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IVF
If you're about to start an IVF cycle, there's a good chance the thing you're most anxious about isn't the retrieval, the transfer, or even the outcome — it's the injections.
This is one of the most common anxieties patients bring to their first consultation. You've seen the photos online — a kitchen counter covered in vials, syringes, alcohol swabs, and sharps containers. It looks like a lot. It looks clinical. And the idea of injecting yourself, every day, for two weeks, feels like something you shouldn't be doing without a nursing degree.
Here's what most patients say afterward: it was manageable much faster than expected. Not painless. Not fun. But genuinely manageable.
This guide covers everything you need to know — what the medications are, how to prepare and administer them, what the injections actually feel like, how to manage side effects, and what support looks like at Pollin.
IVF stimulation medications fall into several categories, and your protocol will include some combination of the following:
These are the core medications that stimulate your ovaries to develop multiple follicles. Brand names include Gonal-F, Puregon, and Menopur. They contain follicle-stimulating hormone (FSH), luteinizing hormone (LH), or both.
Route: Subcutaneous injection (into the fatty tissue just below the skin, typically the abdomen)
Frequency: Daily, usually in the evening
Duration: Approximately 10–14 days
These medications prevent premature ovulation — stopping your body from releasing the eggs before your doctor is ready to retrieve them. Common brands include Cetrotide and Orgalutron.
Route: Subcutaneous injection
Frequency: Daily, usually beginning around Day 5–6 of stimulation
Duration: Until trigger shot
A precisely timed injection that matures your eggs and prepares them for retrieval. This is either hCG (Ovidrel) or a GnRH agonist (Lupron), depending on your protocol and OHSS risk.
Route: Subcutaneous (Ovidrel, Lupron) or intramuscular (some hCG preparations)
Timing: Exact time prescribed by your doctor — typically 35–36 hours before retrieval
Frequency: Single injection (or occasionally two injections for a dual trigger)
Progesterone supports the uterine lining after embryo transfer. It may be administered as vaginal suppositories, oral capsules, or intramuscular injections — depending on your protocol.
Route: Intramuscular injection (into the upper outer quadrant of the buttock) if injectable form is prescribed
Frequency: Daily, beginning around the time of transfer
Duration:Through the first trimester if pregnancy is confirmed
The majority of your IVF injections are subcutaneous — meaning the needle goes into the layer of fat just under the skin, not into muscle. These use small, short needles and are considerably less intimidating than they look.
1. Wash your hands thoroughly with soap and water.
2. Gather your supplies: Medication vial or pen, syringe and needle (if not using a pen), alcohol swabs, sharps container.
3. Check the medication and dose: Verify the medication name, dose, and expiration date against your protocol. If anything doesn't match, contact your care team before injecting.
4. Let refrigerated medication sit at room temperature for 10–15 minutes before injection. Cold medication stings more.
If using a medication pen (Gonal-F, Puregon):
If mixing medication (Menopur, some hCG):
- Draw up the supplied diluent (sterile water) with the mixing needle
- Inject the diluent into the powder vial and swirl gently — do not shake
- Draw the mixed solution back into the syringe
- Switch to the injection needle (smaller gauge)
Choosing your injection site
The standard site for subcutaneous IVF injections is the abdomen — approximately two inches to either side of the navel. Alternate sides each day to reduce soreness and bruising.
Avoid injecting:
Administering the injection
1. Clean the injection site with an alcohol swab. Let it dry completely — injecting into wet alcohol stings.
2. Pinch a fold of skin between your thumb and forefinger. This lifts the fatty tissue away from the muscle underneath.
3. Insert the needle at a 90-degree angle in a smooth, confident motion. Hesitating makes it hurt more.
4. Inject the medication slowly and steadily. There's no rush.
5. Wait 5–10 seconds after the plunger is fully depressed before withdrawing the needle. This allows the medication to disperse and reduces leakback.
6. Withdraw the needle and release the skin fold. Apply gentle pressure with a clean swab if there's any bleeding. Do not rub.
7. Dispose of the needle immediately in your sharps container.
Some medications — particularly progesterone in oil and certain hCG trigger preparations — require intramuscular (IM) injection. These use a longer needle and are injected into the upper outer quadrant of the buttock (the dorsogluteal or ventrogluteal site).
Many patients have a partner, family member, or friend administer IM injections, as the injection site is difficult to reach on your own. If you don't have someone available, it is possible to self-administer — your care team can demonstrate the technique.
1. Identify the injection site. The upper outer quadrant of the buttock — above and to the outside of an imaginary cross drawn over the buttock. This area avoids the sciatic nerve and major blood vessels.
2. Clean the site with an alcohol swab.
3. Stretch the skin taut with your non-dominant hand (rather than pinching, as with subcutaneous injections).
4. Insert the needle at a 90-degree angle in a quick, dart-like motion.
5. Inject slowly. Progesterone in oil is thick — it takes longer to push through the syringe than water-based medications.
6. Withdraw the needle and apply pressure with a clean swab.
7. Massage the area gently for 30 seconds to help disperse the oil and reduce knots.
Tip: Warming the progesterone vial in your hands or against a heating pad for a few minutes before injection thins the oil and makes it easier to inject and less likely to form lumps.
There's no way around it — injections involve needles, and needles involve some degree of discomfort. But the reality is usually less dramatic than the anticipation.
Subcutaneous injections: Most patients describe a brief pinch or sting on needle entry, followed by mild pressure as the medication goes in. Some medications (particularly Menopur) sting more than others during injection. The discomfort typically lasts a few seconds.
Intramuscular injections: The needle insertion itself is often less painful than expected because the gluteal area has fewer nerve endings than the abdomen. The main discomfort is from the thickness of the oil-based medication, which takes longer to inject and can cause a deep ache afterward. This improves with the warming and massage techniques described above.
After the first few days: Most patients find that the anxiety around injections decreases significantly within the first three to four days. The routine becomes familiar, and the technique becomes more confident. Many patients describe being surprised by how quickly it became "just another part of the evening."
Bruising
Bruising at injection sites is common and not a sign that you did anything wrong. Some people bruise more easily than others. Alternating injection sites and applying gentle pressure (not rubbing) after injection can help minimize it.
Lumps and knots
Particularly common with intramuscular progesterone injections. Warming the medication before injection, injecting slowly, and massaging the area afterward all help. A warm compress applied to the area for 10–15 minutes after injection can also reduce lump formation.
Redness or itching
Mild redness at the injection site is normal. Significant redness, swelling, or warmth that spreads beyond the immediate injection area should be reported to your care team — though true allergic reactions to fertility medications are rare.
Medication errors
If you inject the wrong dose, miss a dose, or aren't sure the full dose was delivered (medication leaking from the injection site is a common concern), contact your care team immediately. Most situations are easily resolved with guidance — and it's always better to call than to guess.
The injection phase is one of the places where the gap between clinics is most visible.
At many clinics, you receive a verbal overview of your medications at a nursing appointment, possibly a printed handout, and then you're on your own at home with a counter full of supplies and a YouTube search bar.
At Pollin, your injection support is built into the Pollin App:
This matters most at the moments when you're alone with the needle and something doesn't look right. Having immediate access to guidance — visual, written, and direct from your care team — is the difference between confident self-administration and anxious guesswork.
Do IVF injections hurt?
Most patients describe subcutaneous injections as a brief pinch or sting lasting a few seconds. Intramuscular injections involve a deeper sensation but are typically less sharp. The anxiety before starting is almost always worse than the reality, and most patients report that injections feel routine within the first few days.
How many injections are in an IVF cycle?
A typical stimulation phase involves daily injections for 10–14 days — usually one or two subcutaneous injections per evening, plus an additional antagonist injection starting around Day 5–6. Including the trigger shot and post-transfer progesterone, a full cycle may involve 30–50 total injections.
Can I do IVF injections myself or do I need someone to help?
Subcutaneous injections are designed for self-administration and most patients do them independently. Intramuscular injections (typically progesterone) are easier with help due to the injection site location, but can be self-administered with practice. Your care team will demonstrate the technique.
What time of day should I take IVF injections?
Your care team will specify the timing. Stimulation medications are typically taken in the evening — often between 6pm and 9pm. Consistency matters more than the exact time. The trigger shot has a specific time that must be followed precisely.
What if I miss an IVF injection or give the wrong dose?
Contact your care team immediately. Most situations — a late dose, a slightly incorrect amount, or uncertainty about whether the full dose was delivered — can be resolved with guidance. Do not double up on a missed dose without speaking to your team first.
Where do you inject IVF medications?
Subcutaneous injections go into the abdomen, approximately two inches to either side of the navel. Intramuscular injections go into the upper outer quadrant of the buttock. Alternate sides daily to reduce soreness and bruising.
Starting your IVF cycle and want support through every injection? The Pollin App includes step-by-step medication videos, daily reminders, and direct messaging with your care team. Book a consultation — no waitlist, and we handle your referral.
Pollin Fertility was founded in 2023 with a mission to develop the most advanced clinical, digital and IVF, egg freezing and andrology lab technology to improve the fertility patient experience and treatment outcomes.
Pollin has 2 flagship, full-service clinics:
Pollin Toronto: located at 2360 Yonge St.
Pollin Ottawa: located at 303 Moodie Dr. in Bells Corner
To provide greater access to patients who need high-quality fertility care, Pollin has satellite monitoring clinics in Markham and Sudbury Ontario, with more on the way.
To learn more about the fertility treatments and services offered at Pollin visit www.pollinfertility.com
To book an OHIP-covered consultation with one of fertility specialists or click the link below.
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