Intramuscular Injections of Progesterone in Oil

As part of the process of in vitro fertilization, you may have to take daily progesterone injections. Not every reproductive endocrinology or fertility practice uses this form of progesterone, and, in those cases, your healthcare provider may have you take a vaginal progesterone insert instead.

If your healthcare provider requires you take progesterone via injection, you will need to do intramuscular injections, a process which, for some women, can be arduous and tiring.

Doctor comforting patient in office
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Purpose of Injection

Before getting started, it's important to understand why you are taking this medication. Progesterone is the primary hormone of pregnancy, and the daily injections are helping your body prepare for a pregnancy.

Knowing that you may be helping your chances of success can make the discomfort a little easier to bear. And remember, it’s only temporary.​​ 

It's also important to alert your healthcare provider to any food allergies you may have. Progesterone is usually compounded in sesame oil. If you have any allergies to peanuts or sesame, make sure to mention it to your healthcare provider so he can prescribe progesterone in olive oil instead.​

Performing the Injection

If you are currently taking progesterone injections and finding it difficult, the following tips can help simplify the process.

Keep the oil in a warm place, not in the refrigerator. Oil can congeal when in a cold environment, which can make it more difficult to draw up or inject.

Before you inject yourself, change the needle after drawing the medication into the syringe. A sharp needle, not dulled after passing through the rubber stopper on top of the vial, will actually make the injection itself a little less painful.

Once you've picked an injection site—for intramuscular injections this will most likely be your buttocks, arm, or thigh—use ice to numb your skin before cleaning it with alcohol.

Don't forget to rotate your injection sites. Never inject your medication into the same spot repeatedly. This can increase your chances of tissue damage.

Make sure you palpate your muscles before choosing a site. Sometimes progesterone in oil can accumulate in your muscle, causing little knots or bumps. The injection should not go into one of these bumps and should be about an inch away. Beyond causing pain, the injected progesterone will not be absorbed properly.

If you are finding it difficult to inject yourself, ask a friend, family member, or partner for help. If that isn't an option, call your healthcare provider's office and ask for a tutorial.

After the Injection

Once you've injected yourself, use heat or a heating pad to warm the injection site. Because the progesterone is contained in the oil, it can take a while for the progesterone to absorb into your muscles. The heat will warm and thin the oil, helping boost absorption.

You should also massage the area after the injection is complete. Stimulating your muscle can also help the progesterone be absorbed.

Always monitor for any side effects and report anything concerning to your healthcare provider.

If you are truly having difficulty tolerating the daily injections or notice any side effects, do not hesitate to speak with your healthcare provider about switching to an alternate form of progesterone. Most healthcare providers are willing to discuss other options.

Frequently Asked Questions

  • What are progesterone oil injections used for?

    Intramuscular progesterone oil injections (marketed under the brand name Gestone and others) have different uses:

  • How are progesterone oil injections given?

    Intramuscular progesterone oil is delivered by injection into a large muscle, usually the buttocks. It is typically self-administered. When used for IVF, the daily injections are started three to five days before the scheduled embryo transfer and continued until the 9th week of gestation.

  • What are the side effects of progesterone shots?

    Common side effects of intramuscular progesterone injections include:

  • What are the alternatives to progesterone shots?

    In addition to intramuscular injections, there are different methods of delivering progesterone for IVF:

    • Crinone (vaginal gel)
    • Cyclogest and Milprosa (vaginal pessaries)
    • Prolutex (subcutaneous injection)
    • Utrogestan (oral capsules)
  • Are intramuscular progesterone injections the best option for IVF?

    Intramuscular progesterone appears to work as well for IVF as the other forms of progesterone. Each has its benefits and drawbacks. Speak with your healthcare provider.

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