She does ~60-100 dives/year. I generally let it go a year unless I see the telltale occasional bubble out of the ambient chamber indicating the O-ring is going. This last time I checked it after a 30 dive Philippines trip. The IP had gone up (?) to ~150 but was stable. I found the piston O-ring nibbled on but not yet leaking. Pulled 2 shims, cleaned it up and only replaced the piston O-ring (stock SP). Pretty solid IP ~130 this time but it whistled a little. Luckily that went away after some cycling and she hasn't told me it's an issue diving. I'm happy with 130 as we dive cold most of the time.
Last build I had some challenges getting the IP to behave, AND the whistling wouldn't go away until I swapped out the piston, seat, and O-ring shims. I let her dive it a couple times to see if it would settle down but it would not and she was not happy with the noise on a dive. I lubed it plenty (Cristo) and do use an insertion bullet thinking maybe I was doing the O-ring damage. Oddly I inserted the piston for years sans bullet without ever nicking anything.
Have you noticed there is a fair amount of discussion about IP creep in the MK20? Every other piston I have (Sherwood, Oceanic) I just put them together and they work. No fuss at all.