While IVF medication protocol may vary from patient to patient, one consistent is estrogen. A supplement, often in the form of Estrace, or estradiol, is most commonly prescribed and is essential for a gestational carrier or any woman utilizing donor egg or donated embryos.
But why do fertility patients need estrogen? We’ll break down the benefits of this supplementation, the different forms, and why studies show it could be the link to a successful pregnancy.
What is estrogen?
First, it’s important to understand the purpose of this hormone. Estrogen is the primary of two main female sex hormones. The other is progesterone, and both play a major role in the female reproductive system. Estrogen’s main functions include:
- The start of puberty (growth of breasts and the start of menstrual cycles}
- Control of menstrual cycles
- Maintenance of cholesterol levels
- Protection of bone health
- Prominent effect on brain and mood, skin, heart and other tissues
The body can make too much or too little estrogen, and this can have a major impact on fertility. Estradiol is the most common type of estrogen in women of childbearing age, so this is the supplement that most surrogates and intended mothers will take to further prepare their bodies for assisted reproductive technology (ART).
Why do fertility patients need estrogen?
In order to grow and maintain the uterine lining and ultimately sustain a pregnancy, estrogen levels must be just right. While a variety of fertility medications are necessary as part of an IVF cycle, they can also disrupt the body’s natural rhythm. Estradiol in IVF supports natural estrogen needs, thickening the uterine lining so that it is prepared for implantation. It also helps the placenta to function, boosts blood flow to the uterus and prepares the body to breastfeed after birth.
Which estrogen supplements are used in IVF?
There are several different medications intended mothers or surrogates will take to prepare for IVF. One of the most common forms of estradiol is Estrace, which is administered via oral tablet or vaginal suppository. While some women experience bloating, discharge, mild nausea or breast tenderness, others have no Estrace side effects at all.
An estrogen patch is also sometimes used during fertility treatment. It is applied directly to the abdomen and the estrogen is absorbed through the skin. This can occasionally cause skin redness, irritation or rash, or nausea and fluid retention. Again, some women experience these side effects during IVF, but others have none at all.
Estrogen supplements are typically prescribed in the days prior to the IVF cycle, and a patient can expect that any monitoring and blood work will also review the estrogen’s effect on the endometrial lining and overall hormone levels. Ultimately, the reproductive endocrinologist will determine the need to start or discontinue the supplements; typically by week 11 or 12 of pregnancy, the placenta takes over any subsequent needs.
While protocol can vary, an analysis of 11 studies involving estrogen supplementation along with progesterone as luteal phase support showed a higher clinical pregnancy rate than progesterone alone.
If you’re struggling with infertility, we are here to support you as you explore your options. If you’d like to learn more about the possibility of building your family through egg donation or surrogacy, please don’t hesitate to contact us.