When I cycled in fall 2014, my nurse said I could do del estrogen shots in the thigh, but the needle for PIO was too big to do in the thigh.

One tip (from my nurse) that makes both easier (esp PIO) is warming the contents of the shot before injecting. I did this by putting the shot (tightly capped!) in my armpit, or in my bra, for a couple minutes prior to injecting. The fluid goes in faster and more smoothly when it's closer to your body temp.

Long time infertility nurse and one time IF patient here. It is perfectly okay to use upper outer quadrant of buttocks, closer to hip than butt crack. The incidence of sciatic nerve damage occurs when injection is too close to sciatic nerve which runs closer to middle/lower butt cheek. I've done thigh and upper arm injections for PIO and found them to be much more painful than butt.

Thigh shots are not really painful at all, Just stretch the skin tight as you can with your hand before inserting the needle, and ice beforehand. You won't hardly feel it!

PP nursing student -- thanks so much for that information. Maybe this will eventually prompt more doctors to prescribe progesterone suppositories. Because all I've read suggests that PIO in the thigh is quite painful (not the injection itself, necessarily, but the oil)

Anonymous wrote:I don't think the recommendation to avoid intramuscular injections in the buttocks is commonplace. At least not yet. Those studies are from 2010. Within the past year I've cycled at two large clinics, both of which allowed -- in face, encouraged for ease and pain reasons -- IM injections in the buttocks rather than the thigh.

No, it's not commonplace yet, and I definitely believe that you should give/get the injection in the spot that you are most comfortable with! I just wanted to give a heads up to those who may not be aware of the risk of hitting the sciatic nerve.

Oops, only one study, not studies.

I don't think the recommendation to avoid intramuscular injections in the buttocks is commonplace. At least not yet. Those studies are from 2010. Within the past year I've cycled at two large clinics, both of which allowed -- in face, encouraged for ease and pain reasons -- IM injections in the buttocks rather than the thigh.

pp here: here is the link to the full article

http://www.ncbi.nlm.nih.gov/pubmed/20670272

Anonymous wrote:I'm not understanding who is giving this new recommendation or where this new advice is coming from. The sciatic nerve and its location has not recently been discovered, so why now is it all of a sudden now a a concern? Is this some new guidance coming from an individual doctor, a group of doctors, the association that governs reproductive endocrinologists...?

I'm a nursing student and this is what is now being taught. It was also the new protocol at a couple of hospitals that I had clinicals at. If you have access to nursing journals, you will find information there. You can also see this article from the NIH:

Sciatic nerve injury from intramuscular injection: a persistent and global problem.
Mishra P, Stringer MD.
Source

Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
Abstract
BACKGROUND/AIMS:

An intramuscular (i.m.) injection into the buttock risks damaging the sciatic nerve. Safe injection practices need to be understood by doctors and nurses alike. The aims of this study were to determine if sciatic nerve injury because of i.m. injection is a continuing problem and to establish the availability of published guidelines on i.m. injection techniques.
METHODS:

Intramuscular injection related sciatic nerve injury claims to the New Zealand Accident Compensation Corporation between July 2005 and September 2008 were reviewed. Nursing organisations were surveyed to enquire about guidelines on i.m. injection. I.m. injection related sciatic nerve injuries in the medical and medicolegal literature (1989-2009) were systematically reviewed.
RESULTS:

There were eight claims for sciatic nerve injection injury made to the ACC during the 3-year study period; all were in young adults. Only one of the nursing organisations contacted had published guidelines on i.m. injection technique, and these related specifically to immunisation. Seventeen reports of patients with sciatic nerve injury from i.m. injection were identified comprising a total of 1506 patients, at least 80% of which were children. Nine court decisions finding in favour of the plaintiff were identified, all from the North American legal system. A broad range of drugs were implicated in the offending i.m. injections.
CONCLUSIONS:

Sciatic nerve injury from an i.m. injection in the upper outer quadrant of the buttock is an avoidable but persistent global problem, affecting patients in both wealthy and poorer healthcare systems. The consequences of this injury are potentially devastating. Safer alternative sites for i.m. injection exist. These should be promoted more widely by medical and nursing organisations.

© 2010 Blackwell Publishing Ltd.

I'm not understanding who is giving this new recommendation or where this new advice is coming from. The sciatic nerve and its location has not recently been discovered, so why now is it all of a sudden now a a concern? Is this some new guidance coming from an individual doctor, a group of doctors, the association that governs reproductive endocrinologists...?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just a word of caution - shots in the buttock are not recommended anymore, because of the risk of hitting your sciatic nerve.

When did they change the recommendation? I was told to do it in the buttock just a couple of months ago.

... my nurse was just suggesting- 4 days ago?- that was a possibility.Who is to say that someoen else wouldn't hit you in the sciatic nerve?

If you can you get the nurse to draw a mark on where you should give the shot, why does it matter (other than how much it sucks to give yourself a shot) who gives it?
(genuine question)

PP here: the recommendation is relatively new...many nurses who were taught the old way dont know about the new evidence. The nurse could definitely hit your sciatic nerve herself as well, that's why they suggest shots in the thigh area instead ( whether self-administered or administered by the nurse).