BONUS 190: Progesterone 101

January 18, 2019

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

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Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Sandra has battled Hashimoto’s, low morphology, and bleeding symptoms. She asks about the removal of her intramural fibroid and if that could improve her fertility chances.
  • Patricia has PCOS and is preparing for her third IVF cycle, for which her doctor recommends repeating the same protocol as the previous failures. She asks about trying a different protocol or possibly doing uterine testing first.
  • Brittany has been diagnosed with hypothalamic amenorrhea. She asks if there is anything she can do to ovulate sooner or lengthen her luteal phase, and if her problem could be an egg quality issue.
  • Mia is currently in her sixth IUI cycle and has encountered sperm count issues and lupus. Her doctor recommends moving to IVF, so she asks about how her lupus might be affecting her fertility.
  • Alessandra has had two missed miscarriages in the last eight months, and recurrent pregnancy loss testing has been recommended. She asks about the details of RPL tests, which conditions might be most likely associated with miscarriage, and whether ovarian reserve should be tested in a patient under 35.
  • Roop had her first IVF cycle recently, which failed even though she had many follicles. She asks if her problem could be strictly poor egg quality or a combination of poor egg quality and poor protocol.

Dr. Rodgers and Heather continue the episode by discussing everything you need to know about the hormone progesterone:

  • Let’s start with a foundation. What is progesterone, where is it produced, and broadly speaking, what parts of the body does it impact throughout your life?
  • What is progestin, and how is it different from progesterone?
  • Let’s dive deeper into progesterone. Tell us how blood progesterone levels have peaks and troughs.
  • What level of progesterone is considered proof of ovulation? Do you only use progesterone levels to detect ovulation?
  • How does progesterone impact your endometrium in the luteal phase of your menstrual cycle?
  • What level of progesterone is considered ‘receptive’ to an embryo, and why?
  • What level of progesterone is considered normal in early pregnancy? What about as the pregnancy progresses? Please explain.
  • I wanted to ask you two controversial questions:
    • How would you define a luteal phase disorder, and do you believe this is actually a medical condition? Why or why not?
    • Do you believe progesterone should be prescribed after ovulation is confirmed or after pregnancy is confirmed? Please explain.
  • What are the different types of progesterone an infertility patient might be prescribed? During what types of cycles and at what doses? Please explain.
  • What are the possible side effects of prescription progesterone? How long do these side effects last?
  • Is there such a thing as having too much progesterone during a cycle?
  • Is there any new, exciting research in the area of progesterone and fertility?
  • Is there anything else you’d like to add?
  • What words of hope would you offer to listeners who’ve been worried about their progesterone levels?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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