IVF: A Tale of Two Needles
That first day of IVF is full of an endless number of emotions. I remember feeling giddy, hopeful, nervous, and anxious as I bounced around the city picking up my various medications. My first shot would be that night, between the hours of 6pm and 9pm, and I couldn’t wait. I was a naive schoolchild, anticipating that within six months I would be pregnant (now in year two of IVF I am no longer that same naive schoolchild).
I had faced no issues conceiving naturally and so, when my husband and I chose to terminate that pregnancy and pursue IVF due to chromosomal issues, I just assumed we would, in the words of Allison Kraus, be the lucky ones. The needles didn’t bother me, the idea of blood didn’t bother me, but I was schvitzing over whether or not I would do the injections the “correct” way. Of course, now I know it is nearly impossible to misstep when doing an IVF injection, but at the time it felt as though I had been entrusted with this grave responsibility upon which all of my potential IVF success rested.
Luckily, I had a friend who was eight months ahead of me in the IVF struggle who was willing to sit on the phone while I did my first shot. Unfortunately, FaceTime wasn’t working, and I settled for voice guidance, a detail without which this story would not exist. I took out my syringes, which were already set up for me with the needles attached and went about collecting the various medications I would be administering. Three vials of Menopur and about 300 units of Follistim. Slowly, I unwrapped the needle for my Menopur shot. For some reason the lyrics to “The First Cut is the Deepest” seemed to be on repeat, at high volume, in my head. I thought perhaps my mind was trying to provide comfort with the idea that it would all be second nature after these first shots. I scoffed at that idea, how could jabbing needles into one’s abdomen ever become second nature. I recall thinking back on this moment a few months ago as I was out to dinner with friends, and I took out the vial of Lupron that I needed to inject into my stomach. Historically, I would have excused myself to the bathroom, put out a clean paper towel, perhaps even bleached the whole bathroom (maybe twice) before nudging my body towards fertility with my syringes of hope. Instead, I took out the vial and needle and just quickly did the injection at the table. So accustomed to these injections I was amused to find looks of shock greeting my gaze when I looked up. I THINK I at least used an alcohol swab on my stomach. It turns out that after four rounds of egg extractions, jabbing yourself with a needle in the abdomen does, in fact, become second nature.
As I unwrapped the syringe I gasped. Staring back at me was, what felt like, a foot long WMD (in truth it was about 1.5 inches). I shrieked to my friend “I can’t put this in my stomach, I’m going to hit an organ!” Laughing, she said “it’s not THAT bad, you’ll be fine.” I couldn’t understand how my friend, much skinnier than me, could have even managed to get this needle in her stomach. I pictured her puncturing her stomach only to have the needle pop out the other side, an “exit wound.” I imagined my internal organs pushing each other out of the way to try and avoid being stabbed by the menacing intruder. I tried to recall what I had gone over with the nurse at my consultation. I didn’t remember the needle being this long but, perhaps because at the time of the consultation I wasn’t in the process of injecting myself, it just hadn’t SEEMED that large. Could this be right? It felt like I had just sat down to take a final exam and all of the knowledge I had entrusted to my brain was flooding out of me in a raging river as I desperately tried to grasp at things as they rushed past. I didn’t trust myself. This needle didn’t seem right, but it was what the pharmacy gave to me with my medication, it is what the fertility clinic had ordered. Convinced my brain had abandoned ship and was playing party tricks on me, I decided to forge ahead. I mixed the various Menopur vials and worked to draw out the medication. Each time I withdrew the solution from the vial a tiny droplet or two decided to stay behind. Desperate to get every last bit of the medication I tried pushing the solution back into the vial and then pulling it back out for what felt like a thousand times. I didn’t succeed. As I put each vial aside, I saw a lonely drop or two sitting at the bottom, taunting me with their resistance.
My friend, sitting patiently on the phone, jolted me back to reality “did you do it yet?” “Not yet, “I responded. I was trying to figure out exactly the right angle at which to do the shot. Maybe if I angled the needle more to the side, I would avoid any severe internal damage. Taking a deep breath in and pushing aside the images of internal hemorrhaging due to my own malfeasance, I pushed the WMD into my abdomen and it HURT. “Done!” I exclaimed to my friend. I finished up with my Follistim shot, with a needle that looked like the infant child of the Menopur one.
For four days I continued like this and my abdomen become severely bruised. At one point I wasn’t sure I would be able to do the shots for two weeks because I was running out of space free from purple tinge. On day five I woke up early; normally I was rushing to get the Menopur shots done and get out the door but for some reason that morning, I found myself with endless time. Frustrated by the lack of organization in my IVF kitchen corner, I decided to try and tidy up a bit. I took out jars for my needles so I could finally get rid of the brown paper bag in which I currently had them stored. After removing all the Menopur syringes from the bag, I realized that there was still something sitting at the bottom, like money forgotten in a jacket pocket re-discovered at the start of winter. Reaching my hand inside I pulled out a packet of needles, just needles. And then, in a flash, I knew, I had been using the wrong needles!
I couldn’t decide whether to laugh, cry or yell. I felt both relieved and angry at myself for not just asking someone from the beginning about whether I should be injecting a 1.5-inch needle into my abdomen (the answer is clearly no). Here I was, a smart woman who, in an instant, had become a brainless wing-bat. It was definitely my first, but not my last, lesson in speaking up during the IVF process. Speaking up is never something I have excelled at. If there is a god, I imagined him/her watching me, having a chuckle and thinking, “maybe THAT will teach you.”
When my husband joined me in the kitchen I told him, between chuckles, of the mix-up (he had watched me do the injection the previous morning and had been horrified at the size of needle going into my stomach). As we both tend to run on the anxious side of life, he told me that I should go to the doctor for an ultrasound to ensure I hadn’t punctured any organs. I told him he was being ridiculous and laughed him away, dismissing his concerns as being one of an overly anxious individuals. In truth, the only thing more overpowering than my own anxiety about the possibility that the insides of my intestines might be infiltrating areas foreign to digested material, was the overwhelming embarrassment I felt at the idea of admitting to my doctor that I had, at one point, thought it perfectly normal and appropriate to be jabbing my stomach with a 1.5-inch-long needle. I found solace in the fact that, if I had in fact done irreparable damage to myself, some kind of symptom would likely arise within the coming days. When I finally got a moment to tell my friend the error that had occurred, she informed me, to my absolute horror, that I had been using the needle that gets used with progesterone in your ass cheek when you finally reach the stage of implantation. My rear end, with its notable absence of essential organs, did seem a much more appropriate place for a needle of that size.
The days rolled forward and luckily no dire symptoms (other than the typical IVF symptoms of raging hormones, inexplicable emotions, and a non-stop craving for any and all food despite a digestive system that seemed to be dealing with a multi-vehicle crash) emerged. Before I knew it, my first egg extraction was complete and the bruises on my abdomen that had served as a constant reminder of my stumble slowly faded.
In a conversation with my same friend a month or so ago, she mentioned how her surrogate chose to do a progesterone shot every day in place of the progesterone suppositories. A fellow progesterone suppository hater myself, I fully agreed. They are painless, but there is something about the discharge that comes out of me with the suppositories that makes me feel like the least sexy human on earth. My friend was shocked at my agreement, something about the size of the needles required for the progesterone shots set her on edge. At this I gently reminded her, “You don’t have to remind me how intimidating those needles are, I did, after all, spend four days injecting it into my stomach. . . I guess after that it’s almost a relief that it only has to go in my ass.”
Medical Disclaimer:
The information provided in this blog is intended for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider or qualified medical professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog.
