In order for an embryo to implant in the uterus, the uterine lining must first be prepared with estrogen followed by progesterone. In order to prevent a miscarriage, progesterone must continue to be present after the embryo implants. In a natural pregnancy, progesterone is initially produced by the ovaries. Eventually, the placenta will take over production of progesterone from the ovaries.
In an IVF cycle, some of the medications used to prevent early ovulation. Like Lupron or Ganirelix can compromise the progesterone production from the ovaries. Also, doing an egg retrieval can further reduce progesterone production. In a frozen embryo transfer, all of the hormones used to prepare the uterus are given to a woman so there is no progesterone production from the ovaries at all. So in both cases, extra progesterone must be taken by a woman until the progesterone production from the placenta is adequate to support the pregnancy.
But when does this shift of progesterone production from the ovaries to the placenta occur? Scientists were able to figure this out by doing studies in monkeys. They found that if you remove the ovaries of a pregnant monkey before the 7th week of pregnancy, progesterone levels dropped and then the pregnancy always miscarried. On the other hand, if the ovaries were removed after the 8th week, progesterone levels stayed about the same and miscarriages didn’t occur. However, if you removed the ovaries before the 7th week but you gave the monkey progesterone - then the progesterone levels didnt drop and the pregnancies continued just fine.
The same timing occurs in humans. Its always possible for there to be a little variation from one woman to the next so at top IVF programs like ours at the Naperville Fertility Center, we keep progesterone going until about 9 to 10 weeks.
Here is how to determine how many weeks your pregnancy is. If you are doing a blastocyst transfer, then you are 2 weeks and 6 days along on the day of transfer so you should continue progesterone for another 6-7 weeks.
I didn't talk about the different types of progesterone in this video. You need to learn about the specific types of progesterone and how to use them to maximize your chances for IVF success. Check out this video about Crinone vaginal progesterone next.
Before you go --like this video. If you have questions or an idea for a future episode, leave it in the comments. and you should definitely subscribe to infertility TV now for new episodes weekly. It's like having a fertility specialist in your phone.
Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV
Infertility TV is your weekly source for the best medical information if you have infertility, recurrent miscarriage or are just trying to conceive. (TTC). InfertilityTV covers infertility testing, fertility treatments such as Clomid, Follistim and Crinone and fertility treatments like IUI and IVF (in vitro fertilization)
One of the most popular playlists on InfertilityTV are the TTC tips which are great even you are not struggling with infertility
Dr Morris is a practicing IVF and infertility expert who sees patients at IVF! located in the Naperville Fertility Center.
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