delivery methods that eliminate needles entirely or significantly reduce their number.
Needleless options may include: nasal sprays, oral gonadotrophin preparations, transdermal patches, or vaginal suppositories — depending on what is appropriate for your specific protocol and response profile.
Most side effects are mild and temporary — a result of elevated hormone levels as multiple follicles develop.
Most injections are self-administered. The nurse at Mother Hospitals will train you before you start. Here are the key steps.
MBBS, DGO · ART Training — Kiel University, Germany · TGMC Reg: 50624
19+ Years Experience · 5,000+ ICSI Cycles · Mother Hospitals & IVF Center, Boduppal, Hyderabad
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