Why Progesterone Is Used During IVF

Progesterone Is Called the "Pregnancy Hormone"

Pregnancy test not pregnant
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If you're undergoing fertility treatments, such as in-vitro fertilization (IVF), you may have been told that you need progesterone treatments. IVF involves various medications that are administered in different ways.

The hormone progesterone is typically either applied vaginally or given by intramuscular injection. Here's what to expect if you're put on progesterone therapy.

Overview of Progesterone

Progesterone is often called “the pregnancy hormone.” It is necessary to help the uterus prepare for pregnancy and the implantation of an embryo. Progesterone is produced by the ovaries during ovulation (the release of a mature egg from an ovary).

Specifically, progesterone is produced by cells of the ovarian follicles, which are cysts that contained the eggs prior to ovulation. Progesterone prepares the lining of your uterus (endometrium) for implantation of a fertilized egg. If the fertilized egg does not implant itself into the uterus, your levels of progesterone drop and menstruation begins.

If implantation is successful and pregnancy occurs, about 10 weeks into your pregnancy, the placenta takes over and produces progesterone until your baby is born.

How Does Progesterone Help Treat Infertility?

Taking progesterone is an essential part of assisted reproductive treatments. During IVF, your normal production of progesterone may be lowered for several reasons:

  • Medications used to slow down premature ovulation (such as Lupron, Antagon or Cetrotide) may reduce the production of progesterone following collection of your eggs.
  • At the time of follicle aspiration to obtain mature eggs, many progesterone-producing cells may also be removed due to the mechanics of the procedure itself.

To assure that the lining of the uterus is prepared for implantation of the fertilized egg, most women undergoing IVF will be given progesterone after the retrieval of her eggs.

How Is Progesterone Given?

If you are undergoing IVF, you may begin using progesterone starting at the time between egg retrieval and embryo transfer. Once a positive pregnancy test is confirmed, progesterone treatment will continue for a total duration of up to 10 to 12 weeks (the first trimester).

The use of vaginal progesterone avoids the pain of progesterone injections, although either option appears to be equally effective. The choice mainly depends on your personal preferences. There are three types of progesterone preparations that can be used vaginally:

  • Progesterone suppositories are made to order by a pharmacist based on the dose of progesterone and frequency of use as prescribed by your IVF specialist.
  • Progesterone gel is placed in your vagina once a day for progesterone supplementation or twice a day for progesterone replacement using a special applicator.
  • Progesterone tablets are placed in the vagina once or twice a day using a special applicator.

Stay Informed

Brand name vaginal progesterones are Crinone, Endometrin, and Prometrium. If you are using vaginal progesterone, you should not use any other vaginal medications for the duration of treatment unless instructed by your physician.

Adverse effects may vary by type and brand of vaginal progesterone, and you should make sure to discuss any concerns with your physician.

Possible side effects of progesterone treatment include increase in appetite, back pain, mood swings, fluid retention, and gastrointestinal disturbances. Although these symptoms aren't usually serious, you should still tell your doctor if you experience them.

More serious symptoms to address right away include:

  • Abnormal bleeding
  • Allergic reactions (such as swelling, itching, or hives)
  • Breast changes or discharge
  • Confusion or issues with balance or vision
  • Dark urine or light-colored stools
  • Pain in the right upper abdomen
  • Poor appetite
  • Severe headaches
  • Shortness of breath or chest pain

Be sure to discuss all treatments with your physician before you begin. Your physician is there to help guide your treatment and answer questions. Feel free to discuss any questions or concerns that come up at any point during your treatment.

A Word From Verywell

The multiple medications required during IVF can become overwhelming. If you experience negative side effects or want to explore other options, talk to your doctor about trying a different brand or route of administration. You can stay in control of your treatment as long as you're informed and willing to work together with your healthcare team.

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Article Sources
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  1. American Society for Reproductive Medicine. Progesterone supplementation during IVF. Updated 2016.

  2. Washington University Physicians, Fertility & Reproductive Medical Center. Progesterone and IVF: So why do I need to do this?.

  3. Barbosa MW, Silva LR, Navarro PA, Ferriani RA, Nastri CO, Martins WP. Dydrogesterone vs progesterone for luteal-phase support: Systematic review and meta-analysis of randomized controlled trials. Ultrasound Obstet Gynecol. 2016;48(2):161-70. doi:10.1002/uog.15814

  4. Cleveland Clinic. Progesterone vaginal suppositories.