Progesterone is a natural hormone and it is made by the ovary and it is very important to support the pregnancy. The ovary before ovulation makes estrogens which is the female hormone. After the ovulation after the egg is released it starts making progesterone and the role of progesterone is to prepare the uterine lining so the embryo can implant and sustain the pregnancy until the placenta takes over which usually happens near the end of the first trimester after 10 weeks gestation. Progesterone supplementation is an important part of the fertility treatments.
In IVF after the eggs are harvest doctors will aspirate the eggs and also some of the cells that make progesterone concerns for many years. The ovaries may not be making enough been always a part of the IVF protocol to supplement with some extra progesterone after the eggs are harvest.
Progesterone is needed because it is the part of an artificial cycle for women who are using donor eggs they did not produce the eggs so they do not make their progesterone. So the doctor has to supplement that progesterone as a part of the artificial cycle similarly sometimes with frozen embryo transfers with EMS have been frozen before and the patient has not been produced the egg that month so doctors have to supplement the progesterone.
Different types of progesterone
Progesterone can be administered in different ways. It can be taken orally, pills, injection, intramuscular injection and can be used vaginally. The difference between the vaginal and injection is blood levels that can be achieved with the injections are higher than the levels that are achieved with vaginal progesterone. The progesterone works mainly on the uterus directly and through the vagina so that it does not get into the blood.
Some patients require blood levels to be higher for certain reasons so for them doctors prefer injections and for the patients who are not worried about their blood levels so that doctors use it through vaginal. Tablets can be used three times a day but they dissolve a little bit better.
Progesterone incorporated with IVF cycle:
Progesterone is used in the IVF cycle usually after the eggs harvest starting the next day. one of the concerns after that is egg retrieval or the harvesting of the eggs is that removing some of the cells that making progesterone. Production of progesterone by the ovaries may not be as robust as it needs to be so doctors like to supplement as part of IVF protocol.
Another reason to supplement progesterone is that hormone levels during an IVF cycle are very much higher than the natural cycle so that to balance that with some supplement progesterone. Progesterone can also be used to create an artificial cycle for other parts of the IVF treatment.