Why should I care about Progesterone?

Progesterone medicineBecause it’s kind of a big deal and this is why: Progesterone, also referred to as “the pregnancy hormone,” is a common female hormone found naturally in a woman’s body. It also happens play an essential role for both before and during a pregnancy. When a fertility workup is suggested, there are two main sex hormones an overseeing medical provider will look test: estrogen and progesterone.

Progesterone (as a prescribed hormone supplementation) is often necessary during Assisted Reproductive Technology (ART) procedures, such as in-vitro fertilization (IVF). Partly because the medications you may use during these procedures can suppress your body’s ability to produce progesterone. Certain procedures can even, unintentionally, remove progesterone-producing cells from your ovaries.

Sometimes, there are other reasons to use progesterone supplementation, such as little or no progesterone production from the ovaries or poorly developed follicles that do not secrete enough progesterone to develop the uterine lining.

The bottom line is this — all women who wish to become pregnant need progesterone to help their uterus prepare for and maintain a pregnancy. Follow the links to learn more about the important connection between progesterone and how it impacts both fertility and pregnancy.

Before Becoming Pregnant

The role of Progesterone in overall fertility health, is that it helps prepare the uterus for pregnancy. After ovulation occurs, the ovaries start to produce progesterone needed by the uterus. Progesterone causes the uterine lining or endometrium to thicken. The overall goal is to have a thick lining which will helps create an ideal supportive environment in your uterus for a fertilized egg/embryo.

During Pregnancy

Progesterone balance in a pregnancy is essential. A consistent supply of progesterone to the endometrium continues helps nurture the developing fetus throughout the pregnancy. Following a successful implantation, progesterone also helps maintain a supportive environment for the developing fetus. After 8 to 10 weeks of pregnancy, the placenta takes over progesterone production from the ovaries and substantially increases progesterone production.

The Different Forms of Progesterone

Not all forms of progesterone are created equal. There are several types of progesterone are available, including vaginal products that deliver progesterone directly to the uterus. The different forms include the following:

Vaginal gel:

  • Used once a day for progesterone supplementation
  • Unique — the only once-daily FDA-approved progesterone for ART for up to 12 weeks of pregnancy
  • The only FDA-approved progesterone for replacement for donor egg recipients and frozen embryo transfers
  • Over a decade of experience and over 40 million doses prescribed
    In studies where patient preference was measured, a majority of women preferred the gel for comfort and convenience over other progesterone formulations
  • Some discharge reported during use

Vaginal suppositories:

  • Compounded at specialty pharmacists
  • Wax-based
  • Widely used but not FDA-approved
  • Used 2 to 3 times a day
  • Leakage can be messy

Vaginal inserts:

  • Designed for vaginal use
  • FDA-approved for progesterone supplementation but not for progesterone replacement
  • Effective in women under 35 years; no established results in women over 35 years
    Used 2 to 3 times a day

Progesterone oral capsules, used vaginally:

  • Not formulated or FDA-approved for vaginal use
  • Fewer side effects when capsules are used vaginally instead of orally
  • Used up to 3 times a day

Injections:

  • An oil-based solution (sometimes called progesterone in oil)
  • Widely used; the oldest, most established method of progesterone delivery
  • Injected into the buttocks once a day
  • Require long, thick needle to penetrate layers of skin and fat
  • Difficult to administer by yourself
  • Injections may be painful
  • Skin reactions are common

Which supplementation is right for you?

This is a decision that you and your health care provider can make together. Progesterone is an important part of infertility treatment because it supports implantation and pregnancy. Health care providers often have a preference for which form of progesterone they prescribe for infertility treatment. Their preference is generally based on their experience with the various methods. But patient convenience and request are also important considerations.

Most women prefer a progesterone formulation that is easy, convenient, and comfortable. So, be sure to discuss your options with your health care provider.