Luteal Phase

In IVF, the luteal phase is the second part of the menstrual cycle after eggs are retrieved and embryos are transferred. During this time, the body produces hormones that help prepare the uterus for a possible pregnancy. This phase is closely monitored to increase the chances of successful embryo implantation and pregnancy.

Progesterone Supplement

In a natural menstrual cycle, following ovulation, the body will produce the hormone progesterone, which serves to thicken the uterine lining and help an embryo to implant and grow, thus initiating an early pregnancy.

In an IVF cycle, progesterone is taken most commonly by intravaginal insertion of micronized progesterone. Less commonly, patients can take progesterone via intramuscular injection. Progesterone supplementation is administered for two weeks until the patient takes a pregnancy test at the clinic. If the test is positive, supplementation is continued for an additional three weeks. If there is no pregnancy, progesterone supplementation will be discontinued and the patient’s period should begin in 2 to 5 days. If there is no period within 5 days of discontinuing the medication, call the clinic.

Estrogen Supplement

When individuals undergo IVF stimulation medications, their estrogen levels typically rise significantly by the end of this phase. However, these levels tend to decline following egg retrieval. To prevent a sudden drop and reduce the risk of early uterine bleeding, we often prescribe Vivelle estrogen patches to maintain a stable level during the luteal phase. Estrogen supplementation is discontinued after the first pregnancy test, regardless of the outcome.

It is very common to have light bleeding during the luteal phase. It is also common to have a sensation of heaviness or cramping in your pelvic area up to 10 days after egg retrieval, as the ovaries typically increase in size during this time.

Call our clinic anytime if there are any concerns, and contact us immediately if any of the following symptoms occur:

  • Intense cramping
  • Bleeding that is more than spotting
  • Nausea
  • Bloating
  • Weight gain of more than 10 pounds in 3 days
  • A fever above 100 degrees Fahrenheit
  • Shortness of breath
  • Pain
  • Constipation

Pregnancy Testing

Two weeks after the embryo transfer procedure, the patient will come back to the clinic to obtain a blood pregnancy test, sometimes called a beta or beta-hCG level. If the test is positive, they will be asked to receive a second blood test two days later. A pregnancy at this early stage is referred to as a chemical pregnancy.

Two weeks and again four weeks after the first blood pregnancy test, an ultrasound is given to confirm a clinical pregnancy, which is the presence of a gestational sac in the uterine cavity (the gestational sac can be seen before the embryo is visible).

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