Jenn's Top 5 Tips for Surviving that PIO

Disclaimer: I am in no way, shape or form a medical professional. In fact, I'm a marketing manager in the agricultural field. Please understand that these are tips that helped me survive the PIO, but are not intended to be medical advice. Please talk with your doctor with medical questions. :) 


If the abbreviation PIO means nothing to you, consider yourself lucky. Progesterone in oil is a necessary evil for the IVF crowd, as well as some non-IVF mommas who need to boost this essential hormone during pregnancy. It's a viscous liquid injected via really long needles into the upper/outer quadrant of your hind quarters. It's miraculous that we can supplement progesterone when we need it and it's so worth it when it helps bring beautiful babies into the world.

Those injections, though? They suuuuuuuuck. #KeepingItReal

Just because IVF Cycle #1 didn't end the way I would have hoped, I still learned a few things along the way that make the process a little easier.

So, if you're about to tackle you some PIO, here are my top 5 tips that made it not suck so much:

1. Lidocaine and ice are your best friends forever. For real. Numb that injection site! I found some spray-on lidocaine at my local pharmacy that I could spray on and let dry before applying an ice pack. Leave the ice on for 10-15 minutes (until you're good and numb) and WA-LA! You won't even feel the injection.

2. You're going to want 25 gauge needles. TRUST ME. My IVF nurse told me that they use 18 gauge needles to draw up the PIO, then 22 1/2 gauges to inject it. SHE IS EVIL (okay, she isn't actually evil, but a 22 1/2 gauge needle is a thing of Satan). When you order, ask the pharmacy to send 25 gauge needles. Draw up the PIO with whatever comes on the syringes (mine were 22 1/2 gauge, but yours might be 18), then swap that needle out for a 25. It will take longer to inject the liquid because it's viscous (but you can't feel it because you listened to tip #1 and numbed yourself), but your rump cheeks will thank you.

3. Find a position that is comfortable for you  to receive the shot. For me, that was laying on my side across the end of my bed so that the injection site was visible and easy for my husband to see. Another option is leaning over a counter top. Just make sure you are somewhere that allows you to relax. IM shots are never fun when you're flexed.

4. Have the person administering the shot look carefully for visible blood vessels. It's not the end of the world if you hit one, but it definitely stings and there is lots of bleeding and bruising afterward. Your nurses will tell you to be sure you aspirate the needle once it's in, but it's always best to just avoid hitting a vessel from the start, when at all possible.

5. Make sure the person administering the shot does not hesitate when doing it. The shots really don't hurt at all since you're bum is numb, but if your spouse starts to stick the needle in, then panics and yanks it back out, that's not going to feel so nice. Plus, then you'll have two stab wounds instead of one (okay, they aren't stab wounds, but you know what I mean). My husband assured me the needles went in easily. In fact, he compared it to sticking a needle in butter (I'm not sure whether I should be offended by that or not). So tell your shot administrator not to panic. Just hold that syringe like a dart and go!

My husband and I were told to learn how to administer these shots via a video on a pharmacy website. As I told my friend Joanna this morning, the video is awful and looks like it was shot on someone's VHS camcorder in 1987. Thankfully, there are lots of other tutorials on YouTube that are far more helpful. Two of my favorite PIO video resources come from a YouTube channel called Heartships of Hope. Maybe you'll find these helpful too:

Live PIO Shot (AKA Progesterone Party)

5 PIO Tips

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