Progesterone when planning pregnancy: deviations from the norm during conception and possible consequences. Progesterone - the effect of the hormone on successful conception. Does progesterone affect conception?

Progesterone is responsible for the normal course of pregnancy; it is produced even before conception. Responsible for the process, its development and successful gestation of the fetus.

Without progesterone, the embryo would be rejected. The hormone reduces the frequency of uterine contractions, preventing involuntary miscarriage.

From the beginning and until pregnancy, it is produced by the corpus luteum. Without it, conception would be impossible. It prepares the body for childbirth and in every possible way contributes to the healthy course of pregnancy:

Allows the fertilized egg to gain a foothold in the uterus and creates a favorable environment in it.
Compacts and supports the inner layer of the uterus.
Ensures normal secretion.
Helps rebuild the mammary glands, prepares them for milk production.
Prevents the development of fibroids.
Participates in the conversion of fat deposits into energy resources.
Controls blood thickness and sugar content.

What is the norm?

The concentration of the hormone depends on the phase of the menstrual cycle:

In the first phase, its level is minimal - in the range of 0.3-2.24 nmol/l.
With the onset of ovulation, the content increases, reaching a peak. At this time, indicators fluctuate between 0.45-9.45 nmol/l.
If conception has successfully occurred, the numerical value jumps to 7-56.6 nmol/l.
In the absence of pregnancy, its concentration decreases to a minimum and is approximately 0.3 nmol/l.

Why donate blood?

Knowing the indicators helps the doctor predict possible deviations and take timely measures if there is a threat of pregnancy failure. If infertility is diagnosed or after a number of unsuccessful attempts to get pregnant, the causes of the pathology are determined based on the results of the study.

Before you need to go to the antenatal clinic, take the necessary tests. Among them is donating blood for progesterone concentration, which is required in the following cases:

when planning to make sure that everything is in order in the body;
with hormonal disorders;
to diagnose problems that impede conception;
after treatment of diseases of the reproductive system.

Which is correct?

After setting the date for the study, you must carefully prepare for the test. On the eve of the procedure, the doctor should explain the features. With a regular cycle of 28 days, the procedure occurs on days 22-23. If the study is carried out after pregnancy, the date is set on an individual basis.

Refrain from eating 8-10 hours before blood sampling.
Do the procedure in the morning.
You must not smoke or drink alcohol during the day.
Avoid intense physical activity.

Peculiarity! The concentration of progesterone depends on the menstrual cycle if the study is carried out before conception.

What to do if rejected?

During gestation, the level increases, which promotes normal development. To have an idea of the norm, indicators are monitored even when planning pregnancy.

If they differ, it is worth taking appropriate measures:

if progesterone is elevated, it will not prevent conception, but it is worth considering how high it is. Usually a diet prescribed by a doctor is enough to normalize it;
at low levels, conception may not occur or there may be a risk of miscarriage subsequently. Then the specialist prescribes drug therapy taking into account the general state of health and the degree of deviation;
if the fluctuations in indicators are small, this is equated to the norm. Then medical intervention is not required, because each organism is individual;
The degree of severity is determined by the doctor.

Low level

With such indicators, the chances of getting pregnant decrease several times. Conception with low progesterone is possible if the following conditions are met:

the expectant mother will have to be under the close attention of doctors;
if the hormone level remains unchanged throughout the entire cycle, this is a sign of lack of ovulation. Then it is carried out;
completing a course of drug therapy;
maintaining a healthy lifestyle;
sometimes an additional diet is prescribed.

Attention! If the level of the hormone is below normal, it is difficult for the embryo to implant in the uterus, even if conception is successful, there is subsequently a threat of termination of pregnancy or lack of nutrients.

Indicators after conception

As a result of successful fertilization, it increases, activating the process of restructuring the body. This ensures comfortable conditions for pregnancy and fetal development.

The longer the period, the higher the indicators:

At an early stage - in the range of 7-56.5 nmol/l.
In the first trimester - about 9 - 467 nmol/l.
In II – approximately 71.5-302 nmol/l.
In III – from 89 to 772 nmol/l.

Duphaston for drug correction and treatment

This is an artificial analogue of progesterone. It is used when there is a threat of spontaneous miscarriage or low levels of the hormone. Application has its own characteristics:

The drug is especially effective in the early stages, when the body is most sensitive and vulnerable.
When taking Duphaston, pregnancy is successfully maintained and childbirth goes well.
The dosage is prescribed by the doctor and depends on the degree of deviation from the norm and the condition of the expectant mother’s body.
When planning a pregnancy, it is drunk to prepare the body for a successful conception.

17-OH progesterone when planning pregnancy

Low levels of 17-OH progesterone also cause problems during pregnancy. For this purpose, drugs based on it are prescribed. With their help, metabolic processes are regulated and possible deviations are prevented.

A normal level is the key to successful conception and harmonious development of the fetus. This is the basis for the production of cortisol and estradiol.

Spontaneous miscarriage may occur.
The embryo may lack nutrients.
Metabolism is disrupted.

Important! If there is a lack of necessary enzymes, their deficiency is compensated by increased testosterone synthesis.

Progesterone is called the pregnancy hormone because it plays a significant role in the growth and development of the fertilized egg and pregnancy. Does this mean that it is necessary to take additional progesterone during this time?

Why donate blood for progesterone?

Before planning a child, undergo an examination by a gynecologist and take all the necessary tests, including. This will help avoid various negative factors during pregnancy. In addition, knowing your progesterone level, the doctor will be able to help avoid “futile attempts” to conceive.

A doctor may prescribe a progesterone test in the following cases:

at ;
in case of infertility, if ovulation is preserved;
with induced ovulation.

How to donate blood for progesterone

Blood is taken for analysis to determine progesterone levels on a certain day of the cycle. So, if you have a normal cycle length (28 days), then a blood test for progesterone will be prescribed for you on days 22-23 of the cycle. If your cycle is irregular, several tests may be prescribed on different days.

It is best to donate blood in the morning, on an empty stomach. Please note that at least eight hours must pass after your last meal.

Deviation from the norm: what to do

If the test results show abnormalities, the doctor will prescribe you medication to adjust progesterone levels. The course of treatment is selected individually, based on test results and the general condition of your body, and, as a rule, hormonal therapy is prescribed. Be sure to ask your doctor about all the positive and negative aspects of hormone therapy.

Should I take progesterone when planning a pregnancy? This question will be answered by Yaroslava Nesterenko, a gynecologist at the Oxford Medical clinic.

Progesterone is responsible for the formation of a woman’s figure, and during pregnancy for the formation of the placenta and the attachment of the fetus to it. During pregnancy, a lack of this hormone can lead to miscarriage.

Typically, a number of symptoms indicate a threat of miscarriage: nagging pain in the lower abdomen, back pain and bleeding. The last symptom is especially dangerous. To maintain pregnancy, hormonal medications with progesterone may be prescribed.

Since there can be many reasons for infertility and miscarriage, it is important to make a correct diagnosis before prescribing hormone therapy. Progesterone may be prescribed if pregnancy does not occur and there is laboratory confirmation that the reason is low progesterone levels.

2014-05-05 01:55:15

Elvira asks:

Hello! My menstrual cycle was disrupted after childbirth, I was prescribed Duphaston because I had low progesterone, I took 14 tablets, my period started, I stopped drinking on the doctor’s advice and I have no menstruation again, what should I do? I really want to give birth to a second baby, but I just can’t get pregnant. The birth took place in December 2011!

2014-02-18 11:14:46

Bogdan asks:

Hello, please tell me what to do?
I am 21 years old, and for several years in a row I have been bothered by brown discharge in the middle of my cycle. Everything was fine on the ultrasound (done many times), and when examined at the doctor’s appointment everything was fine too. I took tests for hormones, including progesterone. All hormones are normal, but only I had low progesterone (I repeated the test 2 times), that is, there is no ovulation. I took Duphaston for 3 months, rested for a month from the drugs and did the progesterone test again - the result was good. 2 months later my husband and I We started to have an open sexual life. We want children. It's been a year now and I'm not pregnant. 2 months ago I took an estradiol test (the result was good), but the progesterone test was bad (it was low again). I took Yarina for 2 months, and after that, during the next menstruation, on the first day of the cycle, I started taking the drug CLOMID (5 days), I live abroad, I don’t know if there is such a drug in the CIS countries. The local doctor explained that this drug will increase the number of eggs during ovulation. Today is the 8th day of the cycle. I did an ultrasound today (since the doctor will go on vacation tomorrow), and the eggs are small again, one of the largest is 11mm.
The local doctor advised me to get an injection (to enlarge the eggs). I said that I would think about it, and maybe next month we will try this injection. The doctor also said that the drug is not dangerous. It is similar to Clomid, but just stronger.
I don't know what to do. I’ve taken Clomid (to enlarge eggs) several times this year, and she gave me Duphaston for one month (I didn’t get pregnant that month. My husband’s spermogram is fine, the results are very good. What should I do? What do you recommend? do? We want children. Thanks in advance for your answer.

Answers Palyga Igor Evgenievich:

Firstly, stimulation with clomiphene (Clomid or clostilbegit) can be carried out no more than 3 times.
Have you had folliculometry done while taking Clomid? How many eggs were there? Did they ovulate? No one performs stimulation blindly. In addition, the situation with progesterone levels is not completely clear to me. It is necessary to take a progesterone drug and immediately plan a pregnancy, and not wait 2 months. Ideally, it is advisable to donate blood for antibodies (!) to progesterone.
It’s difficult to say virtually, but if you don’t get pregnant naturally, then you need to analyze and, possibly, conduct mini IVF. If possible, I invite you to visit us in Lviv, at the “Alternative” clinic.

2013-03-12 18:58:34

Elena asks:

Good afternoon I am 38 years old, my husband is 36. This is my second marriage, my husband’s first, in my first marriage I have 2 children, the youngest is 6 years old, I have never experienced problems with conception and pregnancy. With my second husband, pregnancy occurred in the first month of planning (October 2009), but unfortunately, I was forced to terminate it with an abortion, since my husband was not quite ready for children, 7 months after the abortion I took her away. again - in the second month of planning, and at the 9th week I had a miscarriage - the first in my life due to low progesterone (Aug 2010), since then I was not able to get pregnant until October 2012, during which time I completely examined myself, There was even laparoscopy + hysteroscopy, monitoring of hormones and ovulation - everything was in order, but after examining my husband it turned out that he had a bad spermogram and low testosterone levels, the doctor’s conclusion was only IVF + ICSI, in November 2012 we did the IVF + procedure ICSI in Israel, 15 eggs were taken, 9 embryos were obtained, 2 embryos were implanted in me, one implanted, the pregnancy developed perfectly, we even managed to do screening for the first trimester, everything was fine, but after a few days the fetus froze - for unknown reasons , my husband and I passed all the necessary tests, karyotype, immunogram, histocompatibility. We received two test results - the karyotype - everything is normal, my husband’s genetics are normal, so am I, except for the fact that I have poor absorption of folic acid, I asked if this was an acquired problem or a congenital one? - to which they answered that it was a congenital problem. I then thought, since this is a congenital problem, how could I give birth to two children without taking this acid at all? Now we are waiting for the histocompatibility analysis, but it will be ready in a month, please explain what kind of analysis this is and how its result affects pregnancy? does it make sense (is it dangerous) to use the remaining embryos after a fresh protocol in which pregnancy occurred and died?
and how good is their quality, and accordingly their ability to take root, here are the embryos left, what can you say about their quality: 2c A, 2c A, 2c A\B, 3c B\C, 8c A\B, 6c A\B , 7c V., they hooked me up with two identical ones - 9c A
And yet, I am worried about the endometrium, from my own bitter experience I know that it is not easy to restore, with
On the second day after the curettage, I started taking Yarina again - probably for three months, what else can you do for me?
Any advice for restoring it? I’m very worried, because age is running out, I need to recover as quickly as possible so that
don’t waste time, give up, I’ve always been healthy, but now I don’t have the strength for all these experiments
A\B, 7c V., they gave me two identical ones - 9c A, Thank you very much!

Answers Silina Natalya Konstantinovna:

2010-12-21 17:18:47

Marina asks:

Hello, I have primary polycystic ovary syndrome. There was no menstruation without hormones, I got pregnant immediately after laparoscopy, gave birth without problems, after giving birth, menstruation comes, but every month three days later, if in the first and second month it was the 7th, then the third month is the 10th then 13th and 16th. I got scared and started taking Diane 35 so that the situation wouldn’t get worse. Because I want a second child. I want to get pregnant while on Diana withdrawal, I succeeded once, but I was pregnant at 5 weeks due to hormones. High testosterone and low progesterone, I would like to know if I get pregnant while discontinuing Diane, I know that I can take Duphaston, but I won’t risk it, but what about androgenia, because with polycystic testosterone can be high and while you are taking Diane, androgens are low and when I get pregnant they will increase. I know that in this case they take dexamethasone during pregnancy, but this medicine helps if you have polycystic adrenal gland origin. Well, if, like mine, it’s primary, that is, of ovarian origin. What do they do then? I read that in this case, dexamethasone does not help reduce androgens, well, maybe only slightly, but during pregnancy it is dangerous, I’m afraid of another missed abortion. I would like to know what pregnant women with polycystic disease do in this case? Or maybe I’m wrong and dexamethasone is all does it help even in this case? Thank you and sorry for the long text.

Answers Sergienko Alena Nikolaevna:

Marina, firstly, they undergo hormonal testing for pregnant women in the 1st trimester (TSH, progesterone, testosterone, estradiol, hCG) and then everything depends on the results of the treatment.

2014-11-06 17:40:05

Elvira asks:

Hello! I constantly have delays in my cycle, diagnosed with opsomenorrhea! Ultrasound did not reveal any abnormalities at all, no genital infections were found; tests for hormones FSH, LH, estradiol are normal; low progesterone 1.1; thyroid hormone tests are normal except that TSH is slightly elevated but not much; I have it 3.57, I have a child, but I want a second one I haven't been able to get pregnant for 2 years. Please help with advice, I really want another baby!! Yes, and they also cauterized my cervical erosion, but it was unsuccessful and I need to re-cauterize it.

Answers Palyga Igor Evgenievich:

Hello Elvira! Have you taken a blood test for AMH? What is FSH? What is the number of antral follicles on ultrasound? How old are you? Do you have a history of pelvic inflammatory disease? If it is determined that the ovarian reserve is sufficient, then it is necessary to check the patency of the fallopian tubes.

2014-04-03 16:54:14

Dana asks:

Hello. please tell me.. My husband and I are unable to have children; we have been living openly for over a year now, but we cannot get pregnant. My husband's sperm count is fine. I took hormone tests, progesterone is low, ovulation is not happening, other hormones are fine. I was stimulated twice with Clomid, without results. During the second stimulation on the 15th day of the cycle, one follicle was 17.4 mm. We gave a hCG injection on the 16th day. No result. The doctor says that we need to continue stimulation, but with Clomid + injections... but I insisted on examination of the thyroid gland (thyroid hormones are normal), examination for sexually transmitted/sexually transmitted infections (ureoplasma was discovered). My husband and I took the pills. Somewhere from the fifth day of taking the pills, I started having cloudy white discharge without any odor and slight itching around the labia. I finished the tablet. I finished the pills and after three days the discharge stopped.

And one more thing...after I get rid of ureoplasma, I want to check the pipes for patency (hysterosalpingography
) and get tested for compatibility with your husband. I'm afraid to be stimulated..I'm only 21 years old. What tests and examinations are required in our situation? When do you need to take a repeat test for ureoplasma after taking the pills? And is HSG dangerous? And could ureoplasma be the reason why I don’t get pregnant?
Sorry for the many questions. And thank you..

Answers Palyga Igor Evgenievich:

Hello Dana!
Let's go in order.
Ureaplasma is a conditionally pathogenic microflora and can only be treated if detected by PCR. Infection is not the cause of infertility. The main reason is the non-occurrence of ovulation. Your gynecologist told you correctly - you need to use stimulants. It is, of course, mandatory to check the patency of the fallopian tubes before stimulation.
It is advisable to conduct metrosalpingography as the most informative method of examination. There will be no harm from the procedure, but you cannot plan a pregnancy during the month of the examination. It is also possible to be stimulated with drugs at your age. A control test for ureaplasma can be carried out no earlier than after 1-1.5 months.
Health to you!

2014-01-19 19:16:10

Dilya asks:

Hello, I have already asked you for help. I’m writing again because I re-tested. I’ll write in more detail. please help me decipher the test results. We are trying to get pregnant, but my doctor doesn’t give us any hope. my results: Follicle-stimulating hormone (FSH) 28.92 mIU/ml Luteinizing hormone (LH) 42.29 mIU/ml Progesterone 0.40 ng/ml Prolactin 334.98 IU/ml
Estradiol 1009.0 pmol/l Anti-Mullerian hormone 0.10 ng/ml. CAN estradiol be so high? But what about low AMH? is there any hope for pregnancy? maybe not soon, but at least... I'm 28 years old. I’ve been taking Regulon since I was 21 because I had a cyst on my ovary. The doctor prescribed Regulon until I get pregnant. I had my period on November 10, 2013. (I drank Duphaston from November 25 to December 5, after which my period did not come and at the same time I had cystitis, I took besiptol and nitroxoline) in fact, they still seem to be going on now, but only bloodless. The process before menstruation is normal, my breasts hurt, only this month they have not become larger as usual, but on the contrary have become smaller. after that she became normal again. Maybe the body is recovering after taking it for so long OK? I also did an ultrasound and the doctor said that I have ovarian dysfunction.

Answers Korchinskaya Ivanna Ivanovna:

Elevated FSH and low AMH indicate depleted ovarian reserve. It is necessary to further evaluate the number of antral follicles on ultrasound. Theoretically, there is little chance of getting pregnant naturally. I’m not scaring you, I’m just stating a fact. Even IVF using your own eggs, I think, will not bring results, although you can try stimulation.

2013-02-14 20:07:54

Asks Alina, Kharkov, 32 years old.:

Good afternoon I've been trying to get pregnant for 3 years. We've reached IVF. I had a laparoscopy and found nodular adenomyosis of 21*17 mm, and endometriosis was also removed from the left ovary. The tubes are clean, the ovaries are normal, ovulation is occurring, hormones: progesterone is low, LH, FSH are reduced. My husband has normospermia. My husband is 36 years old. 9 months after the operation, on an ultrasound scan on the 22nd day of the cycle, the doctor sees an adenomyosis node of 32*20 mm. Please tell me, does it make sense for us to do IVF? What are our chances? The doctors don’t say anything, I don’t know how to figure it out. There is only money for one IVF attempt. We’ll be able to save up for the next one in a year, not earlier. If adenomyosis begins to grow in the absence of pregnancy, will I have to do laparoscopy again? Thank you very much for your quick response, we really need professional advice now.

Answers Palyga Igor Evgenievich:

It is difficult to speak virtually, since everything depends, first of all, on the location of the node. If it deforms the uterine cavity, then before the IVF program it is necessary to carry out diagnostic hysteroscopy and, possibly, conservative treatment (with gonadotropin-releasing hormone agonists, for example) to reduce the size of the node. The dimensions are large, as for adenomyosis; perhaps it is a myomatous node. By the way, it is better to undergo an ultrasound immediately after menstruation, on the 6-7th day of m.c. If the node does not deform the uterine cavity, then you can go to the program. When pregnancy occurs, it will be necessary to monitor the dynamics of the ultrasound; the node will increase slightly. You must clearly understand that after one IVF attempt, pregnancy occurs in 40% of cases on average; with endometriosis, the chances are somewhat reduced; it is not a fact that pregnancy will occur on the first attempt, although reproductive specialists make every effort on their part. If you follow a long protocol, the size of the node after stimulation should not increase. If you wish, you can send an ultrasound report with a photo, I will evaluate it. To assess the ovarian reserve, it is rational to take AMH and estradiol on days 2-4 of the cycle; they can be used to predict the result of stimulation. If there are a sufficient number of eggs, then even if the first attempt is unsuccessful, some of the embryos can be frozen and then a cryoprotocol can be carried out without ovarian stimulation. Good luck to you!

Progesterone provides support for phase II of the menstrual cycle. With its deficiency, various menstrual cycle disorders occur, and, as a consequence, ovulatory and anovulatory uterine bleeding. That is why without normal progesterone production, pregnancy is almost impossible.

If pregnancy does occur, then the low progesterone level can have irreversible consequences: from miscarriages to underdevelopment of the embryo. You can get pregnant with low progesterone using medications that contain this hormone and increase it in the blood. A completely different question is whether a woman will be able to bear and give birth to a healthy child?

What to do if there is not enough progesterone in a woman’s blood?

When the function of the corpus luteum is impaired, natural or synthetic progesterone must be administered every other day or daily for several weeks until conception occurs. Then the drug is administered up to 4 months of pregnancy, and in case of miscarriage - up to 36 weeks of pregnancy. The treatment regimen, the specific drug and its dosage are prescribed by a doctor, who is based on the results of a hormone test. Under no circumstances should you carry out treatment on your own or arbitrarily change the dosage of prescribed medications!

The level of progesterone in the blood is increased by medication, one drug or a combination of them. Typically these are capsules used intravaginally or orally. In the first case - 100-200 mg every 12 hours, in the second - 200-400 mg with an interval of 6-8 hours (three times a day), for 12 weeks inclusive.

Duphaston (dydrogesterone) is prescribed in an amount of 10 mg with an interval of 8 hours, the course of treatment is individual, usually the drug is taken until 14-20 weeks of pregnancy. An injection 1% solution of Ingest should be administered every day or every other day, 0.5 or 2.5 ml, and a solution of progesterone (oil) - 10-25 mg, until the threat of miscarriage disappears.

How to maintain sufficient progesterone levels?

When progesterone levels are low, but not so critical as to warrant taking medications, the hormone level can be increased by taking herbal tinctures or decoctions, having previously notified the doctor of this desire. If the doctor finds such treatment safe and useful, you can use these methods.

There is also a special preventive diet that helps increase the level of progesterone in the blood. It involves eating dairy, soy, legumes and meat products, as well as nuts, cheeses and eggs.

The main thing is not to worry about the results of your hormone test, but to consult your doctor and strictly follow all his recommendations. Then the likelihood of conception will increase significantly, and the pregnancy will proceed favorably and end with the birth of a healthy baby.