Help! PIO - Phobia!! Suppository-success, anyone?

(32 posts)(13 voices)
  1. Is there any way to get other meds? I have a combo of PIO and suppositories and at this point know enough about the process that I wouldn't be afraid to do what I felt was right for me. I am cycling at SDFC and they feel PIO is the gold standard. That being said, I think that is part of my problem and even if not, I don't feel suppositories vs. PIO will hurt anything. I will be doing suppositories 3 times a day. I have PIO and if there was a concern can add in a shot every third day -

    I wish you luck - I don't know why the RE won't listen to you. You would think that no women ever get pregnant on suppositories, which simply isn't the case.


  2. Hi,

    I took 200 mg of Prometrium orally and vaginally twice/day on my DE cycle and now have a 5 month old DD. The clinic (in the US) also checked my progresterone levels weekly via a blood test, and my progesterone levels were always high, which is better than low levels.

    My RE in Canada did not think there was any difference in taking prometrium versus PIO. He did however say not to do PIO shots every 3 days as the fluctuation in progesterone levels may lead to miscarriage.

    My thought is do prometruim orally and vaginally and have your progesterone levels checked weekly.


  3. Donnie - I'm sorry, I saw your post asking me the same question on another thread, and I was going to PM you, but now that you're here, I'll answer here! (sorry for the delay!) You know, what it MAY come down to, is perhaps I have never spelled out everything to my RE, the way I certainly have to everyone here, regarding my concerns and past adverse reaction to PIO. I asked my RE at our initial phone consult about his usual regimen, and he told me that RE's in general, "still" see IM shots as the "gold std." for supplementation, and he pointed out that in DE cycles in particular, he feels it's most precarious, and he simply, "is not willing to take the risk" of anything short of PIO. Pretty adament about it, and at the time, I was very disappointed but did not press my own issue, since after all, there were still so many hurdles to cross, I felt, before we'd get to this point. I thought "no problem, I'll get over it by the time it's actually time to cycle." More recently, over the phone, we again touched on the subject. He brought up PEO as an alternative that he has prescribed before, and he stated that his patients found it much easier to inject and better tolerated, and he was satisfied with performance overall, in sustaining BFP's at equal rates as PIO. Clinically, he had come from a large clinic in LA that I believe solely used PIO, so his background has influenced his bias. I've not to date, laid all my concerns on the table, and I think that through my disclosure and discussion on these boards, I have been preparing myself for the discussion that I know is coming up.

    Amshel - Thanks for your input, your experience with previous DE speaks volumes. I know from your other posts on the boards that this has been a long journey for you, and through your trials, you have learned much, both about your own body, as well as about the many variances in treatment protocols between different clinics. I was wondering: what do you mean when you said that you think PIO is part of your problem? I think I saw in a previous post from you that you've had problems with injections as I've had, but I don't recall that you went into any specifics. In what way do you feel that it has impacted your outcome? I DO believe that we do owe it to ourselves to use intuitive sense as a guide to go by, in subsequent similar situations, in order to learn from previous "misses". I like that I hear in you a strong inner strength to act according to your gut, and I do have a strong sense within me, for sure, but it takes me awhile to get my engine revving so that I can find my clarity and then ASK for it. That's just me. :| !!

  4. jotikaur - Whoa--!! Great to hear from you, thanks so much for sharing your experience and protocol...Congratulations on your success with DE! (I think there are many thoughts to ponder over and learn from, both from the cycles that don't go as they are expected to, and the ones that do!) I did not know that Prometrium comes in vaginal suppositories (besides oral tablets,) if that is what you used vaginally. Could you please specify? Or did you use a compounded suppository, and if so, what was the amount of prog. dosed? Also, you said that your serum prog. was always found to be "high." Do you know what range it was? I haven't heard much about successes using oral supplementation, so I'm very interested to learn about your combination regimen. Thanks again, I'm so glad you replied.

  5. Hi Mohamed - Prometrium can be administered orally or vaginally. It was the same prometrium (as my clinic said sounds strange but it works). No fancy compounding etc... Just 200 mg of prometrium orally and vaginally twice/day. I like the idea of orally and vaginally to ensure that progesterone levels are adequate.

    my progesterone levels were always over 100, which my clinic in the US (CNY) said was fine. My RE here in Canada said they were high but he also said better high than low so had no concerns. My RE here usually does not test progesterone levels but that was the protocol for CNY when prometrium is used (they usually do PIO but let me do prometrium) .I think if you are going to do prometrium it does not hurt to test the levels weekly. Also it was only once the blood test confirmed at 10 weeks that my body was producing progesterone that I stopped doing the oral but continued the vaginal for another 2 weeks.

    also check the pregnant with DE thread as I think there was a poll a while ago re PIO and alternatives.


  6. I experienced severe localized swelling and inflammation (i.e. heat and redness) with radiating pain and widespread bruising in my unsuccessful OE IVF, where even the nurses who administered for me felt that there was diminishing unaffected area to inject, if I would have needed to continue through 8 more wks. of a pg. I am petite (5 feet tall,) with not a lot of real-estate to work with, so that, combined with what seemed to equate to an allergic response either to the prog. itself or all the undiffused oil, I just need to get acquainted with my alternatives.

    I hear ya! I'm petite and have very little real-estate to work with. My last DE/FET cycle, I had the worst time with my PEO and PIO... huge welts, pain, bruise and fever (not to mention a m/c too). BTW... When I was running out of real estate, my nurse told me NOT to inject over the welts b/c of risks of infection, so she told me to inject in my thighs. For my upcoming EA/FET, I told my nurse to tell my RE "After my butt's experience with PEO/PIO from last cycle, my butt is on strike. It will NO longer do any more injections. Please give me an alternative!" My RE Rx'd Prometrium oral and vaginal supps. without debating with me.

  7. Christyen - That exactly, is my case, to a T! I have been doing my due-diligence in researching my options, getting a very calculated sense of risk involved with abandoning injectables, and feel w-a-y more comfortable with the apparent performance and effectiveness of alternatives, and I am prepared now to go to bat, for my butt!

    You clearly experienced the similar extent and level of "adverse rxn" that I did with PIO, and I feel that finally someone truly "gets" what I've been addressing, with my "phobia" and unwillingness to overlook my previous problem, as I am now staring down the barrel of my next IVF cycle! Only if you've had a similar type of reaction to PIO as we've apparently both had, is it possible to truly understand all the contention. Thank you, thank you - for adding to this thread.

    And, to all others who posted, thank you for your kindness in sharing what alternative worked for you. I am cynical but convinced -- that if all IVF patients were "not female," more definitive trial studies would have been conducted by now to put these injections in the past.

    We just need to band our butts together and in the famous footsteps of one of my fave IVF "activists" Christyen -- put our butts ON STRIKE!

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