Frequently Asked Questions
We understand that fertility can be complex. To help you navigate your journey with us, our team has created a robust list of our patients’ most frequently asked questions. We encourage you to refer to it and familiarize yourself with our office protocols, so together we can facilitate your care and treatment as efficiently and effectively as possible. Hardcopies are also available in office. As always, please do not hesitate to reach out to us with any additional questions.
Q: How do I get in touch with the office with a question?
A: During office hours, call the office at 201.666.4200 for all questions. During on-call hours, for urgent questions only, call 201.666.4200. After on-call hours, wait until the next morning to call with your question, or go to the nearest hospital for any medical emergencies.
Q: My period began. What do I do now?
A: If during office hours, call the office for further instructions. If after office hours, just come in the next Monday, Wednesday, or Friday between 6-8:30am.
Q: I’m in the middle of my IVF stimulation cycle and I got my period. Is this normal?
A: Yes, it is normal since you stopped the birth control pills prior to starting your IVF injections. This is called a withdrawal bleed and it may be slightly different from a normal period.
Q: I came in for monitoring today but didn’t receive any instructions or next steps. What should I do?
A: Check your voicemail for a message. Always ensure that your mailbox has free space for our clinical staff to leave a message. If we are unable to leave you a voicemail (the preferred method), we will send you an email to the address on file. If you didn’t receive a voicemail or email, call the office during office hours. If after office-hours but during on-call hours, call the office number and speak to the answering service. The answering service will take a message and the on-call clinician will reach out to you.
PLEASE NOTE: Our on-call clinician is only available for urgent questions, and only according to the above schedule. If you have questions or require clarification about your medications, please call the office earlier in the day.
Q: How do I administer my medications?
A: Please visit Freedom Fertility Pharmacy’s website for medication administration videos:
Q: Where do I inject my medications?
Follistim, Gonal-F, Menopur, Cetrotide, ganirelix (Fyremadel), Ovidrel, HGH (somatropin), Lupron (leuprolide/GnRH), and Pregnyl/Novarel/hCG are administered in the belly, 2 fingers-width area below the belly button as depicted here:
Progesterone in oil is administered in the upper outer buttock area (alternating sides daily) as depicted here:
Q: How do I store my medications? (please note that some of the following medications may not be applicable for you)
A: YOU MUST REFRIGERATE: Follistim, Gonal-F, Ovidrel, Cetrotide and Human Growth Hormone (somatropin), MIXED Pregnyl/Novarel/hCG, Lupron (leuprolide/GnRH) (which is drawn up by clinical staff in the office) and MIXED Menopur.
STORE AT ROOM TEMPERATURE: Menopur powder (unmixed), ganirelix (Fyremadel), progesterone in oil and Pregnyl/Novarel/hCG powder (unmixed).
Q: I administered my medications and blood came out or there is a bruise now. Is this normal?
A: Inadvertently injuring a small blood vessel while injecting medications is common. This can cause bleeding or bruising. The medication is still being absorbed, so don’t worry. For the next medication administration, slightly shift the injection site to avoid that same blood vessel.
Q: I forgot to take my medication(s) tonight. What should I do?
A: Note: ***To help you remember when it’s time to take your medications, we recommend you set a daily alarm/calendar reminder.
See below for guidance, depending on which medication you missed:
- letrozole or Clomid: Take the pill(s) as soon as you remember, and call the office during office hours for further instructions.
- IVF cycle (NOT the trigger medication; see instructions in box below specific to missing the IVF trigger): Take the medication as soon as you remember and call the office during regular office hours for further instructions.
- Estrace: If a dose of Estrace is forgotten, double up on the next dose and then continue your medication dosage as previously instructed.
- Progesterone in oil: The timing of the initial injection of progesterone is vital. If you were given an exact time to start the progesterone but missed the first dose by more than 3 hours from the time you were instructed to start, do not take it, and call the office the next day. If a subsequent dose is forgotten, administer it as soon as you remember and continue taking progesterone as previously instructed.
- Ovidrel: If you forget to take your Ovidrel, take it as soon as you remember.
Q: I don’t have enough medication to administer my morning injection tomorrow. What should I do?
A: Call the pharmacy to see if you have any refills remaining (you will have refills available for most medications for this reason) and fill the medication. Also call the office to alert us between 6-7am on Monday, Wednesday, and Friday, and between 8-9am on Tuesday and Thursday for additional instructions, or call the answering service at 8am if during a weekend or holiday.
IVF “Trigger” Injection FAQ:
As soon as you receive our instructions for the time of your trigger injection, please set your alarm for that time. It is extremely important to take the injection on time.
Q: I forgot to put my trigger injection in the refrigerator. Can I still use it?
A: Yes, you can still use it. If you are doing a dual trigger, place the additional dose in the refrigerator until it’s time to administer it.
Q: I forgot to take my trigger shot. What should I do?
A: Call us if during on-call hours. If it is after on-call hours, and you remembered within 1 hour of your assigned time, go ahead and take the injection as soon as possible. If it is more than 1 hour before or after your assigned time, do not take it, and call the office the next morning for further instructions.
Q: I was instructed to take a dual trigger and I forgot which one goes first?
A: The larger syringe with the gray needle cap (hCG) and one of the smaller syringes with the orange cap (GnRH) is administered at night, precisely at the time provided to you by our office. The second smaller syringe with the orange cap (GnRH) is administered the following morning at the time provided to you (which is usually 12 hours after the first orange cap injection is administered).
Q: When should my partner provide the semen sample for my egg retrieval?
A: Your partner should produce the sample at home and bring it in within 1 hour. It should be brought with you when you arrive for your egg retrieval, if possible. If you live more than 1 hour away, please let the clinical staff know, so that arrangements may be made for him to produce at the office.
Q: Can I eat or drink before my egg retrieval?
A: Please do not eat or drink after midnight the night before your egg retrieval. For the procedure, light anesthesia will be administered, and your stomach must be empty. If you routinely take a prescribed oral medication in the morning, do not take it unless you check with our office, and we instructed you to.
Q: I had my egg retrieval and am experiencing a lot of cramping and bloating. What can I do?
A: Alternate taking ibuprofen (Advil/Motrin) and acetaminophen (Tylenol) as frequently as instructed on the medication bottle. Apply a heating pad to your lower abdomen or back. Eat salty foods and drink electrolyte-rich or salty fluids such as sports drinks. Cramping and bloating may normally last up to a week, but if pain becomes severe and the office is closed, go to your local emergency room.
Q: I had my egg retrieval and have not been able to urinate for 6-8 hours post-retrieval despite feeling the urge to. What should I do?
A: Go to your local emergency room.
Q: I have been administering my progesterone injections and I have been experiencing subsequent bruising, lumps and soreness. Is this normal and what can I do?
A: Yes, this is generally normal. Make sure you are alternating sites for injection (left and right sides).
Some tips:
- Draw the medication into the syringe and warm the syringe in your hands, armpit, or a cup of warm water for a few minutes.
- While you are warming the medication, numb the injection site by applying an ice pack for 1-2 minutes.
- After the injection, apply a heating pad and/or massage the injection site for a few minutes.
- If no improvement, please call during office hours to speak to our clinical team.
Q: I’m having my embryo transfer today; when should I take the Valium?
A: You should take the Valium 1-hour prior to the transfer time. You are not permitted to drive if you have taken Valium, so arrange for someone to drive you to and from the office.
Q: I’m having my embryo transfer today; can I eat and drink prior to it?
A: Yes, you may eat and drink normally prior to coming to the office for your transfer. Don’t forget to drink 2 (two) 16oz bottles of water approximately 1 hour prior to your transfer.
Q: I’m pregnant and bleeding. What do I do?
A: Depending on the color and amount of blood, it can be normal. Follow the instructions below:
- If the discharge is pink or brown tinged, this can be normal. Keep an eye on it and call us during office hours to let us know.
- If the discharge is bright red but only present when you wipe, keep an eye on it and call us during office hours to let us know.
- If the discharge is bright red and flowing (not just present when wiping), increase progesterone injection dose by 0.5mL, with a maximum dose of 2mL. If you are already injecting 2mL of progesterone, do not increase your dosage. Call us during office hours for further instructions.
- If you are heavily bleeding (soaking a pad in 30 minutes) and cramping and the office is closed, go to your local emergency room.
Q: I’m pregnant and I have a headache. What can I take for it?
A: You can take acetaminophen/Tylenol as instructed on the bottle, but do not exceed 4,000mg in a 24-hour period.
Q: I’m pregnant and I can’t hold any food down. What should I do?
A: Drink ginger ale, eat crackers or bland food (BRAT diet – bananas, rice, applesauce, toast) and call the office during regular hours for further instructions. If the vomiting is constant and severe and the office is closed, go to your local emergency room.
Q: I graduated last week with a pregnancy but am bleeding. What should I do?
A: Call your obstetrician, and you can also call us during regular office hours.