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Writer's pictureKimberly Schamroth, RN

Progesterone in Oil: Making Shots Less Painful

Whether it's your first time or you are a seasoned pro, the progesterone in oil (PIO) shot is often one of the most dreaded parts of the IVF process. But don't worry- you've got this! And if you are feeling a bit anxious, our Patient Empowerment Coaches (PECs) are here to help.


Why does the PIO shot get such a bad reputation?

  • Big Needle: The PIO shot uses the largest needle among all IVF injections

  • Thick Medication: The oil-based medication is thick, so it takes longer to inject

  • Intramuscular Injection: PIO shots are injected into the muscle of your buttocks, rather than the fatty tissue, making it more painful.


Quick Tips to Make the Process Earlier:
Warm Up the Vial
  • Pro-Tip: You can rub the vial between your hands. The friction creates the right amount of heat to thin the medication, making it a little easier to inject.

  • Warning: Don't use a microwave or submerge the vial in warm water as this could affect the medication's effectiveness.


Have an Injection Buddy
  • Having a partner or friend to administer the shot can be a huge help. It's challenging enough to give yourself an injection, especially from behind. An injection buddy can ensure you hit the right spot.

  • You can also look to see if there are local services or nurses that will help you administer shots. If you need help finding someone qualified and can trust, our Patient Empowerment Coaches can help you find someone local!


Confirm the Spot
  • Injecting into the wrong area is far from ideal- PIO must be injected into the muscle of the buttocks for maximum absorption. To find the right spot, place your hands on your buttocks and feel where the back pocket of your jeans would be. The ideal injection location is where the upper outer corner of the pocket would be.


PIO shot injection location
Grain Fertility partner 412 Fertility made this graphic to help identify the perfect spot for your PIO shot

Still need help? Talk to your nurse in person or schedule a call with a Patient Empowerment Coach who can help show you exactly where to inject.


Relax- Don't Flex Your Buns
  • Laying down on your stomach helps ensure your glutes aren't flexing. Staying relaxed will make the shot less painful. Remember to breathe in and breathe out.


Apply Warmth at the Injection Site
  • After injecting, use a warm compress can help the oil absorb better. Simply soak a washcloth in warm water and place it on the injection site.


Massage the Injection Site
  • Massaging the injection site for a few minutes afterward will help break up the oil and increase absorption into the muscle.


Alternate Sides
  • Switching which glute you inject each time helps reduce the risk of swelling and soreness.


Additional Resources to Help!

Registered nurse, fertility patient, and founder of 412 Fertility, Megan Kukic, wrote another blog post with tips, tricks, and techniques to help make shot administration a little easier. You can read the post here.


We also know shot administration can be overwhelming and are proud to partner with MyVitro, a medication organizer for IVF and other fertility treatments. You can go to their site and get $10 off your order with the promo code Grain to help organize your shots and make them a little less overwhelming.


Finally, our Patient Empowerment Coaches are here to help with any questions you may have. New Premium Members get a 30 minute call with our Head of Patient Empowerment, Kimberly Schamroth, RN, to better understand your journey. You can sign up for an account today at https://app.grainfertility.com/signup.


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