So many people have heard the word Progesterone being used with reference to infertility treatment, but aren’t really sure about what it is. It is essentially a chemical messenger that the ovaries produce; it’s required to support pregnancy. The corpus luteum of the ovary produces progesterone after ovulation. It is required to ripen the lining of the uterus in order that the embryo be able to implant on it. Post ovulation, there is a rise in the progesterone levels in the blood- it reaches its peak level on day 20 and then starts dipping.

Here are some progesterone facts

  • Luteal Phase Defect and progesterone- The 2nd half of the menstrual cycle is called the leuteal phase. In this phase progesterone is produced by the corpus luteum. Once this production stops, it disintegrates; since the uterine lining doesnt get any support from the progesterone, it gets shed- that is when the period begins.
  • Progesterone blood test- when is it used?-This test is used to ascertain whether ovulation has taken place. The progesterone level should be above 15 ng/ml, around 7 days post ovulation. This indicates that the corpus luteum is functioning as it should. A low Day 21 progesterone levels indicates that the cycle was anovulatory (no egg was produced).
  • Low progesterone and miscarriages- Some doctors believe that low progesterone levels during the luteal phase can cause miscarriages. However, this particular concept of a "luteal phase defect" is now considered to be controversial.
  • Progesterone levels post embryo transfer- Luteal phase supplementation with progesterone is also very routinely performed post an embryo transfer in an IVF cycle. This helps support the endometrium. Some doctors also measure progesterone levels 4-6 days post embryo transfer; if the levels are low, they up the dose of progesterone for the patient.

Check your own progesterone levels

If you live in the USA, you can now check your progesterone levels yourself via MyMedLab !

Using progesterone for infertility treatment

Since progesterone is a key pregnancy hormone, and is often used in infertility treatment and is used to induce a period. When your IVF doctor induces a period for you with progesterone, he gives it for a very short period of time (3-5 days). The period then starts 3-8 days after you have stopped the last progesterone tablet.

Since the uterine lining loses the support that progesterone provides this bleeding is known as “withdrawal bleed”. Since the progesterone has been withdrawn, it results in the onset of the period (as it does in any normal menstrual cycle, once the corpus luteum dies and discontinues producing progesterone as there is no embryo to produce HCG to rescue it.

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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