Secondary IF

Starting PIO - tips wanted

I had my ER this morning and my RE wants me to start medrol and progesterone in oil shots tonight.  I'm feeling nervous about the PIO and am wondering what experiences you have had with it.  I know to numb the site with ice and I can put a heating pad on it after.  DH is going to give them except the two nights he is away on business...I'll have to do those myself.  I've done the HCG IM shots myself but I've heard these are a lot worse.  Also, should I lie down or stand up?  I'm so not looking forward to this.
Clomid/IUI #1 Feb 2010- BFN
Clomid/IUI #2 Mar 2010 - BFP April 2010 DD born Dec 2010 :-)
Started TTC #2 Dec 2011 
IUI #3-5 Aug thru Oct 2014 - BFN
HSG revealed one blocked tube but was unblocked during procedure
IUI #6 and 7 Nov/Dec 2014 - BFN
IVF #1 Feb 2015 - 19 eggs retrieved, ZERO fertilized initially, 2 fertilized with rescue ICSI, then 2 more then following day, all 4 frozen
FET #1 planned for mid-March

Re: Starting PIO - tips wanted

  • Good luck!! I once heard to bend your knee and raise your foot backwards towards bum to make sure there is not muscle flexed (I wish I had a pic). Fingers crossed!
    DS: Born November 2011
    TTC #2 since April '13
    DH 35, Me: 34
    DX: Unexplained Secondary Infertility, Slight DOR
    Sept 14 - IUI (Clomid + Ovidrel) = BFN
    Oct 14 - IUI (Clomid + Ovidrel + Progesterone) = BFN
    Nov 14- Benched due to cysts Looking for New Doc
    Feb - IUI #3 (Letrozole + Ovridrel)
    March/April - IVF #1 - Antagonist Protocol - Follistim+HGH+Low Dose HCG - 11R/9M/5F - 2 8 cell 3dtransfer - BFN on April 23, 2014


  • Warm the oil in your bra before injecting, at least 15 minutes, that helps a lot!

    I did not ice first,, I found the oil went in better with nothing being cold, but I did walk around rubbing the site for at least 10 minutes after injection.  It helps to keep the oil moving so you do not get bumps or knots.

    And then heating pad after that.

    When injecting yourself have RE or nurse or your DH draw two circles of injection areas, you can find images on various web sites too if you are unsure.

    Then here is how I inject my own PIO, once drawn up I half sit half lean on the bathroom counter so I can see the injection site in the mirror.

    I twist my body to make sure I can reach.

    Holding the syringe a quick dart like motion.

    I also keep everything on the bathroom counter including my sharps box.

    So a towel to put the needle on once done injecting, if you do not want to try and put it in the sharps box right away, and a gauze pad or alcohol wipe to rub the site with when finished.

    There are some great videos on you*tube of people self injecting PIO I watched them and they helped me a lot, it seemed very scary at first, but it is a bit better self injecting since you know it is coming.

    Good Luck, you will be great :)

    H: 34 dx Azoospermia due to CBAVD from CF  
    ME: 39 IS FINE!!!  DOR and poor AMH/FSH/LH
    IVF/ICSI/PESA #1 Beta 1 373 Beta 2 1783 BOY/GIRL TWINS!! Born April 2010!!
    Natural FET 5/26/12 2 blasts Beta 1 207 Beta 2 513 Beta 3 1377 U/S 6/28 Pregnancy not viable d & c scheduled :( 
    IVF/ICSI/PESA #2 ER 11/15/12 Nothing to transfer :( 
    IVF/ICSI #3 April 2013 MDLF 3dt of 3 embryos, chemical :(  
    IVF #4/ICSI/MESA/CCS/FET EPP April 2015
    ODWU CCRM with Dr. Sch COMPLETE!!!! Put on acai supplement they are studying for DOR and embryo quality.
    DAY 3 Labs Drawn 2/26 put on vitamin D and calcium supplements
    Regroup and Protocol Reveal 3/04 "Bazooka Protocol" EPP with MDLF "Protocol 6 with patches"
    ER/MESA 4/10 ER 9 eggs retrieved MESA success found live swimmers :)
    Fertilization Report 6 eggs mature and ICSI'd 4 eggs fertilized normally
    Day 6 Report to Blast for CCS 4/16: 2 DAY 5 BLASTS BIOPSIED FOR CCS a 4AB and a 3AB!!!!
    CCS Results BOTH BLASTS CCS NORMAL!!!!!!  call on 4/24
    Regroup call to discuss CCS results and FET call on 5/20
    FET prep: CD 1 6/08 CD 3 Start BCP 6/10, HSG 6/12 Lupron Start 10 iu 6/17 End BCP 6/21 CD 1 6/23!!!
    Start vivelle patches 6/25 change e/o/d reduce Lupron to 5iu 6/25 Blood Draw 7/01, 7/08, 7/15, 7/19
    Increase vivelle patches 7/03 2 change e/o/d and 7/05 change e/o/d 3 and 7/07 4 change e/o/d add vaginal estrace 2x a day
    Lining Check/Blood Draw 7/08 and 7/15 End Lupron 7/18  Start PIO 1ml daily 7/18  Blood  Draw 7/19
    Flight to clinic 7/22
    FET 2 CCS BLASTS :):)  7/23 :):) YES YES both thawed and both fully expanded :):)
    7/26 :):) 3dp5dt PM very very faint positive FRER
    7/27: 4dp5dt Neg Digi AM but very very faint positive FRER PM POSITIVE DIGI CLEARBLUE PREGNANT 1-2 :):) 
    7/31:8dp5dt AM POSITIVE DIGI CLEARBLUE PREGNANT 2-3!!!! :):) 
    Beta 1 8/01= 408!!!!!!!!!! at 9dp5dt FET
    Beta 2 8/03 = 1014!!!!!!!!!! at 11dp5dt FET
    8/05/2015 AM POSITIVE DIGI CLEARBLUE PREGNANT 3+!!!! :):) 
    First Ultrasound: 8/20!!!!!! TWINS!!!!!!!!!!!!!!!!!  Genetics says BOTH BOYS!!!!!!!!!
    Second Ultrasound: 9/03!!!!!!!!!!










     










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  • I haven't had to give myself IM, but do you have to give it in the glut? I would think that giving in your thigh (vastus lateralis, like vaccines for babies) might be quite a bit easier for self injection. This muscle is quite large so pinpointing the injection site would be simpler, and you could do this sitting down.

    Two years, two losses and three IUIs...

    We are having TRIPLETS!

    EDD 1/26/16

     GGB born November 2015!


  • At this point, DH gave me the first shot the night of egg retrieval and then we had total fertilization failure followed by rescue ICSI.  That means no transfer this month and so we discontinued the PIO for now and will restart during our FET cycle next month.  The first one went super smoothly though with icing the injection spot, warming the oil, and rubbing it/walking around right after.  I'm not looking forward to doing that many days in a row but the first one was not as bad as I had anticipated.
    Clomid/IUI #1 Feb 2010- BFN
    Clomid/IUI #2 Mar 2010 - BFP April 2010 DD born Dec 2010 :-)
    Started TTC #2 Dec 2011 
    IUI #3-5 Aug thru Oct 2014 - BFN
    HSG revealed one blocked tube but was unblocked during procedure
    IUI #6 and 7 Nov/Dec 2014 - BFN
    IVF #1 Feb 2015 - 19 eggs retrieved, ZERO fertilized initially, 2 fertilized with rescue ICSI, then 2 more then following day, all 4 frozen
    FET #1 planned for mid-March

  • Sorry about the cancelled transfer. I did PIO for 8 cycles as well as a 12 week pregnancy. I've always found icing is the key. I can't give the shots myself, when my husband is out of town my RE has allowed me to use endometrin 3 times a day. I've not had a problem with progesterone levels doing this. Best of luck to you!

    image
    DOR and AMA
    2/12-5/12: 4 IUI cycles = all BFN;
    7/12: DE IVF # 1 (with ICSI)- 20R, 16M, 14F, 5DT of 2 blasts; 6 frosties = BFN;
    Lupus anticoagulant initially high, then found to be normal on hematology consult;
    Follow up testing in September all clear;
    Started synthroid for "high normal" TSH;
    FET # 1- late October 2012- BFP on FRER; beta # 1- 21(low), beta # 2- 48 (still low), beta # 3- 132, beta # 4- 1,293; beta # 5- 5,606; last beta- over 100,000. First u/s 11/21- heard heartbeat
    12/12- Officially an OB patient!
    Level 2 ultrasound at 20 weeks shows vasa previa and VCI
    Referral to MFM and mandatory c section for delivery
    Beautiful baby girl born at 34 weeks
    Finally home after 15 day NICU stay!
    Trying for sibling: FET # 2- May 2014; beta 5/31, BFN
    FET #3, early July 2014; beta 7/14, BFN
    DE IVF # 2- August 2014; 14R, 13M, 11F, 5dt of 2 blasts (3 AA), 5 frosties = BFN
    FET #4- December 2014, yet another BFN

    Dr. KK work up shows borderline uterine blood flow, elevated NK cells, and MTHFR mutation (homozygous for c677t)

    Added baby aspirin, prednisone, supplements, Metanx, and intralipids

    Switched to large clinic for final attempt; had endometrial receptivity testing in January; FET March 2015 = yet another BFN

    Likely OAD- NBC

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