Estradiol is one of the most important sex hormones of the estrogen group. An estradiol test shows information about the development of the fetus after successful fertilization using IVF.

A small level of the hormone in the body leads to abnormalities after embryo transfer and miscarriage. Along with estradiol, the concentration of progesterone in the blood is important. Once implantation of the embryo has occurred, tests for estradiol and progesterone are standard for IVF. If the amount of hormones is insufficient, the doctor prescribes drugs to stimulate their production.

At the final stage of the in vitro fertilization program, the process of monitoring the patient’s condition becomes an important task. It is necessary to monitor changes in hormonal levels, tests and how the implantation went (successful or not).

The level of estradiol and progesterone after embryo transfer depends on the stage at which their content is checked. To know what indicators are normal for the expectant mother, tests for hormone levels should be carried out before implantation.

A hormone from the estrogen group is produced by the ovaries and adrenal glands. Its function is to maintain the inner mucous membrane of the uterus in the required size for the successful implantation of the embryo. If successful, it is responsible for the relationship between the mother and the placenta, the growth and formation of the fetus, and metabolism. And also for changes in the body in the way that the child needs for normal development and nutrition in the womb.

After transfer to the first day, the normal value of estradiol is 75–225 pg/ml. If the blastocyst is fixed in the woman’s body, then the level of the hormone in the blood increases every day, until childbirth.

Low hormone concentrations during gestation can be caused by:

• significant changes in weight;
• excessive physical activity;
• insufficient caloric content of food that a woman consumes;
• bad habits (smoking, alcohol, drugs);
• increased levels of prolactin in the blood;
• deviations in the pituitary function.

In case of violations, special treatment is prescribed. If the hormonal background changes late in pregnancy, the consequences may be a delay in labor and the prescription of special hormonal medications.

Progesterone

Until about two months, progesterone is produced by the corpus luteum. They are formed in the appendages of the ovaries, where the puncture took place. Their main function is to support a successfully planted fetus.

At the same time, the formation of the placenta ends, progesterone, in turn, is produced only by the placenta. After the last stage in the IVF protocol, the concentration of these two hormones increases every day and regulates all processes to support the fetus.

Progesterone concentration after embryo transfer ranges from 6.9 to 56.6 nmol/l. As with estradiol, a deficiency leads to termination of pregnancy and the woman’s body needs hormonal support.

A decrease in the level of progesterone in a woman’s blood may be due to:

• deviations in the body's production of the corpus luteum;
• strong physical activity;
• insufficient placenta function;
• delays in embryo development;
• processes that occur in the uterus.

An increased concentration of progesterone also indicates the presence of pathologies. The main thing is to immediately contact a specialist and not self-medicate.

Survey

Estradiol and progesterone after embryo transfer should be checked:

• on the day of implantation;
• three days after the first check;
• in seven days;
• after 14 days, also checking the level of human chorionic gonadotropin;

If necessary or suspected, you should take a test as prescribed by your doctor. This will avoid fetal abnormalities or any possible abnormalities.

Influence

During the IVF program, a woman’s ovulation is strictly monitored; after puncture of the ovaries, the formation of the corpus luteum occurs (either on the 6th or 7th day of ovulation). The normal concentration of progesterone at the time of implantation should be in the range from 6.95 to 56.63 nmol/l. Hormone levels after undergoing IVF should gradually increase and reach a maximum only at the time of birth (9 months).

A decrease in hormone concentrations can be due to various reasons. For example, controlling hormonal drugs in a woman’s body. HCG, which is administered to patients or is produced by itself, also affects the levels of progesterone and estradiol after embryo transfer. Their content in the body can change within a few hours (especially progesterone). Therefore, test results do not always indicate a problem with hormone concentrations.

Estradiol during IVF after transfer, just like progesterone, does not always need to be determined. A reproductive specialist must know its dynamics, for this they do tests before transplantation. Monitoring changes can be prescribed only in individual cases (presence of problems before the transfer or possible development of anomalies).

The normal level of progesterone is determined by the phase of the corpus luteum. It is monitored in the first week for correction in case of abnormalities through conservative treatment.

The level of progesterone in the blood cannot be determined accurately during IVF and natural pregnancy as it:

• produced by the body in the form of impulses;
• the hormone content in the blood and vessels of the uterus is different;
• depends on the medications the woman takes as prescribed by the doctor.

Therefore, measuring the concentration of hormones in the blood is necessary only in individual cases. You shouldn’t waste your nerves and get tested if your doctor didn’t prescribe it. The main thing is maximum preservation of the psycho-emotional state and calm gestation of the fetus.

The hormones produced by the corpus luteum of the ovarian follicle are responsible for the ability to conceive in the female body - progesterone and estradiol. Their indicator determines the nature of the pregnancy.

In this article we will look at how the level of these hormones can change during the IVF procedure.

What are these hormones?

First, let's figure out what progesterone and estradiol are and what their role is in the female body. Progesterone is a sex hormone that influences the menstrual cycle, pregnancy and embryonic development.

Estradiol is the most important female sex hormone of the estrogen group. It is produced by ovarian follicles and is responsible for female secondary sexual characteristics. It also maintains the lining of the uterus in a condition suitable for the attachment of an embryo. If this process is successful, then the hormone is subsequently responsible for the condition of the placenta, the growth and formation of the fetus, and metabolic processes.
After analyzing the functions of these hormones, it becomes clear why it is necessary to control their levels during pregnancy.

Level norms by week of pregnancy

During the IVF procedure, the level of sexual secretions is determined:

• on the day of IVF;
• three days later;
• seven days after replanting;
• in 14 days.

The following indicators will indicate the successful completion of the procedure:

Why are there deviations in indicators?

After IVF, the amount of progesterone and estradiol may deviate from the norm, up or down. Significant deviations can negatively affect the course of pregnancy.

Low progesterone

Common causes of a drop in progesterone levels in pregnant women include:

• disorders associated with the development of the corpus luteum;
• strong physical activity;
• oxidative process in the uterus;
• delay in fetal development;
• poor functioning of the placenta.

Progesterone is increased

If progesterone is elevated, it causes changes in the lining of the uterus, which is why the implantation process is not always successful.
An increase in hormone levels may indicate:

• disorders in the development of the placenta;
• formation of a corpus luteum cyst;
• renal failure;
• disturbances in the functioning of the adrenal glands.

Symptoms indicating an increase in the level of sexual secretion:

• fatigue;
• depression;
• dizziness;
• vision problems.

If the indicators are not returned to normal, the pregnancy may be terminated or the fetus may die.

Low estradiol

Reasons for decreased estradiol levels during pregnancy:

• sudden weight loss;
• strong physical activity;
• vegetarianism or lack of fats and carbohydrates;
• bad habits;
• hyperprolactinemia;
• malfunctions of the adrenal glands.

In addition, if the amount of estradiol has dropped after refilling, this may indicate:

• threat of miscarriage;
• the presence of chronic diseases of the genitourinary system.

Estradiol is increased

The reasons for the deviation of indicators from the norm to a greater extent include the following:

• overweight or obesity;
• cirrhosis of the liver;
• genital endometriosis;
• follicular ovarian cyst;
• follicle persistence;
• estrogen-producing tumor in the uterus or ovary;
• problems with the thyroid gland.

Some drugs can also provoke an increase in the level of sexual secretion.

Estradiol and progesterone create favorable conditions in a woman’s body for the attachment of a fertilized egg. Under their influence, modifications of the uterus occur that are necessary for the normal development of the embryo. Therefore, how well the pregnancy will proceed depends on the amount of these hormones.

Early pregnancy after IVF

Surely you yourself will remember with what care and special care your friends talk about their children, who did not appear right away. Of course, it cannot be said that an “easy pregnancy” is less joyful and desirable, it’s just that, you see, there is less anxiety with it. Therefore, I especially want to talk about pregnancies that were conceived as a result of using the IVF technique. If you understand the reasons for the failure of a developing pregnancy, you can understand how to preserve it.

I would like to immediately note that the right attitude is important for a woman who has achieved pregnancy using the IVF technique; remember that pregnancy itself is only the first stage on the path to motherhood. Now it is very important for you to save the conceived life and carry the baby to term, since according to statistics, unfortunately, this does not always work out (60–80% of pregnancies with IVF use end in childbirth). It follows that the remaining cases of pregnancy are terminated, most often this occurs during the first trimester of pregnancy before 12–14 weeks.

Pregnancy failure can occur either in the form of a miscarriage with the eruption of fragments of the fertilized egg from the uterus, or in the form of a stopped pregnancy, while the fertilized egg continues to be in the uterus. Why does this happen?

Causes of pregnancy failure after IVF

The causes of abortion can be divided into two types: maternal factors and embryonic causes. In the second case, the main cause is considered to be genetic problems - deviations in the development of the embryo at any stage of pregnancy. In most cases, interruption at such moments occurs at a period of 4–6 weeks.

In most cases, a breakdown occurs in women with a disorder in the hormonal system, in particular in the absence of ovaries. Also, the age and health of the pregnant woman, and the tactics of pregnancy management by the doctor himself influence the bearing of the fetus.

The IVF program is mainly used by women, among whom pathologies of somatic and reproductive health are noticed an order of magnitude more often than in the general group. A miscarriage can also occur due to an immune conflict, in which case the pregnancy is terminated at a later date.

Under the influence of superovulation stimulation, certain hormonal changes occur in a woman’s body, which subsequently affect pregnancy. For hormonal support, it is necessary to periodically determine the blood levels of two leading hormones that are responsible for maintaining pregnancy: estradiol and progesterone. Estradiol itself is considered an indicator of the presence (or absence) of ovarian hyperstimulation syndrome.

Continue to work with your healthcare provider throughout your pregnancy, remembering that you need medical support not only to conceive your baby, but also to carry it to birth.

How to support pregnancy after IVF

To maintain pregnancy, your doctor may prescribe you various medications, for example, Duphaston in the form of pellets, which can be taken both orally and vaginally, or Progesterone, administered into the body in the form of oil injections. Which specific drug to use depends on the specific situation. In most cases, support is started with Duphaston, and Progesterone injections are added when the level of the hormone decreases, and even large doses of Duphaston do not help.

The level of the hormone estradiol is maintained in the body with the help of Progynova or Estrofem, or the Divigel gel and the Klimara patch. These drugs are prescribed only by a doctor individually; there is no room for initiative and personal choice of medications.

There is no need to worry too much about the need to take such drugs; they are also prescribed to many women who become pregnant on their own, but are at risk of miscarriage.

To regulate the immune relationship between the mother and the fetus, Dexamethasone is often prescribed, and sometimes Cortisol. Aspirin is also a fairly common drug in the support course, although, to be honest, it is not a mandatory component.

In addition, to support pregnancy, any medications necessary to normalize the woman’s condition due to existing concomitant diseases (if present) are used.

Finally, like other pregnant women, you will be prescribed vitamins. In particular, antihypoxic vitamins (E, C, b-carotene), and also folic acid (up to 400 mcg per day is allowed). In the case of a burdened obstetric history (i.e., with a fetal malformation), the dosage of folic acid is 4 mg/day from the early stages.

There is no need to perform an ultrasound to detect pregnancy status earlier than 3 weeks after embryo transfer. At this stage, it is already possible to see the fertilized egg, assess the condition of the ovaries (to be taken into account when determining the dose of drugs) and the endometrium.

Ultrasounds can be performed at weekly intervals to monitor the dynamic condition of the fetus, as well as the ovaries and uterus. During this, the location of the embryo is also examined (too low a location can lead to miscarriage), the detection (or absence) of free fluid (specifically blood) in the uterine cavity can provoke detachment of the fertilized egg, etc. Such control allows early detection of the threat of interruption and implementation of preventive measures.

Multiple pregnancies, which are quite likely to occur with IVF, lead to approximately half of all early miscarriages. This especially applies to cases of the presence of four and three fruits. Because of this, one of the methods of preserving pregnancy is considered to be reduction of the fetus (or fetuses) - removing it from the uterus without affecting others (or others). But this is not a guarantee of success.

According to recent studies, approximately a third of multiple pregnancies as a result of IVF are subject to spontaneous reduction (up to 8–9 weeks). The body itself stops the development of one or several fruits at once. This cannot be called a miscarriage, because one or two fetuses continue to develop.

Here is another, not unimportant fact. Among women who, in the 1st trimester of pregnancy conceived through IVF, were observed in antenatal clinics at their place of residence, the rate of pregnancy termination is three times higher than among those who spent their first weeks of pregnancy under the supervision of doctors at fertility clinics. In any case, let the conceived pregnancy necessarily end in the birth of a healthy baby.

Estradiol for IVF

Estradiol is one of the most active steroid hormones from the group of estrogens, which is produced by the follicular apparatus of the female reproductive glands. A small amount of the hormone is secreted by the adrenal cortex, as well as by the testicles. The level of estradiol in the female body can be used to judge the success of in vitro fertilization, as well as the characteristics of pregnancy after implantation of the blastocyst into the uterine wall.

The hormone estradiol - what is it?

Estradiol is produced by granulosa cells of follicles that mature in the ovaries, as well as by the adrenal cortex and adipose tissue. The correct functioning of the reproductive organs and the likelihood of conception during IVF depend on its content in a woman’s body.

The steroid hormone affects the functioning of organs that contain receptors sensitive to it. The target organs of hormones from the estrogen group include:

• uterus;
• vulva;
• mammary glands;
• vagina;
• fallopian tubes (oviduct).

The steroid hormone takes part in ensuring normal delivery by regulating the rate of blood clotting, as well as the tone of blood vessels in the tissues of the birth canal.

In women planning pregnancy, the concentration of estrogen is regulated by luteinizing and follicle-stimulating hormones. In the period between 1 and 14 days of the menstrual cycle, the content of estradiol in the blood serum increases and reaches a maximum value during ovulation.

The function of estradiol in the female body

The hormone estradiol in women - what is it? The gonads in women produce three types of steroid hormones: androgens, progesterone and estrogens. Estrogens include the following substances:

The generative function of the ovaries is controlled through the interaction of endocrine organs with the corresponding parts of the brain. Under the influence of estrogens in the female body, on the 14th day of the menstrual cycle, ovulation occurs - the release of an oocyte (egg) from the follicle into the fallopian tube.

The dominant follicle turns into the corpus luteum and begins to synthesize progesterone and estradiol. An increase in their concentration in the body entails loosening of the endometrium, which increases the chances of successful implantation of the embryo into the uterine wall.

The effect of estradiol on pregnancy

Gestation is the period during which estradiol has a significant effect on the functioning of the woman’s reproductive organs and the development of the fetus. From the moment of conception to the birth of the child, its concentration continuously increases from 215 units in the 1st trimester to 27 thousand units at the time of birth.

Until three months of pregnancy, estradiol is synthesized by the ovaries, after which the mature placenta begins to produce this hormone in large doses. Thanks to its presence in the body, the uterus prepares for the birth process; with normal levels of this substance, pregnancy proceeds without complications. If E2 levels decrease during gestation, this may indicate a dysfunction of the placenta and an increased risk of spontaneous abortion.

Functions of estradiol in the male body

The hormone estradiol in men - what is it? The female sex hormone is found in small concentrations in the male body. Its level in blood plasma does not exceed 3-55 pg/ml. Estrogens are formed from anabolic hormones under the influence of the aromatase enzyme. It is also produced by adipose tissue cells, and therefore, with obesity, feminization of men occurs, the manifestations of which are: gynecomastia;

• decreased libido;
• female type hair growth;
• change in voice timbre;
• erectile dysfunction;
• thickening of the fat layer at the hip level.

Normal estradiol levels are important in maintaining sexual function and fertility. It prevents baldness and is an important factor in maintaining bone density and lipid metabolism. A deficiency or excess of this substance can lead to the development of pathological processes in a man’s body.

What role does estradiol play during IVF?

The IVF procedure involves stimulation of hyperovulation, thanks to which it is possible to obtain not one, but several dominant follicles in one menstrual cycle. Oocytes extracted from a woman’s body are fertilized with sperm in vitro, after which the resulting embryos are cultured in a nutrient medium for 3 or 5 days.

Before IVF, specialists determine the period during which the level of estradiol in the body reaches its maximum. In reproductive medicine, it is called the implantation window, since the probability of conception during this period is maximum.

The norm of estradiol during IVF is one of the reliable signs of hyperstimulation of the female reproductive glands. An analysis of the hormone content is carried out before the blastocyst is implanted into the uterine cavity. In this way, it is possible to track the dynamics of an increase or decrease in its concentration in the blood plasma of the expectant mother.

Indicators of Estradiol during IVF

Estradiol during IVF is a significant sign of pregnancy after the fertilized egg has been transferred. If its indicators are less than normal, this can provoke problems with the implantation of the fertilized egg, and also lead to termination of pregnancy. The hormonal background of any woman is the main criterion for her health.

Women's ovaries produce hormones: estrogens, progesterone, and androgens. Estradiol is estrogen, or rather, part of it, since this group includes two more hormones: estrone and estriol. Therefore, estrogens do not exist as a specific substance.

Estradiol is considered a strong natural estrogen, the functions of which include the development of a woman’s sexual characteristics, that is, the formation of a figure and mammary glands. This means that the difference between estradiol and estrogen is that estrogens are a group of three hormones.

Progesterone and estradiol after embryo transfer are responsible for preserving the baby.

Artificially created stimulation of superovulation provokes a hormonal shift in the female body, which affects the result of IVF. To monitor hormones, the patient must constantly donate blood.

Norm of indicators

The norm of estradiol during IVF is a sign of the presence of ovarian hyperstimulation. Ideally, a test for this hormone should be carried out before implantation of the embryo into the uterine cavity. This is done to track the dynamics of changes in its content in the blood of the expectant mother. Hormone levels after embryo transfer differ in their indications at different time intervals.

What should estradiol be after embryo transfer? The norm is in the range of 5,000–10,000 pmol/l. The hormone is produced by the ovaries as well as the adrenal glands. It is responsible for the thickness of the endometrium after implantation of the embryo, so that there are favorable conditions for strong attachment, as well as maturation.

Estradiol during IVF after fertilized egg transfer provides:

• functioning of the fetoplacental system;
• formation of the baby’s bone skeleton;
• enhances the metabolic process;
• provides stretching and growth of uterine tissue;
• increases blood flow;
• ensures the delivery of nutrients to the unborn baby.

In the female body, 90–98% of substances arrive in a bound state, the rest are in free form. Free estradiol is a free and active form of the hormone, which, together with progesterone, creates good conditions for the formation of the embryo and its growth.

The level of estradiol and progesterone in the body increases after embryo transfer, which creates conditions for a favorable course of the entire pregnancy, affects the metabolism between the mother and the unborn child, stimulates the enlargement of the uterus, participates in the process of childbirth and controls blood pressure.

Analysis result

The norm of estradiol and progesterone after embryo transfer gradually increases, but the indicators are constantly changing. Thus, the level of progesterone in the blood changes within 2–4 hours. Because of this, many experts do not consider it informative.

The same applies to estrogen. After the embryo is implanted into the uterus, the amount of the hormone in the blood fluctuates significantly. Therefore, doctors do not prescribe this test after IVF. However, some fertility specialists do it. Estradiol on the 5th day after embryo transfer shows the specialist the result of the consistency, consistency, and level of work of the corpus luteum.

In addition, based on the test result, the doctor may prescribe medication correction of the hormone. So, if estradiol has dropped after embryo transfer, a drug is prescribed to raise it. At low levels, there is a possibility of a threat of miscarriage or the onset of premature labor.

Estradiol, as well as progesterone, create favorable conditions in the mother’s body for the implanted fertilized eggs to develop. They prepare and modify the uterine mucosa, which allows women to bear a healthy and long-awaited child.

Norms of hormones FSH, LH, estradiol for IVF

Hormonal monitoring in the IVF program is carried out in three stages:

1. before entering into the protocol;
2. at the stimulation stage;
3. at the moment when the decision is made.

The most important of them are the initial examination and the final stage, when you need to weigh the pros and cons of transferring in a stimulated cycle or doing a segmented cycle (with a break).

• Hormones during IVF
• Hormones before IVF
• Hormones for IVF are normal
• Ovulation stimulation
• Hyperstimulation syndrome
• Natural cycle
• Standards for embryo transfer

What types of monitoring exist?

1. Ultrasound monitoring of the ovaries is traditional. During an ultrasound, the doctor measures the diameter of the follicles: those leading in development and the cohort catching up with the “leaders”. The diameter is measured in two perpendicular directions, so the doctor understands how stimulation affects the maturation of eggs, whether there is a need to adjust dosages or replace medications. The size of the follicles “tells” the date of appointment.
2. Ultrasound monitoring of the uterine mucosa. Using the study, the doctor evaluates the quality of the endometrium - thickness, structure. Endometrial thickness is an important parameter when deciding on replantation.
3. Hormonal monitoring is a blood test for the level of female sex hormones during stimulation.

Hormones during IVF

Hormonal monitoring involves receiving results on the day the test was taken. The laboratory technician “gives” the answer 2 hours after administering the sample. Such monitoring of hormones during IVF is valuable, as it allows for timely correction.

Reproductive hormones:

• (ovarian reserve hormone);
• follicle-stimulating hormone - FSH;
• LH – luteinizing hormone;
• estradiol is the main estrogen in the female body;
• – a hormone that ensures pregnancy and gestation;
• androgens;
• , it belongs to hormones, but plays an important role in the onset and maintenance of pregnancy.

The most important hormones for IVF are:

• prolactin;
• estradiol;
• luteinizing hormone, it is responsible for ovulation.

The actual release of the egg from the follicle occurs during the luteinizing “peak”, when the concentration of the hormone is maximum.

The LH peak is preceded by a “peak” of estradiol. The follicle grows under the influence of estradiol and reaches its maximum size during peak concentration. Estradiol, through a positive feedback mechanism, affects the pituitary gland, which stimulates it to produce LH. It is the high concentration of estradiol that triggers ovulation.

As soon as ovulation occurs, the level of LH and estradiol drops sharply, and progesterone, which begins to be produced (at the site of ovulation), begins to “grow”.

It will depend on the level of progesterone whether this happens or not (the same relationship with natural pregnancy).

Hormones before IVF

A woman cannot be accepted into the IVF program if she has hormonal disorders. Below is a list of hormones that need to be tested before IVF in the form of a table. The first three points are mandatory for everyone. The remaining hormones are given according to indications.

Hormones for IVF (norm) and timing for testing

When to take hormones for IVF?

Hormones are always taken strictly on an empty stomach (food and liquid intake can distort the results) in the morning, because their levels change throughout the day.

Androgens are given strictly at 8 a.m. local time!

In order to take the tests correctly, you must first familiarize yourself with the requirements. The reliability of the results depends on: correctly selected drugs, their doses, and the drug prescription regimen.

If a deviation from the norm in thyroid hormones is detected, before IVF it is necessary to correct and bring the thyroid hormones back to normal.

When a woman has already entered into the protocol, the doctor may prescribe a repeat hormone test (if indicated).

For example, if you have adjusted your thyroid hormone levels, your doctor should make sure that the results are achieved and that your hormones are back to normal.

IVF hormones for hyperstimulation syndrome

High estradiol is a marker, but ultrasound is more informative in this regard, because you can see large, enlarged ovaries with many follicles (more than 15 on each side). In some patients, it is rare, but there are such paradoxical “responses” of the body to stimulation. Then the cycle is segmented and embryo transfer is carried out in the next cycle, and ovarian puncture is performed so as not to miss the only mature egg. LH rise. begins 36 hours before ovulation.

IVF hormones for embryo transfer

The main hormone that affects implantation is progesterone. Under its influence, pinopodia grow in the uterus - microgrowths of the mucous membrane that come into contact with. The uterine mucosa should be open. There are 3 known conditions of the endometrium:

• pre-receptive;
• receptive;
• post-receptive – refractory, which occurs in response to a sharp increase in progesterone levels.

The window for implantation is opened by a reproductologist with the help of intravaginal administration of progesterone drugs. But it happens that, under the influence of stimulation, a high level of hormones leads to redistribution - ovarian synthesis of progesterone earlier than necessary. And the level of progesterone increases, and the implantation window begins to open earlier - not synchronously with the development of the embryo. Normally, the “implantation dialogue” occurs 5-6 days after the puncture.

With a rapid ovarian response, progesterone can be high due to the conversion of part of estradiol to progesterone. And this progesterone is already beginning to open the implantation window ahead of schedule.

A test for the hormone progesterone must be taken at the time the ovulation trigger is prescribed, when the permissive dosage of hCG is given (an injection is given intramuscularly). On this day, progesterone should be low, the lower the better.

Progesterone after embryo transfer, the norm of which is determined in the blood, is a steroid hormone produced by the ovaries. Its level changes throughout the menstrual cycle, gradually increasing towards ovulation. Its maximum values ​​are observed on days 6-7 after ovulation, which can be said to correspond to the period of implantation. This period is also called the implantation window.

If estrogen causes proliferation and growth of the epithelium, then progesterone promotes its transformation when the endometrium enters the secreting phase, which is important for the development of the embryo. Estrogens and progesterone are produced in the ovaries; after ovulation, the corpus luteum of pregnancy begins to produce them.

Increased progesterone in the luteal phase

With IVF, as a result of controlled ovulation, after puncture the corpus luteum begins to form and the peak of progesterone production occurs on the sixth day, so it is at this time that they try to transfer embryos. The norm of progesterone at this moment is 6.95-56.63 nmol/l. Progesterone levels gradually increase after embryo transfer.

Low progesterone levels indicate corpus luteum deficiency; the reasons for this may vary. Controlled ovulation itself can cause hormonal imbalance, since it uses drugs that affect the production of sex hormones. Human chorionic gonadotropin also affects progesterone levels. In addition, its concentration normally changes even over 2-4 hours. Therefore, many fertility doctors believe that a progesterone test is not informative. Not every woman needs it, and the norms of estradiol and progesterone after embryo transfer must be considered in dynamics, in order to ensure a sufficient amount of hormones for normal proliferation and secretion of the endometrium.

Progesterone, the norm after embryo transfer must correspond to the indicators of the luteal phase, and is indicated above, is checked on the day of transfer and a week after it. This is necessary to check the function of the corpus luteum and correct it with supportive therapy.

Determination of progesterone after pregnancy

The level of progesterone during IVF is not always an indicator of implantation; what is more important is the state of the endometrium, in the preparation of which it participates, and the relaxed state of the myometrium caused by it. In the first trimester, the progesterone norm is 8.9-468.5 nmol/l. Reducing it below normal can cause early miscarriage.

Scientific research shows that it is impossible to accurately determine the concentration of progesterone in the blood after transfer and even during normal pregnancy, because it:

• produced in impulses;
• its concentration in the blood does not correspond to the level in the vessels of the uterus;
• production is affected by support medications, many of which are in the form of vaginal tablets.

Therefore, analysis for progesterone and estrogens is used only according to indications, not for every woman, and is taken into account in conjunction with other indicators and the clinical picture. Women after IVF should under no circumstances worry about the level of progesterone or estrogen in the blood; any worries or stress can cause much more damage. Follow your doctor's recommendations and consult with him or her if unusual symptoms occur.

Estradiol and other estrogens

Estradiol does not change significantly after transfer. Normally, its amount in women’s blood is up to 14 ng/ml. If a woman becomes pregnant, then levels from 10.5 to 16 ng/ml are considered normal. As you can see, estradiol cannot in any way be called a pregnancy hormone.

But there are other estrogens. The main hormone during pregnancy is estriol. During gestation, its share among all estrogens reaches 85%. It is considered a pregnancy protector. This hormone regulates uteroplacental blood circulation. It is responsible for the blood supply to the fetus, providing it with oxygen and nutrients. If before pregnancy there is not much estriol in a woman’s blood – less than 2 ng/ml – then after embryo transfer and as pregnancy progresses, its level increases. The norm for pregnant women is 80-350 ng/ml.

Estriol is produced in the placenta. It is synthesized from another hormone called DHEA sulfate. That, in turn, is produced by the adrenal glands of the fetus and, to a lesser extent, by the adrenal cortex of the mother. But no more than one tenth of all DHEA sulfate is of maternal origin.

Most estriol circulates freely in the blood of the mother and fetus. This hormone is utilized in the liver by binding to glucuronic acid. The result is the production of inactive metabolites that are excreted in the urine. Previously, hormone excretion was considered an important laboratory indicator. Estriol was measured in urine. If its level decreased, this indicated problems with the course of pregnancy. Today, more informative diagnostic methods have appeared, so estriol in urine is no longer determined.

To a lesser extent, the placenta produces other estrogens. These are estradiol and estrone. They are responsible for the following functions:

• regulation of water and electrolyte balance;
• sodium retention;
• increased amount of intravascular fluid;
• dilatation of blood vessels;
• synthesis of steroid binding globulins.

Estradiol plays an important role during all periods of pregnancy. It stimulates the growth of the uterus and other genital organs. The hormone enlarges the mammary glands, preparing them for lactation.

Estradiol interacts closely with progesterone. It increases the number of receptors for this hormone in the uterus. This is important for subsequent labor.

The effect of progesterone on pregnancy

Progesterone plays an important role during pregnancy. Immediately after transfer it is synthesized by the corpus luteum. This is a temporary gland. It is formed at the site of the follicle from which the egg was obtained during puncture.

But the provisional organ is not able to fully provide the woman’s body with progesterone throughout pregnancy. Over time, this function will be taken over by the placenta. In addition, after IVF, progesterone production is often insufficient. Therefore, doctors always prescribe it in the form of drugs to support pregnancy. They are used both in oral forms and in the form of vaginal tablets.

From week 10, the trophoblast begins to produce large amounts of progesterone. 50% of it enters the fetal bloodstream. There progesterone breaks down. It is used by his adrenal glands to synthesize other hormones. Corticosteroids are produced. In addition, estrogens are synthesized from progesterone.

Progesterone performs essential functions in the mother's body. It is under the influence of this hormone that the fertilized egg is implanted into the endometrium. This happens immediately after the transfer. Subsequently, together with estrogens, progesterone stimulates the enlargement of the mammary glands and genital organs of a woman. It reduces the tone of the myometrium and prevents the onset of premature labor.

In a woman's body, progesterone causes a number of noticeable changes and symptoms. The expectant mother often suffers from constipation, as the hormone reduces intestinal tone. It inhibits the central nervous system. Therefore, the expectant mother looks sleepy and lazy. Her concentration is impaired. Fatigue is increased. Progesterone stimulates the growth of body fat mass.

Progesterone value after transfer

Many women who undergo IVF have luteal phase deficiency. Progesterone is used to reduce the risk of miscarriage. It is prescribed mainly in vaginal or oral forms.

The drugs are used for 12 weeks. Duphaston is often prescribed for this purpose. It has established itself as an effective and safe synthetic analogue of progesterone. Taken orally. It has good bioavailability and affinity for progesterone receptors.

The main advantage of the drug is that it does not have the other effects of steroid hormones. Progesterone receptors respond well to dydrogesterone. But at the same time, it practically does not interact with estrogen and androgen receptors, glucocorticoids and mineralocorticoids. Accordingly, there are no side effects characteristic of many other progesterone drugs.

The advantage of dydrogesterone after embryo transfer is its higher efficiency. Often, with luteal phase deficiency, women's hormone levels remain normal. But at the same time, the sensitivity of the endometrial receptor apparatus to them decreases. Dydrogesterone is used in significantly lower doses than micronized progesterone. However, it has a greater affinity for receptors.

Luteal phase deficiency is almost always observed during assisted reproductive technologies. This is due to the lack of a fully functioning corpus luteum. The risk of luteal phase deficiency increases when using gonadotropin-releasing hormone agonists or antagonists in the cycle.

Progesterone medications are completely safe during pregnancy. Although they do not always contain this particular hormone, they often contain synthetic analogues; they are prescribed specifically during pregnancy, and in the early stages. Some drugs have been used for more than 50 years around the world. During this time, vast experience has been accumulated in their use both to support natural pregnancy and in in vitro fertilization cycles. The conclusions are clear: this group of drugs does not have a mutagenic or teratogenic effect on the fetus.

Progesterone preparations after embryo transfer help maintain pregnancy. They also have a number of other positive effects. They normalize carbohydrate metabolism, reduce the risk of fetal malformations and complications during pregnancy. Progesterone creates the conditions for the normal development of fetal-placental structures.

3 months after conception, the placenta takes over the function of the corpus luteum. She begins to synthesize progesterone in quantities of up to 300 mg per day or more. Gradually, the level of secretion of this hormone increases. Its concentration in the blood increases tens of times in the third trimester compared to the initial period of pregnancy.

Use of progesterone drugs before embryo transfer

Progesterone is always prescribed after embryo transfer. But they begin to use it a few days before this procedure. This hormone is required not only to maintain pregnancy, but also to increase the chances of its occurrence. It prepares the uterine lining to accept the embryo, thus increasing the chance of successful implantation.

In cycles with ovulation stimulated by hormonal drugs, asynchronous maturation of the endometrium is often observed in relation to ovulatory processes in the ovaries. For example, the eggs are already mature, but the uterine mucosa is not yet ready to receive the embryo. Or vice versa: at the time of transfer, the implantation window is already closed: the endometrium has lost the structure necessary for successful implantation of the embryo.

Research shows that only in 50% of cases is timely maturation of the endometrium observed, when at the time of embryo transfer the uterine mucosa has optimal thickness and structure. In other cases, the desired result is achieved with the help of progesterone drugs.

The hormones produced by the corpus luteum of the ovarian follicle are responsible for the ability to conceive in the female body - progesterone and estradiol. Their indicator determines the nature of the pregnancy.

In this article we will look at how the level of these hormones can change during the IVF procedure.

What are these hormones?

First, let's figure out what progesterone and estradiol are and what their role is in the female body. Progesterone is a sex hormone that influences the menstrual cycle, pregnancy and embryonic development.

Under its influence, the uterine mucosa prepares for the implantation of a fertilized egg. In addition, its level determines whether fertilization will occur. Therefore, it is called the “pregnancy hormone”.

Did you know? A group of doctors from the University of Portsmund established a connection between the amount of progesterone in the blood and sexual relations. So, if a woman’s hormone levels are elevated, then most likely she will be interested in relationships with members of her own sex. It's the same with men.

Estradiol is the most important female sex hormone of the estrogen group. It is produced by ovarian follicles and is responsible for female secondary sexual characteristics. It also maintains the lining of the uterus in a condition suitable for the attachment of an embryo. If this process is successful, then the hormone is subsequently responsible for the condition of the placenta, the growth and formation of the fetus, and metabolic processes.
After analyzing the functions of these hormones, it becomes clear why it is necessary to control their levels during pregnancy.

Level norms by week of pregnancy

During the IVF procedure, the level of sexual secretions is determined:

• on the day of IVF;
• three days later;
• seven days after replanting;
• in 14 days.

Why are there deviations in indicators?

After IVF, the amount of progesterone and estradiol may deviate from the norm, up or down. Significant deviations can negatively affect the course of pregnancy.

Low progesterone

Common causes of a drop in progesterone levels in pregnant women include:

• disorders associated with the development of the corpus luteum;
• strong physical activity;
• oxidative process in the uterus;
• delay in fetal development;
• poor functioning of the placenta.

Important!Since the hormone reduces the contractility of the uterus, its sharp drop can cause severe pain in the lower abdomen and spotting. If this happens after implantation of the embryo, you must immediately consult a doctor, as a miscarriage is possible.

Progesterone is increased

If progesterone is elevated, it causes changes in the lining of the uterus, which is why the implantation process is not always successful.
An increase in hormone levels may indicate:

• disorders in the development of the placenta;
• formation of a corpus luteum cyst;
• renal failure;
• disturbances in the functioning of the adrenal glands.

Symptoms indicating an increase in the level of sexual secretion:

• fatigue;
• depression;
• dizziness;
• vision problems.

If the indicators are not returned to normal, the pregnancy may be terminated or the fetus may die.

Low estradiol

Reasons for decreased estradiol levels during pregnancy:

• sudden weight loss;
• strong physical activity;
• vegetarianism or lack of fats and carbohydrates;
• bad habits;
• hyperprolactinemia;
• malfunctions of the adrenal glands.

In addition, if the amount of estradiol has dropped after refilling, this may indicate:

• threat of miscarriage;
• the presence of chronic diseases of the genitourinary system.

Important!A drop in estradiol levels late in pregnancy can cause a delay in labor.

Estradiol is increased

The reasons for the deviation of indicators from the norm to a greater extent include the following:

• overweight or obesity;
• cirrhosis of the liver;
• genital endometriosis;
• follicular ovarian cyst;
• follicle persistence;
• estrogen-producing tumor in the uterus or ovary;
• problems with the thyroid gland.

Some drugs can also provoke an increase in the level of sexual secretion.

Estradiol and progesterone create favorable conditions in a woman’s body for the attachment of a fertilized egg. Under their influence, modifications of the uterus occur that are necessary for the normal development of the embryo. Therefore, how well the pregnancy will proceed depends on the amount of these hormones.