Sunday, March 6, 2011

Royal Oil: Progesterone in Oil Shots (as administered by Husband)

You might think from all the shots that I've had to give myself during the IVF process (click here and here and here), that no new shot would phase me. Such is not the case: I was actually super terrified of the fourth and final shot of the IVF process.

Subcutaneous needle (top) and intramuscular needle (bottom).
 The progesterone in oil shot is different from other shots for two major reasons. First, rather than an subcutaneous needle, it requires an intramuscular needle. And second, because the shot has to go in my back, I couldn't administer it myself...meaning I had to trust Husband to give me the shot.

I love Husband. Obviously. And I really do trust him, in every single regard. But truthfully Husband has not handled this whole medical situation very well. He had a panic attack at the doctor's office when we found out about the miscarriage. And another in the middle of my HSG procedure.

Despite him having the very best of intentions, I just couldn't shake the mental image of him sticking me with the needle, promptly passing out, and then me having to retrieve a 1.5 inch needle from my own backside before driving him to the hospital.

It wasn't a pretty picture, readers.

Husband assured me that he could get through it and to show him that the shots aren't that painful, he watched me inject some Follistim when we first started the IVF cycle. I purposely neglected to tell him that the shot for which he was responsible involved a needle three times the size of the Follistim needle.

Before the first shot, I did a ton of research online, looking for tips on how to make the shot less painful or reduce the likelihood of bruising. My search did not yield very successful results: most women offered some tips, but still stating that they had bruising and welts all across their backsides. This did nothing to ease my mind.

Luckily the nurse at my retrieval had asked if I wanted her to draw circles where the shot needed to be administered. Brilliant! I agreed right away and when the circles started to fade, we redrew them. Walking around with two huge Sharpie circles on my backside was no small consolation for Husband knowing exactly where to give me my progesterone in oil shot.

On the first day, I used ice to numb the spot. Afterwards I ended up finding it unnecessary, but for anyone else going through these shots, this will help you relax. I climb onto our bed and lean all my weight to the side opposite where I'm getting the shot: we alternate sides and Husband moves around within the circle so that one spot doesn't get too tender.

When Husband pulls the needle out, he immediately takes a wet warm washcloth and massages the area with it. This supposedly helps disperse the medication throughout the body without allowing it to get all clogged up in one area. On the package, it recommends activity following the shot, but that's not been possible since I was on bed rest during this time. I didn't find that the lack of movement led to any significant discomfort; however, the one day that we didn't use the warm towel (we were traveling and had to do the shot at a friend's house), I definitely felt more discomfort than most days.

I joked that my doctor will want to hang Husband's picture on the wall of his office as a Super Star Progesterone in Oil injector since after ten days of injections, I don't have a single welt or bruise.

Unfortunately I did have some side effects with the progesterone in oil, some seriously uncomfortable side effects. The worst being constipation. Husband being the stickler for rules that he is, he refused to allow me to take any medication until we contacted the after hours doctor on call. Thankfully the doctor called right back and gave us a list of "more natural" remedies, including warm prune juice.

I've never had prune juice before but figured it can't be all that bad. After all, there's a recurring storyline on Star Trek: The Next Generation involving prune juice. Worf loves prune juice! It's the only Earth drink that he allows Guinan to serve him! Prune juice! If you had to pick one drink that you enjoyed above all others, wouldn't it have to be a pretty nice tasting drink?


Prune juice is awful. Warm prune juice is even worse.

I finally came to the conclusion that Worf must like prune juice because he considers himself a warrior. And to be a proper warrior, one must deal with horrible, terrible, unthinkable prune juice. I swear he must drink it as part of a pain regime designed to strengthen and/or deaden his taste buds.

After choking down two full glasses of warm prune juice, I waved the white flag. The doctor had listed out a few other safe remedies that I could use, including Colace and Miralax. Once Husband saw my prune juice-related misery, he ventured out to the store to get a few of the recommended real and thankfully tasteless medications.

Progesterone injections are really important during the IVF cycle: so much so that after a week, my doctor increased my dose from 1 cc to 1.5 cc. For some reason my body doesn't generate enough progesterone on its own so I'll likely have to continue the shots well past the pregnancy test, which is scheduled for two weeks following the retrieval (assuming it's positive, that is).

I'm so glad that Husband has managed to be such a great shot giver. It turns out that when I really need him, as expected, he rises to the challenge!

Again, I'd emphasize that, like most of the IVF process, the anticipation of the progesterone in oil shots is much worse than the actual shots. Surprisingly, I don't even find that they hurt much beyond a small prick when Husband first puntures my skin. I mentioned to the nurse at my embryo transfer that I should be thankful for my "extra padding", but she says that when someone is super thin, they use a shorter needle so these shots will be relatively pain free for most everyone! Good to know!

We started the progesterone in oil shots the night after my retrieval and then two days later, I went in for the final stage of IVF: the embryo transfer. Check back on Tuesday to read about that!


  1. lol...i feel bad always laughing at your posts, but i just can't get over all your star trek allusions.

    congrats to the hubby for his bravery (oh, yeah, and your bravery too :) )

  2. oh my gosh....that picture of the needles made me nauseous. Way to go, Husband, with his awesome needling skills - if he ever decides to quit his job, he could always go work at the Red Cross!

  3. Holy cow.....Im with Ashley, I about passed out looking at BOTH needles...yikes...hang in there hunnie...its for the best cause ever:)

  4. i love how you find humor throughout this ordeal--hang in there, kathleen!

    one more tip for hubs--try practicing on an orange! my husband was quite reticent about IM injections and he tended to use a slow poke rather then a quick jab (which was less painful for me, but he felt bad 'stabbing' me!)

    we drew a circle on the orange and he practiced over and over stabbing that--made him less nervous and a better injector! :)

    best of luck! like the other poster mentioned--it'll all be worth it in the end!

  5. Two medical comments:
    (1) when it comes to precision needlecraft, it helps if both needler and needlee are as much at ease as possible -- so try to allow as much space as possible for the needler to faint on the bed if that's what the needler needs to do;
    (2) if you are talking about constipation, then there is a very high likelihood that you are magnesium deficient -- so either add all your favorite high-magnesium foods (guacamole, apples, broccoli) or OTC tabs; Mg also is anti-anxiety, anti-irritability, muscle-relaxant, calms aberrant heart beats, stabilizes blood pressure, etc, etc [hmm, perhaps both needlee and needler could use this guidance].

  6. Suz - LOL I'm glad you enjoy the Star Trek allusions. I figure I'll go insane if I don't try to stay positive and find humor in all of this!

    Ashley - Yeah the needles really do look terrifying. And it's even worse when you have to turn your back to it and just wait to get stabbed! Eek!

    Collette - I felt the same way before all this started. I hated getting shots or having blood drawn, but after the last six months, I'm like, "Eh whatever!" I guess that's some unexpected good to come from this! LOL

    Anon - Good tip! There was actually a class for the shots that we missed and I'm pretty sure they had Husband's practice on oranges. Supposedly it's about the same consistency as the skin so it's a good way to get a feel for it! I asked Husband if he wanted to try that but he much preferred to just get straight to stabbing me!

    rp - Great tips. Thanks! And LOL about the shot giver fainting on the bed. He's been such a trooper through this: I'm so proud! :)

  7. I realize this post is very old, but google just brought me to it. I laughed right through your post, completely relating to it in all aspects. Thanks for allowing your post to still be google-searhable. It gave me comic relief, now if only it would give me relief from the progesterone in oil constipation! (1st time IVF, transfer tomorrow).