Progesterone is secreted by the corpus luteum after ovulation to stabilize the uterine lining, creating an optimal environment for embryo development and growth in case of conception.During pregnancy, stimulation from human chorionic gonadotropin (hCG) secreted by the placenta enables sustained progesterone production. Thus, the corpus luteum continues supplying progesterone for approximately 8-9 weeks post-conception. Subsequently, the corpus luteum gradually degenerates, and progesterone production shifts to the placenta.
Consequently, insufficient progesterone disrupts conception and normal pregnancy maintenance. In other words, low progesterone levels not only impair fertilization but also hinder implantation, potentially leading to risks like early miscarriage.This is why progesterone is also known as the "pregnancy hormone." To stabilize the embryo, doctors often recommend that expectant mothers receive progesterone via injection or oral medication. Progesterone: Key Facts Concentration During the pre-ovulation phase of the menstrual cycle, progesterone levels remain low, typically below 2 ng/ml.During the luteal phase after ovulation, it increases to over 5 ng/ml. If pregnancy occurs, the concentration remains at luteal phase levels during early pregnancy. Once progesterone production shifts to the placenta, levels rise to 100-200 ng/ml.
Diagnosis
Diagnosing luteal insufficiency is straightforward. Simply "monitor basal body temperature" to reveal the answer. If the high-temperature phase lasts less than 10 days, luteal insufficiency should be strongly suspected. Further blood testing for progesterone during the late menstrual cycle is necessary. If progesterone levels are below 12 ng/mL, this indicates a case of "progesterone deficiency."
Treatment
How should progesterone deficiency be treated?Treatment for luteal insufficiency is divided into two approaches: For women with luteal insufficiency due to anovulation, ovulation-inducing medications are administered. Examples include clomiphene citrate, which works by competitively binding to endogenous estrogen receptors, thereby stimulating the pituitary gland to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH), promoting follicular development.For women who ovulate but experience insufficient luteal function, natural progesterone supplementation is required. This involves daily supplementation starting 12–14 days after ovulation or before the expected onset of the next menstrual period to compensate for inadequate luteal secretion.
The Hormone You Must Know About—Progesterone
Progesterone plays a crucial role in women's bodies—
Endometrium: Progesterone primarily promotes secretory changes in the uterine lining, preparing it for implantation of a fertilized egg.
Fallopian Tubes: Progesterone also promotes secretory changes in the mucosal lining of the fallopian tubes, providing essential nutrients for the fertilized egg as it travels through the tubes before uterine implantation.
Breasts: Progesterone stimulates the development of breast lobules and alveoli. However, progesterone alone does not induce milk production; significant levels of prolactin are required for lactation.
Oral progesterone & injectable progesterone
Did you know?There are many types of progesterone. Some are not suitable for infertility treatment. Those used for infertility treatment can be divided into two main categories: "natural" and "synthetic." However, to date, "natural progesterone" remains the most commonly used.
Currently, natural progesterone is available in three forms: injectable, oral, and vaginal cream.
Injectable Progesterone
The injectable form uses natural progesterone, the earliest type of natural progesterone. It is an oil-based formulation that can be painful during injection and carries a risk of muscle hardening and atrophy with prolonged use.
Oral Progesterone
While oral progesterone is far more convenient than injectable formulations, its success rate in assisted reproductive technology (ART) is lower than that of injectable natural progesterone.
Vaginal Cream
The latest natural progesterone formulation is the "vaginal cream." When used in ART, its success rate rivals that of injectable formulations.Designed specifically for vaginal use, it matches the vaginal pH more closely, reducing issues like inflammation or infection.
How it works: A specially designed applicator is inserted into the vagina. Squeezing releases the progesterone gel, which then spreads evenly across the vaginal lining through movement. It is absorbed directly through the vaginal mucosa.
Advantages: Requires only once-daily application upon waking, offering exceptional convenience for working individuals.
Disadvantages: Residual white residue may form after absorption, potentially accumulating in the vagina. Combined with vaginal secretions, this can cause discomfort in some patients or may affect drug absorption.
Preventing Threatened Miscarriage
The first trimester is the most unstable period for fetal development. To mitigate the risk of miscarriage during this stage, physicians may prescribe progesterone for pregnant women experiencing bleeding to prevent (reduce) the risk of threatened miscarriage.
However, beyond potential progesterone deficiency, the primary causes of early pregnancy loss are often embryonic developmental abnormalities or chromosomal abnormalities.
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