As a nurse doing consultations before IVF treatment, I'm often asked, "Does it hurt?"
The IVF process can be intimidating, and many patients naturally have a fear of the unknown. To help ease this anxiety, in this blog I'll review key parts of the IVF cycle and discuss how patients typically experience them in terms of physical sensation.
All Those Needles
The first and probably most common fear among patients is all the needles. This includes the ones used for the stimulation injections and also the frequent blood draws during the morning monitoring appointments. Typically you are on stimulation shots for 8-12 days to prepare your follicles for the oocyte retrieval. Depending on what type of cycle you are doing, you may have suppression injections for 2-3 weeks before this.
The injections used in cycles are subcutaneous and the needles used are tiny. This is a dramatic change from the days when the injections were given in the muscle with big needles. Subcutaneous means the fat layer below the skin. These needles are small in length and width.
Where We Inject
The two most common injection sites we use are in the abdomen or in the outer part of the thigh. Each patient is different and some people will prefer one site over another in terms of which is more comfortable. Since these injections are growing your follicles, it is very common to have some abdominal tenderness while in stimulation. It may take several weeks for your ovaries to get back to normal size so you may have this discomfort during this time.
With some other types of cycles, you may be prescribed Progesterone in oil injections. Those injections are intramuscular. They are typically given in the buttocks. These shots can be a little more uncomfortable than the others, so we encourage patients to use ice compresses to numb the area before and heat compresses after. This will help with the discomfort of the injections and also the absorption of the oil.
Monitoring appointments will involve frequent vaginal ultrasounds to measure follicles. Most patients can tolerate this fine and only complain of mild vaginal pain or cramping during the ultrasound.
The next component of an IVF cycle that sometimes makes patients nervous is the oocyte (egg) retrieval. On the morning of the retrieval, during your admission, the CRNA (Nurse Anesthetist) will start an IV. During the retrieval you will receive a “twilight” anesthesia. This ensures you remain comfortable during the entire procedure.
This medication is enough to keep you sleeping and keep you comfortable during the procedure, but unlike general anesthesia, you are not intubated and you wake fairly quickly afterwards.
The whole procedure lasts 5-30 minutes. You will then stay in our recovery area for 30-60 minutes while we watch to see if you are waking from anesthesia smoothly. Most patients will complain of only mild cramping the day of the retrieval and the few days after. Usually, taking a couple Regular or Extra Strength Tylenol is enough to manage the pain.
The last part of the IVF process is the embryo transfer. Your embryo transfer will occur anywhere from 2-6 days after the retrieval. There is no anesthesia needed for this procedure. It is very similar to a pap smear with the combination of the speculum insertion and full bladder being the most uncomfortable parts. This procedure typically takes 5-10 minutes and you are able to empty your bladder right away and help alleviate that discomfort.
Your Comfort is Our Concern
In summary, some parts of the IVF process can be uncomfortable. It helps to know what to expect and ask questions. A qualified fertility specialist will be eager to help you avoid unnecessary pain. While we can’t make every procedure 100% pain free, we can work with you to minimize pain and answer any questions you may have.
Katie Coss graduated from Northern Illinois University in 2002 with her Bachelor of Science in Nursing degree. She started working at InVia in Sept 2011 after almost 9 years of working as a Labor and Delivery RN. She nad her husband conceived their second son through IVF and she always remembers thinking she wanted to take care of other people going through the same thing.