Should I Expect Side Effects When Taking Progesterone for IVF?

As if you're not being poked, prodded and dosed up enough during the whole IVF process, your doctor might prescribe some progesterone for good measure. So what you want to know is, how bad is this going to be, really? We've got answers about progesterone during IVF, including its side effects (and hopefully it won't be so bad). So here goes.

What's the point of progesterone during IVF, anyway?

Progesterone is a sex hormone that exists in the body. It does a lot of things, but in essence, it's necessary for a healthy pregnancy, most notably because it helps get the uterine lining (the endometrium) ready for an embryo to make a home there.

For IVFers, progesterone might be prescribed in addition to the usual injections. You probably already know that your injections—a.k.a. gonadotropins such as Follistim, Gonal-F, Pregnyl, Repronex, etc.—help you ovulate. Progesterone, however, is taken later, often starting the same day the eggs are retrieved during a fresh cycle.

According to Dr. David Diaz, MD, reproductive endocrinologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California, progesterone supports the lining of the uterus, which helps during embryo implantation. Implantation is what you want—that embryo needs to "stick" to the uterine wall, so you can officially get pregnant and stay that way.  

The nitty gritty on taking progesterone for IVF

Don't kill the messenger, but although some IVF clinics will prescribe progesterone orally, you're likely going to have to take this drug through one of two not-so-fun ways:

• Shots: For IVF, progesterone can be taken via intramuscular injection. By intramuscular, we mean in your butt cheek, or maybe a hip or thigh. The shot will contain the hormone, as well as a little bit of natural oil for dissolving purposes.
• Vaginal capsules: Yep, a suppository inserted your lady parts could be an option for you if the shots are a no-go. "[The capsules] dissolve internally," says Dr. Diaz." They work well and provide a good alternative to patients unable to tolerate the injection or those allergic to the injectable form." Basically you'll insert it similar to how you would put in a tampon.

You'll have to take progesterone according to doctor's orders until you get your pregnancy test results. If you do get pregnant, your doctor may want you to continue taking progesterone throughout your first trimester, says the ASRM, since it may help prevent pregnancy loss.

Side effects of progesterone during IVF

Watch out for progesterone side effects during your IVF journey. Common side effects include:

For the shots

• Pain at the injection site
• Swelling at the injection site
• Small knot in the muscle at the injection site

For the vaginal suppositories

• Vaginal itching or burning
• Yeast infection

For either

• Dizziness or tiredness
• Mood swings
• Bloating
• Nausea
• Cramps

No matter how you're taking your progesterone for IVF, you'll want to notify your doc if you have serious or sudden side effects. According to the University of Michigan Medicine, this could include:

• Signs of allergic reaction
• Unusual vaginal bleeding
• Pain or burning when you pee
• Symptoms of depression
• Lump in your breast
• Sudden vision problems
• Severe headache
• Chest pain or pressure
• Jaundice (yellow skin or eyes)
• Sudden numbness or weakness
• Sudden severe headache
• Slurred speech
• Other problems with speech or balance
• Sudden cough or wheezing
• Rapid breathing
• Pain, swelling, warmth, or redness in one or both legs

Pro tips

None of this sounds like a walk in the park, but we do have some tips that can make the whole progesterone process a little easier.

If you're doing shots

• Have your partner or a trusted friend or family member help. This is not an easy solo feat.
• Invest in both a heating pad and ice pack. "We recommend using a cold pack alternating with a warm pack to minimize discomfort," says Dr. Diaz.
• Switch injection sites. Shooting in the same place on the body will just cause more pain and possibly tissue damage.
• Massage the muscle gently after injecting.

If you're doing vaginal suppositories

• Use an applicator if it came in your pack. But throw it away after use. (Reusing is just a hard no.)
• For a PM dosage, insert it before bed, so gravity's on your side.
• Use panty liners, since you'll probably have some oily discharge. (Ew.) You'll thank us later for this tip.

Always take your meds according to the doctor's or nurse's instructions. If you're doing progesterone shots, you'll likely get a full run through of the whole process. Ask lots of questions about anything that's confusing or weird.

And let's hope that progesterone—no matter how you take it—helps this IVF stick. Good luck!

FAQs about progesterone for IVF

Why is progesterone given after IVF? Progesterone helps get the uterine lining ready for embryo implantation to occur. It might be prescribed in addition to your other IVF injections, but often starts the same day as eggs are retrieved during a fresh IVF cycle and continues on until you take a pregnancy test—if it’s positive, you’ll continue to take progesterone as long as your doctor recommends (usually through the first trimester) to support a healthy uterine lining.

How long do you take progesterone after IVF? In a fresh IVF cycle, progesterone often starts the same day as an egg retrieval. You’ll continue taking progesterone according to your doctor’s orders until you get your pregnancy test results. If you do get pregnant, your doctor may want you to continue taking progesterone throughout your first trimester, which may help prevent pregnancy loss. If not, your doctor will likely want you to stop taking progesterone. ‍

‍
Does progesterone help implantation? The goal of taking progesterone is to help get the uterine lining ready for implantation, and hopefully, for that embryo to “stick.” It also may help prevent pregnancy loss, according to the ASRM, which is why if you do get pregnant, you may be told to continue taking the medication for a period of time.  

What are the side effects of progesterone injections for IVF? When taking progesterone shots for IVF, you may experience pain or swelling at the injection site or small muscle knots near the injection. If you’re taking the vaginal capsules, this may result in vaginal itching or burning or even yeast infections. Keep a close eye on symptoms and report anything unusual to your doctor. For either method of taking progesterone, you may experience dizziness, fatigue, mood swings, bloating, nausea, and/or cramps.  

Does progesterone affect implantation? That’s the point of progesterone in the first place! Taking progesterone during IVF is meant to support your uterine lining (endometrium) so that embryo implantation can occur. Effects of progesterone go beyond implantation, though. According to the ASRM, continuing to take progesterone beyond a positive pregnancy test—often through the first trimester—may help prevent pregnancy loss.