Embryo quality and stimulation

[lisvna]

Hi,
I have heard that embryo quality is in relation with the spot you do your stimulation shot. Is this true?

For example:I do my menopur shots in the muscle in my but. The embryos were severe fragmented. Some people say its better to do it it the leg in muscle instead of the but.

Who is right?

TIA

[nuthinbutpink]

I'm obviously not Carole but Menopur is a subcutaneous med and I thought all of those are in the lower abdomen, alternating sides. Intra-muscular injections go in the muscle like you mention- your butt or leg muscle.

I used Repronex, which is the same and did all of them in my abdomen, alternating sides. The only one I did in my backside is PIO.


Menopur Injection Instructions (http://www.center4reproduction.com/injection-instructions/menopur-injection-growth-hormone-instructions.htm)

[Carole]

I'm obviously not Carole but Menopur is a subcutaneous med and I thought all of those are in the lower abdomen, alternating sides. Intra-muscular injections go in the muscle like you mention- your butt or leg muscle.

I used Repronex, which is the same and did all of them in my abdomen, alternating sides. The only one I did in my backside is PIO.


Menopur Injection Instructions (http://www.center4reproduction.com/injection-instructions/menopur-injection-growth-hormone-instructions.htm)

Hi Everyone,
I have never heard that the site of administration had anything to do with embryo quality, assuming that you are getting the right dose in --so just follow the instructions of your IVF nurse for each med and it shouldn't be a problem. Fragmentation is not well understood. We have seen fragmentation in young patients who go on to become pregnant and have a healthy baby. Older patients with the same fragmentation may have poorer results- most likely due to other age-related factors, not the fragmentation per se.
Hope this helps, Carole.

[lisvna]

In the paper what comes with the menopur (I don't know the name in English) is written that you can use it intra musculair or sub cutaneous. Last cycle (where my son is born from) dr Savvas preferred intra musculair and said in the but. But the embryos were fragmented so I thought maybe this cycle in June I will do it in the muscle in my leg if that's better.

But I understand I makes no difference right?

[lisvna]

NBP I read the instruction in English what you posted. I will check the Dutch instruction. If I can I will make a photo of it then you can see it can insert in the muscle too. Strange huh?!?!

[nuthinbutpink]

Menopur just has to get under the skin- subcutaneous. It means just under the skin.

The needle you are using for them may not even be long enough to reach the muscle.

You can do them in the upper butt if you want to but the majority of patients do them in the abdomen.

From the Wiki page for subcutaneous injection-

The outer area of the upper arm.

Just above and below the waist, except the area right around the navel (a 2-inch circle).

The upper area of the buttock, just behind the hip bone.

The front of the thigh, midway to the outer side, 4 inches below the top of the thigh to 4 inches above the knee.

The injection should be given under the skin. This is what it says about going into the muscle when it is a SubQ injection-

Gather gently about 1 1/2 to 2 inches of skin between your thumb and first finger creating a slight mound of skin taking care not to bruise or damage the tissue. Warning: When gathering your skin, do not gather any muscle tissue. Subcutaneous medications are not intended for injection into muscle and may result in bleeding into the muscle tissue

[lisvna]

Ok i made a photo of the instruction in Dutch. I took it right now out the box of menopur.

They write you can insert het "in de spier" that's the muscle ("menopur in de spier injecteren"). And then the picture of the upper leg or but.

10616

[nuthinbutpink]

But right above that are the subcutaneous instructions!

"onderhuids" means subcutaneous

Maybe people do them in the muscle. For me, all stims were subcutaneous and given in the abdomen with a short needle not designed to hit the muscle.

The PIO needles were way longer and designed to penetrate the muscle when injecting.

[lisvna]

Yes I know its possible to do it sub with the sort needles. But dr Savvas prefers in the muscle in the but. That's what I did in my 2 previous cycles.

I did get longer needles from my phamasist to inject intramusculair.

But my question is is there a difference between the but or leg intramusculair or is it the same for quality of the egg/embryo? Maybe I should do it this time in the legg (intra muscular) instead of but?

[nuthinbutpink]

From the maker of Menopur's website-


Absorption
The SC route of administration trends toward greater bioavailability than the IM route for single and multiple doses of Menopur®.

So, subcutaneous injections are preferred according to the manufacturer.

[lisvna]

Ow really? Didnt read that in Dutch! I will take a look then!

Thanks!

[ever hopeful]

Hi Lisvna, wonder if you are slightly confused with merional, which Savvas used to prescribe? Reason I ask, is that I was told him by to do those intra muscular and just superfact (similar to Lupron, I think) in the abdomen? He now seems to have changed his main stim meds to menopur.

[vickyaust]

We had severe fragmentation in cycle 1 and Dr Potter mentioned that it can be from sperm issues. He recommended DH start Cyvita.

BTW as a nurse I can say an intramuscular injection is the same regardless of the area injected. I was told never to inject my meds in my leg as they would hurt more as the leg muscle is used more than the butt.

Personally I have always injected Menopur subcutaneously and would much prefer that method.

[lisvna]

Ever thanks for you thought. But im sure its menopur because I always used menopur. Actually my son is a Savvas baby from menopur hihihihihi. I always injected it intra musculair because a Savvas told me to do it that way and b it was less painful too for me.

The only reason for me to change is if it will better the embryo quality.

Vickey why would you prefer to do it sub?

Forgot to mention my husband is going to use now Cyvita too we have it at home now!

[vickyaust]

Vickey why would you prefer to do it sub?

Forgot to mention my husband is going to use now Cyvita too we have it at home now!

I prefer Subcutaneously cause it so much easier for me. I can only manage IM on one side of my butt cause I am so left handed dominant. So if I was doing lots in there it would get very overused.

Awesome news about the Cyvita. It really helped us this cycle.

[S&D]

What is cyvita exactly, is this some kind of Supplement for the man to improve sperm or something else?

[lisvna]

Yes, it helps for better sperm quality it probably also helps against DNA fragmentation. Dr Potter recommended it to us.

[S&D]

thx Lisvna!