Progesterone for FET

I know I've asked about this before, but now that I might be starting my progesterone in a few days (if everything goes ok at my ultrasound) I have a decision to make. PIO or suppositories. The standard protocol for FET's at my clinic is PIO. But this wasn't the case a few years ago when I did my fresh cycle. I did suppositories with my cycle, and my friend did suppositories with her FET. The head of the clinic left and I'm wondering if this new approach is the opinion of the new head of department. (I really trusted and respected the old one, so if his view is still suppositories, that's what I would go with. But there's no way of knowing now).

I would prefer suppositories, and I can get them if I request them. But knowing that it's not the recommended protocol makes me feel guilty, like I'm not giving it the best shot at working. And if I end up pregnant and then miscarrying I'll feel like it will be my fault.

I'll likely have to give them to myself. And the nurses keep warning me that will be difficult. So I just took the shots out now to look at them. And they are bigger, fatter, and scarier then expected. I also poked my thumb trying to get the cap back on, and even that hurt and bled!

The research I'm reading is going both ways. I read something that says PIO is definitely the way to go, and then I see something else that says suppositories are just as good. So if you had a FET, what was the recommended progesterone protocol? Maybe what I learn here will help me decide.

 

I used the PIO at first and then they switched me to the oral. The oral made me feel drunk so they told me I could use the capsules as suppositories I tried that once but seemed to loose so much of it that I decided to deal with feeling drunk. I took them before bed and then woke up at like 4:30 and took the next dose so that I would sleep through the feeling drunk.

 

The great thing about IVF and FET is that it is constantly evolving and new research is always coming out on ways to improve the cycles, etc. When I did my first IVF and the two subsequent FET's, I used suppositories. When I did my 2nd fresh IVF, resulting in the boys, I did suppositories as well. A year later when I did an FET, I did the PIO shots. And was scared like crazy! That's because I read alllll about them and how much they hurt from everyone else! :laughing: To be honest-they were not that bad at all. As long as I massaged the area before and after-no problem. And I asked why not the suppositories. My doctor/nurse informed me that there was a greater success rate they found with the PIO with FET's vs suppositories.

So, to me-it couldn't hurt. And it could be the thing needed to switch things up, kwim? Good luck with whatever you decide!

 

From my experience with progesterone deficiency, PIO is used for the most extreme cases. Suppositories are preferred for most and orals are recommended least (because the liver tends to break it down too much before it reaches the necessary beneficial level). I've only used suppositories of compounded natural progesterone. I haven't done the PIO...and the idea scares me, too.

 

I'm supposed to go in for my FET transfer Tuesday, and they have me on suppositories and PIO. For my fresh IVF a couple of years ago, I was on the PIO only. It's not fun, but it's probably not as bad as you might imagine or have read. However, I don't know if I would be able to give them to myself. I do better if I focus on breathing and not tensing up and then massaging it like crazy afterwards. Good luck!

 

I used PIO for both my fresh cycle and my FET cycle. The thing with FETs is that you won't be producing any progesterone at all on your own (assuming you are doing the typical protocol with estrogen and ovulation suppression followed by progesterone). But protocol does just seem to vary by clinic/doctor. A friend of mine did a FET last year and did suppositories but my clinic just used PIO for everything.

I never had any problems with my PIO shots, but I also had a husband who was very good at giving them. I think I could have done them myself, but wouldn't have wanted to (there are videos online showing how to do it yourself).

I always requested 18-gauge needles to DRAW up the progesterone from the bottle (makes it faster), then you switch it out for the 22-gauge needle for the shot. This way the needle isn't dulled by drawing up the progesterone and it stays nice and sharp and goes in easily. The syringes should come with a removable needle so you can swap them out (mine came with the 22-gauge attached and my husband would just take it off, put on the 18-gauge, draw up the PIO, remove the 18-gauge and put the 22-gauge back on). It sounds complicated but is actually very easy to do.