What’s an injectable?

Well, my husband and I have made a decision. I’m done with Clomid.

I say that, though if the option of stair-stepping with a lower dose is available, I’d try that. But if that isn’t on the table, I am done with Clomid.

I had my CD 12 ultrasound and bloodwork done this morning, as I requested. Originally, I wouldn’t have had this until at least CD 24. Remember the last time I spoke with my nurse and she said “I just know you won’t have to stair-step this time,” and I said, “How do you know” and she said, “I just know”? Yeah – she was wrong. As of this moment, I have zero follicles developing.

It wasn’t as upsetting as it was frustrating. I know my body – on Clomid, I only ovulate when there are two doses in one cycle. That’s it – it doesn’t matter the dosage, it only works the second time. So on 150 mg, as the first round of Clomid this cycle, it didn’t work.

And, also as I predicted, the nurse who called me this afternoon said that my doctor would like to have me stair-step, again, now up to 200 mg. And that’s where I drew the line.

#1 – I can’t ever be sure, but I believe that the serious depression and lack of rational thinking that occurred this past weekend had everything to do with this high dosage of Clomid. I was not myself at all, and since then I’ve completely snapped out of it and felt so much better.

#2 – I am sick and tired of 60 day cycles. I understand I should be grateful to have cycles, and I am, but really – I don’t have cycles, unless I’m on Clomid. Even with Clomid, it’s 60 days. So perhaps there are other options out there?

The nurse who called (a nice one, not my usual) confirmed that she has heard people say Clomid causes severe mood swings, and that yes, there are other options.

So here’s the plan as of right now: Even though I had no follies developing, apparently my estrogen was really high. I have no idea what this means, or if this is a bad thing, but the doctor would like me to do another blood test in 2 days. So it’s back there I go on Thursday, before work, mind you, a 40 minute drive. And of course, I can’t be late for work with 23 kids waiting for me, so I have to make sure to get my blood done right away. You know what time I was there this morning for a 7:00 opening? 6:30 – and there was still one person in front of me. Crazy.

After the blood test Thursday, I will get another phone call, and in this call I will request an appointment with my doctor. I’m done with Clomid – what’s next?

The nurse did mention injectables. She said some people don’t like to take them (not sure why?) but they don’t cause the mood swings like Clomid does. Sign me up.

She did not mention Fermara. I will bring that up at our appointment we have to make, as I am willing to try it. However, I’m also willing to try injectables.

Only thing is – what, exactly, are injectables?

Are they the shots, like, in the butt cheek? Or are they the suppositories some of you talk about? And how is an injectable different from a trigger shot? What do you guys know about this?


And in other news, as you know, I love my class this year. I will definitely miss them, as they make me laugh, and are so good-natured and spirited. This week, they are also proving to be very giving.

There is a student in my classroom whose mother has recently been diagnosed with a pretty severe, rare autoimmune disease. My school is putting on a fundraiser, a competition called “Penny Wars”. Basically, it’s every class against each other. Each week, we collect pennies, or any money, and there are weekly prizes for the class with the most money. First week’s prize is breakfast with donuts and juice. Then, there is a grand prize for the class with the most money raised overall – a pizza party.

Last Friday, I sat down with my class, and with the student’s help whose mother is sick, we explained the fundraiser. I stressed two important things: #1 – no one has to give money, especially when money is tight. If they happen to have any spare change, great, but no worries otherwise. #2 – on the other hand, I said, it would be pretty awesome to win the school competition – since the student is in our classroom. We have to represent her! After my speech, telling them we would start officially yesterday, students went rushing to their backpacks, giving whatever change they had right away. It was darn cute.

However, I am most touched by yesterday and today’s actions. In 2 days, my class has raised $170. 2 days. The kids, and their parents, are being so generous and kind. We all had a blast today counting the money, and the kids got very excited. They are owning this competition, and the cause it surrounds.  We are hoping to win this week, for sure, but the big goal would be to win the whole thing, and be able to present my student’s mother with a bucket-load of money. It’s just one of those nice, touching moments with kids, reminding me how much I do love children – they can be so very kind, with no reservations.

It’s definitely one of the highlights of this school year, and it takes my mind off of IF, for which I am grateful.



9 thoughts on “What’s an injectable?

  1. TheStorkWhisperer says:

    I’m raising my hand! I have the answer! Injectables are drugs that you use to produce a higher number of follicles than Clomid and Femara alone. They are basically shots that you inject into yourself. For me, I used a special pen to give myself a shot of Follistim into my abdomen area over a couple of days. They are suprisingly easy to administer with minimal pain. The trigger shot is the shot that induces ovulation and uses a syringe, not a pen. For some reason, this shot always stings a little more than the injectables. The downside to it all, of course, is the cost!!!

    I think the idea is that if you have more follicles available, the sperm have more areas to target, thus increasing the chances of a pregnancy. There’s also the argument that having multiple eggs increases the chance that at least one or two of them are good enough for fertilization.

  2. thefamilyvan says:

    I’m sorry you’ve had such a frustrating cycle. I tried Femara this month, but only developed one follicle as opposed to the 3 I had one cycle with Clomid.

    Injectables are needles that you use often. My friend used them in her latest cycle, and though she experienced similar mood issues to what you described, she had no issues with the injectables. The only thing she mentioned was that she experienced crazy bloating. She said It felt like she was injecting pure fat into herself.

    The difference between these injectables and the trigger shot is that the trigger brings on ovulation, or rather the release of the egg, while the injectables encourage those little follies to grow.

    Hope that helps!

  3. Kate @ Infertile First Mom says:

    I’m not sure you’d be escaping the mood swings with injectables, unfortunately. Everyone is different, of course, but at the end of the day you are still introducing lots of hormones into your system… And those suckers cause the mood swings. My experience with Clomid was worse than my week of injecting 3 shots/day of the highest med protocol there is (which produced very little, whereas Clomid produced several follies). But I was pretty all over the map, emotionally, during and after the injectable cycle. Plus I gained a bunch of weight. Joy.

    Another reason some people don’t like to use injectables is that they come with a higher risk of multiples, but that may only be if you are doing an injectable IUI cycle. Something to talk to the doc about, though, if higher order multiples is a concern for you.

    Hope this helps. I don’t blame you for saying No More Clomid! That stuff is from hell, truly! My doc said if Clomid has not worked in three or four cycles then it probably won’t work at all. We only gave it one cycle before moving on to the bug guns, but that’s bc of my poor prognosis for conceiving.

    Keep us posted!

  4. Brave IVF Girl says:

    Injectables include stimulant drugs like Follistim or Gonal F (equivalent drugs that provide high doses of FSH), and Menopur or Bravelle (equivalent drugs that provide a combination of FSH and LH). Other injectable drugs are Lupron (an agonist which encourages your body to release LH, thus preventing a build up and surge) and Ganirelix or Cetrotide (equivalent drugs that are antagonists – they stop the LH surge from happening naturally).

    I did an injectable IUI cycle before going to IVF. As others have pointed out, one risk is that they’re stronger than Clomid or Femara, so it’s possible you can develop too many follicles to make IUI safe. Typically injectable IUI cycles use very low doses compared to IVF cycles for that reason.

    All of these shots are typically done subcutaneously, meaning it’s a little thin needle (28-30gauge, usually 3/4″ long), typically in the fleshy part of your belly. Some doctors let you do some of those shots in other areas, but most will recommend the belly.

    The shots in the butt are usually progesterone in oil (or ethyl oleate, which is thinner) or estradiol valerate (liquid estrogen). Those are intra-muscular shots, and require bigger, longer needles (non-intuitively, I don’t find they hurt more).

    Trigger shot is usually hCG, which tells your follicles to release the eggs. If you do injectables for stimulation, you’d likely also do a trigger shot to time things precisely for the IUI.

    Side effects for all these meds exist, but none were as bad as Clomid for me. Lupron is the worst, but I doubt you’d be using that for an IUI cycle.

    Good luck!

  5. storkchaser says:

    Good for you! Clomid is horrid at 100mg and even though I’m back down to 50, it feels like I’m still up at 100. So there is no way I would do 200 and I can’t believe your RE prescribes 250!!! From what I can see, most won’t go past 150mg. And yes, Clomid alters your mood dramatically. Since it’s not working very effectively for you, I’m glad you’ve decided that enough is enough and to look into alternatives. Good luck and I’m crossing my fingers for you!!!

  6. Jenn says:

    I don’t have much to offer in your quest for answers about injectables. In fact, I read everyone’s replies myself because my doctor also suggested that as a possible next step and I have no idea what they are.

    I did, however, give myself the trigger shot my previous two cycles. It was super easy, didn’t sting at all, and I didn’t notice any side effects….other than ovulation, of course 🙂 My insurance didn’t cover the trigger shot at all so it cost me about $100 out of pocket. I hope this is finally your answer!

  7. queenelizabethi says:

    Sorry your nurse was so frustrating, but good for you for asking for alternative options. It can be tough to stand up for yourself with any doctor/doctor’s office.
    We did penny wars when I was in school, but never for so noble a cause as yours. I teared up a bit at the generosity of your kids. Good luck with everything!

  8. Emily @ablanket2keep says:

    Like everyone else said. Usually for IUI or a cycle with just the horizontal polka, the injectables come in a pen form where you put a needle on, dial up your dose and inject into your belly around your button or in your upper thigh. Sometimes it stings a little, but it’s really nothing. I have been using follistim. It comes in cartridges that you put in the pen. I have had absolutely no emotional side effects with it! With clomid it was bad. Here is a video of what I do. http://youtu.be/02eyCAM0vQ0

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