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Progesterone and IVF: Why It’s Important for Pregnancy

Progesterone and IVF go hand in hand. After all, progesterone is known as the pregnancy hormone for good reason. It prepares your body for implantation, helping the fertilized egg “stick.” 

So if you’re trying to conceive, progesterone is key to getting…and staying pregnant.

Yet, if you’re undergoing IVF treatment, progesterone is even more crucial. IVF procedures and medications weaken progesterone production – right when you need it most. 

That’s why fertility specialists recommend progesterone for women undergoing IVF. 

So let’s explore what progesterone is and how it supports pregnancy and IVF success.

What is Progesterone?

Progesterone is a steroid hormone secreted by your adrenal cortex and ovaries. It’s essential for both your menstrual cycle and pregnancy. 

Each time you ovulate, your body releases an egg. The follicle that releases that mature egg forms the corpus luteum. This temporary structure produces progesterone during the early pregnancy. 

If a fertilized egg fails to “stick” to the uterus, your corpus luteum breaks down. This causes your progesterone levels to dip, triggering menstruation. 

However, if the egg implants, your corpus luteum secretes high progesterone levels to support pregnancy. 

Around 8-10 weeks after implantation, your placenta takes over progesterone production until delivery.

Progesterone’s Functions in the Body

Let’s break this down a bit more. Progesterone prepares the lining of the uterus (endometrium) for a fertilized egg to implant. 

It does this by triggering the uterine lining to thicken. This creates the ideal environment for the embryo to make its home in your womb. 

If an egg implants, progesterone stimulates blood vessels to the endometrium. This helps supply nutrients to the growing fetus. 

But that’s not all. Progesterone also inhibits uterine muscle contractions, preventing the body from rejecting an egg. 

Basically, it helps your body get pregnant…and stay that way!

Later in pregnancy, progesterone helps the breasts get ready for milk production. 

Progesterone and IVF: How it Helps

Progesterone is crucial in the early stages of pregnancy for all women. But this is especially the case for those undergoing IVF. 

IVF can weaken the body’s natural progesterone production in two different ways:

  • Many progesterone-producing cells may be removed during egg retrieval (follicle aspiration). This leaves your body less equipped to maintain the progesterone levels needed to support pregnancy.
  • Medications are used during an IVF cycle to prevent premature ovulation. Unfortunately, these meds often impair the body’s ability to produce progesterone. 

Progesterone is even more critical for frozen embryo transfers. That’s because your body doesn’t make any progesterone during most frozen embryo transfer cycles.

So if you want your frozen embryo transfer to be a success, progesterone is key.

That’s why most fertility specialists prescribe progesterone. It helps prepare the uterine lining for implantation and prevents miscarriage. 

Do I Need Progesterone While Conceiving Naturally?

Yes. If your body’s running low on progesterone, it’ll make it difficult to conceive and stay pregnant.

Women with low progesterone are more likely to have repeated miscarriages. 

Research shows progesterone supplementation may help prevent preterm birth. Having a short cervix or a history of premature birth puts you at higher risk of it recurring. As of 2020, preterm birth accounts for 1 in 10 pregnancies in the US. 

Low progesterone levels also put you at a higher risk of ectopic pregnancy. An ectopic pregnancy is when the fertilized egg attaches outside of the uterus.

Some women are prone to low progesterone due to a luteal phase defect. Luteal phase defects prevent the uterine lining from developing enough to allow implantation.

That’s why for some women, progesterone supplementation can improve fertility and pregnancy outcomes.

Signs of Low Progesterone

So, how can you tell if you’re lagging in progesterone? While testing is the most accurate gauge, there are some warning signs to watch out for.

Signs of low progesterone include:

  • Headaches
  • Irregular menstrual cycles
  • Anxiety or depression
  • Breast tenderness
  • Fertility issues

If you suspect you might be low in progesterone, you may want to consider testing.

One option is to go to your doctor and have them order blood tests. 

However, if you want to go the easy route, you can use a fertility monitor like Inito. It allows you to check your progesterone levels whenever you like – right from the comfort of your home. 

Does Everyone Need Progesterone During IVF?

If you want the best chances of getting pregnant via IVF – then yes!

As stated before, IVF medications lower the body’s ability to produce progesterone naturally. 

That makes it more difficult for a fertilized egg to attach to your uterus.

Research shows IVF success rates are much higher in cycles where progesterone was used. 

IVF treatment can be an emotional roller coaster. The waiting game in the days and weeks after an embryo transfer is nerve-wracking. 

So it makes sense to do everything in your power to support IVF success. Progesterone appears to be one piece of that puzzle. 

One IVF study found that the quality of embryos and progesterone levels were the two most important predictors of live birth.

Now that you understand how crucial progesterone is for IVF – let’s cover when to begin and stop taking it.

When to Take & When to Stop Progesterone After IVF

Progesterone is typically started a few days after egg retrieval during a fresh IVF cycle. It’s usually recommended for around 8-10 weeks. 

That’s because the placenta takes over progesterone production after around the 10-week mark. 

There is evidence that progesterone can be stopped as soon as the patient has a positive pregnancy (hCG) test. 

Ultimately, when you stop progesterone is up to you and your doctor.

What if I Have Low Progesterone During IVF?

Progesterone is needed for successful implantation. So, If you’re low on progesterone during IVF, you may struggle to get pregnant. 

Low progesterone also puts you at increased risk of miscarriage. 

Research suggests the ideal progesterone levels after an IVF transfer are between 10-20 ng/mL. This range appears to offer the best chance of implantation and ongoing pregnancy.

However, you don’t want your progesterone levels to get too high. One study found levels over 20 ng/mL were linked with lower birth rates and higher pregnancy loss. 

You can easily check your progesterone levels with a monitor like Inito to see if they fall in the ideal range.

If they do, great! If not, you’ll want to talk with your doctor. They may tweak your dosage until you find your sweet spot.

Your doctor may also suggest lifestyle changes to support healthy progesterone levels. 

Reducing stress is a good place to start. Stress raises your cortisol levels, which can hinder hormone production. 

Since progesterone is a hormone, it’s not found in foods. However, certain foods may help stimulate your body’s natural progesterone production. 

Look for progesterone-friendly foods rich in these nutrients:

Vitamin C is linked with increased progesterone production. Foods high in vitamin C include citrus foods, kiwi, bell pepper, broccoli, and cantaloupe. 

Magnesium helps regulate the stress response and promotes hormone balance. Magnesium-rich foods include dark chocolate, spinach, nuts and seeds, beans, and quinoa. 

Vitamin B6 helps support healthy progesterone levels in the body. Foods rich in vitamin B6 include salmon, chicken, avocados, bananas, and sweet potatoes. 

How is Progesterone Given During IVF?

There are two different options for taking progesterone during IVF: by intramuscular injection or vaginally: 

  • Progesterone injections are given in the buttocks, hip, or thigh area. While effective, the injections can be painful.
  • Vaginal progesterone is offered in suppositories, gels, or tablets that are inserted into the vagina. 

If IVF has you feeling like a pincushion, vaginal progesterone may be a good option. Although some women prefer injections.

While oral progesterone is available, it doesn’t work as well due to poor absorption. For that reason, it’s not recommended during IVF.

Speak with your doctor to find what progesterone supplementation is right for you. 

Which progesterone supplementation is more effective?

Most research shows that vaginal progesterone and injections are equally effective. However, some recent studies suggest vaginal progesterone may have the edge.

One study from 2019 found that women who took vaginal progesterone had higher implantation, delivery, and live birth rates than those who received injections.

That being said, more research is needed to confirm this. How you choose to get progesterone during IVF is up to you and your doctor.

Are There Any Risks Involved?

Studies show natural progesterone poses no risks to you or your baby. However, synthetic progesterone is another story.

According to a 1999 FDA review, synthetic progesterone is linked with birth defects.

So if you’re considering progesterone supplementation – going the natural route may be a safer bet.

While natural progesterone is safe, there are some potential side effects.

Talk to your doctor if you notice:

  • Allergic reactions (such as skin rashes, hives, or itching)
  • Coordination issues or changes in visions
  • Chest pain or shortness of breath
  • Migraine headaches
  • Trouble breathing or swallowing
  • Extreme dizziness or fainting
  • Abnormal vaginal bleeding

Your doctor will help determine the correct progesterone dosage for your body. Monitoring your progesterone levels can confirm if you’re absorbing it properly to help fine-tune your dosage.
 

Progesterone and IVF: Summing it Up

  • Progesterone is a steroid hormone that helps regulate your menstrual cycle and prepare the womb for pregnancy.
  • Progesterone triggers the uterine lining to thicken, helping the fertilized egg to implant.
  • It also inhibits uterine muscle contractions to prevent miscarriage.
  • IVF medications and drugs impair the body’s ability to produce progesterone naturally. That’s why fertility specialists often prescribe supplemental progesterone.
  • Women who take progesterone during IVF treatment have higher pregnancy rates than those who don’t.
  • Supplemental progesterone can be taken by injection or vaginally. It’s typically taken the first 8-10 weeks after egg retrieval.
  • Progesterone is important for those trying to conceive naturally as well. Low progesterone levels are linked with repeated miscarriages and ectopic pregnancy.
  • If you’re struggling with fertility, testing your progesterone levels may explain why.
  • Monitoring your progesterone during IVF can also ensure your levels are optimal to support a healthy pregnancy.

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