Self administering the trigger shot can be one of the most crucial moments of the in vitro fertilization (IVF) treatment process, but it can also be one of the most nerve wracking.
“[Women undergoing IVF treatment] are afraid they will do it incorrectly or are intimidated by the size of the needle,” says Dr. John F. Payne, a South Carolina fertility doctor with the Piedmont Reproductive Endocrinology Group (PREG).
The “trigger shot” is essentially a dose of Human Chorionic Gonadotropin (hCG), a pregnancy hormone produced by the placenta that encourages the production of progesterone. It is usually administered after gonadotropins are used to spark ovulation during the IVF process.
It can be helpful to think of hCG as similar to the luteinizing hormone (LH)—in fact, the two are quite similar chemically. Similar to a natural LH surge, a shot of hCG causes the follicle to release its egg. As a result, ovulation usually occurs about 36 hours after the trigger shot is given.
To help ease the stress surrounding the shot, Dr. Payne shared some tips and need to know information when self-administering the trigger shot.
What type of needle is used when administering the trigger shot? 25 guage 1 ½” needle
Where is the trigger shot administered? Intramuscularly in the hip/buttocks area.
Why that location? More adipose tissue in this area makes the injection more tolerable.
Will the shot be painful? It is normal to feel some discomfort with the injection but it is generally well tolerated.
Will the shot cause any sudden effects? Typically, no. Mild soreness in the area of the injection can be expected though.
What fertility medication is typically administered? Brand names: Pregnyl or Novarel or generic Hcg: human chorionic gonadotropin.
How can you best time when you should administer the trigger shot? You should be instructed by your REI clinic when to administer the trigger shot. Typically, 36 hours prior to the planned egg retrieval time.
What are the best ways to reduce anxiety around self administering the trigger shot? Try to relax and have your partner, other family member, or experienced health professional administer the injection for you, if needed.
How should you prepare leading up to giving yourself the shot? You can ask your REI nurse to mark the exact spot on you where the injection needs to be given. A handout sheet or injection video should also be available to give further instruction and clarification about administering the injection.
Anything to keep in mind when preparing the medication or filling the needle? Wash your hands before you begin and try not to contaminate the medication or the needle.
Anything to keep in mind during injection? Relax. Also, pull back on the plunger of the syringe to check for blood return before administering the medication. If blood return is found, take the needle out and move to a different location then try again.
Anything to keep in mind directly after injection? Hold pressure on the area until bleeding has stopped, then cover with a bandaid or gauze.
What could cause the trigger shot to not work? If you do not mix the powder and water together appropriately, or be sure to inject the actual mixture not just sterile water, the medication will not be effective.
What are your top 3 tips when administering the trigger shot? Have everything you need ready prior to doing the injection, prepare yourself beforehand by viewing the instructions and or asking your REI nurse if you have questions, be excited that your egg retrieval is the next step in this process!