How To Survive Progesterone Shots: A Fertility Doctor’s Insider Tips

What are progesterone in oil (PIO) intramuscular shots and why do people hate them so much!?

Progesterone in oil (PIO) shots are usually the part of IVF treatment people dread the most – WHY?

• Oil is thick which makes it more difficult to inject & takes longer to do than other IVF shots
• PIO needs a big needle that has to be injected right into your glute muscle (intramuscular injection)
• Some women can have pain, swelling, or small knots in the muscle from these injections

It is important to know you don’t *have to* use injectable progesterone – you could opt for oral + vaginal. I tend to prefer injectable because it only needs to be taken once a day (easier to remember) and has less of the systemic side effects of pills (feeling woozy and tired). 

How do you make progesterone in oil less painful? 🙈

Here are some tips:

✅Confirm you’re injecting the progesterone in the right spot!

The area you’re meant to inject progesterone in oil is a higher on your *peach* than you think!

Split your butt cheek into four quadrants. Then find the upper, outer quadrant (aka the top corner of a back pants pocket).

✅ Get an injection buddy

Ask your partner or a friend to help you out. Injecting yourself can be challenging (although it can be done – see section on auto injectors)

✅ Warm up the vial

You can warm up the vial by rolling the vial back and forth in your hands or putting it in the crease of your elbow – warming can help thin out the thick oil and make it easier to inject.

PSA: Never use hot water/microwave to heat as it could diminish the effectiveness and cause a burn!

✅ Relax your glute

Relaxing the muscle before injecting will make it less sore. You can lie down. Or if standing, make sure to bend your knee on the side you are injecting to help relax the muscle and avoid tensing up. Slightly lift the leg on the side that you’ll be injecting to take the weight off that glute muscle and keep it relaxed.

✅ Use numbing cream or an auto-injector

I have found lidocaine based patches and gels very helpful. Autoinjectors might also take the stress out of injections and make it easier to self administer.

✅ Use a warm compress after injecting

You can massage the area with a warm wash cloth. The heat and moisture will help the muscle to absorb the medication a little better.

✅ Massage the injection area afterwards

Make sure to massage the injection site for 3-5 minutes after the shot to prevent knots from forming and encourage absorption. 

A foam roller is a great way to do this. 

✅ Walk if off

Going for a short walk afterward can also help with soreness.

✅ Switch sides

Switch between the left and right glute every time you do your injection so that each side gets a break.