Progesterone is an important part of infertility treatment, with fertility specialists often prescribing progesterone supplements to help improve IVF pregnancy rates. So why is progesterone supplementation used and can it also help with natural conception rates?
What is progesterone?
Progesterone is a hormone produced by the ovaries. It is first detected in the middle of the menstrual cycle when an egg is released (ovulation). One of the most important functions of progesterone is to prepare the lining of the uterus (endometrium) to allow a fertilized egg (embryo) to implant. If pregnancy does not occur, progesterone levels decrease and a period follows. If an embryo implants in the lining of the uterus, the resulting conception produces the hormone human chorionic gonadotropin (hCG), which in turn directs the ovaries to produce progesterone until eight weeks into pregnancy. After this time, progesterone is produced by the placenta for the rest of the pregnancy.
Do I need progesterone if I'm trying to conceive naturally?
There is no evidence to suggest that progesterone supplementation in otherwise healthy women in early pregnancy has additional benefits or reduces the risk of spontaneous abortion. A recent randomized trial also found no benefit from progesterone supplementation in a group of women with recurrent miscarriages. However, despite this, there may still be some benefit to this approach in individual cases, always after discussion with your doctor in light of your own particular circumstance.
Why is progesterone prescribed during IVF treatment?
During an in vitro fertilization (IVF) cycle, drugs are usually used to prevent the early release of an egg (premature ovulation). These drugs affect progesterone levels. Therefore, the fertility specialist may prescribe a progesterone supplement to compensate for this decrease in the ability of the ovaries to produce progesterone. In this way, an embryo can implant and develop inside the uterus. Many scientific studies have looked at pregnancy rates in IVF cycles that used progesterone. These studies have shown that the rates are much higher compared to cycles where no progesterone was used.
When and how should I take progesterone?
Fertility specialists usually prescribe progesterone supplementation a few days after egg collection. Progesterone supplements generally come in the form of a vaginal suppository or intramuscular injection. While both the suppository and injection methods appear to be equally effective, vaginal preparations are preferred by most women and fertility specialists. Alternatively, luteal phase support with intermittent or multiple hCG injections can be used to stimulate the ovaries to produce progesterone. This is not recommended if more than ten follicles are found on ultrasound, as this can cause an ovarian cyst or ovarian hyperstimulation (OHSS). For women undergoing IVF, progesterone supplementation can be safely withdrawn at the time of a positive pregnancy test (hCG), as the body regains its ability to secrete progesterone at this stage.
Are there any risks of taking progesterone?
Many studies have been conducted to examine the use of natural progesterone during IVF treatment. These studies have shown that progesterone poses no risk to you or your baby. Although, for some women, vaginal preparations can cause discharge and local irritation. If you have any questions about taking progesterone and the options available, contact the Center for Reproductive and Fetal Medicine – Dr. Alexander Trajan for a consultation. For information call the phone (+30) 2310 277 032 or send a message to
email alexandrostraianos@gmail.com.