Using Progesterone for Infertility

from "What Your Doctor May Not Tell You About Menopause" by John Lee, MD page 244.

The use of natural progesterone can give women the power to enhance their fertility without a lot of expensive office visits and prescription hormones. It also flies in the face of mainstream medicine's approach to fertility, which doesn't trouble me since their success rate in acheiving conception is depressingly low. It's no wonder--they are precribing the wrong hormones! Synthetic estrogens and progestins generally cause more harm than they solve.

I believe that estrogen dominance from progesterone deficiency has casued a near epidemic of infertility among women in their midthirties. Excess estrogen seems to stimulate the ovaries to overproduce follicles, which, combined with delayed childbearing, results in an early burnout of the follicles. If you are having difficulty in conceiving, you may be able to use progesterone to your advantage.

I had a number of patients in my practice who had been unable to conceive. For two to four months, I had them use natural progesterone from days five to 26 in the cycle (stopping on day 26 to bring on menstruation). Using the progesterone prior to ovulation effectively supressed ovulation. After a few months of this, I had them stop progesterone use. If you still have follicles left, they seem to respond to a few months of suppression with enthusiasm, and the successful maturation and release of an egg. Some of my patients who had been trying to conceive for years had very good luck conceiving with this method. There are even a few children named after me!

On the other side of the coin is the fact that using progesterone prior to ovulation can supress ovulation. In a normal munstrual cycle, the release of progesterone by one ovary functions as a signal to the ovther ovary not to ovulate-- Nature's brilliant plan for avoiding multiple births. If your're using progesterone cream prior to ovulation, chances are good both ovaries will interpret its presence as a sign that the other ovary has ovulated, thus effectively suppressing ovulation.

If you decide to use progesterone while trying to conceive, be sure to begin using it only after you have ovulated each month. You can track your ovulation by taking your temperature each morning before you get out of bed. When you ovulate, the release of progesterone will cause a slight rise in body temperature. Once that has happedned, you can safely continue using the progesterone cream.

If you think you maybe pregnant and want the pregnancy, do NOT stop the progesterone until you have done a pregnancy test, as a sudden drop in progesterone levels would signal the body to shed the uterine lining, possibly inducing an abortion. While the urine pregnancy tests you can buy at a drugstore are reliable after day 28 of your cycle, a blood pregnancy test is reliable within several days of conception. (You usually do not need a doctor's prescription to get a blood pregnancy test at a local medical lab.) If it is positive and you want to remain pregnant, you should continure to use progesterone cream to prevent the scheduled menstrual shedding and to protect the developing fetus from early miscarriage. Progesterone should be continured at least until the third month of pregnancy, when the placenta becomes the major producer of progesterone, at which time you can GRADUALLY taper your progesterone supplementation. If blood progesterone levels remain good, you can discontinue it altogether. By the third trimester, the placenta will be making hundreds of times more progesterone than you would be getting with the cream alone.