Does time of day for PIO matter?

[bextoliver]

Hi everyone,

Question about PIO shot timing. My clinic says that the time of day doesn’t matter as long as it’s at the same time each day. But that just doesn’t seem right to me. I’ve had two unsuccessful FETs, and did the shots in the morning the first time and night the second. I have my final transfer coming up at 8 AM on Thursday and want to make sure I do what makes the most sense! Have you heard the same thing or did your clinic recommend morning vs evening depending on timing of transfer?

[Fingerscrossed38]

My first FET is next cycle so I haven't started PIO but my protocol is to have PIO each morning and 1x cyclogest each evening. I have naturally low progesterone hence why I have to do both. I'll have them test my levels a few days after to guarantee my levels are ok.

Interestingly my PIO will be subcutaneously injected which I had to double check because I'd only ever heard of intramuscular. I'm hoping subcutaneous is less painful...

Have you had an ERA to check they're transferring on the right day? Were your blastocysts pgs tested? There could be lots of other reasons they've failed rather than the time of day you do PIO I think? Hopefully your Dr is changing things up a bit each transfer

[bextoliver in reply to Fingerscrossed38]

Thanks for the info! That’s great that they monitor your progesterone levels throughout.

I haven’t done an ERA yet. I’m pretty sure my issue is egg quality as I have Endo and low AMH. I also haven’t had PGS testing, because I only had three embryos the clinic froze them all on day 3. I just find it odd that the timing doesn’t matter when clearly progesterone exposure does make a difference as people have found out after doing an ERA. Best of luck with you upcoming transfer!! Xx

[Fingerscrossed38 in reply to bextoliver]

They monitor it but I pay for it haha. £145 per blood test ouch!

Timing is crucial but the ERA will usually add a day of progesterone on prior to FET if nothing else. Whether or not you do PIO in the morning if evening shouldn't really matter as it's still within the same 24 hours...but who knows. Best of luck with it all

[bextoliver in reply to Fingerscrossed38]

Oh wow that’s a lot! Yea it’s all so complicated. Thank you!!

[Poppy_2018]

Hi, I'm currently in my 2ww following my first FET. At the final scan I had they told me to start my PIO and cyclogest that evening and then continue at same time from then onwards, although my cyclogest was twice a day from the following day. They checked my progesterone levels the day before my FET (day 5 transfer) and adjusted my cyclogest accordingly. I'm not sure if the timing of progesterone affects anything, i thought it would be more so that your levels are high enough. Are your clinic monitoring your progesterone levels? If not perhaps you can ask them to to give you reassurance. Hope all goes well and good luck with your transfer 🤞🤩🤗

[bextoliver in reply to Poppy_2018]

Thanks so much for the info. It’s great that they monitor your progesterone as well. I live in Canada and at least at my clinic they don’t check blood once you start progesterone. I just figured that the amount of exposure to progesterone changes your uterus and that’s why the ERA can indicate if some people need more or less exposure time. Like for instance, my transfer is in the morning, but I decided to start my injections at night which means that on the morning of the transfer I will have one less injection than someone who chose to start theirs in the morning. It seems weird that that wouldn’t matter. But maybe it doesn’t! Sending you lots of baby dust for your 2ww!

[Poppy_2018 in reply to bextoliver]

Hmm I actually have no idea! I've also just had to google ERA testing to see what that was. What you're saying does make sense. I started my POI in the evening as my clinic advised and they worked out my transfer date based on that. If I'd waited until the next morning to start I'd have had 1 day less by transfer day. IVF is so complicated and there is so much to learn! Thank you so much for the baby dust. Wishing you all the best 🤞🤩🌈

[bextoliver in reply to Poppy_2018]

See that makes more sense to me but I guess I just have to trust them. Thank you!!