[Ryles]

Hi Everyone-

I wonder if some of you can help me. I am seeing a fertility specialist here in Spokane and he is apparently the cat's meow. He has very high success rates and from what I can tell I am in good hands. The only thing that has been bugging me is he says there is rarely a need to prescribe Progesterone after trying to concieve or to keep a baby. I asked him if I should be taking it after sex or IUI and he said absolutely not. He said he would give it to me if I really wanted it but it would do me no good. My mom said she almost lost a pregnancy because her progesterone was low. Does anyone know scientifically the role progesterone supplementation plays in keeping a baby or is it bogis like my doc says? I am just not sure what I am going to do after I try to concieve this month.

[HopefulinCO]

I can tell you what progestone does and why it's given after IVF or with some cycle issues particularly... Progesterone is the hormone that keeps the uterine lining together and healthy during the second half of your menstrual cycle (from ovulation to AF). In "normal" non-pregnant cycles, estrogen builds up the lining during the first half of the cycle. Then ovulation happens and the cells in the ovary that surround the egg (the corpus luteum) start to make progesterone after the egg is released. THis progesterone is made for about 14 days, after which the cells of the corpus luteum degenerate and the body responds by shedding the uterine lining - hello AF!

In a "normal" pregnant cycle the same thing happens in the ovary. However, by the time the corpus luteum progesterone production is tapering off, the embryonic and placental cells are themselves making progesterone. Thus, the body never "sees" the decrease in progesterone from the corpus luteum and the uterine lining continues to be able to support pregnancy rather than being shed.

In IVF progesterone "has" to be given (that's in quotation marks because I'm sure there are folks out there who haven't done progesterone post-IVF) because suring the egg retrieval process the corpus luteums (not sure about the plural) are disrupted by the needle and don't make the progesterone needed to support pregnancy until the embryo takes over. There's also a condition called a luteal phase defect where supplemental progesterone is important because for those women the cells of the corpus luteum peter out too early, so instead of lastingthe full 14 or so days they may only produce progesterone for say 5 days. After 5 days the embryo has not yet started to produce sufficient progesterone on its own and so the body will sense the drop in progesterone as the signal to shed the uterine lining and the embryo with it.

Having said that, I'm not sure why so many of us are on progesterone when we have normal luteal phases and haven't undergone IVF. Like I was on it after each of my IUIs. I think that some REs figure that there might be a chance that supplemental progesterone has few risks and may potentially help support a pregnancy in the weird case that the corpus luteum was to fail prematurely.

Bottom line - if you trust your RE, I'd stick with his/her plan, but I think the more information we have the better questions we can ask. Maybe he can specifically tell you what it is about your situation that makes him say that there's no role for progesterone. Good luck!

[flashgal24]

My doc says there is no scientific eveidence that says it helps or doesn't, one way or the other. He tells me to take it if I want, but I don't have to. However, he said if there was sufficient evidence to say it WOULD help, then would make me take it.

[wtnganother1]

I asked my RE about it, too. My progesterone wasn't too low, but my RE put me on it anyway. I asked if low progesterone was the cause of a pregnancy not taking, or just an effect that naturally happens when it doesn't take. The RE said it's not really known. Based on what he said, taking it wouldn't hurt, although they don't know if it really helps, either. Or maybe it helps some, but not most of the people. But since it doesn't hurt, they prescribe it for more of us than probably need it. If your RE has that good of a reputation, I would trust him and stick to his plan unless you have good reason not to.

[Kris79]

I have a very conservative RE and he never even mentioned the use of it after my IUI's. I really don't think it's necessary unless you have a known problem like a luteal phase defect.

[Ryles]

Thanks for your responses ladies! So if my issue is that I havn't had my period on my own for over 2 years is it possible I have luteal phase defect? I know when ever they test me I have almost no progesterone in my system. I guess I am just paranoid about not taking it if it could help but dosn't hurt anything. If it dosn't help me get pregnant maybe it could help me get my cycle back?? I really feel clueless with this stuff sometimes.