What kind of support after migration. What is IVF? Progesterone support after successful IVF. The Global Progesterone Myth - Read to All Women! Hormonal support after embryo transfer

Most women are prescribed drug support for IVF after embryo transfer. It depends on it how successfully the protocol will be completed. Several types of medicines are used.

The woman's health status, age, the presence of unsuccessful previous protocols affect which drugs are prescribed after embryo transfer. IVF allows previously infertile couples to have a child, but all the conditions of the protocol must be met.

One of them is drug support for IVF after embryo transfer. If the doctor has not prescribed any medications, you should clarify this point with him yourself. Since the preparations after embryo transfer help to maintain the pregnancy, which was so difficult for future parents.

Post-transfer support drugs

The range of drugs used in in vitro fertilization is very diverse.

It includes:

1. vitamins;
2. hormones;
3. substances that prevent excessive blood clotting.

Post-transfer support drugs are needed to maintain the pregnancy and maintain its normal course. Therefore, their purpose is very important.

The post-transfer preparations include an extensive list of vitamins. The most commonly prescribed complexes for pregnant women.

These include:

• Vitrum;
• Femibion;
• Elevit Pronatal.

The doctor can prescribe a vitamin complex himself, but sometimes leaves the choice for the expectant mother. All drugs are similar in composition and action, so there is no significant difference between them.

Important! When choosing a vitamin complex, it is worth considering the range of pharmacies closest to the place of residence, so that there is always an opportunity to buy exactly the remedy that was taken earlier. It is highly discouraged to change the medicine during pregnancy, especially if there is no allergic reaction or side effects to the prescribed drug.

Support after embryo transfer with IVF includes folic acid supplementation. It is prescribed in the same amount as for all pregnant women.

The advantages of this acid are that it:

1. prevents pathology of the neural tube of the fetus;
2. helps the development of all organ and tissue systems;
3. prevents spontaneous abortion.

Folic acid can be taken alone or in complexes if the amount is in accordance with the prescribed dosage.

And also to the support drugs after embryo transfer includes magnesium, which has the following properties:

• allows you to reduce anxiety;
• calm the nervous system;
• prevents the appearance of uterine tone.

It is prescribed in the form of drugs "Magne B6" or "Magnelis". After embryo transfer, these tablets relax the woman's nervous system and prevent dangerous contractions of the uterine muscles that can provoke the rejection of fertilized eggs.

Progesterone to support pregnancy

Hormonal drugs allow the embryo to gain a foothold in the uterus, as well as reorganize the body to the state of pregnancy. Progesterone has this effect.

Injections after embryo transfer with this drug are quite common. But more often Progesterone is used in two forms:

1. a gel that is injected into the vagina (Crainon);
2. capsules or suppositories used intravaginally (Utrozhestan).

The choice of the dosage form is carried out by the gynecologist, depending on the indications and purpose of treatment, as well as the patient's condition. Most often, candles are assigned because of the ease of use.

Progesterone has several main properties:

• changes the structure of the endometrium, which facilitates the attachment of the embryo to the wall of the uterus;
• reduces the contractile activity of the uterine myometrium, allowing tight closure of the cervical canal, reducing the risk of spontaneous miscarriage at the beginning of pregnancy.

Progesterone support after IVF is a common method of maintaining a long-awaited pregnancy. The drug is withdrawn gradually from 8 to 20 weeks.

The duration of admission is determined by the reproductive physician of the medical center performing in vitro fertilization. It is calculated based on the main indicators:

1. patient history;
2. type of IVF protocol;
3. age;
4. hormonal background of a woman;
5. the presence or absence of artificial insemination prior to this experience and their results.

If you have a strong allergic reaction or other side effects to drugs that support the luteal phase, you need to consult a specialist.

The doctor will select an adequate replacement for the medication. The drug should be withdrawn gradually, reducing the dosage. Abrupt cancellation or skipping of the appointment is unacceptable, as this threatens the safety of the pregnancy.

Duphaston after transfer

This drug is also analogous to human progesterone. Duphaston after embryo transfer helps to maintain the pregnancy, to ensure a successful course. The use of this drug is considered normal for in vitro fertilization protocols. Progesterone increases the chances of successful implantation of an egg into the endometrium of the uterus.

Duphaston belongs to the group of retroprogesterones. These drugs, used as support for the luteal phase in in vitro fertilization, have a strong gestagenic but low androgenic effect.

This gives them a number of advantages:

• lack of feminization of the male child;
• lack of masculinization of the reproductive system in a female child;
• does not affect the liver;
• does not affect blood clotting;
• does not cause rashes, hirsutism, change of voice towards the male;
• does not affect metabolic processes (does not change the concentration of blood glucose, as well as its lipid spectrum);
• lack of influence on the pituitary-ovarian system;
• does not provoke adrenal atrophy.

Due to the presence of these properties, doctors actively prescribe Duphaston after transfer during artificial insemination. It is a dydrogesterone with a methyl group at position 10 in human progesterone).

This altered molecular structure allows Duphaston to be more easily absorbed during oral administration. The use of the drug in a dosage of 20 to 30 mg stimulates the secretion phase in the endometrium. Thus, dydrogesterone supports pregnancy.

The use of the drug begins from the moment of embryo transfer at a dosage of 30 to 60 mg per day. Reception continues until the 12th week of pregnancy. If there is a threat, treatment is extended to 20 weeks.

Duphaston is absolutely safe for the fetus. The absence of a teratogenic effect has been confirmed by a mass of studies, therefore the drug is widely used as a support for artificial insemination.

Analogues of drugs for maintaining pregnancy

After in vitro fertilization, it is necessary to compensate for the lack of natural estradiol. To do this, use the drug Proginova. It contains synthetic estradiol (estradiol valeriate), which allows the fetus to become firmly attached to the wall of the uterus.

The dosage form of the drug is a tablet for oral administration. The scheme of application is developed individually by a reproductive physician conducting a pregnancy, taking into account all contraindications and research results.

Proginova is not appointed in the following cases:

1. with endometriosis;
2. if there are malignant neoplasms of the liver;
3. with diabetes mellitus of any type;
4. with increased blood clotting ability;
5. if a pregnant woman is overweight.

It is impossible to cancel the drug on your own, as this can have consequences up to the termination of pregnancy. The dosage is reduced gradually, the individual course is calculated by the doctor.

Another progesterone drug is Crainon. It comes in the form of suppositories or gel. Most often, candles are assigned, their use is easier. The drug can be used once a day, which is more convenient for patients than multiple doses.

Conclusion

Prescription of the medicinal product must be carried out by a physician. It is unacceptable to prescribe independently, to replace the drug with a similar one, to change the regimen of administration or to completely cancel it. Self-medication in this case threatens to disrupt the long-awaited pregnancy.

Video: Pregnancy management after IVF

Javascript Disabled Detected

Please enable JavaScript.

Every year the number increases all over the world. Whether it is good or not, it is impossible to say unequivocally. Such is our harsh reality that a combination of unfavorable factors, and these are bad ecology, unhealthy diet, past illnesses, stress - leads to an increase in the number of married couples experiencing problems with conception. In vitro fertilization for many becomes the only chance to become parents and acquire long-awaited offspring. The IVF procedure includes several stages: after the embryos that have grown in artificially created conditions are transferred into the womb, the woman is prescribed hormonal support with progesterone preparations.

What is progesterone for?

To understand why we are prescribed such large doses of drugs containing progesterone and its derivatives, we need to know its effect on the female body.

• Progesterone organizes secretory endometrial modification, most favorable for embryo attachment.
• Reduces the ability of the myometrium to contract, therefore, eliminates the risk of miscarriage.
• Plays a role in the tight closure of the cervical canal.

What drugs are prescribed for progesterone support

Currently, it is customary to prescribe progesterone medications in the form of tablets or vaginal suppositories (capsules). The use of injectables is discouraged due to the inconvenience of use and in the form of hematomas and abscesses after long courses of injections, although it is also common.

1. Duphaston(dydrogesterone) is an artificially created analogue of the hormone progesterone. It is administered orally in pill form. This drug is safe for the mother and fetus, even with long-term use. Usually the daily dosage is 30-60 mg. Duphaston is taken orally at the same time every day.
2. Utrozhestan is a widely prescribed drug for hormonal support in artificial insemination cycles. It contains natural progesterone, which is obtained from plant materials. In IVF protocols, Utrozhestan is prescribed in capsules for vaginal use. At the time of its introduction, it is advisable to try to place the capsule as deep as possible in the vagina, closer to the cervix, in order to minimize leakage outward. The recommended dose is 600 mg (1 capsule 200 mg three times a day at regular intervals). In some cases, according to indications, a large daily dose of the drug is prescribed: 800 mg (4 capsules per day, 200 mg each) in combination with injections of a 2.5% oily solution of progesterone twice a day.
1. with endometriosis;
2. if there are malignant neoplasms of the liver;
3. with diabetes mellitus of any type;
4. with increased blood clotting ability;
5. if a pregnant woman is overweight.

It is impossible to cancel the drug on your own, as this can have consequences up to the termination of pregnancy. The dosage is reduced gradually, the individual course is calculated by the doctor.

Another progesterone drug is Crainon. It comes in the form of suppositories or gel. Most often, candles are assigned, their use is easier. The drug can be used once a day, which is more convenient for patients than multiple doses.

Conclusion

Prescription of the medicinal product must be carried out by a physician. It is unacceptable to prescribe independently, to replace the drug with a similar one, to change the regimen of administration or to completely cancel it. Self-medication in this case threatens to disrupt the long-awaited pregnancy.

Video: Pregnancy management after IVF

After the final stage of in vitro fertilization - embryo transfer - hormonal support is mandatory. It is aimed at maintaining optimal levels of hormones responsible for the onset and development of pregnancy. The fact of the birth of a new life is confirmed by a blood test for hCG (human chorionic gonadotropin) 14 days after the embryo transfer. Control tests for hormones are also taken, after which the question of the need for their further administration is decided.

Progesterone support after embryo transfer

Post-embryo transfer support with progesterone is prescribed on the same day. Progesterone is formed in the ovaries by the corpus luteum, which appears at the site of punctured follicles. Its peak in the blood is observed 5-6 days after the puncture. Performs the following functions:

• Modifies endometrial secretion, creating favorable conditions for embryo implantation.
• Reduces the contractile activity of the myometrium.
• Affects the tight closure of the cervical canal.

Progesterone support after embryo transfer is carried out to prevent impairment of these functions, as dysfunctions can lead to miscarriage. Medicines are prescribed in an individual dosage according to certain schemes, the choice of which depends on the characteristics of the IVF procedure, and the initial indicators of progesterone in the blood. Support after embryo transfer is carried out by Dufaston (tablet form), Utrozhestan (vaginal suppositories) or Progesterone injections.

Post-embryo estradiol: hormone support

Estradiol is formed in the ovaries and serves as a stimulant for endometrial growth. Under its influence, the optimal structure of the uterine mucosa is created, which is necessary for the correct attachment of the embryos. If the ultrasound reveals an insufficient thickness of the endometrium, drug support is prescribed before the embryo transfer and continues after it. A decrease in estradiol results in a decrease in progesterone production.

Medicines with estradiol analogues are prescribed in the form of gels or tablets. Widely used:

• Divigel;
• Estrogel;
• Proginova.

Their doses are selected for each patient individually, based on the test results and ultrasound data.

Hormonal support after embryo transfer is provided until 12-14 weeks of gestation. In the future, the formed placenta takes over the function of producing hormones. If, during the examination, a lack of hormonal substances persists, maintenance with artificial analogs continues for a longer time. The duration of therapy is determined by the attending physician.

After embryo transfer, it is important to follow all the doctor's instructions and follow his recommendations. Self-canceling or renewing drug support is not allowed. This can lead to serious consequences and, as a result, termination of pregnancy.

A woman's desire to become a mother is conditioned by nature, but, alas, sometimes for a number of reasons, pregnancy does not occur naturally. Modern medicine offers couples who want to become parents, not only in vitro fertilization, but also effective methods to maintain pregnancy. How this happens, and what you need to know about support after IVF, will be discussed below.

Why do you need support after IVF

It is known that often problems with conception are associated with a violation of the level of female sex hormones, which causes abortion. That is why, before and after the IVF procedure, a woman is shown to take hormonal drugs. Hormonal support is designed to accelerate the transformation of the endometrium and ensure the preservation of pregnancy.

Did you know?For the first time, the transfer of an embryo into a woman's uterus was carried out by British specialists from Cambridge. In 1978, the first test tube baby, a girl, Louise Brown, was born.

Post-transfer support drugs

Medical support after embryo transfer is necessary and imperative, especially in the first weeks after pregnancy is confirmed. The main hormones that ensure the normal bearing of the fetus are estradiol and progesterone, and preparations containing these hormones are included in the IVF program.

"Divigel" is an alcohol-containing preparation in the form of a gel, which is a source of synthetic estradiol, which is aimed at replenishing hormones before the IVF procedure. The drug is prescribed to thicken the endometrium and prepare the uterus for embryo transfer, as well as to increase estrogen levels to avoid fetal rejection.

Divigel improves the functionality of the female reproductive system and helps create ideal conditions for pregnancy. The drug has a transdermal effect and is intended for topical use, it is applied to dry, clean skin of the lower body, with an area of ​​at least a palm.

Important!The place of application of the gel must be periodically changed, while it should not be applied to the area of ​​the mammary glands, face and mucous membranes of the body.

This tool belongs to the sources of a synthetic analogue of the hormone progesterone. Available in pill form. Due to the fact that the drug does not have an androgenic effect and does not affect ovulation, it is considered relatively safe in preparation for IVF and with further gestation.

A drug containing micronized progesterone. It is prescribed in IVF programs for luteal insufficiency. It is produced in the form of tablets for sublingual use, or in the form of vaginal tablets.

A source of progesterone in the form of a gel for intravaginal administration. The tube is equipped with a special applicator. This form of application allows the hormone to be rapidly absorbed through the mucous membranes of the vagina and saturate the body after 3 days of use.

Progesterone oil solution

The drug is available in ampoules in the form of an oily solution of the hormone progesterone for injection. Typically, injections are given subcutaneously or intramuscularly according to the schedule prescribed by your doctor.

Important! With the introduction of progesterone in the form of an oil solution, soreness, induration and redness at the injection sites are often observed, which must be notified to the attending physician.

When is IVF pregnancy support canceled?

As you know, medical support after the transfer of the embryo into the uterine cavity is the key to successful implantation of the future fetus. Women undergoing IVF are prescribed hormonal drugs already at the planning stage, and they must be taken until 14 days after the embryo is inserted.
After confirming the onset of pregnancy based on the results of a blood test for the hCG level, the doctor who performed the procedure can correct the support scheme or cancel it altogether. Usually, progesterone supplementation is continued throughout the first trimester of pregnancy, estrogens are taken up to 8 weeks. In some threatening cases, the woman is forced to continue support throughout the gestation period.

Supportive therapy can be canceled only with the permission of the reproductive physician and according to the scheme prescribed by him. The peculiarity of sex hormones is that the process of their cancellation should take place with a gradual decrease in dosage until the end of the intake, abrupt cancellation is unacceptable, in order to avoid negative consequences due to a jump in hormone levels.

Did you know? When IVF is performed, it is technically possible to plan the sex of the unborn baby, since reproductive specialists know the chromosome set of sperm, but the ethical laws of medicine prohibit the selection of suitable embryos by gender, so it is impossible to "order" a son or daughter.

Why are there no periods after canceling support?

In case of an unsuccessful IVF protocol, support is canceled and after that, normally within 3-5 days, menstruation should begin, if this does not happen, you need to consult a doctor in order to clarify the reasons:

• it is possible that the embryo has taken root somewhat later than the designated date;
• the likelihood of an ectopic pregnancy is high;
• stress suffered after an unsuccessful procedure, nervous tension, depression can lead to a cycle failure;
• a temporary disruption of the hormonal background after the cancellation of support can cause instability of the cycle, while, if no other reasons are identified, hormones should return to normal within 3-6 months.

So, the features of drug support during in vitro fertilization were considered above.

This information will help to understand the peculiarities of the influence of sex hormones on the stimulation of the reproductive system and will rationally assess the need for their use.

Even after embryo transfer, a long-awaited and so expensive pregnancy can often fail. Therefore, correctly selected medical support after IVF often serves as a lifeline that can “keep afloat” a problematic pregnancy.

A positive pregnancy test after IVF pleases any couple, but this is only the beginning of a long journey to the birth of a healthy baby. Pregnancy did not occur naturally for some serious reason, so certain efforts are needed to maintain it in the female body.

The first trimester of pregnancy is especially important for a woman. Only by stepping over it and keeping the pregnancy, the expectant mother can breathe out a little.

It is known that a third of all pregnancies after IVF end with interruption in the first trimester. Negative factors of maternal health or fetal health can be the reasons for this trouble. After all, most women cannot get pregnant on their own precisely because of violations in their state of health. And artificial hormonal stimulation for the onset of pregnancy contributes to a hormonal shift in the female body. All this increases the risk for the normal bearing of the fetus. It is especially important throughout pregnancy after IVF to determine and timely adjust the amount of two main female hormones in the blood of a pregnant woman:

• Progesterone.

The reasons for the termination of pregnancy after IVF can be the following factors:

• endocrine disorders;
• immunological shifts;
• improper management of pregnancy;
• mother's age;
• chromosomal abnormalities;
• immune conflict;
• antiphospholipid syndrome;
• infections that have arisen during this period.

It is especially important for a woman to be under medical supervision during the first 6 weeks of pregnancy. On average, after IVF, only 60-80% of women reach childbirth. The causes of miscarriage are usually miscarriage or.

Most of these tragedies occur in exactly 1 trimester. After this period, such a risk for a woman is significantly lower.

There is an opinion of some reproductive specialists that hormonal support after IVF is not needed during normal pregnancy. After all, any have a high cost and a lot of side effects. However, even these specialists consider hormonal support necessary for many pathologies of gestation.

That is why drug support is so often needed to maintain pregnancy after IVF.

Progesterone support after successful IVF

Progesterone is one of the most important. Its main functions at this moment are:

• creation of the most favorable conditions for the endometrium for reliable fixation of the embryo;
• reducing the risk of endometrial contraction, preventing the risk of termination of pregnancy;
• maintaining the cervical canal closed.

Currently, women after IVF are prescribed progesterone in the form of regular or vaginal pills. Progesterone in the form of injections at this point is extremely rarely used due to the inconvenience for the expectant mother. In addition, prolonged injection often leads to soreness, bruising, or even abscesses at the site of administration of the drug.

Progesterone Support Drugs

1. Duphaston. It is used in pill form. It is believed that this medicine can be used for a long time without the risk of harm to the mother or fetus. However, some reproductive specialists are wary of prescribing it to pregnant women. Duphaston should be taken daily, at the same time. Its dose ranges from 30 to 60 mg.
2. ... This is the most popular drug for hormonal correction of the female body. It is invented by the French company Besins and is micronized progesterone. This medicine is obtained from plant materials. It is used in the form of vaginal capsules. In this case, 600 mg of the micronized drug is comparable to 6 injections of progesterone. To prevent leakage, it is advisable to place the capsule as deep as possible, closer to the cervix. Most often, the drug is used 1 capsule (200 mg) two to three times a day at regular intervals (600 mg per day). Sometimes the doctor may prescribe an increased dose of this drug: a capsule 4 times a day with a parallel two-fold administration of a 2.5% oil solution of the same drug.
3. Progesterone in the form of an oil solution (1 ml of 2.5% or 1%) can be administered in the form of intramuscular or subcutaneous injections. But the method of taking in the form of "oil injections" can cause pain during injection and increase appetite. After a week of injections, women complain of pain in the buttocks from injections.
4. Lutein. Contains all the same progesterone, but it is used sublingually 3-4 times a day, 100-150 mg (under the tongue) or intravaginally 2 times a day, 150-200 mg (inside the vagina). The dose for hormonal support is determined by the doctor.
5. Crynon. This is a gel for vaginal use with progesterone. It is introduced with a special applicator. This type of support is good in that it provides saturation of the body for 3 days after ingestion. This drug flows out of the vagina less than Utrozhestan, especially in summer. Also, this medication has a minimal effect on the liver.

Features of use

Any hormonal drugs must be taken taking into account their "insidiousness", since their thoughtless intake or cancellation can harm the health of a woman or a fetus.

Therefore, there are a number of rules when using progesterone-containing drugs:

1. Preparations containing progesterone are usually started on the day of a woman's egg collection, continuing until pregnancy is confirmed, and then until 12 weeks of pregnancy. When prescribing their dosage, the doctor must take into account all the individual factors of the pregnant woman (endometrial thickness, own level of progesterone, etc.)
2. The use of this group of drugs can bring some inconvenience to a woman's life: the need to inject the drug into the vagina or inject several times during work.
3. The appearance of "side effects" when using drugs for progesterone support in pregnant women in the form of weight gain, increased appetite, dizziness or weakness.
4. Cancellation of drugs containing progesterone is carried out according to the cancellation scheme (with a gradual dose reduction). In no case should you abruptly stop taking these drugs. Before canceling the drugs of this group, a blood test is most often prescribed to determine the level of the hormone in the woman's body. It is most often possible to completely abandon progesterone support at a gestational age of 14-15 weeks. But at the same time, there should be no deviations in the body of the expectant mother. In addition, the woman must have a fully formed placenta, which takes over all the functions of maintaining the pregnancy. If a woman has risks of threatened abortion during this period, then progesterone support can last up to 20 weeks.

Estradiol after IVF

Estradiol is also a natural estrogen. It is produced in the corpus luteum of the ovaries and partially in the adrenal glands. It is this hormone that is responsible for the formation of female sex differences. After IVF, estradiol, along with progesterone, is responsible for maintaining pregnancy.

When combined with progesterone, estradiol is able to keep the endometrium in an ideal state for pregnancy.

If the analysis reveals that this hormone is not enough in the blood, then it is introduced additionally in the form of drugs. The rate of estradiol after IVF is approximately 5,000 - 10,000 pmol / l. After implantation of the embryo, estradiol is responsible for the thickness of the endometrium.

It depends on the thickness of the endometrium whether the embryo can normally be fixed in the uterus so that a woman can bear the fetus until the end of its ripening.

Also, estradiol after fertilization with IVF is responsible for such important processes:

• ensuring the growth and stretching of uterine tissues;
• the formation of the bone skeleton of the future baby;
• normal work of the fetoplacental system;
• stimulation of metabolic processes;
• delivery of nutrients to the embryo;
• activation of blood circulation in the uterine tissues.

Along with progesterone, estradiol creates favorable conditions for pregnancy, supports metabolic processes between mother and fetus, controls normal blood pressure and participates in labor.

If the estradiol level drops sharply afterwards, then there is a serious risk of preterm labor and miscarriage.

In no case should the dose of hormonal drugs be exceeded. No hormone will make a good embryo out of a bad one, but hormones can harm the fetus.

It is because of the possible toxic effect on the embryo that it is unacceptable for a woman to independently prescribe, cancel or increase the dose of hormonal drugs during pregnancy.

After effective IVF, reproductive specialists use estradiol in the form of tablets (, Estrofem) and the form of a cutaneous gel (, Estrogel).

Proginova

This hormone replacement drug should be canceled immediately upon the onset of a normal pregnancy. So it says in the instructions. However, with an IVF program, this drug can be used for up to 3 weeks. It all depends on the scheme chosen by the attending physician. Usually the dose of Proginov ranges from 0.5 to 7 tablets per day.

It is important to use the drug at the same time, without lowering or increasing its dose on your own.

Proginova is called to maintain the level of estradiol in the woman's body stable and not dependent on infections, stress or exacerbation of chronic ailments in the expectant mother.

In any case, this drug should be canceled no later than 15 weeks of pregnancy. It is canceled very gradually, reducing the dose every 3 days, starting with ¼ of the pill.

Other forms of using estradiol during IVF are Estrofem tablets, Microfollin, Divigel or Estrazhen gel, Klimar patch.

The peculiarities of the abolition of these drugs is also the principle of gradualness, so as not to harm the body of the mother and the unborn baby.

Other IVF drugs

In addition to hormones, other drugs are also used in the practice of reproductive medicine. The most common ones are:

• Adrenal cortex hormones (Dexamethasone, Prednisolone, or Cortisol) are often used to create immune bonds between the mother and the fetus she is carrying, and to lower androgen levels. Also, these drugs eliminate the factors of the development of antigen k, eliminating fetal hypoxia and preventing premature birth in a woman.
• Preparations of gonadotropins for the physiological maintenance of the mechanisms of pregnancy. In this case, two types of these hormones are used: HMG and FSH preparations. Most often, the drugs used in clinics are "", "Elonva", "", "". All of these drugs are perceived by the body as natural and do not cause reactions from the immune system. However, when they are taken, there may be side reactions (fatigue, anxiety, flatulence, etc.). Also, when taking gonadotropes, there may be a danger of ovarian hyperstimulation.
• HCG preparations duplicate the natural hormones of the female body and contribute to the development of mechanisms for the preservation of the fetus. As analogues of hCG, Profazi or drugs are used.
• Blood thinning drugs (Aspirin, Heparin, Curantil) are often prescribed to pregnant women to maintain normal blood density and reduce platelet aggregation. These medications are prescribed under the control of a blood test. They provide normal blood circulation in the uterus and placenta, preventing oxygen starvation of the fetus.
• Antihypoxic vitamins (folic acid, vitamins A, B and E, beta-carotene) are prescribed for vitamin support of the mother and the unborn baby's body, supporting their immunity at a sufficient level.

Any pregnancy after IVF should not be allowed to take its course. The in vitro fertilization technique is used by women with pathologies that, without modern technologies, would be doomed to life-long infertility. As a rule, in these difficult situations, the body does not have the resources to help a woman not only become pregnant on her own, but also to maintain the incipient pregnancy.

If a woman has already decided on IVF, then without drug support, in most cases she will not be able to endure the pregnancy that she has so dearly inherited. The main thing is to trust a good doctor and take all drugs according to the schemes prescribed by the doctor. But all this is done so that a woman can experience the great happiness of becoming, finally, a mother.

Progesterone therapy is often prescribed. However, horror stories that evil doctors prescribe hormones to the right and left, causing irreparable harm to a woman's health, do not allow pregnant women to sleep well. What if the doctor has prescribed a progesterone drug? Scared? Change your doctor urgently? Or believe that the doctor knows what he is doing?

Where do fears come from?

This story began a long time ago. In 1958, the first publication appeared on the connection between hormonal support of pregnancy and the development of pseudohermaphroditism in girls. The newborns had an enlarged clitoris and fused labia majora. At the same time, the internal genital organs and urinary system were developed normally, adrenogenital syndrome was excluded. Why did it happen?

The fact is that the 1st generation hormones - ethisterone, norethinodrel, norethisterone - were obtained from androgens. Unsurprisingly, they produced anabolic and androgenic effects. The women put on weight, developed acne, and were eyeing the purchase of a newly invented electric shaver.

The benefits of hormone therapy at the time remained highly questionable. “Unfortunately, hormonal treatment has not been shown to increase the likelihood of live births; at the same time, it is clear that only by limiting it, it is possible to minimize the threat of violations of sexual differentiation "- wrote the scientists of that time.

And in 1961, the thalidomide catastrophe broke out, when a drug for the treatment of early toxicosis caused the birth of children with gross malformations. As a result, this became the reason for the revision and tightening of the requirements for the licensing of drugs. Since then, every drug for pregnant women has undergone a thorough study of many years.

Dozens of years have passed. Scientists have succeeded in synthesizing safe, highly selective molecules that enable safe and highly effective progesterone support to prevent pregnancy loss.

On the safety of modern drugs

In our country, three forms of progesterone preparations are traditionally used during pregnancy: dydrogesterone in tablets, micronized progesterone for vaginal use and synthetic progestin 17-hydroxyprogesterone caproate for intramuscular administration. At the same time, dydrogesterone, which does not hide its "synthetic origin", is subjected to the maximum attacks.

However, a 2009 Kaiser-Loft review 1 summarized the results of 40-year use of dydrogesterone in more than 90 countries, including Russia, Belgium and the Netherlands. The conclusions of the review authors are that there is no causal relationship between the use of dydrogesterone during pregnancy and birth defects.

Also, to date, there is no evidence of a negative effect of progesterone support on fetal sexual differentiation. For 40 years of widespread use of drugs in clinical practice, even rare side effects would inevitably “surface”.

Over the same 40 years of observation, convincing data have been accumulated confirming that progesterone helps prevent another miscarriage with recurrent miscarriage, improves the prognosis for sporadic miscarriages, prolongs pregnancy with shortening of the cervix and threatening premature birth.

And these are not ghostly possibilities, but a real reality, confirmed by clinical experience and numerous studies. Progesterone preparations are absolutely indispensable for in vitro fertilization, when progesterone is simply indispensable for the progression of pregnancy.

The main thing is not to be smart with the dosage.

At the same time, the routine and thoughtless prescription of hormonal drugs "just in case" is completely unacceptable.

In 2014, during an educational seminar, prof. Radzinsky said that 21% of women with the threat of spontaneous abortion receive two progesterone preparations (in intravaginal and oral forms), and 7% - three (additionally an oil solution intramuscularly). It is quite obvious that such "gestagenic polypharmacy" can lead to undesirable pharmacological effects 2 and is completely unacceptable.

In this regard, in the summer of 2016, a new National Clinical Protocol "Miscarriage in early pregnancy: diagnosis and management tactics" 3 was released, which emphasizes the categorical inadmissibility 4 of the simultaneous use of drugs of the same action (especially drugs for progesterone support) and the prohibition of exceeding the dosage of drugs established by the instructions.

From now on, dydrogesterone (Duphaston), and micronized progesterone for vaginal use (Utrozhestan, Iprozhin, Prajisan) are approved for use during pregnancy according to strict indications and in strict accordance with the instructions.

Physicians are well aware that our knowledge of the human body is still imperfect. In our crazy times, it is not always possible to go through the entire pregnancy without difficulties and problems, but it is imperative to try. Without panic, maintaining calmness and sanity, you can avoid excessive drug load and apply only those methods that are really necessary.

Oksana Bogdashevskaya

Photo thinkstockphotos.com