Many people who do IVF are always nervous and anxious about the level of hormones on the test sheets when they are reviewed after embryo transfer. Why do I need progesterone for IVF? There are two types of IVF embryo transfer: 1. Fresh embryo transfer: 3-5 days after egg retrieval for fresh embryo transfer. In order to increase the success rate of IVF, most of the cases are treated with medication to promote ovulation, often multiple follicles are developed at the same time and removed at the same time after maturation, just like boiling a pot of water, when the water is boiling, the firewood below is taken away for a similar reason, the temperature of the water will naturally drop, the hormones secreted by the ovaries drop after egg retrieval, which is not conducive to embryo implantation and development, so medication support is needed. 2. Frozen embryo transfer: The endometrium is adjusted with medication before the transfer, and the embryo can be implanted and developed only when the endometrium is in the best condition, just as a new house should be beautifully and comfortably decorated first, and the bride is willing to move in only after she is satisfied with the inspection. Therefore, regardless of fresh embryos or frozen embryos, embryo transfer needs to be supported by medication regulation. How to keep the fetus in IVF? Progesterone is the most commonly used drug for fetus preservation, there are three main types: 1. Intramuscular injection of progesterone: 40-100mg of progesterone is injected daily. Advantages: exact efficacy, cheap, high concentration of progesterone in blood, the most common application. Disadvantages: painful injection, easy to form local hard nodes, and in a few cases, local abscesses and sciatic nerve damage. 2, vaginal progesterone gel and progesterone capsules (1) progesterone extended release gel (Xeno Tong): containing 90mg of progesterone, once a day. (2) Progesterone capsules: 300-800mg per day, divided into 3 applications. Advantages: the effect of fetal preservation is the same as that of progesterone injection, easy to use, no painful injection, high local drug concentration in the uterus, and has become the first choice of fetal preservation drug for IVF in some countries. Disadvantages: more vaginal bleeding phenomenon, low blood progesterone value, easily lead to patient anxiety, but does not affect the result of pregnancy. 3.Oral progesterone dydrogesterone: 2 times a day, once 10-20mg micronized progesterone capsules: 200-300mg a day, divided into 1-2 doses Advantages: easy to take. Disadvantages: oral progesterone capsules have side effects such as dizziness and drowsiness, and the effect of fetal preservation is not as good as intramuscular injection of progesterone and vaginal application, which is not recommended for IVF alone. How long does IVF need to keep the fetus? 1. Blood check at 12-14 days after embryo transfer: Check blood HCG negative: it means no pregnancy, stop using the medicine. If the blood is positive for HCG, continue to use the medication. If the ultrasound is repeated 4-5 weeks after the embryo transfer and you see the gestational sac and fetal heartbeat, continue to keep the pregnancy until 8-10 weeks after the embryo transfer (10-12 weeks of gestation), when the placenta has formed, you can stop using the medication. 2. Be alert to ectopic pregnancy: After checking the blood HCG for pregnancy, review the ultrasound 4-5 weeks after embryo transfer, and if no gestational sac is seen in the uterine cavity, you need to be alert to the possibility of ectopic pregnancy. The doctor will carefully ultrasound the pregnancy to see if the gestational sac is visible outside the uterine cavity. If ectopic pregnancy is confirmed, medication or surgery will need to be performed according to the situation. 3.Watch out for embryonic abortion: If the ultrasound is repeated 4-5 weeks after embryo transfer and there is a gestational sac in the uterine cavity, but no fetal heartbeat is seen, the embryo may be aborted, so you can continue to keep the fetus for 1 week, and if no fetal heartbeat is seen, you can stop keeping the fetus. Some patients may have spontaneous abortion with vaginal bleeding and abdominal pain; if there is no spontaneous abortion, medication abortion or abortion can be considered. The cause of embryonic abortion is 50% due to the poor quality of embryos. Increasing the time of birth control is not only not beneficial, but also increases the chance of bleeding and infection. Frequently Asked Questions: 1. Why is the progesterone concentration low after embryo transfer? After embryo transfer, if progesterone gel for vaginal use and oral dydrogesterone are applied, the progesterone concentration is often found to be low after blood check at the hospital, and many of you will be depressed and think that the embryo has not bedded down! The vaginal gel mainly works through local absorption to ensure the concentration of drugs in the uterus, and the concentration absorbed by the uterus into the blood of the whole body is very low, and the oral absorption of dydrogesterone cannot be shown in the blood check, so after embryo transfer, doctors will give enough progesterone drugs to support the clinical effect, which is not reflected by the concentration of progesterone in the blood, and regular medication can be administered on time. 2. Is a positive urine pregnancy test after embryo transfer a pregnancy? After the embryo transfer, the embryonic chorionic villi will secrete a hormone —- chorionic gonadotropin, abbreviated as HCG, so check the blood HCG 12-14 days after the transfer to clarify whether you are pregnant, note: not progesterone! Some people even check the urine pregnancy test while injecting HCG (to increase the effect of birth control) and are very happy to see a positive result, thinking they are pregnant, but in fact, the urine test paper detects the concentration of urinary chorionic gonadotropin. Some people also checked their own urine HCG negative on the 12th day of transplantation, stopped using birth control medication, and then went to the hospital to check their blood HCG and became pregnant. So try to take blood for HCG, it is accurate and reliable. Special reminder: If you are doing IVF, you need to remember: the effect of progesterone to preserve pregnancy cannot be judged by the concentration of progesterone in blood; blood HCG is an important indicator to determine whether the transfer is successful and to detect embryo activity; ultrasound is an important tool to check embryo and fetal development, and together with HCG monitoring, it can detect ectopic pregnancy and embryonic abortion early. We hope that all IVF friends will keep a quiet and calm state of mind, master the necessary knowledge to help you conceive, cooperate well with your doctor and take medication regularly, so that you can have a good pregnancy as soon as possible and make your dream come true!