Intermuscular Injections of Progesterone Oil: Thigh vs. “Buttocks”

Needle for subcutaneous injections (top) vs. needle for intramuscular injections (bottom)
Needle for subcutaneous injections (top) vs. needle for intermuscular injections (bottom)

In vitro fertilization (IVF) cycles require self-injecting of multiple medications, including those designed to stimulate the development of multiple eggs, to stall ovulation while these eggs are growing, and to control the timing of ovulation.  During my two IVF cycles this summer, all of my injections were subcutaneous, meaning they just had to be inserted under the skin.  While my subcutaneous injections caused stinging and bruising on my stomach, their side effects were minor compared to those of the intermuscular injections I’ve been receiving for the past five days.  My advice:  Avoid the thighs at all costs.

Last Wednesday, I learned that I am pregnant with twins; however Baby B’s gestational sac is “considerably smaller” than Baby A’s, plus is separating from my uterine lining.  In an attempt not only to rectify what may be an implantation problem with Baby B, but also to save Baby A from a potential joint miscarriage, my reproductive endocrinologist directed me to start intermuscular injections of progesterone oil, which should thicken my uterine lining.

The IVF coordinator outlined that these injections have to be done in either of my thighs or my “buttocks.”  Deeming it impossible to stick a 22-gauge, 1.5-inch needle into my backside, I did my first injection in my right thigh.  I couldn’t get the needle all of the way into the muscle, so I just did the best I could, making sure that all of the progesterone oil was injected. 

I was so sore the next day that I could barely walk.  If I stood for a few minutes, my leg would give out.  So I spent my day on the couch, with my 4-year-old trying to be chivalrous by putting his arms around me “to help me walk” whenever I had no choice but to get up and limp around.

I am a do-it-yourself kind of girl, but I knew I needed help.  If I kept self-injecting, I’d have no choice but to continue giving myself my shots in my thighs, but, if I rotated the injection site each day, as directed, I’d have to move from right thigh to left to right to left, making myself an invalid.

Now, not everyone is comfortable giving injections to another person, and I’m not comfortable with just anyone giving me shots in my ever-growing rear-end.  But, my friend and neighbor Kristy has been through two IVF cycles herself, and she’s a close friend whom I knew wouldn’t judge me by my ass size, so, even though it’s hard for me to ask for help, I gave her a call.

Rock-star that she is, she came on over to give me my injection on Thursday afternoon, but, when she saw the needle, she said, “There is no way that this can go into your body!”

I told her we had no choice, so she pinched more than an inch of my skin and did her duty.  I wasn’t sore at all afterward, so the buttocks it is. 

Kristy did Friday’s injection too, which was a bit sore afterwards, but I didn’t want her to have to be on call for me every afternoon, so on Saturday and Sunday I enlisted my sweet husband.  One of my stepsons has juvenile diabetes, so my husband is experienced on the injection front.  But, my stepson’s needles are subcutaneous, just like my previous ones, so my husband did a double take when he saw the super-sized one. 

“This needle is ridiculous,” he said. 

I squeezed my own more than an inch for him, then stopped him when he was about to jab the needle into me. 

“Sweetie, you don’t need to stab me.  The needle is sharp enough to slide in, so just go slow.  I know it doesn’t seem like it will work, but it will.”

He did it, then collapsed on the couch, overwhelmed by the task.

Yesterday, he did the same, exclaiming, “That needle is incredible.  It doesn’t look like it would even go into your body.”

“You see how dedicated I am,” I responded.

I am so dedicated to this pregnancy, to trying to help Baby B successfully implant, to attempting to save Baby A no matter what, that here I sit, with my six-day-sore right thigh, plus my two sore sides of my “tush,” as my son calls it.  

But, the sore thigh was completely unnecessary, so anyone who has to do intermuscular injections, don’t be a self-injecting hero.  Simply ask for help upfront.  And, if you live in Chicago, I’m happy to be your girl…

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