Fertility Medications: Progesterone
(Progesterone in oil, suppositories, Crinone, Endometrin)
What is Progesterone?
Progesterone is only administered after ovulation has occurred (i.e., 4 days after an LH surge or HCG injection, two days after insemination is completed, or the evening following IVF egg retrieval.) (See “Progesterone Supplementation” for more information on why Progesterone is used in Ovulation Augmentation.)
How does Progesterone work?
Progesterone changes the lining of the uterus to make it more receptive for implantation and it is responsible for slightly raising the body temperature during the second half of a women’s menstrual cycle.
You will receive progesterone either in the form of an intramuscular injection or vaginally. Your dosage by injection (or vaginally) will be discussed with you. Some patients prefer injection while other patients prefer to avoid injection and can tolerate a vaginal medication. For those patients bothered by the messiness of suppositories, we suggest wearing a pad to absorb the discharge associated with the suppositories. If intercourse takes place, insert the suppository afterward.
You must continue your progesterone therapy until your pregnancy blood test result is known. And since progesterone may delay the onset of your period, a pregnancy test should be scheduled two weeks after ovulation, regardless of whether you have started bleeding.
To support the lining of your uterus in IVF (fresh, FET, or recipient), you will be asked to take daily injections of Progesterone beginning the day after egg retrieval. You may give your injections at night before bedtime. It is important to be consistent with the timing. This type of progesterone is made from natural progesterone and is not thought to cause an increased risk of birth defects. However, the package insert lists abnormalities that have been associated with the use of synthetic (man-made) progesterones. Please do not let this alarm you; virtually all IVF programs use progesterone.
Occasionally, women will complain about an itchy discharge with vaginal progesterone use. It is also possible to develop a yeast infection while using this hormone. This is not a serious complication and it will not affect fertility. If you are bothered by increased discharge accompanied by an itch or raw feeling, then please let us know. In most cases this is not yeast, only irritation from the progesterone.
Progesterone therapy is a standard part of our fertility medication / insemination program, as well as our IVF and egg donation program. We have had many years experience using this medication and feel comfortable recommending it to you as part of your therapy.
The progesterone medication used in your prescription is similar to natural progesterone produced by your ovary. Please note that progesterone is related to a variety of hormones known as progestins (for example, Provera; or the progestin in the birth control pill). All progestins are required by law to have a package insert that describes some studies that suggest a slight increase in birth defects associated with its use.
Please note that all of these studies have involved synthetic or man-made progesterones and do not describe the progesterone that we use. There appears to be no increase in birth defects linked to the more natural progesterone (“progesterone” in oil or “progesterone” in suppositories) that we will prescribe for you at Carolina Conceptions. These studies also involved a higher dose, and were administered at a later time in the pregnancy.