Ranked among the top gynecology programs by U.S. News & World Report
Published: Sept. 26, 2008
Updated: Sept. 8, 2010
Progesterone is produced by the corpus luteum in the ovary after ovulation. During the retrieval process some of the hormone producing cells are removed from the inside of the follicles.
As an attempt to support the lining of the uterus and prepare for implantation, supplemental human chorionic gonadotropin (HCG) or progesterone is usually used.
This supplemental HCG can further stimulate hormone production in the ovary and worsen the symptoms of ovarian hyperstimulation. To avoid this undesired effect progesterone can be administered.
There are several forms of progesterone available including vaginal suppositories and injectable progesterone. Progesterone injections and suppositories are usually dosed as 25 to 50 mg twice daily.
In patients suspected of having inadequate progesterone secretion after ovulation (luteal phase defect), supplemental progesterone may be administered to support the lining of the uterus and the early embryo.
There is no definitive evidence or consensus that luteal phase defects actually exist. There is also no conclusive data supporting the use of progesterone. Since progesterone is normally made by the ovary and placenta in early pregnancy, use of progesterone has not been associated with any serious effects. By 10 weeks of pregnancy the placenta makes sufficient quantities of progesterone that supplementation is not necessary.
Patients undergoing "programmed cycles" (oocyte recipients and frozen embryo transfers) will begin taking progesterone in oil 25 mg twice daily starting the day after the oocyte donor is given HCG. Crinone 0.8 percent twice daily can be substituted.
This dosing will be continued to 10 weeks of pregnancy.
Crinone is a form of progesterone that is administered in the vagina as a gel.
This takes the place of supplemental HCG, progesterone suppositories, and progesterone in oil.
Crinone 8 percent at bedtime is usually continued to seven weeks when used to replace supplemental HCG in patients at risk for hyperstimulation and twice daily until 10 weeks when used with programmed cycles.
Learn more about fertility medications below.