What do Pessaries do in IVF?

What do pessaries do in IVF?

Progesterone supplementation is crucial for successful conception following fertility treatment, but the effectiveness of different progesterone products may vary in terms of side effects, benefits, and cost. 

The need for additional progesterone during IVF treatment is due to a chemical imbalance. In a natural ovulation process, the follicle that releases the egg transforms into the corpus luteum, which triggers progesterone production and prepares the uterine lining for the fertilized embryo.

Why is Progesterone Necessary after Undergoing IVF?

Progesterone is administered immediately after egg collection during an IVF cycle, as the manipulation of hormones doesn’t end with the regulation and stimulation of the ovaries. Progesterone supplements are required after egg collection, either until a negative pregnancy test or for the first trimester, depending on the clinic’s guidelines. 

During IVF, the egg retrieval process typically removes the cells responsible for creating progesterone after ovulation. The supplements are necessary to prepare the uterine lining and support the embryo’s implantation and growth. Various forms of progesterone are available, including intramuscular injections, pessaries/suppositories, oils and gels, and oral tablets.

What do Progesterone Pessaries do in IVF?  

Progesterone pessaries are used in IVF to supplement the body’s natural progesterone production after egg retrieval. During a typical IVF cycle, the follicles that contain the eggs are stimulated to grow, and then the eggs are retrieved. However, this process can disrupt the body’s natural hormone production, including progesterone. 

Progesterone is crucial for thickening the uterine lining and preparing it for implantation of the fertilized embryo. Therefore, progesterone supplementation is necessary to support successful embryo implantation and pregnancy. 

Progesterone pessaries are one of several forms of progesterone supplementation used in IVF and are inserted vaginally. They release progesterone directly into the uterus, where it can be absorbed by the body to support the early stages of pregnancy.

Does Progesterone Help Embryo Transfer?

Progesterone can help with embryo transfer during IVF. Progesterone is a hormone that plays a critical role in preparing the uterus for implantation and maintaining a healthy pregnancy. After an IVF cycle, the body’s natural progesterone production may be disrupted due to the stimulation of the ovaries and the egg retrieval process. Therefore, progesterone supplementation is typically prescribed to ensure that the uterine lining is adequately prepared for embryo transfer and to support the early stages of pregnancy. 

Progesterone helps to thicken the lining of the uterus, making it more receptive to the implantation of an embryo, and it can also help to support the embryo’s growth and development in the first few weeks after conception. So, progesterone is an essential component of the IVF process that helps to increase the chances of a successful embryo transfer and pregnancy.

How Long do you Take Progesterone Pessaries for IVF?

The length of time that progesterone pessaries are taken for IVF can vary depending on the specific clinic and individual patient circumstances. Typically, progesterone pessaries are started immediately after the egg retrieval procedure and are continued until either a negative pregnancy test or for most or all of the first trimester of pregnancy, depending on the clinic’s policies. Some clinics may prescribe progesterone pessaries for 9 weeks or until 12 weeks of pregnancy.

The placenta takes over the production of progesterone from the second trimester of pregnancy, so the need for progesterone supplementation decreases after this point. However, it’s essential to follow the specific instructions provided by your fertility clinic and not to stop taking progesterone pessaries without their guidance. Stopping progesterone supplementation prematurely can increase the risk of miscarriage, so it’s crucial to follow your doctor’s advice regarding the duration of progesterone supplementation. 

Side Effects of Progesterone Pessaries

When undergoing IVF treatment, many individuals find progesterone pessaries an essential component of their regimen. These pessaries are typically well-received; however, some users may encounter adverse effects. Although these reactions are often minor and transient, awareness is crucial for those embarking on this journey. Firstly, vaginal discharge or spotting emerges as a prevalent reaction. Notably, the discharge’s appearance might range from clear to slightly bloody, signaling the body’s response to the medication. Moreover, breast tenderness often manifests, echoing the discomfort familiar to the latter phase of the menstrual cycle. Furthermore, progesterone’s influence extends to causing bloating, a sensation akin to pre-menstrual symptoms.

  • Vaginal discharge or spotting
  • Breast tenderness
  • Bloating

Additionally, headaches stand out as a common side effect, paralleling the experience with numerous other medications. Lastly, mood fluctuations might occur, although these swings are generally mild and dissipate independently within a few days. Importantly, these side effects underscore the body’s adaptation to the progesterone pessaries, pivotal for supporting the IVF process. Despite these potential discomforts, the benefits often outweigh the temporary inconveniences, marking an important step toward achieving pregnancy.


Barinov, S. V., Shamina, I. V., Lazareva, O. V., Tirskaya, Y. I., Ralko, V. V., Shkabarnya, L. L., … & Klementyeva, L. L. (2017). Comparative assessment of arabin pessary, cervical cerclage and medical management for preterm birth prevention in high-risk pregnancies. The Journal of Maternal-Fetal & Neonatal Medicine30(15), 1841-1846.

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