Doctor says progesterone level is not important

Some doctors say that progesterone is not important. In the article "Should I supplement corpus luteum copper if my progesterone level is low during pregnancy?" we talked about this. Of course, during pregnancy, low progesterone level is largely the result of a poor pregnancy, not the cause of miscarriage. We added a premise: of course pregnancy. So for patients undergoing in vitro fertilization, will the level of progesterone affect pregnancy and subsequent pregnancies?

Previous scientific research tells us that the progesterone level is always at a low level before ovulation. After ovulation, the progesterone level rises sharply. If pregnancy occurs, the progesterone level will continue to rise until it reaches the highest value. If not, it will slowly return to the bottom.

Now we consider the whole process of test tube transplantation in in vitro fertilization. There are two types of IVF: fresh embryo cycle and frozen embryo cycle.

In fresh cycle transplantation, due to ovulation induction, a large part of the uterus develops, and the progesterone level will be very high, and the blood test value can generally reach more than 40ng/ml. During the frozen embryo transfer process, the eggs do not grow and develop, and exogenous hormones are used to control the changes in the uterine wall to achieve a state suitable for receiving test tube embryos. Therefore, the progesterone concentration in the blood is extremely low.

In order to ensure that the uterus can achieve the state of mutual development with the test tube embryo, vaginal packing drugs can be used to supplement progesterone levels after embryo transfer.

Vaginal packing supplements progesterone by partially absorbing the drug through the vaginal mucosa, and then supplementing the body's drug clearance function. Therefore, the progesterone concentration around the uterus will be very high, while the progesterone concentration in the blood will be relatively low. Therefore, the progesterone measured in the blood test does not mean the progesterone concentration in the uterus, nor does it mean the progesterone concentration in the test tube transplant environment, and has nothing to do with the success of the test tube transplant. In other words, after embryo transfer, we only need to care about the doubling of HCG and do not need to consider the level of progesterone.