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Progesterone
The most important hormone in promoting a healthy pregnancy is progesterone, meaning "pro" (supporting) "gesterone" (gestation). The production of progesterone is vital to your menstrual cycle because it ensures the shedding of your uterine lining each month. When fertilization occurs, natural progesterone in your uterus allows the egg to implant itself and remain in place by thickening the endometrium, increasing blood flow and preventing the premature shedding of your uterine lining. If a woman's ovaries do not produce enough progesterone during the first trimester of her pregnancy, it is likely she will suffer a miscarriage.
Progesterone can be administered for many purposes and comes in several forms. It is most commonly used as luteal phase supplementation or to trigger menstruation in women who do not produce sufficient progesterone on their own and want to have children, those who have luteal phase defects or irregular or absent periods, and those who are undergoing certain assisted reproductive technology (ART) procedures. In each of these instances, progesterone therapy has been shown to increase a woman's chances of achieving a successful pregnancy.
The different forms of progesterone therapy are described below.
Synthetic progesterone - Although it mimics the way natural progesterone works, synthetic progesterone is not progesterone at all; it is a progestin, which means it is made up of synthetic progesterone-like compounds manufactured by pharmaceutical companies. Synthetic progesterone is far more powerful than your body's natural progesterone and is used to trigger menstruation. While synthetic progesterone is less likely to cause the uncomfortable side effects of natural progesterone, such as fatigue and dizziness, it has been shown to increase the risk of cancer, abnormal menstrual flow, nausea, depression and fluid retention. Synthetic progesterone can be taken orally or through injection, but it is not considered safe to use during pregnancy. Oral progesterone - Ease and convenience are what make oral progesterone appealing to women with luteal phase defects or those who are undergoing intrauterine insemination (IUI) cycles. Taking progesterone in its oral form is simple because you do not have to learn how to give yourself an injection or deal with the discharge that often comes with vaginal application. However convenient, oral progesterone also has its disadvantages. Side effects include fatigue and dizziness, and at least one study suggests that it may not have as promising success rates as other forms of progesterone. Progesterone suppositories - Used during the luteal phase of a woman's menstrual cycle, progesterone suppositories consist of natural progesterone suspended in a base similar to cocoa butter, and they are administered vaginally. Vaginal administration allows the progesterone to be placed closer to the uterus where the suppository melts and releases the hormone. Although they are pretty easy to take, some women find the discharge associated with suppositories to be messy and uncomfortable. Side effects include insomnia, nausea, vomiting, diarrhea, headache and bloating. Progesterone gel - Progesterone gel, sold under the brand name Crinone, is also applied vaginally, only instead of being suspended in a soft base, it is suspended in a gel and comes in an applicator that resembles a tampon. Like progesterone suppositories, Crinone gel also allows the hormone direct access to the uterus and is often used as a progesterone supplement in IUI and IVF cycles. Many women prefer the gel form over suppositories because it is less messy and better at delaying premature periods. Others, however, may experience vaginal irritation as a result of accumulated gel buildup, as well as the usual side effects, which include bloating, cramps, dizziness, drowsiness, headache and nausea. Injectable Progesterone - The most frequently used form of progesterone therapy is injectable because it is seen as the most effective, particularly for IVF procedures. The progesterone is suspended in an oil, commonly sesame or peanut, and injected intramuscularly once a day. A larger needle is needed to administer progesterone injections than other fertility medications because of the relatively high viscosity of the oily solution, which some women may find intimidating. Progesterone creams - Unlike other forms of progesterone, progesterone creams are available over the counter because they only deliver a small amount of the hormone. Progesterone is very fat-soluble, so it is easily absorbed through the skin and into capillary blood. Creams may be effective for women with fairly normal menstrual problems and those with symptoms of menopause, but the dosages are not high enough to treat serious hormonal issues. Progesterone medications are usually administered starting two or three days after ovulation, and therapy will continue until you get pregnant or begin your period. Doses vary depending upon your individual needs and the form of progesterone you are using. Once you become pregnant, your treatment may be continued for 10 to 12 more weeks to give the placenta time to produce sufficient amounts of natural progesterone for the remainder of your pregnancy. Some of progesterone's other functions include protecting against fibrocysts, helping the body use fat for energy and helping normalize blood sugar levels, but it is proven most effective in increasing pregnancy rates among women with luteal phase defects. Studies show pregnancy rates as high as 77 percent in women undergoing progesterone therapy.
For more information on the benefits of progesterone therapy as part of infertility treatment, talk to your doctor.
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