FAQs on medication & injections

Why do I need injections?

Ovulation is a prerequisite for obtaining pregnancy. To accomplish this, a follicle containing the ovum is formed in the first days of the monthly cycle. In some cases, a hormonal stimulation of the ovaries is required because:

  • There is a hormonal disorder which prevents ovulation
  • A higher pregnancy rate can be obtained when more than one ovum is released in the Ovulation

To this end, either pills (e.g. Clomiphen) or injections (e.g. Puregon, Gonal-F or Menopur resp. Merional) can be used.

How many days do I have to inject the medication?

In general you need to inject the medication on a daily basis between 9-16 days – according to your individual stimulation protocol. During these days you need to administer 1-2 injections subcutaneously (under the skin), in a few cases it can be 3-4 injections as well. Thanks to the modern injection systems you can easily inject the medication at home by yourself.

I have never administered injections. How does it work?

We understand that the injections are a bit intimidating and a completely new experience for you. Because of this you will receive an injection training by our graduate nurses on the day on which you receive the medication from us. Our nursing team will show you how to prepare the medication, set the right dosage and finally how to conduct the injection itself. It is no problem that your partner issues the injection if you feel more comfortable that way. Should you not feel ready on the 1st day of the stimulation we can set the first injection at the Kinderwunschzentrum. However it is our aim that the patients can inject themselves as the injection time is usually in the evening.

Here you can see videos presented by our graduate nurse Lisa Pangan who is demonstrating how the injections work.

Where can I properly dispose of syringes & injection needles?

We kindly ask you to collect the syringes and injection needles in a solid and firmly closed container (e.g. plastic detergent containers). The container can then be handed over to a collection center for hazardous household wastes.

https://www.wien.gv.at/umwelt/ma48/entsorgung/problemstoffsammlung/mobile-prosa-sammeltermine.html

Which medication has to be stored at room temperature and which in the refridgerator?

Storage in the refridgerator: Elonva, Decapeptyl, Decapeptyl Depot, Gonal-F, Ovitrelle, Pregnyl, Puregon

Storage at room temperature: Arefam, Aprednisolon, Bravelle, Cetrotide, Estrofem, Fostimon, Lovenox, Menopur, Merional, Menopur, Orgalutran, Progedex, Proluton, Thrombo ASS, Utrogestan

Hormonal stimulation with subcutaneous injections

Medication for the growth of numerous follicles

Puregon® (recombinant FSH)
Gonal-F® (recombinant FSH)
Merional® (hMG – menopausal gonadotropine)
Menopur® (hMG – menopausal gonadotropine)
Fostimon®
(Gonadotropine)
Bravelle®
(Urofollitropine)
Elonva® (Corifollitropine alfa)

Medication to prevent premature ovulation

Orgalutran® (GnRH-antagonist)
Cetrotide® (GnRH-antagonist)

Medication for ovulation induction

In order to achieve the final maturation process of the ovocytes a special injection has to take place 34-37 hours (depending on stimulation plan) before the ovum pick-up.

Pregnyl® (humane choriongonadotropine)
Ovitrelle® (choriongonadotropine)

Further medication
Decapeptyl® 0,1mg (triptorelin)
Decapeptyl Depot® or Enantone® is a GnRH analogue and is used for preparing the stimulation (down regulation).

Further medication for the treatment

Injections:

Proluton® (progesterone): is an intramuscular injection, which needs to be administered twice a day by a specialist or GP. If pregnancy is achieved you should continue with the medication until the 12th pregnancy week. The desired effect of this medication is to lower the risk for bleedings and miscarriages.
Progedex® (progesterone): a daily subcutaneous injection – used as an alternative to  vaginal capsules or intramuscular injections.
Lovenox® (thrombosis prophylaxis)

Tablets:

Estrofem®: Estrogen tablets, which helps to prepare the endometrium for nidation
Clomiphen®: (clomiphene citrate) is an artificial hormone (anti estrogen) and is used for mild stimulation
Arefam® & Utrogestan®: are progesterone capsules that support the preparation of the endometrium for nidation of the embryo. If pregnancy is achieved you should continue with the medication until the 12th pregnancy week. The desired effect of this medication is to lower the risk for bleedings and miscarriages.
Oral contraceptives – the pill –  is used for fertility treatments as well. It helps to establish an optimal base for the follicles and can lower the risk for cyst development during stimulation.
Thrombo ASS® (thrombosis prophylaxis)
Aprednisolon® (cortisone)

Why is Arefam or Utrogestan administered vaginally?

Utrogestan / Arefam is administered vaginally. Please insert the medication deep into the vagina. Don’t be concerned that the official package insert states to take the medication orally. We made the conscious decision to prescribe the medication for a vaginal application, since you would get really tired when taking the medication orally.

It is normal when a part of the medication comes off as vaginal discharge. Please don’t be concerned that the official package insert states not to use Utrogestan / Arefam during pregnancy. We see a promising effect for the early pregnancy in prescribing it. Please take the medication until the pregnancy test and – if the test is positive – until the 12th week of pregnancy.

Why do I have digestion problems (congestion) in the time after the embryo transfer?

The reason is the hormonal change due to the treatment. The intake of progesterone (Arefam, Utrogestan, Proluton, Progedex) can – as in every naturalpregnancy – cause a slowed digestion.

Normal side effects can be: flatulence, stomach ache, problems with defecation (more often than usually, pain during defecation, hemorrhoids)