Mixing Menopur

pugli

I'm going to be starting my first IVF (hopefully soon, with first injection to be in the next couple days).  It is a short cycle with a natural start.

I will be on 150 Gonal F & 150 Menopur/day.  I've never used either since we decided not to waste our limited drug coverage on using injectibles for IUI.  

I went in for my injection training and the nurse went through it so quickly, that it wasn't at all helpful.  I've watched a number of videos online that have helped a bit.  I have to mix 2 vials and I think I use 1 cc of liquid, but have to check with the clinic since I can't remember if she said 1 cc or 1/2 cc.

I'm worried that when I mix the Menopur and turn the bottle upside down to get the medication into the syringe, that some of it will leak out.  

Is there a hole in the top of the bottle that you put the  needle through or do you create your own?  I guess you have to use the same hole for the large mixing needle and the smaller needle you will inject with to ensure none of it leaks out?

Gonal F seems a bit easier, as long as I can get the needles on, but I'm still a little nervous as medication teaching for both drugs was only a few minutes.

Any advice or tips would be greatly appreciated.  Thanks! 

 

 

 

 

 

pinkmickey24

I have mixed Menopur for all of my IVF cycles and honestly it isn't too hard. My instructions have me use 1cc and mix it with the powder. The Menopur will not leak out when you turn the vial over because you don't take the needle out until you have drawn back all of the Menopur into the needle. You will then mix that with your second vial of Menopur and draw back the mixture and you are all set. Good luck!

Mayzie15

pinkmickey24:

I have mixed Menopur for all of my IVF cycles and honestly it isn't too hard. My instructions have me use 1cc and mix it with the powder. The Menopur will not leak out when you turn the vial over because you don't take the needle out until you have drawn back all of the Menopur into the needle. You will then mix that with your second vial of Menopur and draw back the mixture and you are all set. Good luck!

This! Good Luck!

Hopeful1981

Also, the way these bottles are designed, the medicine does not leak out because the top is made of the hard rubbery material that is able to be pierced by the needle and kind of suctions around the needle.  They might have you inject gonal into the menopur with a needle and then you use the q-cap to inject the liquid.

Trust me, between two IVF's, and all the Menopur, Bravelle, Lupron, and PIO I have used, I have NEVER had any leak out.  After doing it the first time you will feel much better.  Just make sure to read everything you have very carefully and go very slow the first time around so you understand everything.  GL!

CutieGirlLissie

Hopeful1981:

Also, the way these bottles are designed, the medicine does not leak out because the top is made of the hard rubbery material that is able to be pierced by the needle and kind of suctions around the needle.nbsp; They might have you inject gonal into the menopur with a needle and then you use the qcap to inject the liquid.
Trust me, between two IVF's, and all the Menopur, Bravelle, Lupron, and PIO I have used, I have NEVER had any leak out.nbsp; After doing it the first time you will feel much better.nbsp; Just make sure to read everything you have very carefully and go very slow the first time around so you understand everything.nbsp; GL!

This!! GL!

Killer Tomato

It will all make sense when you actually do it, don't worry! 

Like PP said, the top is a sort of self-sealing rubber. Once you pull out the needle, there will be no hole. Here is what I did, step by step, to mix gonal f and 2 vials of menopur:

1. Take tops off vials of menopur and saline. Wipe tops with alcohol.

2. Put mixing needle on syringe, draw up .5cc saline, then inject into powdered menopur vial.

3. Swirl to make sure it is dissolved. Use mixing needle to suck up mixture, then inject into second menopur vial.

4. Wipe end of gonal f pen with alcohol, screw on needle. Dial dose on gonal f pen. Pull out end of pen, remove needle caps, and inject into menopur bottle.

5. Still with mixing needle, suck up all liquid in vial. (I never turned it upside down, as the needle reaches the bottom. I also ignored the qcaps.) Take needle out. (If It is hard to suck up all the liquid, you can inject a little air into the vial (not into the liquid-no bubbles!) to make it easier.)

6. With needle end pointing up, pull some more air in, then replace mixing needle with smaller needle, get rid of extra air, wipe skin with alcohol and inject. 

You also have to prime the gonal pen before first use, if that is what you have, but the instructions included with it are pretty clear.

Again, it will make much more sense when you actually do it. (And just to clarify, the injecting needle won't be going into any of the vials, only into you.) Just go slow, dont panic, and watch out for those needles...they are really sharp! 

GL! 

pugli

Thank you everyone.  That is all really helpful.  The step by step directions are also a big help and I'm not sure what I was thinking - you are right that I won't be using the smaller needle on the Menopur bottle - I don't know why I was thinking that I would when I was typing my original question!

I did see in the videos that you swab the top of the Menopur bottles and the top of the Gonal F pen before.  The nurse didn't do that during the demonstration.  I also asked about air bubbles and she said not to worry about them as they're not a concern, although I've seen elsewhere that you're supposed to get rid of them.

Also, my clinic doesn't allow me to mix the Gonal F and the Menopur, so it will be 2 shots for me (and 3 if I get to the Orgalutran).

Thanks everyone for the tips and advice - it is very, very helpful.

Looks like my CD2 bloods and ultrasound are tomorrow, so first 2 injections are Monday night.   

 

 

 

 

lsgabriel

Everyone said it pretty well, so I don't really need to reply on that front... But I'm curious; why did your Dr say you couldn't mix the meds?

pugli

When my doctor prescribed the medicine, he said thought it would be best to try both Gonal F & Menopur.  He mentioned it would be 2 shots.

 At that point, I wasn't aware that some clinics do allow you to mix the 2.  I read about that during the time I was waiting for teaching class with the nurse. When I met with her, I asked if I could mix the two and she said I could not.   

I know some clinics in the States allow it, but (as far as I know), the clinics in Canada where I am haven't yet moved towards that.

One shot would be much nicer, and I really wonder if it would make a difference if I mixed them together, but I suppose it is best to follow the directions the clinic has given me (although I would much prefer 1 shot over 2!) 

Edwina.McDunnough

lsgabriel:

Everyone said it pretty well, so I don't really need to reply on that front... But I'm curious; why did your Dr say you couldn't mix the meds?

Well, some clinics allow it, but for me, It was not allowed because the drugs came from 2 different manufacturers and there was unknown interaction. I also suspect if your Gonal dose is really small then there isn't enough to dilute/draw up (moot if you're using vials of Gonal w 1cc diluent). It's really no big deal to give 2 shots instead; even 3 is not a big deal, but then I've been giving myself injections of some sort almost nonstop for 2.5 years.

pinkmickey24

Edwina.McDunnough:

lsgabriel:

Everyone said it pretty well, so I don't really need to reply on that front... But I'm curious; why did your Dr say you couldn't mix the meds?

Well, some clinics allow it, but for me, It was not allowed because the drugs came from 2 different manufacturers and there was unknown interaction. I also suspect if your Gonal dose is really small then there isn't enough to dilute/draw up (moot if you're using vials of Gonal w 1cc diluent). It's really no big deal to give 2 shots instead; even 3 is not a big deal, but then I've been giving myself injections of some sort almost nonstop for 2.5 years.

This was the same for my clinic. I could mix my Bravelle cycles with Menopur because they came from the same manufacturer, but I couldn't mix the Gonalf with the Menopur.