Should I take progesterone supplementation during treatment?

Some RE's put patients on progesterone during the luteal phase automatically. The underlying concept is that if you wait and find out if the progesterone is low, even at seven days past ovulation (7 dpo), it can be too late because the lining may not be receptive to implantation. Low progesterone can cause implantation failure, because its role is to vascularize and maintain the uterine lining, which is where implantation takes place. Sometimes women require more progesterone support in the luteal phase on injectables, even if they have a good progesterone level. This may have to do with the high levels of estrogen that occur during injectable cycles. There are four different common methods of progesterone supplementation: progesterone in oil shots (PIO), progesterone suppositories or vaginal capsules, Crinone (progesterone) vaginal gel, and oral progesterone. Also, hCG "boosters" given five days or so after the first dose, are commonly used to cause the Corpus Luteum to produce more progesterone. Progesterone, even in the form of over-the-counter creams, should not be taken before ovulation because it can block ovulation and make the cervical mucus hard for the sperm to penetrate. Crinone and suppositories deliver progesterone in a more effective manner than oral supplementation. Oral progesterone is not used by some RE's due to ineffective absorption. Crinone is quite expensive and progesterone suppositories can be messy. Vaginal capsules (identical in appearance to a capsule used for oral medication, but inserted into the vagina) may be a little hard to place, but are quite inexpensive and available in a variety of doses in the same manner as suppositories. PIO shots can be uncomfortable, but they are effective. Discuss the best medication method and dosage with your doctor.