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    Medication Preparation- Single Injection Technique Ganirelix Protocol

    This instruction sheet has been prepared for you to assist in mixing all of the medications you will need for your stimulation so that they can all be given together in >one single subcutaneous injection.

    Please note that the only exception is the hCG injection (Ovidrel, Pregnyl, Novarel), which must be given at the time you are instructed and separate from all the other medications.

    Please assemble the following items:

    • 2- Alcohol Wipes
    • 1- 3cc syringe
    • 1- 22G 1” needle
    • 1- 25G 5/8” needle or 27G ½” needle
    • Sodium Chloride vial (comes in the Menopur box)
    • Follistim Cartridge and Pen Device or Gonal-F Pen
    • Menopur Vials (each vial = 75 units)
    • Q-Cap (optional)
    • Ganirelix Acetate 250 mcg prefilled syringe

    Procedure

    STEP 1

    Wash your hands

    STEP 2

    Cleanse the top of the Menopur vial and the Sodium Chloride vial with an alcohol wipe

    STEP 3

    Insert the cartridge of Follistim into the Follistim pen (you do not need this step if you are using a Gonal-F pen),

    Attach the pen needle

    STEP 4

    Dial the pen to the correct dosage. You will receive dosage instructions on the portal.

    STEP 5

    Take the 3 cc syringe and attach the 22 G 1½ inch needle to it (or attach the Q-Cap if you are using this instead of the needle).

    Pull the plunger of the 3cc syringe down to the 0.5cc marking (with the needle or Q-Cap pointing up, the top ring of the black piece should be at the long line at the number 0.5cc).

    Insert the needle or Q-Cap through the rubber stopper of the Sodium Chloride vial.

    Turn the Sodium Chloride vial upside down with the needle still through the rubber stopper, and push the plunger in all of the way. This will dispense air into the vial and make it possible for you to remove the fluid.

    STEP 6

    Make sure that the top of the needle is in the fluid, and draw back the plunger until the top ring of the black piece lines up with the 0.5cc marking on the 3cc syringe.

    STEP 7

    Take the 3cc syringe (which has the Sodium Chloride solution in it) and inject it into the vial of Menopur. Swirl the fluid around until the Menopur powder completely dissolves.

    STEP 8 (if you are only using one vial of Menopur, skip to step 9)

    Take the 3 cc syringe, remove the fluid from the first Menopur vial, and injection it into the second Menopur vial. Swirl the fluid around until the Menopur powder completely dissolves.

    Take the fluid from the second Menopur vial and insert it into the third Menopur vial.

    Repeat this step until you have added fluid to the total number of vials of Menopur that you have been instructed to use.

    Remember that one vial of Menopur = 75 units of Menopur.

    STEP 9

    You are now ready to use the Follistim or Gonal-F pen.

    Inject the Follistim or Gonal-F pen directly into the Menopur vial and swirl it gently.

    STEP 10

    Inject the entire pre-filled syringe of Ganirelix into the Menopur vial and swirl it gently.

    Please note that you will not start the Ganirelix right away. Only add the Ganirelix once you are instructed to do so on the portal.

    STEP 11

    Take the 3 cc syringe (with the 22 G 1 1/2 inch needle or Q-Cap attached to it) and insert it into the Menopur vial.

    Remove all of the fluid from this vial.

    STEP 12

    Remove the 22 G 1½ inch needle or the Q-Cap from the syringe.

    Attach the 25G 5/8” needle or 27G ½” needle. Hold the needle facing up and remove all air from the syringe by gently pressing on the plunger. If there are any air bubbles in the syringe, you can tap it gently to remove these. A small amount of bubbles or air is safe to inject.

    STEP 13

    Cleanse the area on your abdomen or thigh where you will be injecting the medication with an alcohol wipe.

    Inject the entire contents of the syringe into your abdomen or thigh. Give injection by pinching area and injecting at a 90-degree angle.

    You may notice a small droplet of blood at the injection site. You can wipe this off with a piece of gauze.

    It is normal to develop a small red area at the injection site.

    STEP 14

    Dispose of the needle into the sharps container that was provided to you with you medication order.

    If you have any questions regarding these instructions, please leave a message with the nurses at 847-884-8884 ext. 3, or email “ask nurse” via the portal. If you have an after hours question, contact the answering service directly at 773-279-0000.

    Further instructions for injecting the medications can be found at our website:

    http://inviafertility.com/onlineteach.html (click on Village Fertility Pharmacy/subcutaneous injection lessons)

    or directly from the Village Pharmacy website:

    http://www.villagefertilitypharmacy.com/medications-and-video-injection-lessons

    Infertility Infertility treatment IVF InVia Fertility Specialists

    Kim Saaby

    Kim Saaby

    Kimberly E. Saaby, has a BA in Health Care Administration, is a certified ultrasonographer, and a medical assistant. Joining the Invia team in 2001 when she began as a receptionist at the front desk where she realized the importance of spending time with patients and their needs. Her background medical experience as a patient care tech/phlebotomist at Central DuPage Hospital sparked an interest in the nursing end of the spectrum. From there she received her certification in ultrasound from Technical School and Medicine and finished her BA in Health Care Administration from University of Phoenix. She is responsible for coordinating IUI and IVF cycles, while providing patients with the education and support they need. Her knowledge extends to insurance and many other nursing activities in the clinic. When away from the clinic Kimberly enjoys the company of family and spending time outdoors with her husband, Mike.

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