PIO shots are a pain in my ass! PIO stands for progesterone in oil and seems to be a staple medication for many fertility clinics. Progesterone is essential for building and maintaining the lining of the uterus see link as well as supporting the developing embryo see other link. The previous links have a ton more information about progesterone, but this blog, not a school lesson. Let’s have more fun.
They are not bad once you get a system down BUT after having close to 100+ over the course of my journey, these still are my least favorite. SO since my FET is right around the corner, let the PIO shots begin!
1. It is an inch and a half long! You could actually spear fish with this needle. When someone comes at you with an effing 1 1/2 inch humongous needle you tend to not be ok with that. If you are, well frankly you are a sadistic freak.
2. The medication is in oil. That makes it THICK which requires a fat gauge needle. So allow me to recap, long-A scary as hell needle, and it is also a mega large thick gauge. Boy, how did I get so lucky? Another thing about this oil awesomeness, it goes in so SLLLLLLOOOOWWW, You can’t lightning fast dart this crap in like the heparin shots, nope, it is like a 90’s Usher, nice and slow.
3. We got a bleeder! Yep that’s right. Want to make your husband pass/flip the eff out? If you hit the wrong spot, you can hit a blood vessel which then turns things into a C budget horror movie. It doesn’t hurt when this happens more just shaves off a few years of the poor supportive partner administering your shot.
4. This is a 2 person party. Look, there are some hard core ladies out there who give themselves their own intramuscular butt shots. They are the Chuck Norris’s of infertility patients. I do not fall in that category. This shot requires your dearest partner to jab you. Partly because of the angle, more so because you have to check for blood in the syringe.
5. They are a pain in the ass. Literally.
6. Ever waddle like a duck from shots? Yep, 1 out of 7 shots I found will be a “bad” shot. This means you will walk with a stylish limp when this happens for about a day. If you are lucky to have 2 in a row that are bad, commence the non-pregnancy waddle. Other nod to infertility being a jerk.
7. Heating pad, you are my only friend. It heats the site where you had the shot. Since it is oil, it helps disperse the medication and reduces knots. It is also KNOT <- haha get it? a bad idea to stick the vial of medication in your bra about 15-20 minutes before the shot. Although it is in a slow administering oil, this will warm it up and help it go in with less knotting.
8. EMLA-U-Lah-Lah! EMLA cream is a numbing agent and you can get/beg for an RX of this if you know you are in it for the long haul with these shots. To spare you the trial and error stories, a tegaderm patch will help immensely. Keep the cream on for 45 minutes prior to the shot and BAM, you won’t feel a thing.
9. You kinda need to take this around the same time every night. This makes planning evening/life activities down-right difficult. We have had to sneak away in run-down bathrooms, abandoned areas of weddings, in the middle of dinner with friends, and my favorite: a close friend’s bedroom where there in-laws barged in on us in the middle of an injection. Yeah, he totally narked on us too and my friend (thank God she knew our situation) had to delicately explain to her soon to be father-in-law we are not heroin addicts, just going through infertility procedures. AWKWAARD!
10. Early pregnancy symptoms and PIO shot side effects: THE SAME. Eff you infertility for making me even more insane. My boobs hurt from air, does this mean? I have weird cramping, could it be? I have hormonal outbursts and want to strangle even Gandhi, COULD I BE PREGNANT? {insert infertility’s evil laugh} MUAH HA HA … That’s the progesterone my friend.
Chris’s take on PIO:
Here’s the thing, there is no way to put a circular saw in someone’s hand that has never used one before and say, “Go ahead and cut through those 2x8s.” and expect that they will be totally comfortable with it. But, that is kind of the situation with the PIO shots. Sure, the fertility clinic will go over every detail with you as many times as you want. But, I don’t care how many times you stab a foam block, it is an entirely different feel when you are sitting there with your dearly beloved’s butt in your face and have to stab her with this needle. I did find a few things out though that may be of interest to share:
1. First, don’t hesitate. Nope, go for it like a dart motion. If you hesitate and fail to fully commit, it is going to hurt her more for you to start stabbing again. Also, quick out seemed to be the best thing for us.
2. Next, I found out that certain points on Candace’s target area were better than others. She did better towards the inside and low. You will see the quadrant thing that splits the butt into 4 sections and be told that it is the upper outside quadrant that these shots need to go into, so it is the lower-inner portion of the upper-outer quadrant that I am referring to. Confusing right? But, if you pay attention to which regions were better than others (more importantly, which regions are worse) you can try to make everything a bit more predictable.
3. Candace did not like a countdown and I did not like giving one. It was just something else to stress about. She knew she was going to get a shot and I knew to give it to her when everything was ready. No fuss, just go through the motions.
4. It is super important to initially pull the plunger back to see if you hit a vein after inserting the syringe needle. Candace and I probably went through 100 PIO shots and never hit one. Then, just the other day, it happened. See the picture below to see what we saw. Just make sure to do this check!
5. Make it fun in any way if possible. Candace and I always had silly band-aids to use for her shot sites. Scooby Doo, Angry Birds, Looney Toons, whatever can bring levity to the situation.
A review then: stab her like you mean it, find her PIO “G” spot, sneak up on her to do the injection, always look for red leaks, and finally, laugh at the sticker you put on her butt. Sounds like another great night in the C & C House of Infertility.
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OMG you guys are amazing, just reading this made me queasy – I’m so scared of needles and blood lol!! This is really the only way they can do it? Yikes, & kudos 🙂
Thanks Flitany amazing no- you will be surprised at how far you can push yourself to make your dreams into a reality. Now don’t stress too much, not every clinic perscribes PIO IM injections. Some will do creams and the majority do progestrone suppositories. <– those require a stash of the ugliest most hideous underware you own, you dare not break out your $12 pair of Victoria Secrets out when you do the progestrone suppositories. This current round I have been blessed with a bruised backside and I get to rock the back of the drawer undies (I take both PIO AND Suppositories). Sorry for the diatribe, here’s where I am going with this, PIOs suck but they are managable, I am a whimp. Also, there are plenty of alternatives the doctors use for progestrone intake that don’t require a sore butt and a 1.5 inch long needle.
Just found your blog. I’m one of those gals that gives herself the PIO injection every morning at 0430 hrs while my Army husband gets ready to leave for work. Really I have no choice since I never know when the heck he’ll be around and if long enough to do this as a routine every morning.
HOLY CANNOLI! That is pretty tough. MUCH respect for you to be able to give yourself a pio. Human will and determination is inspiring. Also, THANK YOU and your husband for your sacrifice. Infertility is hard enough. Its a challenge in its own accord. Much less doing it whilst in the miltary. The miltary wives, are strong amazing women. Thank you Rebecca, for reading our blog but mostly for your sacrifice for our country.
I love it, I’m in the Chuck Norris club! I have to admit it took 2 months to be able to do on my own, and I only do it when my hub’s not around.
Hey two months or not.. you are the Chuck Norris of the IFers out there. DAYUUUUUMMMMMM that is pretty skillful and brave. Not sure how many retakes of me counting to “10” I would have to do before I would finally be able to do it, but its much like stabbing yourself with a spear. Not many can follow through. Thank you for reading our blog, and good luck with your journey.
I am doing my PIO shots myself from Day 1, been on it 2 weeks now, my hubb’s work schedule will force me to wake him up in the morning after only couple hours of sleep, otherwise. The other day, I had to drive on my sore butt and work the brake and drive pedals for 2.5 hours to get to work =(. Hope this all works out for my family!
PIO shots are definitely one of those things that you learn as you go. You will find that shots in certain places hurt less, or stay tender for shorter periods of time. It is kind of like a new adventure every day for the first couple of weeks. Wishing you all the best with your family dreams and no more 2.5 h commutes!
Oh goodness! I’m a GS and we are in the contract phase so we haven’t made it to the shots yet, and I’m definitely not looking forward to it, but I like being prepared. Thanks for the rundown!
What needs to be done if blood gets on the syringe (like in the photo)?
You just take it out, throw it away draw up a new one and try again. I know it sucks to feel like you are wasting the medication but if blood gets into the syringe its as good as trash.
I had sort of phobia of needles but I had to do it myself once as I didn’t have anyone to do it for me, and needed to take in the right time. I prayed for strenght, had a deep breath and voila! It was liberating… The greatest thigng is that I discovered that it doesn’t hurt not nearly as bad as when someone was doing that for me (even the professionals). I am laughing out loud here to be called a hard core Chuck – what a bonus!
Candace and Chris, thanks for sharing your story and making the life of couples going through IVF a little bit easier. Also, Congrats for the beautiful baby! She is adorable!!
Tomorrow, it is my ER and I will have my first PIO injection at night 🙁 I’m so afraid of needles, blood and PIO!!and I want to do whatever it takes to minimize the discomfort/pain…. I asked my Dr. for a prescription of EMLA cream and she will have it ready for me tomorrow. But also. I wanted to ask you….what did you use Tegaderm for? Did you use Tegaderm to locate the injection site? Thanks. I appreciate your response.
GOOD LUCK on your Pios! They are intimidating but I promise you will get use to them. Tegaderm are patches I put over the EMLA cream while it sets. They are also used for IVs. You may find them at the pharmacy but I just ordered a mondo box online. Let me know how it goes. You got this! I was a huge wuss with needles and after 6 rounds I wouldn’t bat an eye when I would have to have an injection. The EMLA cream is also great for numbing your hand for IV’s so when you have retrieval make sure you slap that on there before you leave the house.
Thank you!! 🙂 I’m starting my first PIO right now! I put EMLA cream 10 mins ago. I also bought the patch and I will order some online.
Thanks for all your help! Have a great weekend!!
Hi! I just found your blog. We just went through the whole IVF process and received positive news on Christmas Eve! 🙂 The dr. has me on the vaginal progesterone suppositories but I have had a bad reaction to those so I’ll be switching to the PIO tomorrow. I’m read for a little soreness in my butt as opposed to terrible soreness ‘down there’. Planning to put some Orajel on the site before my husband stabs me 🙂
Reading this made me laugh out loud as I have had the same thoughts/feelings since starting these shots! I’ve only done 2 on my own so far and have sequestered my husband to do the rest. Tonight’s injection went in smoothly, no blood return on drawback, but as soon as he pulled the needle out…all I heard was ‘oh s*%t! That’s a lot of blood!’
He enjoyed reading this as much as I did. Thank you for sharing that it isn’t always sunshine and rainbows when it comes to pio shots!!
Thank you for making this post! Hope Jordan, I am a GS too! We are getting ready to transfer on Friday! How is journey going this far? I just started the PIO 2 days ago. It is not nearly as painful as I thought it would be. I’m sure my DH is more nervous than me. My butt is definitely sore, but more like I did 100 squats at the gym (which I know is not true) Good Luck to all in their journey!!
this has been very helpful, reading all these posts about everyone’s experiences. My wife is pregnant about 5 weeks along and we have been doing the progesterone shots every nite for a few weeks. At first I wasn’t nervous but as the days go by and the shots each nite add up I have become increasingly nervous because my wife is in pain after each shot. Its my job to massage the area after the shot, and apparently I am not a professional masseuse as I have been told..rather screamed at..that I suck. This is not a good feeling at all..but I know I have to suck it up and do the best that I can. which is exactly what I have been doing for the past few weeks. Man I hope the shots continue to do their job and that they are over soon as this is definitely wearing on me. I also have to realize what she is going through since after all, she is the one in pain and not me. Im not a very religious guy but there has certainly been a lot of praying going on. Best of luck to all.
I have been receiving PIO shots for about 4 weeks now. My hubby and I have a system. Emla cream 1 hour before, cover with plastic wrap and wait. Then he gives the shot. I usually cannot feel a thing with the cream. it has been great for reducing stress for both of us. Also for soreness afterwards, I discovered that walking for around 20 minutes (a lesiurely mile) right after the shot makes a big difference. If a walk right after the shot I am not sore the next day. I had two nights where I was ambitious and did more than a mile and was sore, and when I did not walk afterwards I was very sore. One 20 minute mile seems to be the sweet spot for me. I wish my doctor had suggested all of these things from the beginning. I had to research and read blogs on my own, and then beg for EMLA cream (which the nurse gave me a hard time about).
We’re just starting our own journey and I wanted to say thank you for adding the humor. We are fertility clinic shopping and it’s utterly terrifying…. this page is the first blog I’ve read that I haven’t felt completely hopeless and mortified simultaneously. Thank you!
SO. AWESOME. I shared with my hubby- we’ve done this before & hopefully will be “enjoying” these again soon (because it will mean I’m pregnant) Nice to read before that time. ?