[Guest blog post by Melanie Mitchell, RN]
Progesterone is a naturally occurring hormone in the body and is widely used as a supplement for patients actively trying to conceive. It aids in the thickening of the endometrial lining in the uterus and helps provide the ideal environment for an embryo to implant.
Progesterone is produced in the ovaries. As an egg develops and matures within a follicle it produces estrogen. Once it has matured it is released from the follicle during ovulation or through aspiration during an oocyte retrieval. The remnants of the follicle become the corpus luteum, which begins progesterone production after ovulation during the luteal phase.
Once ovulation has occurred the corpus luteum continues to produce progesterone until about 8 to 12 weeks of pregnancy. With those that have used Assisted Reproductive Technologies (ART) such as insemination with controlled ovarian stimulation (COS) or a fresh/natural frozen embryo transfer (FET) a reproductive endocrinologist (RE) will add progesterone supplementation to optimize the endometrial environment. Progesterone is not produced by the body naturally for those that have done a medicated frozen embryo transfer, therefore supplementation is very important prior to embryo transfer, during early pregnancy and as support during the first trimester.
After ovulation, or when preparing for an insemination or embryo transfer, a woman may be prescribed progesterone in various forms:
- vaginal gel
- vaginal effervescent tablet
- oral tablets (which can also be prescribed to use vaginally)
- progesterone in oil (administered as an intramuscular injection which comes in a variety of oil bases such as sesame seed, cotton seed, castor oil or in an ethyl oleate base at a compounding pharmacy)
- vaginal suppositories
It is not uncommon to experience many of the symptoms one may have before a period, though elevated, such as headaches, breast tenderness, drowsiness/ feelings of lethargy, depression, fluid retention/bloating, hot flashes, abdominal pain or cramping, constipation and increased vaginal discharge and/or yeast infections.
Your fertility specialist will outline in your protocol specifically when to start the progesterone supplementation. If there are any concerns regarding when your progesterone start is you should reach out directly to your health care team.The duration of use will be dependent on your specific REI’s recommendations as they follow you through your pregnancy. A compounding pharmacy can work with your health care team to provide progesterone supplementation in a form and amount that is convenient and easy for you to use. For example, they can create suppositories with the exact dosage of medication you need, rather than having to use multiple suppositories each time it needs to be applied.
For any and all of your compounding needs speak to one of the Pace Pharmacy pharmacist.
Melanie Mitchell RN
Founder and CEO of Your IVF Nurse
A little bit about “Your IVF Nurse”