Progesterone

Brand Names

Crinone® (mfg. Wyeth-Ayerst), Prometrium (mfg. Solvay)

Form

Oil injections, suppositories, and oral troches, compounded at individual pharmacies.

Indications

Demonstrated ovulatory dysfunction with:

  • No current pregnancy
  • No evidence of primary ovarian failure
  • No uncontrolled thyroid or adrenal dysfunction
  • No ovarian cysts (except in case of PCOS)
  • Used in conjunction with hCG

Used for

Maintaining pregnancy or potential pregnancy in second half of treatment cycle.

How does it work?

Possesses hormonal activities of follicle stimulating hormone (FSH).

Suggested Evaluations

Pre-RX

  • thyroid disease
  • ovarian enlargement or cyst formation
  • uterine fibroid tumors
  • undiagnosed unusual vaginal bleeding
  • estrogen levels
  • primary pituitary or ovarian failure or enlargement
  • evidence of prostate cancer in men
  • testicular failure
  • renal and hepatic functions

During RX

  • mid-cycle urine LH test (OPK)
  • estrogen levels
  • progesterone levels
  • mid-cycle ultrasound to detect follicle development

Usual Dosage

Dosage must be carefully determined for each patient, and may be changed during treatment cycle.
During a fertility treatment cycle in women, 75 units to 600 units injected once daily for 6 to ten days, beginning on CD (cycle day) 2 or 3.

Instructions

Administered beginning day following hCG injection (usually mid-cycle) and continuing until negative pregnancy test or later in first trimester.

Common side effects

  • Injection site pain
  • Lower abdomen tenderness
  • Fluid retention
  • Headache
  • Emotional irritability
  • Breast discomfort
  • Fatigue
  • Multiple births

Side effects to report to your doctor

  • Severe pain or swelling in lower abdomen or extremities
  • Shortness of breath
  • Vomiting or diarrhea

Precautions

  • Pregnancy Category X: May cause birth defects if used during pregnancy.
  • Exercise caution if patient is breastfeeding.
  • May result in ovarian hyperstimulation.
  • May result in multiple births.

Drug interactions or incompatibility

Herbal preparations using blue or black cohosh.