Progesterone, also known as luteal ketone, is a natural progestogen secreted by the ovarian corpus luteum. It has a significant morphological impact on the endometrium stimulated by estrogen in the body and is essential for maintaining pregnancy. The abbreviation in English is “P.” Progesterone affects women’s menstrual cycles and fertility. Many patients with polycystic ovary syndrome may experience low progesterone levels. What impact does low progesterone have? How should it be treated?
Progesterone has immune protection and suppresses immune reactions. In women, the normal value of progesterone during the follicular phase is 0.6-1.9 nmol/L; during ovulation, the normal value is 2.40-9.40 nmol/L; and after ovulation, the normal value is 20.7-102.4 nmol/L. Different hospitals may have different reference values, which can be compared with the reference values on the laboratory report and the examination data.
Progesterone can help the embryo implant successfully. During ovulation, under the action of progesterone secreted by the corpus luteum, the endometrium transitions from the proliferative phase to the secretory phase, making the endometrium more receptive to embryo implantation and increasing the chances of successful implantation. Additionally, progesterone can induce decidualization of the endometrial stroma and regulate the expression of various implantation-related factors in an autocrine or paracrine manner.
Progesterone can reduce uterine excitability and conductivity, prevent the uterus from expelling the embryo, and have a role in maintaining the pregnancy. By raising maternal blood glucose levels, progesterone increases fetal insulin secretion, promoting fetal growth.
In addition, progesterone can promote the synthesis of certain uterine proteins, aiding in the maintenance of the pregnancy state. During pregnancy, only when a sufficient amount of progesterone is produced in the body, will the embryo not be rejected, thus smoothly implanting in the uterine wall. If there is insufficient progesterone, the embryo may be rejected by the mother and result in a miscarriage. Therefore, progesterone plays a crucial role throughout the entire process of IVF and even natural reproduction.
Causes of low progesterone
Progesterone deficiency occurs when there is incomplete luteal function or incomplete development of the ovarian corpus luteum. Severe dysfunction of the adrenal glands and thyroid can also affect ovarian function, leading to ovulation disorders and corresponding decreased progesterone levels. Insulin resistance in the body can also cause a decrease in progesterone levels.
In cases of low progesterone, during the IVF process, doctors usually supplement with exogenous progesterone to maintain pregnancy. During the IVF stimulation phase, doctors will adjust the medication dosage based on the woman’s luteal function to compensate for the insufficient luteal function. If there is still a severe lack of luteinizing hormone after oocyte retrieval, progesterone medication therapy will be continued based on the situation.
After the IVF transfer, luteinizing hormone stimulation injections will continue until pregnancy is confirmed. If there is no pregnancy, they will be stopped. If pregnancy has occurred, progesterone will be continued for three months. In case of low progesterone in early pregnancy, it is essential to rest, avoid excessive fatigue, refrain from excessive worrying or anxiety, as psychological factors have a significant impact. Learn to relax and cooperate actively with medical treatment. Whether undergoing IVF or natural conception, it is important to start supplementing folic acid 3-6 months in advance.
