Ghost and all - question about progesterone injections

[rsdrisco]

I am not extremely overweight, but I do have a few extra lbs on me (maybe 5-10 extra lbs). I have a question about the progesterone intramuscular injections. Up until today, my husband has been giving me these injections in my hip area where our RE nurse told us to inject them. Tonight, in preparation for me having to give myself the injections while he is gone, I gave myself one. All I could "grab" on my hip area appeared to be fat. And when I inserted the needle, I am sure I came nowhere near the muscle.

So then I asked my husband about whether he always injects into flesh (or fat) and not muscle and he said he probably never reaches muscle, either.

So does it really matter if you inject into muscle?

And that makes me wonder how women who are very overweight ever reach muscle for these injections?

I am not trying to offend anyone. I'm just wondering...

[Ghost]

I doubt it matters all that much. We have some obese patients, and their progesterone levels are usually just fine. You are just a little overweight, so your levels are probably even better.

However, if you are concerned, your clinic can check your levels. Probably they are checking it already. Ask your doctor if your levels have been good. I suspect they'd have told you if there was an issue.

If you have a problem (or doubts) with the injections, there are other progesterone treatments out there. There is a gel (Crinone) and an effervescent vaginal tablet (Endometrin), and these two options are the only ones FDA approved for sustaining a pregnancy after IVF. There are suppositories, too. And there are pills, but the pills alone are often considered inadequate.

What kind of a cycle are you in, and where are you at in this cycle?

[angelaezra]

I am not extremely overweight, but I do have a few extra lbs on me (maybe 5-10 extra lbs). I have a question about the progesterone intramuscular injections. Up until today, my husband has been giving me these injections in my hip area where our RE nurse told us to inject them. Tonight, in preparation for me having to give myself the injections while he is gone, I gave myself one. All I could "grab" on my hip area appeared to be fat. And when I inserted the needle, I am sure I came nowhere near the muscle.

So then I asked my husband about whether he always injects into flesh (or fat) and not muscle and he said he probably never reaches muscle, either.

So does it really matter if you inject into muscle?

And that makes me wonder how women who are very overweight ever reach muscle for these injections?

I am not trying to offend anyone. I'm just wondering...

Rsdrisco- I think there are probably some misconceptions with (IM) intramuscular injections versus SQ subcutaneous injections. I was taught in nursing school to administer injections this way:

SQ: when you administer SQ injections, you need to pinch the skin and inject the needle because you are trying to reach the subcutaneous fat below the skin, which is not as deep as muscle.

IM: needs to be injected by spreading the skin with your non-dominant hand (it's easy to inject by using your thumb and the index finger/pointer finger to spread the skin apart) and inject w/ your dominant hand because the goal is to reach muscle, which is usually a lot deeper than subcutaneous fat tissues that the SQ is supposed to reach. But, remember to pull back on the needle before you inject, also.

I hope this helps!

Angela

[angelaezra]

Rsdrisco - I forgot to add that there are other places where you can inject IM injections if your DH is out of town. I personally like the muscles located on my thighs when I had to inject it myself while I was out of town on business. They are described below:

Vastus Lateralis Muscle: This muscle is located in the thigh. To properly mark this muscle, divide the front of the thigh into thirds from the top to the bottom of the thigh. The needle should go into the middle third.

Deltoid Muscle: The deltoid muscle is located in the upper arm, just below the shoulder. To mark this site, place the palm of your hand on the shoulder and spread your thumb from the other 4 fingers in an upside down V shape. Make sure that the middle of the arm is centered in your V. You will want to give the injection into the middle of the V.

Angela

[rsdrisco]

Thanks for the replies. I am 7 days past egg retrieval for my 3rd IVF. I had no problems with progesterone levels during my 1st two IVF cycles, so I doubt there really is a problem with where and how we are injecting them. My progesterone level has not been checked this cycle yet.

I was pinching the skin for IM injections. I'll stop doing that now!

I was thinking of self administering the shots in my thigh as well, but the nurse told me it can be quite sore in that area as opposed to the upper butt area.

[Ghost]

Thanks for the replies. I am 7 days past egg retrieval for my 3rd IVF. I had no problems with progesterone levels during my 1st two IVF cycles, so I doubt there really is a problem with where and how we are injecting them. My progesterone level has not been checked this cycle yet.

You were almost certainly triggered with hCG. That hCG lingers for several days and keeps the spent follicles (now called corpora lutea) producing progesterone. That's the primary biological purpose of hCG (it's produced by an implanted embryo for that specific purpose, although at this time in a natural cycle, that role is performed by pulses of pituitary LH, as LH and hCG activate the same follicular receptor). So you were probably making more progesterone than you needed regardless of the injections (in natural cycles there is just one follicle making progesterone, typical IVF cycles have many follicles making much more progesterone). Right about now, that hCG is fading, the follicles will stop making progesterone, and those injections become more critical. So I would not worry much about your levels prior to today. That's probably why your clinic does not bother measuring them. My clinic measures progesterone, and at this point it's usually much higher than necessary.

[angelaezra]

Thanks for the replies. I am 7 days past egg retrieval for my 3rd IVF. I had no problems with progesterone levels during my 1st two IVF cycles, so I doubt there really is a problem with where and how we are injecting them. My progesterone level has not been checked this cycle yet.

I was pinching the skin for IM injections. I'll stop doing that now!

I was thinking of self administering the shots in my thigh as well, but the nurse told me it can be quite sore in that area as opposed to the upper butt area.

Your nurse is right; I only used my thighs for a temporary period of time when my DH wasn't around to inject in the upper buttocks/hip area.

Angela