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The Muasher Center
for Fertility and IVF
8501 Arlington Boulevard, Suite 500
Fairfax, Virginia 22031

Ph. 703.876.6311
Fx. 703.876.6317

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Progesterone

Progesterone is produced by the corpus luteum, which is the structure formed by the follicle on the ovary after ovulation has occurred. Elevated progesterone levels are one indication that successful ovulation has occurred. Progesterone and estrogen stimulate the endometrium (lining of the uterus) to thicken and increase its blood supply in order to support a developing embryo. After conception, progesterone is secreted by the placenta and is necessary to an ongoing pregnancy.

Low levels of progesterone can lead to an inadequately developed endometrium and a "luteal phase defect". This can be due to inadequate follicular development.

Progesterone is administered in assisted reproductive technology cycles since medications such as Lupron and Antagon interfere with the body's normal production of progesterone. It is often administered to women with recurrent miscarriage. Progesterone can be administered by injection, oral troches, vaginal suppositories, gels, and oral micronized capsules. Dr. Muasher prefers the vaginal suppository for Clomid and IUI patients and the micronized vaginal preparation for IVF patients. Endometrin has been approved and is available as a vaginal insert for both IVF and IUI cycles.

Parlodel

Sometimes a non malignant tumor can be present at the base of the pituitary gland and cause a condition known as hyperprolactinemia, which means elevated levels of the hormone prolactin. Prolactin is the hormone responsible for breast milk production during pregnancy. Symptoms of hyperprolactinemia include increased breast milk production in the absence of pregnancy and irregular, or no ovulation.

Bromocriptine effectively lowers levels of prolactin thus reestablishing ovulation. Sometimes surgery is performed by a neurosurgeon to remove the tumor depending upon its size and location.

Antibiotics

Infections in the female and male are ruled out early in the infertility evaluation. Untreated infections can have serious consequences including pelvic inflammatory disease with damage to the reproductive organs in the female. Infections of the male reproductive organs can cause scarring, Tubal blockage, and ultimately sterility.

Common infectious agents include chlamydia, gonorrhea, and mycoplasma. Fortunately, these organisms are treated effectively with a variety of antibiotics. If infection is suspected, Dr. Muasher will often order cultures to identify the specific organism and determine the best treatment options.