You will take progesterone by injection, vaginal suppository or gel. Progesterone is the natural hormone that your body uses to maintain an early pregnancy. It improves the lining of the uterus and helps the embryo implant and grow. Although the FDA requires the drug manufacturer to include warnings about adverse effects of progesterone in early pregnancy, long experience with IVF suggests that progesterone has only good effects on the pregnancy.

It is very common to have a small amount of bleeding during the luteal phase. As the embryo implants into the endometrium it may cause a leak in one of the blood vessels in the uterus. If you have a significant increase in pain, are nauseated or constipated, have bleeding more than spotting, a temperature above 100 degrees, or shortness of breath, call the clinic. It is not unusual to have symptoms of pregnancy that come and go during this two week period, so don't stop your medications if your symptoms go away, but continue the progesterone until your pregnancy test is completed. Call with any questions you may have about your symptoms.

It is also common to have a sensation of heaviness or cramping in your pelvis 4 to 10 days after egg retrieval. Your ovaries frequently enlarge at this time. If the sensation is more than moderate, if you feel nauseated or bloated, if you gain more than 10 pounds in 3 days, or if you develop a fever or pain, call the clinic immediately.

Pregnancy Testing

Two weeks after the egg retrieval procedure, you will obtain a blood pregnancy test, sometimes called a "beta" or "beta-hCG level", to see if you are pregnant. If the test is positive you will be asked to obtain a second blood test two days later. Rising blood levels of the pregnancy hormone, hCG, indicate that implantation has occurred. We expect the quantitative value of hCG to increase by a factor of 2, i.e. to double, during that time period. A pregnancy at this stage is referred to as a "chemical pregnancy". Confirmation of a "clinical pregnancy", the presence of a gestational sac in the uterine cavity, is made by ultrasound 2 and 4 weeks after the first blood test. If you are pregnant, you may be continued on progesterone. If your test is negative, you can stop the progesterone and your period will start in 2 to 5 days. If you have not had a menstrual period within 5 days of discontinuing the medication, call the clinic.