Following follicle aspiration, most clinics place patients on progesterone supplementation. The rationale behind the supplemental progesterone is that following egg collection, ovarian hormone production may be impaired because many of the hormone-producing cells are removed at the time of follicle aspiration. In addition, the use of GnRH agonists such as Lupron may diminish ovarian steroid production following egg collection. Progesterone supplementation has evolved over the years to include patients undergoing both stimulated IUI cycles and IVF. Although many clinics tend to use progesterone-in-oil injections, equivalent pregnancy rates have been reported in patients using only vaginal progesterone supplementation. Allergic reactions to progesterone are infrequent, but switching patients to vaginal progesterone usually resolves the problem. Another strategy to maintain progesterone production after IUI or egg collection involves the use of HCG booster shots to enhance steroid production from the patient’s ovaries rather than relying on an outside source. Unfortunately, the use of HCG boosters may also increase the woman’s risk of ovarian hyperstimulation syndrome.
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