How many injections does one IVF cycle need, and how much do they hurt?
In a straightforward IVF cycle, a woman usually takes one hormone injection a day for about ten to twelve days, with a fine, insulin-type needle. After about day six the doctor may add a second injection, making roughly fourteen to fifteen in all. A trigger injection, taken at an exact time, ends the stimulation. Women with PCOS, a low AMH or a higher age may need two a day, about twenty-five in all.
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This video is in Konkani; the guide on this page is in English.
Before IVF, many women worry most about the injections: how many, and how much will they hurt? In this seven-minute talk, our doctor gives a basic idea of what to expect, from the first daily injection to the trigger.
Why does the number of injections differ from woman to woman?
Our doctor divides women into two broad groups. In the first are women whose age is in the usual range and who have no other fertility problems; for them, one type of stimulation injection is usually enough. In the second are women with polycystic ovaries, a low AMH, a higher age or another associated illness, who may need two types.
Within each group the dose is still decided case by case, after your tests and scans.
What is the daily injection in a straightforward cycle?
For women in the first group, our doctor describes one stimulation medicine, HMG (human menopausal gonadotropin), a hormone that helps several eggs grow at the same time. When HMG is the only stimulation medicine, it means one injection a day.
What each IVF medicine does is explained in IVF injections explained.
How fine is the needle?
The daily injection is given with a small, thin needle. At the consultation the team can show you the actual injection, so you can see the size and thickness of the needle before the first dose.
HMG does not come as a pen, so it is given with an insulin syringe, which has a very fine needle. Insulin syringes are easy to get at pharmacies, and they are what our team commonly uses. The team also writes down for each patient which injection to take and when. Some other stimulation medicines come as ready-to-use pens. Both ways are correct, and the choice differs from doctor to doctor.
For how many days are the injections given?
Normally the daily injections run for about ten to twelve days. During this time you have a series of ultrasound scans. On the first day the eggs, inside their small fluid sacs called follicles, are very small; the scans follow them as they grow until they are mature enough to be collected.
Why the scans are repeated is explained in follicle scans explained, and the whole cycle, day by day, in the IVF timeline.
Why is another injection added after about day six?
After about day six, before the egg-collection day, the doctor may add one more injection. Our doctor names it in the video as cetrorelix. It is given alongside the daily stimulation injection, and its job is to stop the body from releasing the eggs before they can be collected.
Our doctor's count for a typical cycle: if your stimulation lasts about ten days, that is about ten HMG injections. Add four or five of the extra injection after day six, and the total comes to roughly fourteen to fifteen injections, before the trigger.
How much do IVF injections hurt?
Any needle that goes into the body is felt, our doctor says, so the pain is not zero. But it is not much. The needles of insulin syringes are very fine, and the amount of medicine in each injection is small, because the medicine is concentrated.
The injections used in the old days hurt a lot. Compared with them, today's injections hurt less, and usually many patients have few complaints about pain.
When are two injections a day needed?
Some women need a stronger plan. Our doctor's examples are polycystic ovaries (PCOS), a low AMH, a higher age, or another associated illness. In these women, he explains, the eggs tend to be weaker than in other women, so the doctor may use two stimulation medicines together: HMG, and a second one called recombinant FSH (rFSH). Both are then given every day.
With two injections a day for ten to twelve days, you can roughly count on about twenty stimulation injections. Add about five of the extra injection after day six, and the total comes to about twenty-five. More about these conditions is in PCOS and fertility and low AMH explained.
Can starting earlier mean fewer injections?
Often, yes. Our doctor explains that when a woman is younger and begins treatment early, fewer injections are usually needed, because her ovaries need less help. When treatment starts at a later age, for whatever reason, or when another illness such as PCOS is present, more injections are usually needed. How age changes fertility is explained in how age affects fertility.
What is the trigger injection?
Once the daily injections have matured the eggs, a special injection called the trigger is given. It prepares the eggs for collection.
Sometimes the trigger is a single injection; sometimes two or three injections are needed on trigger day. Each doctor and each hospital follows its own protocol, so your plan may differ.
Does the time of the injection matter?
Yes. Taking each injection at the correct time is very important.
- The daily injections. Take them at the same time each day. Our doctor says a difference of about two hours either way does no harm.
- The trigger. This one is different. The doctor gives you an exact date and time, and the trigger works as planned only when it is taken at that time. Set a reminder.
So, how many injections in all?
- A straightforward cycle: one stimulation injection a day for about ten to twelve days, plus four or five extra injections after about day six, roughly fourteen to fifteen in all.
- When two medicines are needed: two stimulation injections a day, about twenty, plus about five extra injections, roughly twenty-five in all.
- The trigger: one injection, or two to three on trigger day.
These are rough counts to help you prepare, not a plan. Your own doctor decides the medicines, the doses and the dates after your tests and scans.
About this guide
This guide is by the Pai Hospital Team. Treatment is in Goa, where the scans, the egg collection and the laboratory work are handled by one team. The steps of a whole cycle are in the IVF process explained, and more of our doctor's talks in Konkani are on our Konkani fertility videos page.
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Heartbeats IVF contact no: 95185 02773 (WhatsApp)
Our locations: Vasco · Margao · Panjim
This article is for education only and is not personal medical advice; please consult your doctor about your own situation.
Your questions
How many injections are there in one IVF cycle?
In a straightforward cycle, one stimulation injection a day for about ten to twelve days, plus four or five extra injections after about day six: roughly fourteen to fifteen, then the trigger. With two stimulation medicines, about twenty-five, then the trigger.
Do IVF injections hurt?
A little. Any needle going into the body is felt, so the pain is not zero, but it is not much. The needles of insulin syringes are very fine, the amount of medicine is small, and today's injections hurt less than the injections used in the past.
Why do some women need two injections a day?
With polycystic ovaries (PCOS), a low AMH, a higher age or another associated illness, our doctor explains that the eggs tend to be weaker, so the doctor may combine two stimulation medicines, HMG and recombinant FSH. Both are then given every day.
What is the extra injection added after day six?
Our doctor names it in the video as cetrorelix. It is given alongside the daily stimulation injection for the last few days before egg collection, and its job is to stop the eggs from being released before they can be collected.
Do I have to take the injection at exactly the same time every day?
Try to keep to the same time. For the daily stimulation injections, our doctor says a difference of about two hours either way does no harm. The trigger is different: take it at the exact date and time your doctor gives you.
What is the trigger injection?
A special injection given once the eggs have matured, to prepare them for egg collection. Sometimes it is a single injection; sometimes two or three injections are given on trigger day, depending on the doctor's protocol.
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This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.