Shooting Up: Tips for Self-injection of PIO

In honor of what may be my last night of PIO shots (if the pregnancy test is negative), I’m setting this to be posted the day before my beta. This is adapted from what I wrote to Emmie when she was worried about having to do one of her progesterone in oil shots by herself while travelling. I have done all my own injections (with the exception of the HCG trigger shot) for the three ivf cycles, including the intramuscular PIO shots.

Rather than tips, I would describe this as mostly things I have learned from mistakes I have made. My RE assured me that my progesterone levels were fine, although my two previous ivfs were unsuccessful, so I apparently did not bungle the injections too badly. Unless he was just being nice.

The main thing is that it is eminently possible to give yourself the shots.

However, if you only have to do it once, like Emmie, I’d suggest doing it yourself at least once when you have some moral support at home before you are all alone. Unless you are much calmer and less likely to get anxious about things going wrong than I am.

Things I have learned:

Most important: use the right needles. My clinic prescribed two needles: one for drawing up the progesterone in oil (18 gauge) and a thinner one (22 gauge) for the injection. This meant I had to take the 22G needle off the syringe, put on the 18G needle to draw up the PIO, then switch back to the 22G needle. I was happy to learn that I am not the only person who has used the wrong needle at least once (not that I wish anybody pain, but I felt less ditzy). It hurts a lot more with the bigger needle.

Other things:

Looking in a mirror might help locate the right place to inject, but it does not help me much when I try to use the mirror to help me keep the needle itself in place (ie. perpendicular to skin); in fact it made it worse.

Some of the PIO instructions I found talked about pulling up on the syringe a little to make sure no blood came in to the needle, which would indicate you need to find a better site. I found this impossible to do while trying to inject myself, and my clinic never mentioned it so I ignore it. It might work for you if you are more limber than I.

One of the instruction sheets I found also said to stretch the skin, something else I found impossible to do while injecting myself.

Have a gauze pad or alcohol pad on hand in case it bleeds when you take the needle out, or else can be messy. Personally, I freak out much less at the sight of some blood on a gauze pad than at the sight of blood streaming down the back of my leg onto the floor.

I have been advised to put my weight on the opposite leg. Seems to help.

My experience, at least this time, has been that the needle pricks when it breaks the skin, but getting the one and half inches of needle into the muscle doesn’t hurt. I don’t know why, but it is a little hard to get the needle out of the skin.

My clinic strongly advises not using ice on the skin, but hot compresses instead, and also suggests kneading the injection site after the injection. When travelling, I have used washclothes rinsed in very hot water, or taken a hot shower, or both. It seems to have worked for me. I haven’t have trouble with pain or knots in the injection site. I don’t know if that was luck, or because my dose was low, or if the problems people have come when they have to do the injections for longer, when they actually get pregnant.

Good luck.

UPDATE: here