QuestionHello,
I'm about to be starting my first IVF cycle using Menopur and Gonal F. I heard that they can be mixed so that I only need to do one injection. Is this true? Do you inject the Gonal F into the Menopur vial of powder? Also, how much diluent is needed when I go to inject it? Does this influence the dose in any way or is it better to inject separately?
Also, is there usually any pain following an egg retrieval? Thank you!
AnswerHello Sarah,
Thank you for the question. Yes, some clinics will let the patients mix the Gonal-f into the Menopur so that they only take one injection. You would dial up your Gonal-f dose, then inject it into the Menopur. You would swirl to mix then draw up the remaining liquid with a syringe and needle. You would change the needle to a smaller needle 25G or 30G and inject it subcutaneously.
I do not allow my patients to mix because I worry about the loss of medication in the Menopur vial (some will stick to the sides) and the higher chances of mistakes. Therefore, I have my patients give themselves the medication individually to be sure.
Our center uses anesthesia (heavy sedation) for the egg retrieval so that patients to don't feel the procedure. After, however, you will have cramping. Some patients describe it as a heavy menstrual cramping. Some describe it as intestinal cramping. Some patients only have some ovarian "soreness". The pain is managed by taking Tylenol or Motrin. It usually doesn't need anything stronger. A heating pad helps as well. The pain will usually resolve within 24 hours.
I hope this answers your questions.
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
