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Could progesterone be the missing piece to your pregnancy puzzle?

By Proov inventor and Ph.D. scientist, Amy Beckley

Typically women struggling to conceive need to be actively trying for 12 months before they can seek help from a doctor--but why? This is because most fertile couples will conceive within a year of having unprotected intercourse. However, if you have irregular periods, PCOS, recurrent miscarriage, or generally know something is just not right, it can be frustrating and downright destructive to be forced to wait before getting help. If your body is not ready for conception, waiting 12 months is not going to solve that. In fact, waiting might physically make infertility challenges worse due to the stress and disappointment from seeing month-after-month of BFNs.  

I had this very experience myself. I suffered for more than a year, which included 4 pregnancy losses, before I was “allowed” to seek treatment.  By the time I finally got into the doctor, I was so desperate to hold my baby in my arms that when I was presented the option of continuing to try to figure out what was wrong in exchange for a 5-10% chance of successfully conceiving each month versus going straight for IVF with a 70% chance of success, I immediately jumped at IVF.  

What I learned a few years later after 2 rounds of IVF was that my infertility was caused by a simple progesterone issue. With a $200 supplement, I was able to conceive and carry my daughter to term without issue.  It was this experience that led me to be so incredibly passionate about progesterone and to invent the Proov test, which is the first rapid response progesterone test that allows women to test progesterone at home. My road to treatment was long, hard, and depressing and I want to save as many other women as possible from having the same experience I did. 

Why is progesterone so important?

Doctor's don't usually say the word “progesterone” often, but progesterone is the hormone released after ovulation and is needed to support a pregnancy. The #1 cause of infertility is lack of ovulation or insufficient ovulation. This means you are not producing progesterone or enough progesterone to support conception. The good news is that there are many easy ways your doctor can help you produce more progesterone if you are not making enough.

How can Proov help me learn about my progesterone?

Proov tests are over-the-counter and can be taken the very first month you are trying to conceive. No waiting an arbitrary 12 months, no doctor's appointment--just you, your bathroom, your urine, and 5 minutes a day.

Proov tests are designed to show a positive result when progesterone levels are at the widely accepted minimum threshold for supporting conception (5 ug/ml of the urine progesterone metabolite we measure, which correlates to 10 ng/ml in the blood). In the first half of the cycle, when progesterone is low, a Proov test will be negative; in other words, you will see 2 lines on the test.  As progesterone rises after ovulation, the second line should get lighter and lighter until it completely disappears. When trying to conceive, it’s important to ensure progesterone is elevated throughout the implantation window, which is typically 7-10 days after ovulation. Proov allows you to test every day during this window to make sure your body has the progesterone needed to support conception.

If your test is positive, then amazing! You can feel confident that you are ovulating sufficiently and that low progesterone likely won’t be a major roadblock to successfully conceiving. If your test is negative, that’s OK too. You now have identified a possible cause of your infertility. You are armed with valuable information you can take to your doctor and ask them better questions and get better treatment.

What should I do if I have low progesterone?

Low progesterone is highly treatable. There are many ways your doctor can treat lack of ovulation or insufficient ovulation. The following are common treatments you can discuss with your doctor.

Clomid/Femara: Ovulation inducing medication such as Clomid and Femara are usually the first medications doctors try if they suspect you have a progesterone deficiency. These medications help you to ovulate if you are not ovulating and/or produce “stronger” ovulation if you are ovulating, by acting to increase your progesterone levels. These types of medications work by tricking the body into thinking there is not enough estrogen. This feeds back to the ovary and causes it to start maturing follicles (eggs) in order to increase estrogen levels. Due to the higher hormone levels, the stimulated follicles are more likely to release a mature egg and more likely to produce higher progesterone levels after ovulation. 

Trigger shots: This is slang for a medication that “triggers” ovulation and is usually in the form of purified hCG that is injected subcutaneously to stimulate ovulation. HCG functions to complete the maturation of a follicle and subsequent release of the egg (ovulation). The hCG also functions to tell the corpus luteum (follicle after it releases the egg) to continue to produce progesterone. Therefore, trigger shots can be used to induce ovulation and stimulate more progesterone production. Trigger shots can also be used after ovulation to increase progesterone production from the corpus luteum. Some medical treatments call for 2 trigger shots to be administered, one to induce ovulation and start progesterone production and a second one 7 days later to boost progesterone production.

Progesterone supplements: Bio-identical progesterone is widely available and a good way to give your body more of the good stuff if you aren't making enough. We recommend you steer clear of the over-the-counter creams as they are not a high enough dose to help if you are trying to conceive. You'll need a prescription level supplement, provided by your doctor. Progesterone supplements are most effective at preparing the body for conception if taken right after ovulation.

IVF: To my knowledge, all IVF procedures involve giving the woman supplemental progesterone. Most of the time progesterone is given via intramuscular injection with a large needle right to the booty. But why? Well, when the eggs are retrieved after stimulation, doctor’s use an aspiration to suck them up. When they do, sometimes parts of the corpus luteum, the progesterone producing cells, also come along too. And since progesterone is so critical for conception, doctors always supplement the women’s natural progesterone production with supplements. 

Dexamethasone: I have seen a few clinics give dexamethasone to patients either before or during ovulation. It is also often part of IVF treatment plans. Dexamethasone is a synthetic form of cortisol. It has several functions, the most common of which is to reduce inflammation. Although not completely understood, dexamethasone can play a role in preparing the uterus for conception by reducing inflammation and increasing the receptivity of the uterus to the embryo. Since the job of progesterone is to prepare the uterus for embryo implantation, it is thought that dexamethasone either helps to increase progesterone or helps progesterone to function more effectively.

Why wait if you don’t have to?

I invented Proov to give women more information about their hormonal health. When I started trying to conceive, I had so many questions and very little answers--and this only got worse as time went on and I became more and more frustrated and depressed. I believe women deserve to have answers and options. Using Proov can help provide more information about what’s going on with your body sooner, so you can have more empowered conversations with your doctor.

Questions for Amy? Email us!