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#1 TracyFlick

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Posted 08 June 2020 - 11:13 AM

Not sure if this is the right place for this... I'll be doing my first FET soon (was planning on April but we all now how that worked out, at least in Ontario). I've had two previous miscarriages. For us, IVF was about PGS testing to limit m/c risk.

 

My RE wants me to do the daily, oil progesterone shots. My OBGYN says the suppositories work almost as well. I don't mind getting shots in general (at this point, what is pain?!?) but my husband and I both find them extremely stressful to set up and administer, and for our second round of ER we had a wonderful nurse come over every day to do my shots. While it was a big spend, it relieved stress about a million percent (and I had a way better outcome, though I'm sure that was more about the increase in drugs).

 

However, with the pandemic, we can't have a nurse come over every day and I'm worried about the added stress of daily shots. I'm already super, super stressed out about Covid-19 risk, fear of m/c, don't trust my body, etc. so just looking to chill wherever possible. Has anyone else made the decision between shots and suppositories?


January 2017 TTC

March 2017 BFP

April 2017 m/c

July 2017 BFP

August 2017 m/c

Stopped TTC to investigate issue

January 2018 Cycle monitoring; two misdiagnoses regarding fertility issues

August 2018 Septate found / uterine septum removal

November 2018 IVF #1: seven eggs, six mature, six fertilized with ICSI, four embryos, two PGS-tested normal

July 2019 IVF #2: 21 eggs; 17 mature, 13 fertilized with ICSI, seven embryos, five PGS-tested normal

Sept. 2020 first FET with 4AA PGS-tested embryo; BFP; low rising numbers but excellent scans

June 2021 healthy baby girl via C-section <3.

Future: Considering trying again when permitted following C-section but might be one and done. Will donate embryos to research if any remain unused when we are done.


#2 Cotton

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Posted 08 June 2020 - 12:03 PM

Is there any chance doing them yourself would lower your stress? I found it easier than having my husband do it. I elected to do PIO because I'm a flake and I was worried about forgetting 3x a day dosing

 

Is a natural cycle FET an option? Those can have way less meds



#3 cj123

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Posted 08 June 2020 - 12:12 PM

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  


Me - 31  Hubby - 31

 

Trying to conceive since 2012

 

2013- Husband diagnosed with Congenital Absence of Vas Deferens caused by being a carrier for Cystic Fibrosis

 

2013 - decided to adopt before pursuing fertility treatments

 

November 2015 - Our beautiful baby boy is born!  We got to be there for the birth!  He's ours!

 

May 2016 - Adoption Finalized!!!

 

After a cancelled IVF cycle and an IVF cycle that completely failed for unknown reasons (22 eggs, 10 fertilized, zero on day five), we have moved onto donor embryos! 

 

August 2017 - We received three beautiful embryos from an amazing donor family!  

 

FET #1- One beautiful hatching 5 day blast transferred Oct 11/17 - BFP!!! beta #1- 92 (9dp5dt) beta #2- 297 (13dp5dt)

beta #3- 700 (16dp5dt) beta #4- 3500 (20dp5dt)  

Ultrasound Nov 7 (6w4d) - One little bean, heartbeat of 125 bpm!  Due June 29, 2018

June 19, 2018 It's a Boy!! 7 lbs 2 oz of perfection!

 

FET #2 - One day 6 Blast transferred Feb 26/2020 - BFN 

 

One final chance with one final embryo hopefully soon!  Go away Covid-19!

 


#4 TracyFlick

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Posted 08 June 2020 - 12:51 PM

Is there any chance doing them yourself would lower your stress? I found it easier than having my husband do it. I elected to do PIO because I'm a flake and I was worried about forgetting 3x a day dosing

 

Is a natural cycle FET an option? Those can have way less meds

I guess I am grouping his stress in with mine :) The stress is about doing any shots ourselves. We really struggled with the hormone injections, and these ones are intramuscular (if that's the right word) - the more difficult shots to administer.

 

I don't know what natural cycle FET is but I will look into it! I do want progesterone - anything to cut down on m/c risk - but not sure about the value of the shot vs. the suppository.


January 2017 TTC

March 2017 BFP

April 2017 m/c

July 2017 BFP

August 2017 m/c

Stopped TTC to investigate issue

January 2018 Cycle monitoring; two misdiagnoses regarding fertility issues

August 2018 Septate found / uterine septum removal

November 2018 IVF #1: seven eggs, six mature, six fertilized with ICSI, four embryos, two PGS-tested normal

July 2019 IVF #2: 21 eggs; 17 mature, 13 fertilized with ICSI, seven embryos, five PGS-tested normal

Sept. 2020 first FET with 4AA PGS-tested embryo; BFP; low rising numbers but excellent scans

June 2021 healthy baby girl via C-section <3.

Future: Considering trying again when permitted following C-section but might be one and done. Will donate embryos to research if any remain unused when we are done.


#5 TracyFlick

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Posted 08 June 2020 - 12:52 PM

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  

Me doing it would be as bad/worse than my husband doing it unfortunately! I will be asking my RE but my OBGYN told me that the shots are not necessarily any better.


January 2017 TTC

March 2017 BFP

April 2017 m/c

July 2017 BFP

August 2017 m/c

Stopped TTC to investigate issue

January 2018 Cycle monitoring; two misdiagnoses regarding fertility issues

August 2018 Septate found / uterine septum removal

November 2018 IVF #1: seven eggs, six mature, six fertilized with ICSI, four embryos, two PGS-tested normal

July 2019 IVF #2: 21 eggs; 17 mature, 13 fertilized with ICSI, seven embryos, five PGS-tested normal

Sept. 2020 first FET with 4AA PGS-tested embryo; BFP; low rising numbers but excellent scans

June 2021 healthy baby girl via C-section <3.

Future: Considering trying again when permitted following C-section but might be one and done. Will donate embryos to research if any remain unused when we are done.


#6 Cotton

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Posted 08 June 2020 - 02:11 PM

I heard Shoppers Drug mart will do injections for a fee.



#7 Cotton

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Posted 08 June 2020 - 02:42 PM

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  

It's funny how every clinic is different. A nurse asked me when I was gowned up for egg retrieval if I was doing a fresh or frozen transfer. I was like "WTF, why are you asking *me*?" lol

 

I think the main reason they steer people away from PIO is patient compliance. I asked for it and was on the verge of asking to switch because it left so many angry Charlie horses, but for some reason my body stopped having such a strong reaction after a few weeks.



#8 Cotton

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Posted 08 June 2020 - 02:46 PM

 

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  

Me doing it would be as bad/worse than my husband doing it unfortunately! I will be asking my RE but my OBGYN told me that the shots are not necessarily any better.

 

I think PIO is a little better because you're less likely to forget doses and I believe they can measure the drug levels vs. local progesterone acts locally and doesn't penetrate the blood enough for a blood test to accurately detect the local level. I think the first few weeks are the most critical, if you can manage the PIO until you get a strong beta that might be the best of both worlds.

 

There are studies showing either PIO is better or as good as local progesterone.



#9 Misskika007

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Posted 08 June 2020 - 04:25 PM

I understand the stress of doing the injections wrong, but there are some great guides/videos online to help out with the shots. Self-administering becomes easy as you go! That being said, I'm not sure how much a "choice" we have sometimes in the decision between PIO and suppositories, and I think the decision should be made with your doc based on what your progesterone levels look like, especially with reoccurring miscarriages. I have the same issue and my doc had me on both the shots and suppositories to minimize miscarriage risk. Good luck with your transfer!


Me: 36, Hub: 36

TTC 4 years

3rd IVF cycle, 3rd FET-  BFP,  due June 1 heart.gif

 


#10 TracyFlick

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Posted 08 June 2020 - 04:40 PM

 

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  

It's funny how every clinic is different. A nurse asked me when I was gowned up for egg retrieval if I was doing a fresh or frozen transfer. I was like "WTF, why are you asking *me*?" lol

 

I think the main reason they steer people away from PIO is patient compliance. I asked for it and was on the verge of asking to switch because it left so many angry Charlie horses, but for some reason my body stopped having such a strong reaction after a few weeks.

 

this is SO interesting; it's hard for me to believe that compliance would be an issue in IVF, considering the stakes and cost.


January 2017 TTC

March 2017 BFP

April 2017 m/c

July 2017 BFP

August 2017 m/c

Stopped TTC to investigate issue

January 2018 Cycle monitoring; two misdiagnoses regarding fertility issues

August 2018 Septate found / uterine septum removal

November 2018 IVF #1: seven eggs, six mature, six fertilized with ICSI, four embryos, two PGS-tested normal

July 2019 IVF #2: 21 eggs; 17 mature, 13 fertilized with ICSI, seven embryos, five PGS-tested normal

Sept. 2020 first FET with 4AA PGS-tested embryo; BFP; low rising numbers but excellent scans

June 2021 healthy baby girl via C-section <3.

Future: Considering trying again when permitted following C-section but might be one and done. Will donate embryos to research if any remain unused when we are done.


#11 TracyFlick

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Posted 08 June 2020 - 04:42 PM

 

 

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  

Me doing it would be as bad/worse than my husband doing it unfortunately! I will be asking my RE but my OBGYN told me that the shots are not necessarily any better.

 

I think PIO is a little better because you're less likely to forget doses and I believe they can measure the drug levels vs. local progesterone acts locally and doesn't penetrate the blood enough for a blood test to accurately detect the local level. I think the first few weeks are the most critical, if you can manage the PIO until you get a strong beta that might be the best of both worlds.

 

There are studies showing either PIO is better or as good as local progesterone.

 

I would never forget a dose... Is it useful to know the levels of progesterone? As in, useful toward a successful pregnancy (like, if they're low they give you more of it?) Maybe this is obvious, sorry! Never done a transfer before.


January 2017 TTC

March 2017 BFP

April 2017 m/c

July 2017 BFP

August 2017 m/c

Stopped TTC to investigate issue

January 2018 Cycle monitoring; two misdiagnoses regarding fertility issues

August 2018 Septate found / uterine septum removal

November 2018 IVF #1: seven eggs, six mature, six fertilized with ICSI, four embryos, two PGS-tested normal

July 2019 IVF #2: 21 eggs; 17 mature, 13 fertilized with ICSI, seven embryos, five PGS-tested normal

Sept. 2020 first FET with 4AA PGS-tested embryo; BFP; low rising numbers but excellent scans

June 2021 healthy baby girl via C-section <3.

Future: Considering trying again when permitted following C-section but might be one and done. Will donate embryos to research if any remain unused when we are done.


#12 TracyFlick

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Posted 08 June 2020 - 04:43 PM

I understand the stress of doing the injections wrong, but there are some great guides/videos online to help out with the shots. Self-administering becomes easy as you go! That being said, I'm not sure how much a "choice" we have sometimes in the decision between PIO and suppositories, and I think the decision should be made with your doc based on what your progesterone levels look like, especially with reoccurring miscarriages. I have the same issue and my doc had me on both the shots and suppositories to minimize miscarriage risk. Good luck with your transfer!

I definitely have watched the videos; it's funny, every time I mentioned not wanting to do the shots people recommended the videos, but I had the videos memorized and it wasn't any less stressful. For me/us it was more that some shots were easy, others KILLED, it was difficult to break up the air bubbles, the pens were a little finicky, stuff like that. That's a great point about it not being a choice at all, really. I think I'm just trying to get out of the shots :) Thank you!


January 2017 TTC

March 2017 BFP

April 2017 m/c

July 2017 BFP

August 2017 m/c

Stopped TTC to investigate issue

January 2018 Cycle monitoring; two misdiagnoses regarding fertility issues

August 2018 Septate found / uterine septum removal

November 2018 IVF #1: seven eggs, six mature, six fertilized with ICSI, four embryos, two PGS-tested normal

July 2019 IVF #2: 21 eggs; 17 mature, 13 fertilized with ICSI, seven embryos, five PGS-tested normal

Sept. 2020 first FET with 4AA PGS-tested embryo; BFP; low rising numbers but excellent scans

June 2021 healthy baby girl via C-section <3.

Future: Considering trying again when permitted following C-section but might be one and done. Will donate embryos to research if any remain unused when we are done.


#13 Cotton

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Posted 08 June 2020 - 06:20 PM

 

 

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  

It's funny how every clinic is different. A nurse asked me when I was gowned up for egg retrieval if I was doing a fresh or frozen transfer. I was like "WTF, why are you asking *me*?" lol

 

I think the main reason they steer people away from PIO is patient compliance. I asked for it and was on the verge of asking to switch because it left so many angry Charlie horses, but for some reason my body stopped having such a strong reaction after a few weeks.

 

this is SO interesting; it's hard for me to believe that compliance would be an issue in IVF, considering the stakes and cost.

 

I forgot a ton of estrace because it was 3x a day and I was trying to time it around meals, and I had a then-2-year-old running around. Very uncompliant. lol I knew the PIO played to my strength (not being scared of needles) and the suppositories played to my weaknessess (3x a day dosing, plus I get yeast infections a couple times a year and I read suppositories can do that). A different patient might have the reversed situation, so you don't want to talk someone into PIO who is reluctant (unless they reall need it)

 

I'm 99% sure I never forgot a PIO injection because it was such an "event".



#14 Cotton

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Posted 08 June 2020 - 06:22 PM

 

 

 

My clinic only offers PIO to people that need it added on top of the suppositories.  The suppositories are so gross and do require multiple day dosing.  I would also encourage you to learn to administer it yourself.  And if you want to explore suppositories as well, ask your dr about it.  They are the experts and there needs to be a reason they pick one over the other.  

Me doing it would be as bad/worse than my husband doing it unfortunately! I will be asking my RE but my OBGYN told me that the shots are not necessarily any better.

 

I think PIO is a little better because you're less likely to forget doses and I believe they can measure the drug levels vs. local progesterone acts locally and doesn't penetrate the blood enough for a blood test to accurately detect the local level. I think the first few weeks are the most critical, if you can manage the PIO until you get a strong beta that might be the best of both worlds.

 

There are studies showing either PIO is better or as good as local progesterone.

 

I would never forget a dose... Is it useful to know the levels of progesterone? As in, useful toward a successful pregnancy (like, if they're low they give you more of it?) Maybe this is obvious, sorry! Never done a transfer before.

 

yes, exactly, if it is too low they will give you more