Insufficient support after embryo transfer. In vitro fertilization: embryo transfer and hormonal support. What support after the transfer. What is IVF? Progesterone support after successful IVF What hormones are prescribed after IVF

The main function of sexual secretions is to create favorable conditions for the fertilization of the egg and the normal course of pregnancy.

A woman preparing to become a mother monitors her hormone levels and their changes. In particular, the norm of estradiol during IVF after embryo transfer.

In the first week after embryo transfer under the in vitro fertilization program, follicles begin to grow in the woman’s ovaries, so the body produces estradiol after embryo transfer. Thanks to this hormone, the endometrium is created inside the uterus.

If we are confident that your pregnancy has not been affected, you will return to your woman doctor. Not pregnant in the third cycle of treatment: should I refuse treatment? From a statistical point of view, the fourth clinical trial is almost always as promising as the previous experiments. Even with 5 or more attempts, he may still end up pregnant. We specialize in couples with previous implantation failure.

Causes are not always discovered so quickly that treatment can begin immediately. Each treatment must be carefully planned. If you think long term, avoid frustration and disappointment. Naturally, each treatment will be tailored to your needs. For this reason, deviations from the sequence described here may also occur in individual cases.

In the middle of the cycle, after artificial insemination in large quantities, the woman’s body begins to produce a substance that guarantees the normal course of pregnancy - progesterone.

Progesterone and estradiol after embryo transfer, which are produced by the corpus luteum, are necessary for the full development of the unborn baby.

In most cases, treatment begins in the second half of the cycle before the actual stimulation begins. We call this process down regulation. This makes it easier to manage the stimulation cycle. Possible premature ovulation is prevented. In addition, you can choose the optimal time to start ovulation. This method has been used worldwide for many years and has resulted in a significant reduction in discontinued treatment cycles. We often use birth control pills as a pre-treatment.

It prevents the formation of cysts and leads to better immobilization of the ovaries. After pre-treatment with the antifungal pill, stimulation begins on the day of the cyclone, and the antagonist is injected with a certain size egg bottles according to our instructions.

For an upcoming pregnancy, the level of progesterone is very important, since this hormone creates favorable conditions for the attachment of embryos during implantation, as well as the further nutrition of the unborn baby.

The amount of progesterone after embryo transfer and estradiol is determined directly on the day of transfer of the fertilized egg, and then 7 days later.

In consultation with your healthcare provider, you should contact the appropriate practice at the start of your cycle and make an appointment to lower your levels. Typically, initial regulation begins between cycle day and the first bleeding day of the stimulation cycle. Please call the appropriate practice at the start of your stimulation cycle, even if bleeding does not occur at the expected time. Ultrasound or hormone testing is sometimes required to monitor the success of downregulation.

The actual stimulation of the ovaries with follicle stimulating hormone usually begins on the day of the cycle. Through hormonal stimulation we stimulate several follicles to grow, with the goal also to win several oocytes. This increases the chances of treatment. Stimulation takes from 11 to 13 days. During this time, a certain amount of hormones is injected daily.

Estradiol and progesterone after embryo transfer

The level of the hormone estradiol is important during pregnancy. If the concentration of this hormone is low, it can lead to miscarriage.

Progesterone levels are also important for the expectant mother. A blood test to determine the level of hormones after undergoing IVF is a standard test prescribed to a woman during in vitro fertilization.
The medicine should be administered daily, preferably always at the same time. After approximately 7-8 days of stimulation, we monitor the maturation of the oocytes several times with ultrasound and, if necessary, also with blood draws, in order to find out the most favorable time to obtain a mature, fertile egg.

Cycle of Spontaneity: Return to Nature
A woman is a so-called “low responder”, that is, despite high doses of hormones, only 1-4 egg vesicles develop. The woman's oval reserve is reduced. Rather than forcing ovaries with even higher hormone levels unnecessarily so that the follicles can be brought closer, it makes more sense to back off from one egg in a natural, unstimulated or only slightly stimulated cycle. This egg is basically morphological and superior to the fertility of eggs from high dose cycles.

If the indicators drop, the obstetrician-gynecologist prescribes hormonal drugs to the woman.

The level of hormones at certain periods of time is different. The IVF protocol states that the level of estradiol is initially determined before embryo transfer, and then the dynamics of this indicator are monitored.

Scientific research has also demonstrated that the genetic makeup and developmental competence of oocytes obtained during a spontaneous cycle are improved. In cycles in which a mature egg was produced, the gestation rate is at least twice that of stimulated low responses. The cycle must be carefully monitored to determine the optimal time for follicular punctuation. Then it is not despair because the optimal egg is determined and then the chances of success are very good.

You need to take less medications, the side effects of hormones disappear.
Eggs and enjoyed optimally.
This requires a lot of cooperation with your doctor.
Patience is also required: it is possible that an egg may not be obtained in every cycle.

This time can be found on the stimulation chart.

The hormone estradiol is produced partly by the adrenal glands and ovaries. It is important during the formation of the fetus, since it affects metabolic processes and is responsible for the formation of the skeletal system of the unborn baby.

In addition, the hormone promotes stretching of the uterine tissue, which is necessary for the growing fetus. Estradiol has an effect on a woman’s cardiovascular system, due to which blood flow to the fetus increases, and, accordingly, nutrition.

If you're not sure, just time the syringe correctly. If you have any questions, please don't hesitate to contact us. This syringe is critical whether or not eggs are found on the day of the piercing. This syringe also allows you to inject yourself under the skin. However, you must insert them deeper into the muscles as pain may occur.

To make this procedure easier, you will be given a slight pain or sedative or mild anesthesia. Please come to the clinic on the day of your piercing sober on the agreed date together with your partner. After the piercing, you will still have an hour of practice before he can go home. Two days after the puncture, we will arrange an appointment for the embryo transfer over the phone, depending on the fertilization result.

Table of norms of indicators

After embryo transfer, progesterone is produced in the corpus luteum for the first four months. And after twelve weeks, the maturation of the placenta, which is responsible for the production of this hormone, begins.

After IVF, the level of sexual secretions in a woman’s bloodstream increases daily, which serves as a beacon for the progress of the pregnancy process.

Your partner will be asked to provide a semen sample obtained through hands-on masturbation. It is possible to bring a sperm sample. However, it should not be older than an hour, we provide a transport cup. If there are problems, please contact us. There will be a way acceptable to your partner.

The embryos are then transferred to two different culture media. After 18 hours, the first control is performed under a microscope to determine how many oocytes are fertilized. At the eight-cell stage, embryo transfer or transfer to a new blastocyst culture solution may occur.

What should progesterone be after embryo transfer and what do deviations mean? The normal value of this indicator ranges from 6.9 to 56.6 nmol/l.

But if the hormone level drops below normal, then there is a high probability of miscarriage. Then hormonal support with medications is extremely necessary.

The norm of estradiol and progesterone after embryo transfer is determined:

But an excess of progesterone in a pregnant woman may indicate the development of a pathological process in the body.

If the process of bearing a baby proceeds favorably, then in medical practice a reduced level of progesterone is observed very rarely.

If one of the symptoms listed above is detected, the patient who has undergone IVF should immediately contact the medical specialist observing her.

Under no circumstances should you try to increase your hormone levels on your own, because only your doctor will be able to select hormonal therapy that will help cope with the problem.

Conclusion

When conducting IVF, it is especially important to control a woman’s hormonal levels. During artificial insemination, progesterone levels may be below normal, so many reproductive specialists recommend hormonal therapy before and after embryo transfer.

But self-medication is strictly contraindicated; only a doctor can prescribe effective treatment.

Don’t worry, because most hormonal drugs are of natural origin and are completely safe for a woman’s body and her unborn baby.

Video: Hormonal examination. LH, FSH, progesterone

The ability of the female body to conceive is determined by the production of a special hormone by the corpus luteum. Progesterone is most important during IVF - its indicators determine the success of fertilization. That’s why it’s so important to keep it normal with medications.

"Responsibilities" of the hormone

Under natural conditions, conception occurs if the female body has managed to prepare for ovulation. Yellow cells begin active synthesis of the “pregnancy hormone” 2 weeks before expected fertilization. If there is enough progesterone, the egg will merge with the sperm. Otherwise, by the end of the cycle, the yellow cells die and the woman begins to menstruate.

The main function of progesterone is to prepare the female body for reproduction. The hormone tries to create all the necessary conditions for this.

What does progesterone do:

improves the menstrual cycle, which ensures normal conditions for conception;
helps reduce contractile movements of the uterine muscles. This allows the embryo to attach well to the wall of the uterus;
helps maintain pregnancy throughout its entire duration, eliminating the possibility of spontaneous abortion;
promotes the restructuring of the glands to produce milk at the time of birth.

If female body unable to independently produce the required amount of the hormone, the patient is prescribed medications to replenish the deficiency. But if this does not help to conceive naturally, the woman goes for in vitro fertilization, where this hormone is actively used.

Planning for conception

Having planned to become a mother through artificial insemination, a woman expects that progesterone will be increased to the required level with medications before IVF. Progesterone drops before menstruation, but its active synthesis occurs in the 2nd phase of the cycle.

Therefore, first they wait for regular discharges, and the countdown begins from there. On days 16-17, the patient begins to be given medications that compensate for the hormone deficiency in the body. They have a stimulating effect on yellow cells, and also help the endometrium grow to the desired level.

Before the end of the cycle, the patient undergoes hCG tests. If progesterone is increased during IVF, most likely pregnancy has taken place. Due to the risk of miscarriage in the initial stages, they continue to take progesterone in the first days of pregnancy until the 12th week (or more if necessary). Next, the function of maintaining this hormone is performed by the formed placenta.

The use of hormonal drugs continues until the 26th day of the cycle. Embryos are transferred on the 3rd day from the start of hormone therapy, and cryoblasts – on the 5th day.

Is it possible to do IVF if progesterone is low? After undergoing hormonal stimulation, the woman takes tests immediately before the transfer. If it turns out that progesterone levels are low for fertilization, the IVF protocol is transferred to the next cycle. During this period, the woman should be further examined to understand the reason.

Period after replanting

Not everything goes smoothly with hormonal levels after cryotransfer. Therefore, observation includes monitoring the condition of a patient who has undergone IVF in the first weeks after the protocol. Progesterone after transfer is an important indicator not only of successful fertilization, but also of the woman’s general condition.

The progesterone level after embryo transfer is not always ideal. In half of the cases there are deviations up or down. The patient can even feel such conditions physically - her breasts hurt badly, her stomach is significantly swollen and her mood changes for no reason.
Progesterone is especially important for spotting after IVF. This is vaginal discharge and may be slight, but bleeding is sometimes observed.

To understand that this is a normal phenomenon and not a threat of miscarriage, it is necessary to monitor the hormonal level from the day of replantation for 2 weeks (and for some indications more).

How to donate blood for progesterone? It is advisable to take tests for progesterone after IVF every 2 days in order to switch to hormonal support in time. Before taking blood, a woman must prepare - stop eating 8-10 hours in advance. Therefore, it is most convenient to take progesterone on an empty stomach, that is, in the morning after sleep.

Taking progesterone consistently during the first days after IVF will help to consider the tendency of either a decline in the hormone or its rise, as well as identify deviations from the norm.

Hormonal standards

To understand what progesterone should be normal in the first days after embryo transfer, you should consider the table below. Progesterone increases every week, and by the time of birth it will reach about 500 nmol/l. The table provides approximate data, since in different laboratories the indicators may differ slightly from each other.

Table - Progesterone norm during IVF by week

Gestation period, weeks	Progesterone, nmol\l
1-2	38 – 58
5-6	59 – 69
7-8	65 – 75
9-10	73 – 88
11-12	92 – 100
13-14	96 – 127
15-16	124 - 170

If you look at the level of the hormone in the blood at the end of the menstrual cycle, it will be equal to 0 nmol/l. As soon as the ovaries enter the follicular phase, signs of progesterone begin to appear in the blood, the average level of which is 3 nmol/l. In the ovular phase it becomes no less than 5 nmol/l.

Continuing to increase the amount of the hormone, the body enters the luteal phase, at the beginning of which the minimum value is more than 7 nmol/l. As soon as the embryo enters the body, the level of progesterone begins to increase significantly - this is how nature takes care of the gestation of the fetus.

Deviation from the norm

As mentioned above, hormonal levels after IVF can deviate from the norm in both directions. If these deviations differ too much from those necessary for the normal development of pregnancy, specific regulatory measures should be taken. But first you will have to determine the reasons for the background change.

High progesterone:

a sufficiently high jump in hormone levels may indicate abnormalities in the development of the placenta or the formation of a cyst on the corpus luteum;
deviation from the norm may indicate the development of amenorrhea.

Low progesterone:

if progesterone drops after replantation, the function of the corpus luteum may be impaired;
the indicator may be affected by chronic inflammation of the ovaries;
when progesterone drops in the 5th - 6th week of pregnancy, we can talk about the threat of miscarriage;
a decrease in the level in subsequent periods is a reason to pay attention to the intrauterine development of the fetus (it may be delayed).

Increased progesterone on the day of the trigger will indicate embryo transfer. A stable increase in the indicator in subsequent weeks is most likely a sign of pregnancy. In the last few days, a low level of the “pregnancy hormone” may indicate that the woman is overbearing. and strengthening the placenta.

How to give progesterone injections? First, it should be clarified that ampoules should be stored in the refrigerator. Before giving the injection, the drug should be warmed in warm water to body temperature. This will also allow the oily composition to be made more liquid, so that it is easier to administer the injection subcutaneously (into the shoulder, abdomen or buttock).

"Lutein", produced in tablets and vaginal suppositories, is included in the medication list of IVF protocols. The dosage of the drug is selected individually for each patient, depending on her hormonal levels;

"Krinon" is a gel progesterone preparation inserted into the vagina. Its use begins on the first day of the protocol and continues as needed, stopping at weeks 7, 16, or at a later date.

You should not get carried away with hormonal drugs, since progesterone thickens the blood, which is not always a positive indicator and can lead to increased blood pressure. Other consequences of using the described drugs are also observed.

Side effects:

the drug can provoke vaginal bleeding in the first weeks after IVF, which is not always an indicator of a failed protocol;
due to cholestasis, jaundice may develop;
drugs taken orally can cause dizziness with severe pain and also cause drowsiness;
allergic manifestations in the form of rashes and itching of the skin are possible.

Before prescribing such medications, the woman will be informed about the consequences and side effects so that the described manifestations do not cause her to panic.

Progesterone is so important for bearing a fetus that a woman who dreams of becoming a mother will have to resort to hormonal therapy to maintain the required level that promotes fertilization, as well as the further development of the unborn baby. Preparations containing “pregnancy hormone” become in most cases the basis for IVF protocols. They also help maintain the function of the corpus luteum in the subsequent weeks of pregnancy, helping the woman give birth to a full-term and completely healthy baby.

Even after embryo transfer, a long-awaited and dearly-acquired pregnancy can often be disrupted. Therefore, properly selected medical support after IVF often serves as a lifeline that can “keep afloat” a problematic pregnancy.

A positive pregnancy test after IVF makes any couple happy, but this is only the beginning of a long journey to the birth of a healthy baby. Pregnancy did not occur naturally for some serious reason, so some effort is required to maintain it in the female body.

The first trimester of pregnancy is especially important for a woman. Only by crossing it and maintaining the pregnancy can the expectant mother breathe out a little.

It is known that a third of all pregnancies after IVF end in termination in the first trimester. The causes of this trouble may be negative factors in maternal or fetal health. After all, most women cannot get pregnant on their own precisely because of problems in their health. And artificial hormonal stimulation for pregnancy promotes hormonal shifts in the female body. All this increases the risk for normal gestation. It is especially important throughout pregnancy after IVF to determine and promptly adjust the amount of two main female hormones in the pregnant woman’s blood:

Progesterone.

The reasons for termination of pregnancy after IVF may be the following factors:

endocrine disorders;
immunological changes;
improper management of pregnancy;
mother's age;
chromosomal abnormalities;
immune conflict;
antiphospholipid syndrome;
infections that arose during this period.

It is especially important for a woman to be under the supervision of a doctor during the first 6 weeks of pregnancy. On average, after IVF only 60-80% of women reach birth. The causes of miscarriage are usually miscarriage or.

Most of these tragedies occur during the 1st trimester. After this period, such a risk for a woman is significantly lower.

There is an opinion among some reproductive specialists that hormonal support after IVF with normal pregnancy need not. After all, any have a high cost and weight side effects. However, even these specialists consider hormonal support necessary for many pathologies of pregnancy.

This is why drug support is so often necessary to maintain pregnancy after IVF.

Progesterone support after successful IVF

Progesterone is one of the most important. Its main functions at this moment are:

creating the most favorable conditions for the endometrium for reliable implantation of the embryo;
reducing the risk of endometrial contraction, preventing the risk of miscarriage;
maintaining the cervical canal closed.

Currently, women after IVF are prescribed progesterone in the form of regular or vaginal tablets. Progesterone in the form of injections is extremely rarely used at this point due to the inconvenience for the expectant mother. In addition, prolonged injection often results in soreness, bruises, or even abscesses at the injection site.

Preparations for progesterone support

Duphaston. It is used in tablet form. It is believed that this medicine can be used long-term without the risk of harm to the mother or fetus. However, some reproductive specialists are cautious about prescribing it to pregnant women. Duphaston should be taken daily, at the same time. Its dose ranges from 30 to 60 mg.
. This is the most popular drug for hormonal correction of the female body. It's invented French company Besins is micronized progesterone. This medicine is obtained from plant materials. It is used in the form of vaginal capsules. Moreover, 600 mg of micronized drug is comparable to 6 injections of progesterone. To prevent leakage, it is advisable to place the capsule as deep as possible, close to the cervix. Most often, the drug is used 1 capsule (200 mg) two to three times a day at equal time intervals (600 mg per day). Sometimes the doctor may prescribe an increased dose of this drug: a capsule 4 times a day with parallel double administration of a 2.5% oil solution of the same drug.
Progesterone in the form of an oil solution (1 ml of 2.5% or 1%) can be administered in the form of intramuscular or subcutaneous injections. But the method of administration in the form of “oil injections” can cause pain during injection and increase appetite. After just a week of injections, women complain of pain in the buttocks from the injections.
Lutein. It contains the same progesterone, but is used sublingually 3-4 times a day, 100-150 mg (under the tongue) or intravaginally, 2 times a day, 150-200 mg (inside the vagina). The dose for hormonal support is determined by the doctor.
Crinon. This is a gel for vaginal use with progesterone. It is administered with a special applicator. This type of support is good because it ensures saturation of the body for 3 days after administration. This drug leaks less from the vagina than Utrozhestan, especially in summer. Also, this medication has minimal effect on the liver.

Features of use

Any hormonal drugs must be taken taking into account their “insidiousness”, since their thoughtless use or withdrawal can harm the health of the woman or fetus.

Therefore, there are a number of rules when using progesterone-containing drugs:

Progesterone-containing medications are usually started on the day the woman's eggs are collected, continuing until pregnancy is confirmed, and then until 12 weeks of pregnancy. When prescribing their dosage, the doctor must take into account all the individual factors of the pregnant woman (endometrial thickness, own progesterone level, etc.)
The use of this group of drugs can introduce some inconvenience into a woman’s life: the need to insert the drug several times into the vagina or perform an injection during work.
The appearance of “side effects” when using drugs for progesterone support in pregnant women in the form of weight gain, increased appetite, dizziness or weakness.
Discontinuation of drugs containing progesterone is carried out according to a withdrawal plan (with a gradual dose reduction). Under no circumstances should you suddenly stop taking these medications. Before discontinuing drugs of this group, a blood test is most often prescribed to determine the level of the hormone in a woman’s body. It is most often possible to completely abandon progesterone support at 14-15 weeks of pregnancy. But at the same time in the body expectant mother there should be no deviations. In addition, the woman must have a fully formed placenta, which takes on all the functions of maintaining the pregnancy. If a woman has risks of miscarriage during this period, then progesterone support can last up to 20 weeks.

Estradiol after IVF

Estradiol is also a natural estrogen. It is produced in the corpus luteum of the ovaries and partially in the adrenal glands. It is this hormone that is responsible for the formation of female sexual differences. After IVF, estradiol, along with progesterone, is responsible for maintaining pregnancy.

In combination with progesterone, estradiol is able to maintain the endometrium in an ideal state for pregnancy.

If the analysis reveals that there is not enough of this hormone in the blood, then it is additionally administered in the form of drugs. The norm of estradiol after IVF is approximately 5,000 – 10,000 pmol/l. After implantation of the embryo, estradiol is responsible for the thickness of the endometrium.

The thickness of the endometrium determines whether the embryo can properly attach to the uterus so that the woman can bear the fetus until the end of its maturation.

Also, estradiol after fertilization during IVF is responsible for the following vital processes:

ensuring growth and stretching of uterine tissue;
formation of the bone skeleton of the future baby;
normal functioning of the fetoplacental system;
stimulation of metabolic processes;
delivery of nutrients to the embryo;
activation of blood circulation in the uterine tissues.

Along with progesterone, estradiol creates favorable conditions for pregnancy, supports metabolic processes between mother and fetus, controls normal blood pressure and participates in labor.

If estradiol levels then drop sharply, there is a serious risk of premature labor and miscarriage.

In no case should you exceed the dose of hormonal drugs. No hormone can turn a bad embryo into a good one, but hormones can harm the fetus.

It is precisely because of the possible toxic effect on the embryo that it is unacceptable for a woman to independently prescribe, cancel or increase the dose of hormonal drugs during pregnancy.

After successful IVF, reproductologists use estradiol in the form of tablets (, Estrofem) and in the form of a skin gel (, Estrogel).

Proginova

This hormone replacement drug should be discontinued immediately upon the onset of a normal pregnancy. That's what the instructions say. However, during an IVF program, this drug can be used for up to 3 weeks. It all depends on the regimen chosen by the attending physician. Typically, the dose of Proginov ranges from 0.5 to 7 tablets per day.

It is important to use the drug at the same time, without lowering or increasing its dose on your own.

Proginova is called upon to maintain the level of estradiol in a woman’s body stable and independent of infections, stress or exacerbation of the expectant mother’s chronic ailments.

In any case, this drug should be discontinued no later than 15 weeks of pregnancy. It is discontinued very gradually, reducing the dose every 3 days, starting with ¼ of the pill.

Other forms of using estradiol during IVF are Estrofem tablets, Microfollin, Divigel or Estragene gel, Klimara patch.

The peculiarities of the withdrawal of these drugs is also the principle of gradualness, so as not to harm the body of the mother and the unborn baby.

Other drugs for IVF

In addition to hormones, other drugs are also used in the practice of reproductive medicine. The most common of them are:

Adrenal hormones (Dexamethasone, Prednisolone or Cortisol) are often used to create immune bonds between the mother and the fetus she is carrying, as well as to reduce the level of androgens. Also, these drugs eliminate the development factors of antigen to, eliminating fetal hypoxia and preventing premature birth in a woman.
Gonadotropin preparations for the physiological maintenance of pregnancy mechanisms. In this case, two types of these hormones are used: HMG and FSH preparations. The drugs most often used in clinics are "", "Elonva", "", "". All these drugs are perceived by the body as natural and do not cause a reaction from the outside. immune system. However, when taking them, there may be side effects (fatigue, anxiety, flatulence, etc.) Also, when taking gonadotropes, there may be a danger of ovarian hyperstimulation
HCG preparations duplicate the natural hormones of the female body and contribute to the development of mechanisms for the safety of the fetus. Preparations Profasi or are used as analogues of hCG.
Blood thinning drugs (Aspirin, Heparin, Curantil) are often prescribed to pregnant women to maintain normal blood thickness and reduce platelet aggregation. These medications are prescribed under the control of a blood test. They ensure normal blood circulation in the uterus and placenta, preventing oxygen starvation fetus
Antihypoxic vitamins (folic acid, vitamins A, B and E, beta-carotene) are prescribed to provide vitamin support to the body of the mother and the unborn baby, maintaining their immunity at a sufficient level.

No pregnancy after IVF should be left to chance. Women with pathologies who, without modern technologies would be doomed to lifelong infertility. As a rule, in these difficult situations, the body does not have the resources to help a woman not only become pregnant on her own, but also maintain the pregnancy.

If a woman has already decided to undergo IVF, then without medical support in most cases she will not be able to endure the pregnancy that she has so dearly received. The main thing is to trust to a good doctor and take all medications according to the regimen prescribed by the doctor. But all this is done so that a woman can experience the great happiness of finally becoming a mother.

A woman’s desire to become a mother is determined by nature, but, alas, sometimes for a number of reasons, pregnancy does not occur naturally. Modern medicine offers couples who want to become parents not only the in vitro fertilization procedure, but also effective methods for maintaining pregnancy. How this happens and what you need to know about support after IVF will be discussed further.

Why do you need support after IVF?

It is known that problems with conception are often associated with disturbances in the level of female sex hormones, which causes termination of pregnancy. That is why, before IVF and after the procedure, a woman is advised to take hormonal medications. Hormonal support is designed to accelerate the transformation of the endometrium and ensure the continuation of pregnancy.

Did you know?For the first time, British specialists from Cambridge performed embryo transfer into a woman's uterus. In 1978, the first test tube baby was born, a girl, Louise Brown.

Drugs for support after embryo transfer

Medication support after embryo transfer is necessary and mandatory, especially in the first weeks after confirmation of pregnancy. The main hormones that ensure normal gestation are estradiol and progesterone, and drugs containing these hormones are included in the IVF program.

“Divigel” is an alcohol-containing preparation in the form of a gel, which is a source of synthetic estradiol, which is aimed at replenishing hormones before the IVF procedure. The drug is prescribed to thicken the endometrium and prepare the uterus for embryo transfer, as well as to increase estrogen levels to prevent fetal rejection.

"Divigel" improves the functionality of the female reproductive system and helps create ideal conditions for pregnancy. The drug has a transdermal effect and is intended for topical use; it is applied to dry clean skin lower part of the body, with an area of at least the palm of your hand.

Important!The place where the gel is applied must be changed periodically; however, it should not be applied to the area of the mammary glands, face and mucous membranes of the body.

This product is a source of a synthetic analogue of the hormone progesterone. Available in tablet form. Due to the fact that the drug does not have an androgenic effect and does not affect ovulation, it is considered relatively safe in preparation for IVF and during further pregnancy.

A drug containing micronized progesterone. Prescribed in IVF programs for luteal insufficiency. It is produced in the form of tablets for sublingual use, or in the form of vaginal tablets.

Source of progesterone in the form of a gel for intravaginal administration. The tube is equipped with a special applicator. This form of application allows the hormone to be quickly absorbed through the mucous membranes of the vagina and saturate the body after 3 days of use.

Progesterone oil solution

The drug is available in ampoules in the form of an oil solution of the hormone progesterone for injection. As a rule, injections are administered subcutaneously or intramuscularly in accordance with the schedule established by the doctor.

Important! When progesterone is administered in the form of an oil solution, pain, induration and redness are often observed at the injection sites, of which the attending physician must be notified.

When pregnancy support with IVF is canceled

As is known, drug support after embryo transfer into the uterine cavity is the key to successful implantation of the future fetus. Women undergoing the IVF procedure are prescribed hormonal medications already at the planning stage, and they are required to continue taking them until the 14th day after the implantation of the embryo.
After confirmation of pregnancy based on the results of a blood test hCG level, the doctor who performed the procedure can adjust the support regimen or cancel it altogether. Typically, progesterone medications are continued throughout the first trimester of pregnancy, and estrogens are taken for up to 8 weeks. In some threatening cases, the woman is forced to continue support throughout the entire gestation period.

Cancellation of maintenance therapy is carried out only with the permission of a fertility specialist and according to the regimen prescribed by him. The peculiarity of sex hormones is that the process of their withdrawal should occur with a gradual reduction in dosage until complete completion of use; abrupt withdrawal is unacceptable, in order to avoid negative consequences due to a surge in hormone levels.

Did you know? When carrying out IVF, it is technically possible to plan the sex of the future baby, since reproductive specialists know the chromosomal set of sperm, but the ethical laws of medicine prohibit selecting suitable embryos based on gender, so it is impossible to “order” a son or daughter.

Why is there no period after the cancellation of support?

If the IVF protocol is unsuccessful, support is canceled and after that, menstruation should normally begin within 3-5 days; if this does not happen, you need to consult a doctor to clarify the reasons:

it is possible that the embryo implanted somewhat later than the indicated period;
high probability of ectopic pregnancy;
stress, nervous tension suffered after an unsuccessful procedure, depressive state may lead to cycle failure;
a temporary disruption of hormonal levels after discontinuation of support can cause cycle instability, and if no other reasons are identified, hormones should return to normal within 3–6 months.

So, the features of drug support during in vitro fertilization were discussed above.

This information will help you understand the peculiarities of the influence of sex hormones on the stimulation of the reproductive system and will allow you to rationally assess the need for their use.

"Responsibilities" of the hormone

IN natural conditions Conception occurs if the female body has managed to prepare for ovulation. Yellow bodies begin active synthesis of "" weeks 2 before the expected fertilization. If there is enough progesterone, the egg will merge with the sperm. Otherwise, by the end of the cycle, the yellow cells die and the woman begins to menstruate.

The main function of progesterone is to prepare the female body for reproduction. The hormone tries to create all the necessary conditions for this.

What does progesterone do:

improves the menstrual cycle, which ensures normal conditions for conception;
helps reduce contractile movements of the uterine muscles. This allows the embryo to attach well to the wall of the uterus;
helps maintain pregnancy throughout its entire duration, eliminating the possibility of spontaneous abortion;
promotes the restructuring of the glands to produce milk at the time of birth.

If the female body is not able to independently produce the required amount of the hormone, the patient is prescribed medications to make up for the deficiency. But if this does not help to conceive naturally, the woman goes for in vitro fertilization, where this hormone is actively used.

Planning for conception

Before the end of the cycle, the patient takes hCG tests. If progesterone is increased during IVF, most likely pregnancy has taken place. Due to the risk of miscarriage in the initial stages, they continue to take progesterone in the first days of pregnancy until the 12th week (or more if necessary). Next, the function of maintaining this hormone is performed by the formed placenta.

The use of hormonal drugs continues until the 26th day of the cycle. Embryos are transferred on the 3rd day from the start of hormone therapy, and cryoblasts – on the 5th day.

Period after replanting

To understand that this is a normal phenomenon and not a threat of miscarriage, it is necessary to monitor the hormonal level from the day of replantation for 2 weeks (and for some indications, even more).

Taking progesterone consistently during the first days after IVF will help to consider the tendency of either a decline in the hormone or its rise, as well as identify deviations from the norm.

Hormonal standards

Table - Progesterone norm during IVF by week

Gestation period, weeks	Progesterone, nmol\l
1-2	38 – 58
5-6	59 – 69
7-8	65 – 75
9-10	73 – 88
11-12	92 – 100
13-14	96 – 127
15-16	124 — 170

Deviation from the norm

High progesterone:

a sufficiently high jump in hormone levels may indicate abnormalities in the development of the placenta or the formation of a cyst on the corpus luteum;
A deviation from the norm to a greater extent may indicate the development of amenorrhea.

Low progesterone:

if progesterone drops after replantation, the function of the corpus luteum may be impaired;
the indicator may be affected by chronic inflammation of the ovaries;
when progesterone drops in the 5th - 6th week of pregnancy, we can talk about the threat of miscarriage;
a decrease in the level in subsequent periods is a reason to pay attention to intrauterine development fetus (perhaps it is delayed).

Increased progesterone on the day of the trigger will indicate embryo transfer. A stable increase in the indicator in subsequent weeks is most likely a sign of pregnancy. In recent days, a low “ ” indicator may indicate that the woman is over-pacing.

Any deviation from the norm hormonal levels may predict impending uterine bleeding. In any case, in order to maintain the pregnancy, you will have to resort to supportive medications.

Hormonal support

Low hormonal levels pose a particular threat to miscarriage. To raise it, progesterone drugs are prescribed, which are most often given by injection. Transparent oil solution “Urozhestan” is sold in 1 ml ampoules of various concentrations (1% and 2.5%). Progesterone is injected during IVF to reduce the risk of spontaneous abortion and strengthen the placenta.

Injections after IVF to prevent miscarriage are given 2-3 times a day with a 2.5% composition for the required period. In this case, you will have to adjust to the fact that the drug is quite painful, and this sensation will be present at the injection site for several days.

How to replace progesterone injections:

Urozhestan is also available in 200 mg tablets, which are an addition to injections. Under the same name there are also vaginal suppositories with progesterone. They are considered a more convenient means for self-use, but can cause minor smudging;
the artificial analogue "Duphaston" is available in small tablets. When using it, it is advisable to adhere to the same dosage hours;
"Lutein", produced in tablets and vaginal suppositories, is included in the drug list of IVF protocols. The dosage of the drug is selected individually for each patient, depending on her hormonal levels;
"Krinon" is a gel progesterone preparation inserted into the vagina. Its use begins on the first day of the protocol and continues as needed, stopping at weeks 7, 16, or at a later date.

Get involved hormonal drugs It’s not worth it, since progesterone thickens the blood, which is not always a positive indicator and can lead to increased blood pressure. Other consequences of using the described drugs are also observed.

Side effects:

the drug can provoke vaginal bleeding in the first weeks after IVF, which is not always an indicator of a failed protocol;
due to cholestasis, jaundice may develop;
drugs taken orally can cause dizziness with severe pain, and also cause drowsiness;
allergic manifestations in the form of rashes and itching of the skin are possible.

Before prescribing such medications, the woman will be informed about the consequences and side effects so that the described manifestations do not cause her to panic.