IVF # 1 - How to Mix and Inject Luveris (and a monitoring appoitnment update)

*Update - the clinic just called with my E2 and we're up to 3879 (1057 in US units). Holy huge jump! I'm very pleased with this!

*Monitoring update at the end!

Today we are going to learn how to mix and inject Luveris, one of my daily injections. Luveris is synthetic lutinizing hormone, aka LH, and is used in conjunction with Gonal-F (which is a follicle stimulating hormone, or FSH) to stimulate oocyte growth. I'm now on day ten of injections, so I've kind of got this one down, but the first couple of times I was really nervous that I was going to miss a step and screw something up.

First thing first, you need to get all your supplies in front of you on the table. You need a box of Luveris, a syringe, needle, Q-cap, and two alcohol wipes.

Now go wash your dirty hands. I dry them off using paper towel just to avoid lint and possibly dirty dish towels. First step is to take out the two vials (one saline and one the powdered Luveris) and pop off the tops.

Using one of the alcohol wipes, wipe down the tops of both vials really well.

Set 'em down and open up the Q-cap and syringe. Make sure you don't touch either end of the Q-cap, especially the pointy end (that goes in to the vial).

The Q-cap screws in to the end of the syringe. Screw it in so it's tight (not too tight), and the pull back on the syringe plunger and fill it with 1 ml of air. You do this so you can displace the volume of fluid in the vial as you're drawing it out. Makes things easier, apparently.

Now that you have air in the vial, you can flip it over and push the Q-cap down in to the bottle of saline. It takes a teeny bit of force, but shouldn't be difficult to snap it in. Push the air in to the vial. Then, holding the plunger down (the air will try to push back out), turn the syringe/vial upside down and slowly draw in the saline.

Once you have it all in there, flip it back over and pull off the vial. Don't worry, it won't spill. Next, take your vial of powdered Luveris and pop it on with the syringe right side up. Slowly push the saline in to the vial. Now, swirl it around. Don't shake it, or you'll create bubbles, which are bad. It'll only take about 30 seconds for everything to dissolve.

Now that it's all mixed, flip it back upside down and slowly draw the mixture back in to the syringe. I usually draw back so I have a bit of air in the top, then push it back up so the liquid is right at the very top of the syringe. Next, screw off the Q-cap and open the needle package. The needle screws in similarly to the Q-cap.

Holding it needle point up, take a look for bubbles and flick the syringe to get them up to the top. It's ok if there are a few small bubbles, it's not like it's going in to a vein. Once you get the bubbles to the top, remove the cap and slowly, slowly push on the plunger until a few drops of liquid come out of the needle. Now you're set to inject!

Now is where the second alcohol wipe comes in. I inject in my stomach, but you can also inject on the outer thigh. I tend to move around a few inches each time too, just to avoid too much bruising. Take your wipe and wipe down about 2 or 3 square inches on your injection spot. Let it air dry for a few seconds and then take a good pinch of fat.

Keeping it in a pinch, insert the needle. It really doesn't hurt, just try not to hesitate too much. The anticipation is the worst part, trust me! Once it's in, slowly inject the liquid. It does seem to sting a bit if I go too fast, so I take about 10 - 15 seconds to inject it all. Once it's all in, hold the needle in for another few seconds to make sure it's all in there. Let go of the pinch, and pull the needle out.

Cap the needle, take it apart, and put it in your sharps container. Easy peasy, right?

Honestly, in the beginning of this all, I was thinking there was NO WAY I could give myself injections. But, I will do anything to have a baby, and it is not bad at all once you get comfortable with it. Good luck!

Monitoring update: my ultrasound this morning went well! I now have eight follicles on the left, with the leaders at 16mm, 13mm and 13mm, and five on the right, with the leaders at 13mm and 11mm. My lining is triple stripe at 8.3mm (this is good). They have me on the same dose of Gonal-F and Luveris for two more nights, and then my final monitoring appointment on Thursday morning. I should be triggering Thursday night if it all looks good, which puts the retrieval on Saturday.

Just wanted to post this cute note my husband left for me on our whiteboard the other day:

Yup, I'll get right on that!