5 Tips for Progesterone-in-oil Shots and Estrogen Patches

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I wanted to share (and document) some of the things I’ve learned during my FET.  The requirements are already so much less than going through IVF, but I’ve found some things that have helped make this routine a little easier.

First, the progesterone shots- they are, shall we say, unpleasant.  But, honestly, it hasn’t been as bad as I had feared after my brief stint of doing them when we thought we might go through with the fresh transfer.  Things have been much more calm this time around and a big part of that is that my husband has been here to give me the shots.  I had to do several on my own before, and it was rough.  Not impossible, but for me, it works better when he’s here!

5 Tips for Progesterone Shots:

  1. Ask your nurse to circle the appropriate area on each side so you know where your target is.  Nerve damage is a serious risk if you stray from the correct zone.  You can redraw the lines when they fade, but my husband hasn’t needed to as he can see the little pinpoints of his past injections to know he’s in the right area.
  2. Get a small ice pack and apply it for a few minutes before.  I’ve read some things that say not to do this as it might cause the muscle to tighten, but my nurse suggested it and I find that the ice and the heat in the next steps compliment each other well.
  3. Heat the oil in the bottle before you draw it into the syringe.  Heating the oil helps to thin it, which helps it go in more easily and move through your muscle tissue where the progesterone can be absorbed.  We have a shoulder/neck heating pad that we microwave for 1.5 minutes then nestle the bottle in while I’m icing and while my husband gets the needles, alcohol wipe, and band-aid ready.
  4. During the injection, I like to have something to distract myself, whether it’s music or a TV show or something.  Right before he does the injection I try to take a few deep breaths (which is tricky laying on your belly!), and relax all of my muscles as much as I can.  Then while he does the injection, I count to myself until the needle comes out.  He started at about 30 seconds, now it’s down to 20 and even faster a couple of times!  It helps my mind stay busy and my body relaxed until it’s over.
  5. Then heat, move, and massage!  As soon as the band-aid goes on he places the already warmed heating pad over the area and I takeover holding it on while moving my leg around to exercise the muscle a little to help the oil move around.  Then after he’s cleaned up the equipment he takes over doing a little massage.  The deeper massage is actually good even right after the shot because for me it actually doesn’t hurt until the next day, doing more massaging right after and again the next morning has worked really well.  We alternate sides each night and I make sure both sides get some massage action at least once a day.  Usually the soreness is mostly gone before the next shot on each side.  It’s still not great, but if by some chance our FET did work and we do have to do this for several more weeks, I think I can handle it, which is saying a lot!  I was really dreading the start of these shots!

On to the estrogen patches.  These are much easier than most anything else on our menu in the IVF/FET world, but they too have their own quirks.  I am using the Vivelle dot patches.

5 Tips for the Estrogen Patches:

  1. Make your schedule and set reminders or alarms to remember it.  Since these only get switched twice a week and one time is the morning while the next is at night it can be trickier to remember than something you do every day at the same time.  I’ve had a close call sleeping in a little too much on my Sunday morning 9am change.  Luckily I woke up just in time and went straight into patch change mode!
  2. Know where you are going to put it before you open it.  I have settled on a pretty good system where I go from low to high.  I use 2 patches so one goes on each side of my belly button and I have divided the area below my belly button into 3 zones: low, middle, and high (just below the belly button).  The idea is that on each patch change you want to keep spot where you just removed the patch free for a week.  So, for example, if I place 2 patches low on Sunday morning, I’ll put them just above, in the middle zone, the next Wednesday night.  Then the following Sunday I’ll put them in the high zone, then start over again the next Wednesday back in low.  I’ll also alternate going a little closer or farther left ant right from the midline every time through.  It’s really simple and I know I’m not overlapping with a recently patched area.  *note that if you are going to be wearing a bikini or something else low cut you might want to plan in advance to put your patches in the low zone that time!  Always think ahead!
  3. This may sound silly, but when opening the patch make sure which side peels off!  These patches are basically clear and very thin and so are the peel off bits so it can be hard to tell which side peels off and which side is the patch.  I spent at least a minute or two trying to force the non-peel side to come off and I ended up stretching out the patch a little.  It wasn’t a huge problem, I was not thinking straight and just didn’t stop to think that maybe it was the wrong side until I’d caused some deformation!  Just carefully bend it a little until you see the edges of the peel off part starting to come up, then slide your nail in there and it will come right off.  No need to force it!  I usually stick that side on and then peel the other side off while carefully smoothing it into place, then hold my palm over it for 10 seconds.
  4. Think about your waistbands.  Tight waistbands and heavy waistbands can pull at the edges and cause some of the stickiness to shift to the outside and the edge to not stick as well.  I haven’t had any major problems with this, but one time kind of made me nervous.  I had just put on fresh patches, in the low zone that I figured was the safest from waistbands, threw on my most comfortable jeans and was feeling good.  Somehow though, when I was sitting, the inside bottom edge of the waistband put enough pressure on the top edge of the patch to make it start to peel loose.  Since they were new patches and I still had another 3 days to go before I’d be changing them I was a little concerned, but they stayed on like champs.  I’ve tried to be more careful since though.
  5. You will have a patch shaped outline of sticky stuff with clothes fuzz stuck to it each time you take off your patches.  Sometimes they will be darker and thicker than other times depending on what you wear!  I’m sure there are other options out there, but I usually just sit quietly with a little bowl of olive oil and rub this on the outline and use my fingernails a little to scrape it off.  I find it’s best to just gently rub the oil around for a few minutes before using my nail, but I’m not always patient enough!  Which means I scrape a little more than I probably would if I had waited… but either way, I get those little patch windows off!

*One more thing for the patches, it usually is less painful to pull them off from the outside corner/edge toward the midline of your body, not the other way around!

I hope these are helpful to someone out there (or at least for me when we go through this again)!  I am looking at just 2 more nights of definite shots before we get our blood test and find out if any of this has done the trick!

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8 Comments

  1. I would add that a bit of light yoga, i.e. acouple of sun salutations, and some light hand weights while standing really help for the PIO. By week three, I was a hurting unit. Very sore. The yoga and weights cleared that up in a matter of days.

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  2. Pingback: Back in Acupuncture, Meditation & Estrogen Patches | seaofinfertility

  3. Pingback: PIO Shots, Oh How I Hate Thee… | seaofinfertility

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