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Luteal Phase

You will take progesterone by injection and/or vaginal suppository gel because it has been shown that progesterone supplementation increases the chance of success with in vitro fertilization (IVF). Progesterone is the natural hormone that your body produces to support the uterine lining and maintain an early pregnancy. Although the FDA requires the drug manufacturer to include warnings about using progesterone in early pregnancy, this is due to the fact that progestins (a synthetic progesterone-like substance) or high doses of progesterone in animal experiments have raised concerns. However, you will only receive progesterone, the same natural hormone your ovaries produce, in a dose that is not excessive. After the egg retrieval, you will receive your first dose of progesterone. You will continue this daily for the next two weeks according to a schedule you will receive. This schedule will include the dose you should take.

As noted above, it is common to have a sensation of heaviness or cramping in your pelvis 4-10 days after egg retrieval. Your ovaries frequently enlarge at this time. If you are gaining weight rapidly (more than a pound a day) which can occur due to fluid retention, or if you are not urinating the normal amount for you, or if you have any other concerns, please call. Light bleeding sometimes occurs in the weeks following egg retrieval, even if there is a normally developing pregnancy.

A pregnancy test will be performed approximately two weeks after your egg retrieval. Waiting for your pregnancy test is a difficult time. It is not unusual to have symptoms of pregnancy that come and go due to the hormonal changes with IVF. The only way to know whether or not you are pregnant is by the pregnancy test done two weeks after egg retrieval. Bleeding may occur even if a pregnancy is developing normally. Please continue to take the progesterone that is prescribed until your pregnancy test, even if you think you may not be pregnant. Because the hormones that you are taking may confuse the symptoms that you have come to recognize as signs that you may or may not be pregnant, try not to guess or do home pregnancy tests before the blood test. They may not be accurate.

What are the next steps after luteal phase?

If the first test is positive, you will be asked to return for a follow-up test 2-3 days later to see that the level of the hormone hCG is rising appropriately. Hopefully you will receive good news and find out that the pregnancy test is positive and have follow-up as described below. If unfortunately you are not pregnant, you will be instructed to stop the progesterone and expect a period within 2-5 days (you should call us if a menses does not occur within about 5 days of stopping progesterone). If you do not conceive, you may find it helpful to schedule a follow-up visit with the MD to occur about 2 weeks after your pregnancy test results. This visit is important so we can counsel you regarding your next steps. Another cycle of treatment can begin as soon as one month after a failed cycle.

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