Phase 4: Trigger Shot

Appointments

I was seen again on June 30th (the day after my last appointment) for bloodwork and an internal ultrasound and was told I was ready to go! I was a little surprised because I had such varying sizes the day before, but there were 10 good-sized follicles on each side. Because we were aiming for a healthy amount, my doctor wasn’t concerned about waiting any longer. That evening I gave myself my final injection, which is called a trigger shot.

The next day, July 1st (Canada Day), I was able to drop in any time before 9:30 a.m. to have bloodwork done that would ensure the trigger shot from the night before worked.

Medications

I took my Orgalutran as usual the morning of June 30th (prior to my appointment). I was instructed to take my regular Gonal-F dose without the Menopur in an attempt to grow a few of those eggs that were not far behind (16-17mm) the already-ideal ones. Remember that an ideal follicle size is between 18mm and 24mm at this stage. Out of my six donation cycles, this is the second one where I have been asked to do this.

Then at precisely 10:45 p.m. (I had a five-minute window for the injection) I gave myself 225 units of Gonal-F and administered the two Decapeptyl 0.2 mg trigger shots, which are preloaded syringes that must be refrigerated until the injection.

Pre-loaded syringes make self-administering the trigger shots much simpler and faster.

Just two quick shots and I was ready to move on to the next phase!

Side Effects

I felt bloated, and I had some mild bruising from the injections and bloodwork. At this point I was also experiencing extreme fatigue. I went to bed at 8:00 p.m. and slept right until 8:30 the next morning. It’s common to notice a raised red area after injecting the trigger shot; don’t worry if this happens. You can take Benadryl or use ice to relieve the discomfort.

Warning Signs

Follow up with the nurses. Ask how many follicles you have on each ovary and the sizes of each. They might be annoyed, but this is literally their job. At a bare minimum, I ask for the largest follicle size and smallest follicle size. If my doctor performs the ultrasound instead of a technician, I ask right then and there. Often, my doctor will call out the numbers to the nurse as he counts, and the nurse will record them. I just follow along and confirm at the end by saying something like, “It sounded like we have around X number of follicles” and let him confirm or correct the information.

Ask for your estrogen levels as well. Anything over 3,000pg/mL (US unit of measurement) or 11,000pmol/L (Canadian unit of measurement) puts you at risks for OHSS.

Self-Care Tips

Get extra rest, take it easy, eat soups and other easy-to-digest foods to help with bloating, drink a lot of tea, etc. Really, do whatever you have found to work for you thus far. Keep meditating and get a gentle massage if you can. You deserve it!