Here we share some of our fertility experts’ answers.
Progesterone prepares the lining of the endometrium to help the embryo implant. When you’re going through IVF treatment, fertility experts prescribe progesterone starting from the time of the egg retrieval, and once you get pregnant, it is advisable to continue. For how long should you be taking progesterone after the IVF cycle?
Raúl Olivares, MD Gynaecologist, Medical Director & Owner Barcelona IVF
For how long should progesterone be taken is still a controversial issue. In the majority of treatment cycles, it is recommended to continue it until the patient is 8 weeks pregnant. It is not uncommon to continue the progesterone until the pregnancy reaches the 12th week because that is when the placenta ‘takes over’ from the ovaries and then it is safer to stop the progesterone. However, there are clinics that advise stopping the progesterone intake as soon as the patient is pregnant because they consider that the ovaries can produce enough progesterone to support the pregnancy. However, this is a not very common opinion and, as I’ve mentioned, in the majority of cases it is recommended to continue at least until the patient is 8 weeks pregnant.
Harry Karpouzis, MD, MRCOG, DIUE Gynaecologist, Founder & Scientific Director Pelargos IVF Medical Group
Progesterone is a very important hormone in an IVF cycle. In natural conception, after ovulation (release of an egg), a cyst is naturally created. This cyst is called the corpus luteum and it produces progesterone. During an IVF cycle, at the time of egg collection, all the follicles are sucked so that the eggs can be retrieved, therefore no cyst is created, no progesterone is produced and there is nothing to support the pregnancy. This is why we need to give additional progesterone. Progesterone can be given in many ways: orally, vaginally, subcutaneously, intramuscularly. A woman definitely needs to take progesterone in large doses for about 12 days – until the time that she does a pregnancy test to find out if she is pregnant or not. After that, if the woman is pregnant, we need to carry on with progesterone during pregnancy. The doses can gradually be reduced but not abruptly, and the duration of progesterone supplementation may take up to 12 weeks.
Matthew Prior, PhD, MBBS Gynaecologist, Reproductive Medical Consultant, Founder of The Big Fertility Project
Progesterone is the hormone that normally the ovary produces after it has released an egg. With an IVF cycle, the natural cycle has been altered, so with a fresh cycle of IVF where you’ve had an egg collection, your ovaries are still much bigger than normal and will be producing some progesterone to some extent, however it’s thought that that progesterone may be insufficient and therefore, it’s encouraged to take extra progesterone. In our clinic, we normally would do that for about two weeks or up until the pregnancy test. With a frozen cycle of IVF, treatment is a little bit different because there’s lots of different ways you can you transfer the embryo. For example, you can do it in a natural cycle or a medicated cycle. Different clinics will have different ways of going about it but in some medicated cycles, the supressed ovaries are prevented from producing any progesterone at all. In some cases, it’s absolutely vital to take progesterone supplementation and in those circumstances, I prescribe it for up to 12 weeks of pregnancy. So, that’s the reason why you take progesterone because the body is not producing enough due to the treatment protocol. It’s always worth discussing with your IVF doctor whether progesterone will be supplemented and for how long.
Kristine Kempe, MD Gynaecologist, Obstetrician, IVF Specialist EGV Clinic
When we’re talking about medication after the embryo transfer for better response, we usually use progesterone. We have several types of progesterone, such as an intramuscular injection, oral, or vaginal option. For better comfort for patients, usually, here in Latvia, we use more vaginal progesterone. This support is necessary during the luteal phase in the ART procedure. We don’t have as much progesterone from the corpus luteum as in a natural menstrual cycle.