Estrogen supplementation during an IVF cycle is now commonly used by many infertility specialists. One of the major hormones of pregnancy, estrogen helps maintain the endometrial lining of the uterus. While some early studies have shown that patients taking both progesterone and estrogen supplements during an IVF cycle after the egg retrieval have higher clinical pregnancy rates, newer studies seem to dispute this. However, as more research is still needed to study this, some Reproductive Endocrinologists (REs) prescribe estrogen supplements to help support the growth of the endometrium.
Estrace, or estradiol, is the form of estrogen most commonly prescribed. Dosages of 2mg two to three times a day are typical. Some REs may instruct you to insert the pill into the vagina instead of taking it by mouth. It is the same pill, just given in a different manner. It is important to know a few things if you take Estrace vaginally. First, you may notice a blue-green discharge. This is nothing to be concerned about; it is only the pill fragments breaking. Second, you should lay down for at least a half hour after insertion to prevent the pill from falling out. And third, if you are having difficulty with insertion, you can wear a latex glove to prevent the pill from breaking up under your fingernail.
Your doctor will probably want you to be periodically monitored through blood testing and/or ultrasounds. Periodic adjustments may be needed to optimize your hormone levels and endometrial lining. Make sure to follow your RE’s recommendations regarding estrace dosing.
"Estrogen plus progesterone supplementation for luteal phase support in in vitro fertilization and embryo transfer." S. Chen, H. Li, L. Kong, L. Zhu, X. Zhang, F. Xing. Fertility and Sterility - September 2004. Vol. 82, Pages S191-S192.
"Estrogen addition to progesterone for luteal phase support in cycles stimulated with GnRH analogues and gonadotrophins for IVF: a systematic review and meta-analysis." E.M. Kolibianakis et al. Human Reproduction - June 2008. Vol. 6, pages 1346-54.