Progesterone is one of the most important hormones in pregnancy. It is produced by the ovary during the luteal phase of the menstrual cycle, immediately following ovulation. Its primary function is to induce changes in the endometrium, making it receptive to the embryo, particularly during implantation.
Progesterone and Pregnancy
For pregnancy to develop correctly, progesterone plays a crucial role. Besides promoting endometrial changes, progesterone relaxes the uterine muscles, allowing the pregnancy to grow within the uterus.
Additionally, during pregnancy, the immune response at the uterine level must be suppressed to prevent the body from reacting against the pregnancy. Without this suppression, the mother's immune system could attack the embryo, hindering proper implantation. Progesterone helps regulate the immune system, ensuring the embryo's proper development.
In the early stages of pregnancy, progesterone secretion is primarily controlled by the corpus luteum, which forms in the ovary after ovulation. As the pregnancy progresses, the placenta takes over progesterone production, becoming the main source after the first trimester.
Because of progesterone’s vital role, it is administered during assisted reproduction treatments to support pregnancy.
Progesterone and IVF
In fertility treatments like intrauterine insemination and in vitro fertilization (IVF), progesterone is recommended to support the luteal phase. Particularly in IVF, follicular puncture can have a negative impact on the ovaries’ ability to produce sufficient progesterone, even if they are functioning well. Therefore, exogenous progesterone is administered to ensure adequate levels until the placenta takes over hormone production.
In treatments like egg donation, embryo donation, or frozen embryo transfers, progesterone is essential for achieving and maintaining pregnancy. Since these treatments aim to suppress ovarian function to avoid interference with endometrial preparation, progesterone administration is required to support both pregnancy achievement and development.
In Cyprus, progesterone can be administered vaginally, orally, or subcutaneously. The vaginal route is initially recommended because its effects are concentrated at the uterine level, minimizing systemic side effects like dizziness. Subcutaneous progesterone can be an option for patients with allergies or issues absorbing it via the vaginal routinely and effectively.
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