Let’s get started.<\/p>\n\n\n\n
![\"progesterone](\"https:\/\/alexroblesmd.com\/wp-content\/uploads\/2021\/11\/progesterone-shots-in-ivf-cover-image-of-a-needle.png\")
<\/figure><\/div>\n\n\n\n\n\nWhat are progesterone shots for in IVF?<\/h2>\n\n\n\n
Progesterone shots help your body prepare for embryo implantation and sustain the growth of an early pregnancy.<\/a><\/p>\n\n\n\n Progesterone is a hormone secreted by the corpus luteum. This structure forms in your ovary ONLY AFTER you ovulate.<\/p>\n\n\n\n As such, progesterone supplementation is necessary if you are doing an embryo transfer<\/a> cycle in which you do not ovulate. This is the case if you choose to do a medicated<\/strong> frozen embryo transfer (FET) cycle rather than a natural FET cycle.<\/p>\n\n\n\n Without ovulation (and hence progesterone), an embryo wouldn’t be able to attach to the lining of the uterus and continue growing after implantation.<\/p>\n\n\n\n In general, only patients who undergo an IVF cycle, freeze their embryos<\/a> and subsequently undergo a frozen embryo transfer need to take progesterone.<\/p>\n\n\n\n In both the natural cycle and a fresh embryo transfer, you “ovulate”, and thus, produce natural progesterone. As a result, you don’t need an intramuscular progesterone injection.<\/p>\n\n\n\n Unfortunately, progesterone injections hurt more than the standard IVF stimulation medications.<\/p>\n\n\n\n Progesterone is an intramuscular injection, meaning that the needle is bigger, and injected deeper than subcutaneous injections.<\/p>\n\n\n\n As a result, it can be more painful<\/a> than the other IVF medications.<\/p>\n\n\n\n The most common side effects of progesterone injections are related to your injection site.<\/a><\/p>\n\n\n\n These side effects include:<\/p>\n\n\n\n Rarely, some patients will have an allergic reaction to the oil in the progesterone formulation.<\/p>\n\n\n\n If you develop an allergic reaction, your doctor can have the pharmacy change the oil that the progesterone is made in (usually from sesame oil to olive oil).<\/p>\n\n\n\n Progesterone injections work fairly quickly, usually reaching peak plasma concentration in about 8 hours and lasting up to 24 hours<\/a>.<\/p>\n\n\n\n As such, the injections are administered daily (every 24 hours).<\/p>\n\n\n\n The progesterone injection is intramuscular, meaning it needs to be injected in a location with a large muscle group.<\/p>\n\n\n\n The most common area used is the upper outer quadrant of the buttock.<\/p>\n\n\n\n Another location is the outer side of the upper thigh, the vastus lateralis muscle.<\/p>\n\n\n\n Your preference determines the choice of the injection site. You may find it more comfortable to use one location over the other.<\/p>\n\n\n\n There are two strategies for dealing with pain from progesterone injections.<\/p>\n\n\n\n The first is to use an ice pack on the injection site before and right after the injection. This often reduces the local inflammation, which sometimes helps with decreasing pain and discomfort.<\/p>\n\n\n\n The second strategy is to massage the area around the injection site after the cold pack. This enhances local blood flow and may also reduce some of the pain. A heating pad can also have the same effect.<\/p>\n\n\n\n If none of this helps, you can also apply a topical numbing cream to the injection site before cleaning it with alcohol.<\/p>\n\n\n\n Another great tip for reducing discomfort from the injection is to rotate your injection sites (meaning you switch locations each time).<\/p>\n\n\n\n Most patients find it easy to inject in the right gluteal muscle one day, then the left glute the next day.<\/p>\n\n\n\n This will help avoid inflammation build-up in one area.<\/p>\n\n\n\n Another option is to recruit someone to help you with your injections.<\/p>\n\n\n\n For example, you can have your partner or someone you trust to administer the injection. This way, you can focus on relaxing instead of being anxious about the pain while giving yourself an injection.<\/p>\n\n\n\n Before you administer the injection, make sure you clean the site with alcohol. However, do not proceed with the injection right away.<\/p>\n\n\n\n Let the alcohol dry first.<\/p>\n\n\n\n This may reduce some of the stinging that is associated with the shot.<\/p>\n\n\n\n A new study of over 1000 medicated FET cycles published in 2021<\/a> compared the use of:<\/p>\n\n\n\n They found no significant difference in live birth rates between the group that used IM progesterone alone and the group that alternated vaginal and IM progesterone.<\/p>\n\n\n\n Speak with your doctor to see if you are a candidate for this protocol so that you can use fewer injections and potentially have fewer side effects.<\/p>\n\n\n\n Another recent study also looked at the use of a vaginal gel and saw promising results.<\/a><\/p>\n\n\n\n What if you don’t have someone to help you with the injection? Here is a step-by-step process of how you can self-administer a progesterone injection.<\/p>\n\n\n\n Progesterone injections are usually given daily for up to 10 weeks of pregnancy (about 8 weeks post embryo transfer).<\/p>\n\n\n\n At ~8 weeks of pregnancy, the placenta takes over the function of progesterone production.<\/p>\n\n\n\n In theory, progesterone shots can stop at that time. Still, most fertility specialists prefer to overlap additional progesterone with your endogenous progesterone.<\/p>\n\n\n\n Do not discontinue your progesterone support until your doctor has confirmed that you no longer need it!<\/p>\n\n\n\n If you stop your progesterone too early, you may be at risk of having a miscarriage. This is particularly true if you had a medicated frozen embryo transfer.<\/a><\/p>\n\n\n\n Always be sure to speak with your doctor before you stop taking your daily injections of progesterone.<\/p>\n\n\n\n By 10 weeks of pregnancy, the placenta has taken over the job of progesterone production.<\/p>\n\n\n\n This is known as the luteal placental shift.<\/p>\n\n\n\n Most fertility specialists will have you stop your progesterone supplementation at this time, especially if your progesterone levels are adequate on blood tests.<\/p>\n\n\n\n I go over this in more detail in my post on when to stop estrogen and progesterone.<\/a><\/p>\n\n\n\n Progesterone in oil injections are necessary for patients undergoing fertility treatment with a medicated FET cycle.<\/p>\n\n\n\n The progesterone shot may be given daily for up to 10 weeks of pregnancy (which is about 8 weeks post embryo transfer).<\/p>\n\n\n\n If you underwent a natural frozen embryo transfer cycle, your doctor will likely recommend a different form of progesterone for luteal support.<\/p>\n\n\n\n As always, it is essential to follow the instructions from your fertility specialist regarding how long this treatment should last.<\/p>\n\n\n\n Related Articles:<\/strong><\/p>\n\n\n\n Make An Appointment With Dr. Robles To Discuss Your Fertility Options Today!<\/strong><\/strong><\/p>\n\n\n\nDo all IVF patients take progesterone?<\/h2>\n\n\n\n
Do IVF progesterone shots hurt?<\/h2>\n\n\n\n
![\"picture](\"https:\/\/alexroblesmd.com\/wp-content\/uploads\/2021\/10\/ART.png\")
<\/figure><\/div>\n\n\n\nWhat are the side effects of progesterone injections?<\/h2>\n\n\n\n
How quickly do progesterone injections work?<\/h2>\n\n\n\n
In what location should you administer your progesterone shots?<\/h2>\n\n\n\n
What should you do if you have pain with the progesterone injections?<\/h2>\n\n\n\n
Other tips for administering your progesterone shots<\/h2>\n\n\n\n
Rotate the sites<\/h3>\n\n\n\n
Get some help<\/h3>\n\n\n\n
Let the alcohol dry<\/h3>\n\n\n\n
Talk to your doctor about this study<\/h3>\n\n\n\n
How to give progesterone injections to yourself<\/h2>\n\n\n\n
![\"showing](\"https:\/\/alexroblesmd.com\/wp-content\/uploads\/2021\/11\/intramuscular-injection-vs-subcutaneous.png\")
<\/figure><\/div>\n\n\n\nWhen can I stop taking progesterone? How long do you need to take it?<\/h2>\n\n\n\n
Will I miscarry if I stop taking progesterone?<\/h2>\n\n\n\n
Is it safe to stop progesterone at 10 weeks?<\/h2>\n\n\n\n
Conclusion<\/h2>\n\n\n\n
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![\"alex](\"https:\/\/alexroblesmd.com\/wp-content\/uploads\/2023\/03\/alex-robles-md.jpeg\")
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