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The Key Role of Progesterone in Fertility, Conception and Maintaining A Pregnancy
When my colleague Dame Dr Shirley Bond and I held seminars together on hormonal health, the questions ranged from puberty to post-menopause. However, the most worrisome were women who tried to start a family and failed to conceive, or became pregnant and suffered one or often multiple miscarriages. Basic information about what is needed would have helped these women because, although it is a completely natural process, the “nuts and bolts” of fertility and pregnancy are often not fully understood.
What is needed
For pregnancy to occur, the body needs a very specific sequence of events to happen, and all of them in the right order, so timing is crucial. A healthy egg must meet a healthy sperm and the woman must ovulate. A newly fertilized embryo must be able to survive its journey down the fallopian tube to the uterus, and that’s just the beginning. The lining of the uterus must be in a mature and stable state for implantation to occur and the placenta to form. It is this placenta that takes over the production of progesterone throughout the pregnancy.
Apart from the actual development of the egg and ovulation itself, all of these steps require the presence of progesterone to be successful. Failure to produce progesterone at any point can lead to miscarriage.
What can go wrong
Unfortunately, it is not uncommon for women in their thirties to produce insufficient progesterone during the second half of their cycle. This failure of progesterone levels can be enough to prevent an egg or embryo from surviving, a condition called luteal phase progesterone deficiency. The result is that the endometrium separates and bleeds, which can mean the pregnancy never started or, if it did, a miscarriage. Often these miscarriages are so early that they are not recognized as such and are considered late term.
Some miscarriages that occur a little later, at 10-12 weeks, are due to the early death of the embryo and may also be due to a lack of progesterone, but there may be other reasons.
Anovulatory cycles, in which ovulation does not occur even though a normal period occurs, is another common problem with conception. If this is the case, hormone therapy is recommended, but adding bioidentical natural progesterone can stimulate a feedback mechanism between the ovary and pituitary gland and restore normal hormone cycles and ovulation.
Which can help
The first step is to ensure that the woman is ovulating each month and that her progesterone levels are strong enough to go through with primary fertilization and create a viable fetus.
Usually, a woman’s body begins to produce a large amount of the necessary progesterone – 300-400 mg per day. However, if there have been difficulties conceiving or miscarriages, it can be very useful to add a bioidentical natural progesterone cream before and during pregnancy to ensure a good base level for the body.
During pregnancy, doctors may recommend supplemental progesterone in the first trimester under these circumstances, but for patients with a history of miscarriage, doctors with experience using natural hormones recommend continuing to use it until the 36th week, when the body’s progesterone levels are normal. established.
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