Understanding Progesterone
Progesterone is a female hormone and one of the essential elements for pregnancy. It is also a key factor in the success of assisted reproductive treatments. Naturally, the corpus luteum produces progesterone after ovulation, which transforms the endometrium into a receptive state for embryo implantation. This continues until the 8th week of pregnancy, after which the placenta takes over progesterone production. Insufficient progesterone, which helps stabilize the uterus, may lead to miscarriage.
Functions of progesterone:
１．Stabilizes the placenta.
２．Reduces uterine contractions.
３．Converts the endometrium into tissue suitable for embryo implantation.
４．Suppresses immune responses that may attack the fetus (since half of the fetal genes come from the father and may be recognized as foreign), improving implantation success rate. In cases of immune disorders, progesterone can be continued until week 12.
５．Induces thick cervical mucus.
６．Reduces vaginal epithelial cell proliferation.
７．Stimulates breast development, especially glandular tissue.
８．Inhibits prolactin.
９．Provides negative feedback to the hypothalamus and anterior pituitary.
１０．Increases body temperature.
１１．Improves blood flow and oxygenation to the endometrium.
Why artificial progesterone is used in treatment
Fresh cycle:
After stimulation, the follicles are supposed to become corpus luteum after egg retrieval (equivalent to natural ovulation in pregnancy), but externally stimulated follicles may not transform on time, or may be immature, or granulosa cells that produce progesterone are removed during retrieval. This results in inadequate corpus luteum and requires external progesterone supplementation.
Frozen cycle:
The hormonal preparation involves taking estrogen to build the endometrium, so no corpus luteum is produced. After implantation, all progesterone must be supplemented externally.
The key to progesterone supplementation is consistency: continue until the 8th week
There is no strict upper limit on progesterone supplementation. As long as it is regularly absorbed and not interrupted, it is effective. The number of types of progesterone supplements depends on the physician—there is no “best” option. Typically, supplementation continues until week 8, after which the placenta naturally produces progesterone and continues until delivery.
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