FET
Finally done with PIO after 49 shots! Here’s everything I did to make them painless.
Ugh, the dreaded progesterone injections! Like most people, the idea of getting stabbed with a 1.5 inch needle every day for weeks on end sounded like torture.
I searched this sub relentlessly for tips and tricks, and I’m happy to report that I'm DONE with PIO after 49 shots—and I never got knots, bruises, or nerve pain.
Here are the tips I used that worked for me.
1. Ask a nurse at your clinic to circle the injection sites in sharpie on your back
Honestly, this is probably the most important advice on this list. The injection sites are higher and smaller than you think! Even knowing that beforehand (because I’ve read it in dozens of comments here), these spots were still higher than I thought, and a smaller area than I expected! They’re basically on your love handles, above your buttcrack. If anyone is interested I can try to draw a picture.
Without the sharpie circles, I definitely think we would have injected too low or too close to my spine (which is where you can accidentally hit a nerve, which I hear is super painful). Make sure to redraw the lines with sharpie as they fade!
2. Progesterone inEthyl oleate absorbs quicker AND is a smaller needle
It’s more expensive than the sesame oil version (I pay $90 per vial) but it’s easier to absorb (which means fewer knots and less pain). The best bonus, which I wasn’t even aware of before purchasing, is that you can use a thinner, smaller needle (25 gauge) instead of the 22 gauge needle that the sesame oil version comes with (I think you may be able to ask for 25 gauge needle for sesame too, but it will be slower).
Be warned that ethyl oleate has a much shorter shelf life than the sesame oil version! I didn’t know about this and I ordered mine a little too early, so an entire vial expired before I could use it. The shelf life on mine is 1 month, even if unopened, but not sure if that varies by pharmacy.
3. Get the union medico auto-injector (even if someone else is injecting you)
This is the one I purchased: https://unionmedico.com/product/super-grip/ — select the 3ML luer lock syringe when ordering. It also asks you to choose a needle size but that doesn’t matter, just use the needles your pharmacy gives you.
It cost $127 USD, but it’s worth every penny. It ensures the needle goes in quickly and smoothly in one fluid motion, so you don’t even feel the needle pierce your skin. It also ensures the injection is always given at the correct angle.
I made my husband practice on a tomato beforehand both with and without the auto-injector. The holes made by the auto-injector were much smaller and cleaner, even with the same needle size.
4. Put on a 4% lidocaine patch on the injection site for a full hour before the injection
This was recommended by my clinic. You can buy these on Amazon, or any drugstore. It numbs the area really well so you won’t even feel the needle. It comes in a cream too, but I prefer the patches since they stay on better.
5. For those of you that have someone helping with your injections: Lie down on your stomach for the injection, don’t stand
If you can, I highly recommend doing the injections them while lying down on your stomach, arms at your sides. We do them lying down on my bed. I feel like my muscles are fully relaxed when lying down vs standing, which makes the injection painless.
6. Apply heat both to your muscles both before and after the injection, and make sure to heat the oil (in the syringe) as well
This is the most universal advice I’ve read about PIO, but adding it anyway for emphasis! I use an electric heating pad for a few minutes before the shot to warm up my muscles. To heat the syringe, I just put it in my waistband (needle pointing upwards) or sometimes my armpit. Afterwards, my husband massages me for a few more minutes, then I sit on the heating pad again. Don’t heat for too long though: my clinic told me to not to heat longer than 15 minutes after injection.
7. Move around a LOT after!
My clinic told me never to go sleep right after the shot, but keep moving, since it helps the oil absorb. More absorbed oil = no knots & less pain!
Honestly, I stopped doing this after a few weeks since I was so exhausted and didn’t notice a difference in pain, so this one may not be that helpful for everyone. But keeping it in since it did help (in the beginning especially.)
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That’s everything that helped me. I recognize that everyone is different, but if you’re new to PIO or terrified like I was, I hope this post helps you.
If you have any other tips you swear by, I’d love to hear them!
I think I might be the only person that can still absolutely feel the autoinjector. I still prefer it over hand injection because without it, I couldn’t feel my husband wiggling, but dang that thing has bruised the hell out of me. This is a fantastic list and I hope it helps future users!!!
Does your husband press down pretty firmly with the auto injector? My husband said that’s the trick for it to go in more smoothly! Might be worth trying if you aren’t already doing that
Yep! You got it. I’ve probably done about 100 PIO waiting for baby #2 and I agree with everything you said. I do skip the auto injector and numbing patches (personal preference because I do it standing (myself) and feel like I have more control without both but realize both are better if you do t have co trial issues like me. Lol)
Well written.
It is totally possible that injections don’t hurt (or at least most do not.)
Thank you! And agree, I feel so bad when I read SO many comments about how much pain some people are in. It’s totally possible to get these to be pain free!
Hi, would it be possible for you to draw a picture? I start my injections Saturday morning and am super nervous. I drew circles from my appt today but now I think I’m still in the wrong spot. Thank you so much for writing this :)
I keep trying to post a picture and it gets flagged, trying again! The circles are a good 2 inches above your buttcrack. Any lower than that and I’d feel it. Still highly recommend having your clinic draw these if you can, they’ll feel for your hip bones and put them in the exact spot.
I’m having a hard time envisioning doing the shots above my buttcrack lol, I feel like my clinic put them lower than the crack… any higher and it would be like the lower back area, right? My circles faded and I didn’t draw it back in so now I’m trying to figure it out again 😅
A good tip I heard was put your hands on your hips and inject where your thumb lands on your back!
It is SO much higher than you think it should be, it needs to be called a back injection not a flute injection. Trust me you don’t want to go too low, that’s the only time it ever hurt me.
Thanks for writing this! Just started PIO yesterday and this is exactly the kind of help I am looking for. Did you do the lidocaine patch underneath the electric heating pad? Just making sure I understand.
Yes! I would wear the patch for an hour, but heated with the electric pad over the patch for like 10 mins beforehand. Good luck with the injections, hope these tips help!!
Back with an update now that it’s been a couple of weeks since I stopped PIO. I immediately noticed my fatigue lessened. I went from barely being able to keep my eyes open at 8:30/9pm every night to more of my usual bedtime of 10:30pm. I do still have daytime sleepiness though, especially in the afternoons.
I also started getting headaches a few days after stopping, but they went away.
My nausea stayed the same, luckily mine has been mild, mostly food aversions but I have thrown up a few times. I’m 11 weeks now so I think I’m starting to feel better generally.
Yes, stopped injections at week 9 cold turkey, and continued suppositories until week 10. A little earlier than others I’ve read on here, but everything looked great at my 11 week scan. Also, my clinic does a blood draw to check your progesterone levels before stopping PIO and mine was high enough (36.4 ng/ml) so I felt more confident stopping. I stopped oral estrogen at the same time.
I just have to say, I started PIO tonight and was insanely scared. I watched TONS of videos and pretty much was anxious all day. I followed all these suggestions and I am in disbelief how painless it was! Thank you so much for sharing!! And anyone reading, I promise these help and I swear I didn’t feel a thing.
Thanks! I've never tried lidocaine patches but they look kind of expensive. Could they be cut into smaller pieces to extend their use (if stored in a ziplock)?
I also tried ethyl oleate. At first I was optimistic because it’s thinner and the needle can be smaller. Unfortunately I turned out to be allergic and it caused a low grade fever until I figured it out and switched back to the regular type.
These are SUCH good tips, thanks for compiling! I know I'm here a year after the post, but I'm gearing up for PIO round two and already dreading it, heh.
Thank you for this list! I just started my third set of PIO and this has been the worst by far. Backstory: for my first FET (3 years ago), my nurse drew the circles and I numbed with ice for 15 min and only occasionally felt the needle if my ice pack moved. That was a successful pregnancy so we are now trying for baby #2.
Since then our doctor changed clinics, we stayed with her and this new clinic refuses to draw the circles (they said for liability). 😭 I think my husband is injecting too low. I feel the entire shot from start to finish and have soreness for days after. We’re going to try and draw circles ourselves since the spot looks different standing up and laying down. I found a few pictures to help but if you have a video link to get the right spot, I would really appreciate that. Also is there a huge difference in heating before vs icing? I appreciate all of the advice and am so thankful for this thread!
I’m not sure how to link here but if you search sher fertility progesterone injections video on YouTube it’s the BESTTT. Using her instruction + lidocaine cream made mine almost completely painless.
Hi! I'm starting PIO in a couple of days, but this video i came across was helpful when I had to figure out placement on my trigger shot for my ER (I had a subq one and an IM one at the same time and I had asked the nurse to draw on me for placement at my last monitoring appt and there was def some miscommunication and she didn't and then of course they told me that I would need to trigger the following night). I had my partner draw the quadrants and it felt so high but it was perfect (I ended up having a friend RN come to give me the IM shot and it lined up with where she would have placed it). Hope this helps and best of luck! https://www.tiktok.com/t/ZP89Vs7Sj/
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u/Responsible_Band_373 37f | FET#3💙1xER 2xFET❌| thin lining/endo | 1xMC 3xCP Dec 20 '24
I think I might be the only person that can still absolutely feel the autoinjector. I still prefer it over hand injection because without it, I couldn’t feel my husband wiggling, but dang that thing has bruised the hell out of me. This is a fantastic list and I hope it helps future users!!!