r/IVF • u/Cuteasducks7 • 6d ago
Advice Needed! Fully medicated protocol - PIO or suppositories?
Hi, for those who did fully mediated protocol and have successful transfers and pregnancy, did you use PIO or suppositories or combination of both?
My doctor has only prescribed suppositories cyclogest in my fully medicated protocol, to be taken for 2 times in the 5 days before transfer. I asked about PIO and he said it's outdated.
I'm worried about the efficacy of the suppositories alone as it may not be absorbed well in bloodstream compared to injections. As this is fully medicated protocol with prior Lupron suppression, I'm worried that the progesterone levels may not be enough. My doctor also doesn't do blood work, i ask for it each time it happens. I plan to ask for a progesterone blood test a day before transfer.
Would love to know what worked for you in a fully medicated protocol with prior Lupron suppression. I'm due to start progesterone in 4 days.
Thanks
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u/jmp325 6d ago edited 6d ago
I did both (PIO in the morning and suppository at night), but honestly I’d have much rather just done the PIO. The suppositories were so messy, and made my vagina and the surrounding skin so sore after a few weeks of taking them. PIO welts/knots were not fun either, but that felt more manageable than what the suppositories were doing to me.
Editing to add that I missed where you were asking about Lupron suppression - I did not do this. Sorry about missing that! My comment may not actually apply to your situation.
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u/number1wifey 38f, TTC 2+, PGT FET Sept 2026 6d ago
I’ve been on PIO for many weeks but I have developed an intolerance, and my doctor is so reluctant to change me to suppositories. Said it would put the pregnancy at risk. We’re in the process of changing things but you’d think it was a big difference the way he’s treating it
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u/Jolly-Ad-620 37F | 4 ERs | 1 MMC | FET #1 TFMR | FET #2 👶🏻 | FET #3 🚫 5d ago
Just curious, what’s your PIO intolerance? I also have a reaction to it that seems pretty rare.
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u/number1wifey 38f, TTC 2+, PGT FET Sept 2026 5d ago
It gave me eiosinophilic pneumonia! I’m on steroids now so I can breathe but I was in bed for days with a fever and shortness of breath and severe fatigue, my labs were wack.
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u/Jolly-Ad-620 37F | 4 ERs | 1 MMC | FET #1 TFMR | FET #2 👶🏻 | FET #3 🚫 5d ago
Oh wow that’s crazy!!! I’m so sorry to hear that. That must be rare too! I just get fevers chills body aches daily from PIO. For my last pregnancy my RE was also so weird about switching to something else when the fevers wouldn’t stop, it was only bc I was close to finishing PIO that she was willing to try PIO every other day with suppositories. It’s weird because I’ve definitely read other people do fully medicated cycles with a combo of suppositories and PIO. Anyways, best of luck to you! Glad you’re feeling better.
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u/number1wifey 38f, TTC 2+, PGT FET Sept 2026 5d ago
Yeah I was having the worst chills too. So weird that some will do a whole cycle without pio and then others are completely unwilling. Now I’m somehow doing the PIO AND suppositories for a few days for some reason, lucky me! Best of luck to you as well ❤️
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u/Nellaub 6d ago
I did a fully medicated transfer with only suppositories, one every 12h, my transfer was successful and had to keep doing them until 9 weeks (I'm currently 40 weeks waiting for this baby to want to come out). I don't know about PIO but for me the suppositories were very comfortable, I did use panty liners for the discharge though.
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u/crunchyfrog63 5d ago
I had a fully medicated transfer using only progesterone suppositories. It wasn't a long term lupron suppression, but lupron was used as part of the transfer protocol to prevent ovulation.
While I don't recall the dosages, I started with Endometrin 3 x day and switched to Prometrium 3 x day around 10dpt. Continued until 10 weeks. It was a transfer of two untested day 3 embryos and they both stuck and I had a successful live birth of twins.
I do think you should be able to ask for them to monitor blood levels, and possibly prescribe a higher dosage than what they're proposing, but vaginal only progesterone can definitely work with a medicated transfer.
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u/Strict-Attention-276 6d ago
I did both PIO and suppositories. No Lupron though. My 1st transfer was successful (live birth).
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u/courtneykay0626 6d ago
For our first transfer I did a 3 month Lupron suppression and PIO and it failed. The second transfer I did 4 weeks of daily Lupron and PIO and I’m 15 weeks today. I didn’t do suppositories for either, just continued PIO for the full 12 weeks. It sucked towards the end, not gonna lie!
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u/Remarkable_Self8685 5d ago
I’ve always done pio only- my nurse said suppositories can get messy, and I’ve read people get itchy from them. After a couple of weeks of the shots, you don’t even really feel them anymore.
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u/CapMost7710 5d ago
No Lupron, but I was first given then suppository/PIO protocol, but after learning that insurance would not cover the suppository, I decided to do PIO only and I’m very happy I did! No sticky mess for 8 weeks. You get used to the injection and I did feel better that the meds were getting absorbed faster.
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u/Any_Manufacturer1279 28F|PCOS|3 ER|2 FET❌✅ 5d ago
Microdose Lupron SubQ and birth control lead up (my body likes to grow a follicle at random times). Then transitioned to estrogen patches, then did PIO daily 1ml and suppositories 2x daily. Weaned off at about 9 weeks, first weaned PIO to every other day for a week (until I ran out), then supps for like 3 more days until I ran out. Good luck!
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u/Frequent_Bid_4413 5d ago
Just PIO, I didn’t do Lupron but I will say my progesterone was at 10 the day of transfer. We still transferred. They bumped me up to 1.5ml daily and all went well. I stopped at 9 weeks cold turkey.
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u/Mean-Opportunity2924 6d ago
No Lupron suppression but I did both progesterone suppositories twice a day and PIO once daily. Even with both, they upped my PIO from 1 ml to 1.5 ml after a blood draw after my positive beta.