You must stop taking progesterone during pregnancy once you reach your 16th week.
If you go through in vitro fertilization (IVF) or intrauterine insemination (IUI) to start a family, you will be given progesterone. This is to help the process along and make it easier for a pregnancy to occur. When a woman conceives naturally, the placenta makes the hormone to retain the pregnancy. Taking progesterone in the first 16 weeks of a pregnancy resulting from assisted reproductive technology (ART) helps to prevent the risk of miscarriage.
What Is Progesterone?
According to Cleveland Clinic, progesterone is a hormone found in the female reproductive system. It sends messages to the body to support the menstrual cycle and helps maintain the earliest stages of pregnancy. Progesterone prepares the lining of the uterus to support a fertilized egg – an embryo – to implant. When pregnancy does not occur, the hormone allows the endometrium, the lining of the uterus, to shed during menstrual periods.
When to Stop: General Timing Guidelines
After IVF or IUI results in pregnancy, your healthcare provider will instruct you to take progesterone to prevent miscarriage. According to the Society for Reproduction and Fertility, it’s recommended to stop taking it up until the 16th week. However, some studies indicate that it’s better to stop by the 12th week.
Factors Influencing Progesterone Withdrawal Timing
Certain factors influence progesterone withdrawal timing. They include pregnancy test results, patient history and previous loss, presence of complications and type of pregnancy.
Pregnancy Test Results
A positive pregnancy test result doesn’t mean you stop taking progesterone. Consult with your doctor to confirm how far along you are, and they’ll instruct you on the next steps.
Patient History and Previous Pregnancy Loss
A patient’s history and previous pregnancy loss can determine when she should stop taking progesterone. According to Epic Research, studies have shown that women with a history of miscarriages who take the hormone are 18% less likely to experience a miscarriage.
Presence of Complications
Progesterone sometimes causes complications in pregnant women. These issues can occur from both too low and too high doses and may include fatigue, anxiety, depression, hypertension and even preterm labor. If a patient has experienced prior complications, her healthcare provider will tailor her treatment based on those issues.
Type of Pregnancy
The type of pregnancy can influence when you should withdraw from taking progesterone. If you are carrying a single fetus, it’s best to stop after the first trimester because the placenta will make its own progesterone. However, if your healthcare provider determines that you are in the high-risk category, you may take it for longer.
Key Studies and Clinical Trials
Key studies and clinical trials have shown when you should stop taking progesterone during pregnancy. Specifically, there are insights from the PROMISE trial and other significant studies.
Insights from the PROMISE Trial
According to Facts About Fertility, research from the PROMISE trial was published in the 2020 edition of the American Journal of Obstetrics and Gynecology. The study showed positive outcomes when women took vaginal micronized progesterone in their first trimester of pregnancy. Study participants who previously suffered miscarriages had a 66% rate of live births.
Other Significant Studies
Other significant studies have shown that progesterone during the first trimester may have positive impacts on pregnancy. According to PubMed, participants in the PREGNANT trial were 45% less likely to experience preterm birth. Another study, the MIST trial, also found a lower risk of the same when given weekly intramuscular injections of 17-hydroxyprogesterone caproate.
Risks of Early or Late Withdrawal
Withdrawing from progesterone during pregnancy carries risks. Some occur when stopping early and others when withdrawing late from the hormone.
Risks of Early Withdrawal
The biggest risk of early withdrawal is miscarriage. Going off progesterone too soon can compromise the viability of a pregnancy because it can negatively affect the endometrium, making the uterus inhospitable for the embryo.
Risks of Late Withdrawal
Late withdrawal can also threaten a pregnancy. Key risks are the uterine lining being insufficient for the placenta to produce its own progesterone.
Side Effects and Monitoring
Stopping progesterone after IVF or IUI can result in side effects and must be watched. It’s crucial to know those potential impacts and how levels are monitored.
Potential Side Effects of Progesterone
Some of the side effects of progesterone are common, while others are rarer. According to the Mayo Clinic, the more typical ones include cold or flu-like symptoms, chills, fever, chest pain, urination problems and cough. It’s wise to consult with your doctor if you experience any of these side effects.
Monitoring Progesterone Levels
Your healthcare provider can monitor your progesterone to ensure safety. This can be done by testing your blood or urine or through an ultrasound. If necessary, your doctor can modify your levels.
Making the Decision to Stop Progesterone
If you decide to stop progesterone, you need the facts. This requires working with your healthcare provider and getting individualized withdrawal plans.
Working with Your Healthcare Provider
Work with your healthcare provider when preparing to stop taking progesterone. They will monitor you with ultrasounds to determine the best time and safely taper you off the hormone.
Individualized Withdrawal Plans
Healthcare providers create tailored withdrawal plans for pregnant patients going off progesterone. To do this, they monitor you and consider your potential risks so you can withdraw as your body produces it naturally.
Different Contexts of Progesterone Use
There are different contexts of progesterone use in pregnancy. They involve IUI and IVF, and natural conception, respectively.
Progesterone in IUI and IVF
Progesterone is critical for women undergoing IUI and IVF. According to Stanford Medicine, it is administered in the latter case after egg retrieval and continued daily for the following two weeks. You continue taking progesterone even after a positive pregnancy result as instructed by your doctor.
Progesterone in Natural Conception
Progesterone plays a key role in natural conception to maintain pregnancy. It prepares the uterus by thickening its lining, allowing a fertilized egg to implant. As the fetus develops, the placenta creates its own progesterone.
Frequently Asked Questions
What Happens if I Stop Taking Progesterone While Pregnant?
You can suffer a miscarriage if you stop taking progesterone too early for the placenta to produce it naturally.
Can Too Much Progesterone Harm a Baby?
Too much progesterone can pose risks to a baby. In pregnancies involving IVF, it can lead to miscarriage, and in natural conception, it can cause a molar pregnancy.
Should I Stop Progesterone at 12 or 16 Weeks?
You must follow your doctor’s advice on when to stop taking progesterone. Everyone is unique, so some women must stop earlier while others do so later.
How Long Are You Supposed to Take Progesterone in Pregnancy?
Typically, you must take progesterone up until the 16th week of pregnancy.
