PIO Injections - What I found helped the most

Progesterone In Oil (PIO) Injection Needle

Our infertility journey is turning us into experts on subjects we really didn't want to be experts in...

When I first heard about PIO (Progesterone In Oil) injections, I thought "no big deal, injections are easy".

Well sure, the subcutaneous injections we did so far were not bad at all. The needle was small both in length and in thickness.

Injecting the medicine in my belly fat was not a big deal.

Then came the PIO injections. First, look at this ridiculous needle... It's an inch and a half.

Second, imagine this needle has to go ALL THE WAY IN.

Last, it doesn't go in your soft and cushy belly fat, it goes in your muscle...

Oh and in case that wasn't bad enough to do just once, you'll have to do it for the next 12 weeks...

I heard all the horror stories of pain, lumps and itching and asked around for all the advice I could get. Here is what worked best for me.

1- Get organized:

IVF Medication - Getting Organized

Doing something repeatedly means that one day, you will lose track.

• Start by setting a calendar of your daily medication.

• Have a pen handy so you can cross off what you did already that day.

• Organize your medication and make sure they are all in one place. This will also allow you to know when you are about to run out.

• Lay down all you need in the order that you need it. It will prevent you from missing a step.

2- Determine the injection site:

You can ask your clinic to draw circles so you know where to do the injection, but unless you are diligent about redrawing them every day, they will fade really quickly.

So here is a reminder >>

It also shows you which area to avoid so you don't hit the sciatic nerve, which can be VERY painful!

Alternate side each day and try to avoid injecting in the same exact spot. You will see small red dots as you go and you will know to avoid those.

Use your calendar to remind you which side to do that day.

3- Prepare the injection:

The warmer the oil, the thinner, the less painful

This is the part that made all the difference for me!

Progesterone oil is very thick. Think about Coconut Oil. When it's cold, it's hard and thick. When it's warm, it's a thin liquid.

Progesterone oil is the same.

Here are the steps I follow to prepare the injection:

• Layout everything needed:

Oil, 2 alcohol pads, 1 syringe + 2 needles, heating pad, gauze.

• Use an alcohol pad to clean the top of the progesterone bottle (prevents bacteria from being pushed into the bottle)

• Draw back on the syringe to the amount you need to inject that day (1mL for me).

• Push the needle trough the rubber on top of the bottle and push the air in the bottle.

• Reverse the bottle and start drawing out 1mL.

• Go very slowly and be patient, the liquid will come out SUPER SLOWLY.

• When done, pull the syringe out of the bottle, recap the needle, twist off the needle and replace by a new one.

• Why placing a new needle??? Because it will get dull when pushed through the rubber of the progesterone bottle, making it more painful to pierce through the skin.

Now for the important part that made all the difference to me:

Warm up the microwavable compress ( I do 45 seconds in the microwave).

Wrap the syringe in it for at least 15 minutes. I let mine sit for 30 minutes sometimes!! The thinner the oil, the better.

I don't warm up the oil when it's in the bottle, simply because it will take too long for the whole bottle to warm up. The oil would not be as thin as it is when I warm up the syringe directly.

When doing that, I found that the injection was not painful during and after!! It also doesn't sit under my skin. I don't have lumps either.

4- The injection and after:

Now that the oil is warmed up, find the injection site as discussed before, stretch the skin (easier for the needle to go through the skin) and insert the needle by doing the same movement you would do if throwing a dart. Gentle but quick.

The whole needle needs to go in... Slowly push the oil until nothing is left in the syringe. You want to be as sturdy as possible. The more the needle moves, the more damage it is doing to your muscle.

When done, apply a gauze to stop any potential bleeding and start moving to activate the muscle and make sure the oil penetrates vs. sit under the skin.

My acupuncturist recommended I do squats, which I did!

Some people just walk around the room.

You can massage if you want but activating the muscle is really the most effective.

Last but not least, you can warm up the compress again (only 30 secs this time) and apply it to the injection site, making sure you have either a layer of clothing or a paper towel in between your skin and the compress so you don't burn yourself!!

I've been doing this for the last 25 days and I am pain free so far!

I hope you find this helpful!

What are your PIO injection tips?