My frozen embryo cycle called for a new medication protocol. I’d take an estrogen pill (Estradiol) 3 times a day and I’d also wear a small patch on my stomach (Minivelle) that was to be changed every 3 days…it all seemed so simple and straight forward. Then the nurse casually mentioned to me… “I just called in your progesterone prescription, you’ll most likely start that one on Sunday”

“Progesterone?” I asked, “Is that another pill?” Little did I know…

I’m still not sure how this happened, but for some reason I completely missed the news about progesterone…more specifically, progesterone in oil or PIO as its referred to in the IVF community. It’s an intramuscular injection of an oil based substance. In other words, you take a 1.5 inch needle and stick it right in the muscle above your butt (right below the hip), and because the progesterone is in oil, you then need to press really hard, and wait for what feels like an eternity for all the oil to finally be injected…then you massage the muscle.

There are multiple blogs, message boards and YouTube videos by women talking about the dreaded PIO, there are even shirts for sale on Etsy! The reality of it hit me like a ton of bricks, I wasn’t ready. I had honestly believed I was done with injections, and PIO was the mother of all injections.

We followed the online suggestions (heat the oil in hot water or a heated blanket so the oil goes in faster, numb the area, really massage it in afterwards)…but nothing worked. I could handle the pain of the shot, but the soreness that came the following day was debilitating. My days were spent crying and popping pain killers. It hurt to walk, getting up or sitting down was excruciating, I couldn’t sleep on my side…I would have such anxiety in the hours leading up to the shot, and I would cry as V was administering it because I was terrified of the pain I’d feel the next day… finally after 4 days I reached out to my doctor. I wanted to know if my taking 4 650mg of Tylenol a day was ok, or if he recommended anything else I could do to manage the muscle pain I felt…he immediately switched my medication protocol.

Perhaps it was the hormones, but I cried in relief when I learned that the shots were over. My new progesterone protocol called for progesterone pills three times a day along with a vaginal insert that I had to do twice in the morning, and twice in the evening.

To the the many women who take PIO from before transfer all through the first trimester of pregnancy, I am in complete awe. I couldn’t do it; but I was grateful to my doctor for getting me an alternative.
When I asked if it would work as well, he didn’t hesitate, “if it wasn’t as effective I wouldn’t do it. I actually just published a study in this topic…”

With the PIO behind me, I was finally able to relax. My transfer was only a few days away.

2 thoughts on “PIO”

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