To Progesterone or Not To Progesterone

Do I need progesterone? What are the benefits and risks to taking progesterone and not taking progesterone? These are the questions I have. 

First, let's discuss what progesterone is and what it provides during a pregnancy. Progesterone is made early in pregnancy until about 10 weeks. One of progesterone's most important functions is its role in thickening the lining of the uterus each month such that it can nourish and care for the fertilized egg.

Second, let's talk about why and how I knew to ask about using a progesterone supplement. When I was first diagnosed with PCOS (polycystic ovarian syndrome) in May 2013 I was asked during that same appointment if I was ever planning on becoming pregnant. I was advised then, 5 years ago, that when I do become pregnant, it may be beneficial to also be on a progesterone supplement during my first trimester, due to PCOS and the imbalance of hormones my body suffers from. 

Now, we are at present day. Today I had my second hCG blood draw. With my first one, two days ago, and 16 days post insemination/ovulation, my hCG was at a 272. Today's reading, which needed to approximately double to show that my pregnancy was on the right track, came in at 629. Yay! Great news, right? Well, with the foresight from that PCOS diagnosis 5 years ago, I had also asked my doctor to run a progesterone panel. My progesterone level came back at a 10.1. What does that mean?

An average progesterone level should be between 6 and 20 but above 20 is preferred while pregnant. It's also important to note that progesterone levels lower later in the day and also lower if blood is drawn not during a fast. My blood draw was taken in the late morning and I had no fasted. So I was left with a choice to make -- to progesterone or not to progesterone? My fertility specialist, OB/GYN, and endocrinologist all said the same thing. There is no risk to taking it and there could be a risk to not taking it if my progesterone levels fall. There is really no guarantee one way or the other. So with no risk to my health or the babies, I decided to take it.

Progesterone comes in many forms: vaginal gel suppository, pill/capsule, and injection. My doctor and I both decided that the vaginal gel suppository would be best as it offers a lower amount of side effects. He also wanted me to try it for a week first to make sure that those side effects. And so, that is how we came up with the answer to this important and perhaps not very talked about question.