On Pins & Needles

Well, mostly needles. One needle. The really important hCG injection. The one I always worry that I've screwed up.

Basically, this is the shot that will trigger ovulation. We didn't inject any Gonal-f or Repronex last night; we didn't inject any Lupron this morning. The 12:15 a.m. injection of hCG will trigger ovulation and at a quarter past noon tomorrow, Evelin will be in the OR having her eggs harvested.

All should be well, but since this injection is so critical (and since it's the one that I don't get to practice day after day to get comfortable with), I am worried that I did something wrong. This is going to sound sadistic, but the reason I'm worried is because it didn't hurt Evelin. It's a long (1.5 inch, 23 gauge) needle and an intramuscular shot. All the warnings and prep material say that it is likely to hurt ... but it didn't and the injection site wasn't sore this morning.

The area of Evelin's backside that the nurse had highlighted yesterday morning (literally with a yellow Avery Hi-Lighter) wasn't really visible anymore, so I had to calculate where the injection should go. The doctors wanted us to inject only 5,000 USP of the hCG, instead of the 10,000 USP in the vial, but the intramuscular injection required 2 cc of water, so I had to fill the vial with 4 cc of water to dilute things and then pull back half for the injection. So far, so good. But then, while counting down the minutes to 12:15 a.m., I started second guessing the injection site, retraced the lines, and alcohol-wiped a new injection site a little south of my original estimate.

At exactly 12:15 a.m., the injection was given. Evelin probably won't like to read this, but it seemed to take forever for that long needle to go in. The small subcutaneous injections are in place very quickly; the intramuscular jab, however, seemed to keep going deeper and deeper. I gave a pullback on the plunger to check for blood in the syringe (which would indicate that I was in a vein or the liver or something); there was none, so in went the medicine. After the needle came out, there was a bead of blood that welled up, but that’s supposedly within the normal experience.

Tomorrow morning, Evelin has an acupuncture appointment to help get her body set for the anesthesia and retrieval procedure, then we head over to the clinic ...