Progesterone Infertility

Is This Hormone That Important?

If you are having difficulty getting pregnant, there is a good chance that progesterone infertility is involved.  This important hormone is a central part of a woman’s reproductive system, and if it is in short supply things will not work as intended.  It serves a number of functions in causing the organs to prepare for ovulation and the hoped-for implanting of a fertilized egg.   Even after conception a deficit of progesterone can result in a miscarriage.  Therefore it is essential that the body be functioning under the influence of the appropriate amount of progesterone at the right time.  If not, you very likely have progesterone infertility.

With this in mind it is worthwhile to have a better understanding of the hormone and its effect on the infertility problem.  We will finish by looking at a few ways modern medicine helps deal with low progesterone levels.

Progesterone is one of the most important hormones in a woman’s body.  It is produced by one or more of the egg follicles in the ovary after ovulation.  The entire menstrual cycle depends on this substance for regulation.  It prepares the uterus for conception and causes the endometrial lining to thicken up as preparation for the arrival of the egg.  Not enough and there is not a proper thickening of the wall.  The hormone also conveniently causes the basal temperature to go up slightly during ovulation; this is a tell-tale sign.

If the egg is not fertilized, the source of progesterone disappears after several days.  The drop in the hormone means the uterus cannot maintain the extra thickness, and the lining soon makes its exit in the last act of the menstrual cycle.

Low levels of this hormone can result in a shortened “luteal phase,” that portion of the cycle during which ovulation occurs, among other things.  This phase typically runs between 10 and 16 days, although the time period within this phase when things are ripe for conception is only a couple of days after ovulation.  If the luteal phase is too short there’s not enough time for the choreography to run its natural course.  The result:  no pregnancy.

If the egg is fertilized, progesterone levels continue at higher levels, providing protection for the multiplying and growing new human.  If the levels somehow drop too much during pregnancy there is the possibility of a miscarriage.   By the way, this hormone performs other functions; it is quite a workhorse.

This is, of course, an extreme simplification of the complex process.  But progesterone is one of a few hormones that must be present at the right time and in the right amounts.  Fortunately it is possible to diagnose progesterone infertility and often the addition of a natural or synthetic boost of the hormone can set things right.  Sometimes the problem is actually caused by there being too much estrogen in the system, and that requires its own plan of attack by the fertility specialist.

Progesterone therapy has been shown to be very effective in many cases, with the treatment starting two or three days after ovulation occurs (remember that a lack of progesterone soon causes things to dry up too soon and we want to prevent that).  The hormone is available in oral form, as an injection or as a cream, depending on how the specialist wants to handle it.  It may be that synthetic progesterone has fewer side effects than the natural version; again your doctor will have opinions on that.  The timing is important; if introduced too soon it can prevent ovulation from taking place for example.

Studies have found this therapy can achieve a success rate of over 70% if the source of infertility has been fully determined.  That’s pretty encouraging.  Of course there can be other causes for a shortened luteal phase.  But progesterone infertility is one of the more manageable varieties of the problem, where proper diagnosis and non-invasive treatment can help the patient become pregnant relatively quickly.  Hopefully this explanation will help you ask better questions when you meet with your infertility specialist.