When To Stop Taking PIO Shots: Different Scenarios Explained

| Reviewed By Kimberly Langdon, M.D.

Progesterone plays a vital role in both reproductive function and supporting a successful pregnancy.

Unfortunately, there are several scenarios or circumstances that could affect a woman’s progesterone production, making it difficult for her to conceive or carry a baby full term.

Thanks to advancements in medical research, progesterone injections are available and commonly used to help women whose bodies need extra help producing the hormone.  

When can you stop PIO shots? The duration for which a woman utilizes progesterone in oil injections (PIO) will depend on her pregnancy and why she was prescribed the injections. In the majority of cases, PIO injections are not needed beyond the first trimester. Always ask your doctor before discontinuing the prescribed treatment.

In the following, we’ll learn a little bit more about progesterone injections including why they are needed, when they are used, and their effect on the body.

When To Stop PIO Shots

There is no standard duration for PIO shots. How long a woman needs/uses them depends on her individual pregnancy and her body’s needs. 

When Do You Need Progesterone Injections?

Progesterone injections are commonly used in these three scenarios: 

  • A woman is undergoing IVF treatments
  • Attempting to prevent miscarriage
  • To prevent premature birth

During an IVF cycle, medications are usually used to prevent premature ovulation, when the ovaries release an egg too soon.

These medications, while necessary for the treatment, affect the ovaries’ ability to produce progesterone.

Progesterone is essential for implantation and supporting a pregnancy. Without enough of it, there is a high risk of pregnancy loss or implantation never happening.

Therefore, doctors will prescribe supplements to women undergoing IVF in order to make up for the decrease in their progesterone levels. 

Progesterone supplements are also often used among women who have experienced previous miscarriages in an effort to prevent another from happening.

Similarly, if a woman has a history of premature birth, her doctor may prescribe progesterone injections to help sustain the pregnancy to full term and prevent premature labor. 

How Long Do You Take Progesterone Shots After IVF Transfer?

After IVF transfer, it takes some time for the body to begin producing enough progesterone naturally to support the pregnancy. Therefore, injections are prescribed to assist in the meantime. 

Supplementation is usually started on the day of egg retrieval and, if pregnancy occurs, may continue through the entire first trimester until the placenta has taken over progesterone production.

In most cases, it is safe to begin weaning off the medicine once the patient is 8 weeks pregnant. 

What Happens When You Stop Taking Progesterone After IVF?

Typically, the transition from synthetic to natural hormone production is seamless as long as the patient has waited the appropriate amount of time. 

While continuing injections when they are no longer needed is not a huge cause for concern, stopping them too early creates a high risk of miscarriage.

It is not recommended to stop progesterone injections before you are 12 weeks pregnant if you are undergoing IVF.

Before this point, the corpus luteum of the ovary is producing the progesterone, and the placenta is likely still not producing enough progesterone to support the pregnancy, and discontinuing injections could result in a miscarriage. 

If you wait the appropriate amount of time, your body will begin natural progesterone production and the transition to no injections will be seamless.

When To Stop Progesterone After Frozen Embryo Transfer

Once it has been confirmed by ultrasound that the embryo has implanted into the uterine lining, most doctors recommend continuing with supplementation throughout the first trimester as most miscarriages occur during that critical time period. 

If you did not conceive after the embryo transfer, there is no need to continue with the injections. 

When To Stop Taking Progesterone To Prevent Miscarriage

IVF patients are not the only ones who might undergo progesterone supplementation during their pregnancy. 

Some doctors will prescribe supplementation to women who have a history of recurrent miscarriages in the first trimester.

The supplements are aimed to provide extra support for the pregnancy during the critical period in hopes that a miscarriage can be avoided.

The idea of progesterone preventing miscarriage is controversial. Studies have not necessarily shown that progesterone prevents loss, but that does not mean that a woman might not benefit from supplements. 

In this article from Tennessee Reproductive Medicine, Dr. Rink Murray argues that progesterone supplements do not prevent miscarriage, but he may still prescribe them for other reasons. 

They do not cause harm, they could potentially benefit a woman, and at the very least, they may give her peace of mind in knowing that she is doing all she can to support her pregnancy.  

Research shows that it is usually safe to stop injections around 16 weeks gestation after the pregnancy has survived the first trimester. 

When To Stop Taking Progesterone To Prevent Preterm Labor

In some cases, increased progesterone may be used to prevent preterm labor and premature birth.

Especially if you have a history of preterm labor or have given birth prematurely in the past, your doctor may prescribe progesterone supplementation to prevent it from happening again.

However, recent evidence indicates there is little benefit, and the FDA has removed Makena’s (an injectable form of progesterone) indication for such use.

In this situation, the injections usually start during the second trimester, around 16 weeks gestation, and continue until 36 weeks. 

Stopping Progesterone at 10 Weeks After IVF

In the majority of treatment cycles, it is recommended to continue injections until you are at least 12-16 weeks pregnant. 

After that, it is safe to discontinue the injections, unless your doctor recommends continuing them for another reason.

At 10 weeks after IVF, you are likely in the clear to stop supplementation; however, it is not uncommon for women to continue through 12 weeks. 

Miscarriage After Stopping Progesterone IVF

Sadly, miscarriages after IVF do happen. In most cases, however, this is not because of stopping progesterone supplements.

Rather, it is due to another underlying cause related to the patient’s reproductive health or the health of the embryo. 

Miscarriage After Stopping Progesterone at 12 Weeks

By 12-14 weeks, the placenta should have taken over and no longer needs the aid of progesterone.

If a miscarriage occurs after stopping the progesterone at this point, it is due to another underlying cause, perhaps an issue with the placenta or the embryo itself.

In these situations, sadly, even continuing with progesterone is unlikely to have been able to “save” the pregnancy. 

Long-Term Effects of Progesterone Injections During Pregnancy

Information on the long-term effects of progesterone injections on both the mother and the child is very scarce. There is no evidence that the injections cause any long-term threats to the health of either. 

There is some research still being done on the relationship between progesterone supplementation and developing cancer later in life.

However the information is still limited, and there is not enough evidence to prove whether there is a correlation between the drug and cancer. 

Related Questions: 

Will I Miscarry if I Stop Taking Progesterone?

If you are an IVF patient and stop your supplements too soon, your chance of miscarriage increases. However, if the recommended time has passed, stopping progesterone will not cause a miscarriage.

That is not to say that a miscarriage is no longer possible; it could still happen. However, after a certain point, the pregnancy no longer depends on progesterone, and continuing with supplements does not necessarily prevent a miscarriage from happening. 

Is Progesterone Needed in the Second Trimester?

Typically, by the second trimester, the placenta is producing all of the hormones needed, so progesterone injections are no longer needed.

In some cases, progesterone may be used in the late second trimester to prevent preterm labor. 

Can I Still Go Into Labor While on Progesterone Shots?

Yes, it is possible to still go into labor while on progesterone shots. However, injections can be beneficial in delaying labor if you are at risk for early labor. 

Closing Thoughts 

There is research still being done on the benefits and necessity of progesterone injections, but at this point, we do know that they have made hundreds, if not millions, of pregnancies possible and helped them thrive.

Because each case is different, always follow your doctor’s guidance when it comes to starting or stopping a medication.