This page explains how Progesterone in Oil (PIO) (progesterone in sesame or olive oil) is used in IVF treatment. All information is educational. Talk to your doctor about your specific protocol and any questions or concerns about your medications.
Overview
| Brand name | Progesterone in Oil |
|---|---|
| Generic name | progesterone in sesame or olive oil |
| Category | Progesterone Support |
| How it is given | intramuscular injection |
| Common dosages | 25 mg/day, 50 mg/day, 100 mg/day |
| Typical timing | Starts 1 to 3 days before embryo transfer and continues through early pregnancy confirmation, typically 8 to 12 weeks |
What to expect: common side effects
Side effects vary from person to person. Many people experience only mild effects while others find them more significant. All of these experiences are valid. Report any severe or unexpected symptoms to your care team right away.
- Injection site soreness, lump formation, and bruising (the most commonly reported challenge)
- Mood changes
- Bloating
- Breast tenderness
- Fatigue
- In rare cases, oil embolism (seek emergency care for sudden shortness of breath)
Storage instructions
Store at room temperature between 15C and 30C (59F to 86F). Do not refrigerate as cold oil becomes too thick to inject. Keep away from light.
Traveling with Progesterone in Oil (PIO)
PIO can be stored at room temperature. Pack in a secure case to prevent breakage of glass vials. Carry needles and syringes with your doctor letter declaring medical necessity. Warm the oil by placing the vial in a cup of warm water for 5 minutes before drawing up.
Tips from the IVF community
These are practical suggestions shared by people who have been through IVF. They are not a substitute for your clinic's guidance.
- Warming the oil to body temperature makes it thinner and easier to inject. Hold the vial in your hands or place in warm water for 5 to 10 minutes.
- Use a larger needle (18-gauge) to draw up the oil, then switch to a smaller needle (22-gauge) for injection
- Massage the injection site immediately after injecting to help disperse the oil
- Applying a warm compress for 10 minutes after injection can significantly reduce soreness and lump formation
- Rotate sites consistently. Many patients use a calendar to track left vs. right gluteal sites.
- PIO injections are emotionally hard too. It is okay to grieve the difficulty of this part of the process.
Track this medication with TrackMyIVF
Set dose reminders, log side effects, and share your medication timeline with your care team. TrackMyIVF keeps everything in one place so you never miss a dose.
Learn about TrackMyIVFFrequently Asked Questions
Why is progesterone in oil used after embryo transfer?
After egg retrieval and embryo transfer, your ovaries cannot produce enough progesterone on their own to support the early stages of implantation and pregnancy. Progesterone in oil provides supplemental progesterone to prepare the uterine lining and support any early pregnancy.
How do I reduce injection site lumps from PIO?
Lumps at the injection site are very common with PIO because oil takes time to be absorbed by the tissue. The most effective approaches are: warming the oil before injection, massaging the site immediately afterward, and applying a heating pad for 10 to 20 minutes after each injection. Rotating sites consistently also helps.
How long do I have to take PIO?
Most clinics continue PIO until 8 to 12 weeks of pregnancy, once the placenta produces enough progesterone on its own. Some clinics stop earlier. Your doctor will advise you when it is safe to taper or stop.
Can I switch from PIO to progesterone suppositories?
Some patients can transition to vaginal progesterone (like Endometrin) if PIO is not tolerated well. This is a conversation to have with your doctor. Do not change your progesterone protocol without medical guidance, as this is a critical part of cycle support.
Medical disclaimer: This page provides general educational information only. It is not medical advice and should not replace guidance from your doctor, nurse, or reproductive endocrinologist. Every person's treatment is unique. Always consult your care team before making any decisions about your medications or treatment plan.
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About the author
Viv
BSc, Patient Advocate
Founder, TrackMyIVF
I built TrackMyIVF because I needed it during my own journey. Every feature comes from real experience.