10 Common Mistakes Patients Make With Their IVF Meds

We know what you're probably thinking: I've been waiting to start IVF for how long? I've already put in so much time, money, and effort… there's no way I'll make a mistake. But here's the thing: we're all human, and things happen. With IVF, there are so many moving parts, and even the most Type-A fertility patient can slip up.

Before diving into the most common errors, let's start with the basics: understanding what IVF medications actually are and why they're (mostly) injections.

What are IVF shots?

IVF medications are primarily injectable hormones that do a few key jobs: stimulating the ovaries to develop multiple eggs, preventing premature ovulation, triggering final egg maturation, and supporting embryo implantation. There are two main types of injections. Subcutaneous injections, which go just under the skin, usually in the belly, are used for most stimulation medications. Intramuscular injections, which go deeper into the muscle, typically the buttock, are used for progesterone in oil.

Why injections at all? It's actually pretty straightforward: these hormones can't survive in pill form. Stomach acid would break them down before they ever reached the bloodstream, which means injections are the most effective delivery method.

Common IVF medication mistakes (and how to avoid them)

Whether someone is just starting their first cycle or is a seasoned IVF veteran, medication mistakes happen more often than most people realize. The good news? Most errors are fixable, and knowing what to watch for puts anyone ahead of the game. Here's a breakdown of the most common ones.

1. Panicking about your IVF injections

If needles aren't exactly a comfort zone, IVF can feel like a personal nightmare, and that's a completely valid feeling. But everyone panics over IVF shots, not just you. And the anticipation is almost always worse than the actual shot itself.

If the thought of self-injecting brings on serious dread, try leaning into a partner or loved one during this time. Putting a partner on injection duty is actually a great way to get them involved and makes it feel like less of the burden falls on one person. Ask your clinic for injection training videos or request a demonstration appointment; most clinics are more than happy to walk patients through the process. Many clinics now also offer a "single injection technique" where multiple medications can be mixed into one shot, which can significantly reduce the number of daily injections. It's always worth asking if that option is available.

2. Not refrigerating your IVF meds properly

Getting that first big box of IVF meds can be daunting. It's a completely normal reaction, when receiving the meds, to put the box in a spare room until it's actually needed. But there are certain IVF medications that need to be refrigerated, so please don't do this! Instead, open the box, make sure it includes everything that was prescribed, and refrigerate the meds that need to be kept cold. Everything else can go in a corner until the big IVF-start date comes around.

Here's a quick reference for what goes where: medications that must be refrigerated include Gonal-F, Follistim, Menopur (after mixing), Ovidrel, Novarel, Lupron (once opened), and Ganirelix. Medications that should NOT be refrigerated include progesterone in oil (refrigerating this can actually ruin it), unmixed Menopur powder, and unmixed hCG powder. If there's ever any doubt about whether a medication was stored correctly (maybe it was accidentally left out overnight) call the pharmacy immediately. Many medications can tolerate brief temperature changes, but a pharmacist should always confirm before proceeding.

3. Not taking your medications at the same time every day

Once in the thick of IVF, remembering to take daily medications on time is crucial for optimal success. When the protocol arrives from the doctor, write down exactly when each medication should be taken, then double (and triple) check.

Getting organized will be one of the biggest superpowers during the IVF process. Set phone alarms for each medication and keep a simple medication log to track what was taken and when. One common question: do IVF injections need to be at the exact same time every day? Most clinics allow a 1-2 hour window, but consistency is important. If a dose is missed entirely, call the clinic immediately, and never try to double up to compensate, as this can disrupt the carefully calibrated hormone levels the protocol is designed to maintain.

4. Running out of IVF needles or medication

When it comes to fertility treatments, there is a lot to keep track of, and it's easier than you think to overlook running low on supplies. If reaching for a daily injection reveals that needles (or worse, medication) have run out, there are a few options.

First, most fertility specialty pharmacies offer 24/7 pharmacist support and can often provide same-day or next-day shipping, so start there. Be sure to also call the fertility clinic and ask what missing one dose could mean for the cycle. Most likely, all will be fine, but there might be follow-up steps needed to get back on track. If it's the supplies that have run out, simply call the clinic and ask if they can provide some to hold things over until the pharmacy can deliver more.

5. Bending IVF needles or getting air in the syringe

For IVF newcomers, it's important to know that the needles used for IVF medications are typically very thin. Because of this, accidentally bending a needle when inserting it into a vial of medication can happen. If it does, try extracting the needle from the vial first. If that doesn't work, try disconnecting it from the syringe. Don't panic: this is usually an easy fix. When all else fails, call the nurse or fertility pharmacist.

Another thing to watch for is air bubbles in the needle before injecting medication. The easiest fix is making sure the needle isn't inserted so deeply that the tip rises above the liquid level in the vial, keeping it submerged ensures medication (not air) gets pulled into the syringe. If air bubbles keep appearing, there may not be a full seal between the needle and the syringe, or there could be a small crack in the syringe. Try again with a new needle and new syringe. And one more important note: progesterone in oil must reach muscle tissue to absorb properly. A common mistake is injecting it into fat instead of muscle; aim for the upper outer buttock quadrant to avoid this.

6. Messing up your hCG trigger shot timing

The egg retrieval procedure is always scheduled 36 hours after the trigger shot. The trigger shot stimulates both the final maturation of the eggs and ovulation, so timing is critical.

It's also worth knowing that trigger shots have evolved significantly. In 2025 and 2026, many clinics are moving toward a "dual trigger" approach, which combines two types of medication: hCG (like Ovidrel, Novarel, or Pregnyl) and Lupron. Traditional high-dose hCG can cause a condition called Ovarian Hyperstimulation Syndrome (OHSS), which ranges from uncomfortable to medically serious and occurs in an estimated 1-10% of IVF cycles, according to research from the Iranian Journal of Medical Sciences published in 2018. Lupron alone prevents OHSS but doesn't work optimally for everyone. Research published in JBRA Assisted Reproduction in 2023 shows the dual trigger approach, using a smaller hCG dose combined with Lupron, supports egg maturation while significantly lowering the risk of OHSS, making it an increasingly preferred option for patients who respond strongly to stimulation medications. If a protocol includes multiple trigger medications, that customization is there for safety and best outcomes, not to make things more complicated.

Common trigger shot mistakes to avoid: missing the exact timing window (this is the most critical one), using the wrong dose, storing the medication incorrectly after mixing, and forgetting to let refrigerated medication come to room temperature before injecting. If life gets in the way and the trigger shot timing is off, contact the clinic right away. There may be options to adjust the retrieval schedule. After all, the doctors are on your side and want to see the best possible outcome at the end of all of this.

7. Eating or drinking before your egg retrieval

The egg retrieval process is done under anesthesia or conscious sedation. Before the procedure, the clinic will advise not to eat or drink anything after midnight on the day of retrieval. Please follow these instructions! While minimally invasive, egg retrieval is a surgical procedure, and certain precautions need to be taken.

If something is accidentally eaten or drunk before egg retrieval, there is the option to do the procedure without conscious anesthesia, but that's not exactly a comfortable alternative. Set reminders, write notes, do whatever it takes to remember the pre-op instructions and set things up for as much success as possible.

8. Googling your IVF mistakes instead of calling your clinic

Google will make every IVF mistake feel like the end of the world. If something goes wrong during the IVF process, please don't ask the internet what it means for the cycle. Instead, call the doctor or nurse, describe the error, and ask what the next steps should be. Self-diagnosing is never good for mental health, and it's almost never accurate when it comes to something as nuanced as an IVF protocol. Avoid it at all costs.

9. Not understanding your IVF protocol

One common mistake that doesn't get talked about enough: not fully understanding the medication protocol. When there's clarity on what each shot does and why, it's much easier to feel confident, and to catch errors before they happen.

Here's a quick breakdown of the main medication categories:

Stimulation shots (Gonal-F, Follistim, Menopur) stimulate the ovaries to develop multiple eggs. Gonal-F and Follistim are pure FSH (follicle-stimulating hormone); Menopur adds LH (luteinizing hormone) to the mix. These medications work gradually over 8-14 days, and signs that they're doing their job include follicle growth on ultrasound and rising estrogen levels. Research published in Gynecologic and Obstetric Investigation in 2010 suggests that combining FSH and LH may improve outcomes, especially for women over 35 or those who respond poorly to FSH alone.

GnRH antagonists (Ganirelix, Cetrotide) are typically added around day 5-6 of stimulation to prevent premature ovulation, keeping follicles growing together so retrieval can be timed precisely. They work within hours, which makes them an effective tool for cycle control. Trigger shots handle the final step of egg maturation before retrieval, and support medications like progesterone and estradiol work to prepare the uterine lining for implantation after retrieval.

The clinic will walk through the specific protocol at a teaching appointment, and that's the time to ask every question, no matter how small it seems. Requesting written instructions is always a good idea, too.

10. Not preparing yourself mentally, physically, and financially

The IVF process will test limits: physically, emotionally, mentally, and financially. One of the best things anyone can do before starting IVF is to prepare as much as possible. Prepare finances ahead of time: know what's covered, what's not, and what out-of-pocket costs to expect. Be ready for the physical changes that come with stimulation medications, which can include bloating, mood swings, and fatigue. Acknowledge the emotional weight of the process, because it is genuinely a lot, and there is nothing wrong with needing support.

Get organized. Set up a medication schedule. Build a support system. Those are the best ways to reduce the risk of mistakes and give the best possible chance at a positive outcome.

Set yourself up for IVF success

Not all of the items on this list are directly related to IVF medications, but the truth is, the IVF process is more than just injections. It's a complete overhaul of daily life, and that increases the margin for error. However, if preparation is solid, organization is in place, there's a consistent schedule, and trust is placed in the care team, getting through this unscathed is absolutely possible. You've got this, and your clinic is in your corner every step of the way.