The Art Of The Butt Shot

As I continue to clear out old clutter to make way for new adventures and energy, I am pleasantly surprised by some of the worthwhile things that I have kept.

Almost A Father originally started as a guy’s guide to infertility that I had titled “Shooting Blanks”.

Most of the content ended up on the cutting room floor as Shooting Blanks evolved into Almost A Father.

One section of Shooting Blanks I came across was actually relevant to this week support group meeting.

Talking about giving hormone shots evoked mostly laughter but some moments of flashing anger when the guys in the group were a bit flippant about whether it hurt or not.

Hopefully this will become  a quick resource in those moments when maybe you lost the nurse’s instructions, or are away from home and need to remember what to do and not to do. This is a compilation of personal experience and advice from nurses at the various infertility clinics we went to.   KEEP IN MIND: this was our treatment regimen quite a few years ago, so some of the drugs mentioned may not even be used by REs, but the fundamentals are still relevant in a bind.



Take your time preparing for the shot, and don’t do it at the last minute, or try to cram it in with a bunch of other things you have to do. You have to mix the right amounts of hormone each time, and if you’re not in a rush, you’re more likely to measure it out wrong, or freak out that you’ve forgotten something.

Here is my ritual

FIRST:  Get out all the supplies and lay them side by side.  The needle body, the needle tip, the hormones and the alcohol swabs.

SECOND: Get the mixing drugs ready.  With Pergonal, your are breaking off the tips of glass bottles, so make sure you break them with the tip pointing away from you–the glass sometimes splinters off), discarding extra diluent.  Your RE should have told you how much diluent (fluid) to mix with the powder.

It is best to use a large tip needle for all the mixing–it works better and you leave less diluent in the bottle.  Just make sure you switch tips before you give the shot.  These mixing needles ARE NOT meant for shot giving!

With progesterone, you’ll want to use a thicker gauge needle to make it easier to draw up the oil.  If you try it with the actual shot needle, not only will you dull the needle making it more painful when the shot goes in, but it will take forever to draw up the oil.

You don’t really need to worry about air bubbles in the progesterone–just the big ones if there are any.

THIRD: Count all the bottles that are empty before you throw anything away to make sure you mixed the right amounts together.

LAST: Tap out the bubble at the top of the needle, and bring the liquid to the top of the needle to get ready to give the shot.

Don’t go crazy tapping out every bubble.  You’ll go insane, and the more aggressive you get with tapping, the more bubbles you make.  You just want to make sure there aren’t any really big bubbles in the syringe.

2. When you are ready to give the shot, the best thing to do (at least for us) is to have your wife sit on the edge of the chair. Sitting down there is virtually no way for her to move to her butt out of the “shot zone” (this was a trick from one of our infertility support group friends).

Divide your wife’s butt up into the quadrants that you were shown by your nurse.  Ideally you want it to go into muscle away from bone and nerves–the quadrant will be different depending your wife’s buttock make up.

Alcohol swab the targeted quadrant, and then, holding the syringe as close to the top as possible, insert the needle quickly.  The more straight and fast the needle goes in, the better.  if you go in at an angle, it’s going to hurt more coming out.

3. Once the syringe is in BEFORE YOU INJECT THE HORMONE, pull back just a bit on the syringe, like you’re drawing blood. This is important to make sure you are not injecting the hormone into a blood vessel or vein.  You don’t have to pull back much.

If you’ve hit a vein, the blood will come up into the needle very quickly.  DON’T PANIC IF IT DOES. Just pull the needle out, and pick a new spot 1/2 to 1/4 inches from your first try.  I did hundreds of shots on Lisa and only hit a vein once, so the chance this will actually happen is very small.

4. Once you’re done with the injection, pull the needle out again, as straight and fast as you can.  Don’t be timid. If you pull it out at an angle, be prepared for a slap across the head or cursing–it will hurt .

5. Make sure you have extra alcohol swabs, or better yet, a cotton ball for when you pull out the needle in case you get a bleeder.  The cotton ball works better than the alcohol swab because it absorbs more blood, and there’s no stinging from alcohol going back into the needle hole.

A few other things to watch for:

Leakage: sometimes when you pull the needle out, you’ll notice what looks like the hormone coming out. If this happens, don’t panic.  Just apply pressure with the cotton ball so it doesn’t all come out.

To avoid this with the next shot, twist the skin clockwise before you put the syringe in, and once you’ve got it in, let the skin relax and inject the fluid.  This helps the tissue close over the spot you injected so it doesn’t leak out.

Bleedage: sometimes you’ll just hit a spot that bleeds a lot after the needle comes out.  This doesn’t mean you’ve hit a vein (unless you saw blood when you did the needle drawback test above, but gave the shot anyway).  The bleeding will stop with consistent pressure with a cotton ball for at least a minute or two.

Super-sore butt: this will happen after a week or so of consecutive shots–especially with the progesterone.  Try icing up the spot two to three minutes before the shot.  This numbs the area making the shot less painfull.

When in doubt, or if you think you’ve screwed up, call your RE.  There should always be someone on call to help you if you have any problems. Don’t hesitate to call. You are paying a lot of money for a medical procedure might not work for a number of reasons.  You can remove a lot of stress and agonizing over whether you’ve messed up or not by calling your RE when you are in doubt.

Once I thought I injected meds into a vein on Lisa then some blood was in the needle as I pulled it out.  I panicked and called the RE’s assistant, and she told me in thirteen years of practice, the worst that had ever happened when someone did inject into a vein, was they could ‘taste’ the drug for awhile, and felt a little nauseous.

Trust your instinct, and again–if you are in doubt, call your RE.





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