Proginova maintaining a long-awaited pregnancy during IVF. Successful IVF pregnancy and Proginova: who, why and how to take the drug Proginova, how long does it take to be excreted from the body

Proginova: instructions for use and reviews

Proginova is an estrogenic antimenopausal drug.

Release form and composition

The dosage form of Proginova is tablets (21 pieces in blisters, 1 blister in a cardboard box).

1 tablet contains:

• Active substance: estradiol valerate – 2 mg;
• Auxiliary components: montanglicol wax - 0.075 mg, lactose monohydrate - 46.25 mg, talc - 2.4 mg, corn starch - 26.2 mg, povidone 25,000 - 3 mg, magnesium stearate - 0.15 mg, macrogol 6000 - 3.719 mg, crystalline sucrose - 33.54 mg, povidone 700,000 - 0.323 mg, talc - 7.104 mg, precipitated calcium carbonate - 14.572 mg, glycerol 85% - 0.205 mg, indigo carmine (E132) - 0.051 mg, titanium dioxide (E171) – 0.411 mg.

Pharmacological properties

Pharmacodynamics

Proginova contains the hormone estrogen (in the form of estradiol valerate), which in the human body is converted into natural 17β-estradiol. During therapy, ovulation is not suppressed. The drug has virtually no effect on the production of hormones in the body itself.

Estradiol valerate in women compensates for the lack of estrogen after menopause and is necessary to provide effective treatment of psycho-emotional and vegetative menopausal symptoms (in the form of hot flashes, increased sweating, sleep disturbances, irritability, increased nervous excitability, palpitations, headaches, dizziness, cardialgia, decreased libido, pain in muscles and joints), as well as involution of the skin and mucous membranes, especially the mucous membranes of the genitourinary system (in the form of dryness and irritation of the vaginal mucosa, urinary incontinence, pain during sexual intercourse).

HRT (hormone replacement therapy) with an adequate dose of estrogen contained in Proginova helps reduce bone resorption and delay/stop bone loss in postmenopause. Long-term use of HRT has been shown to reduce the risk of peripheral bone fractures in postmenopausal women. After stopping HRT, the rate of decrease in bone mass is comparable to the rates that are typical for the period immediately after menopause. It has not been proven that the use of Proginova can restore bone mass to premenopausal levels.

HRT also has a beneficial effect on the collagen content of the skin and its density and helps slow down the formation of wrinkles.

Women with a non-removed uterus during the period of taking Proginova are recommended to additionally use gestagen for at least 10 days in each cycle. This reduces the likelihood of endometrial hyperplasia and the concomitant risk of adenocarcinoma in women in this group.

Taking Progynova helps reduce total cholesterol, LDL and HDL cholesterol (low and high density lipoproteins), as well as increase triglyceride levels. The addition of a progestin may slightly interfere with the effect of estradiol on metabolism.

The metabolic effects of HRT are generally assessed as positive. Proginova is believed to reduce the risk of cardiovascular disease in postmenopausal women.

Pharmacokinetics

Estradiol valerate is rapidly and completely absorbed after oral administration. During absorption and the first passage through the liver, the steroid ester is split into valeric acid and estradiol. In this case, estradiol is significantly further metabolized, for example, into estriol, estrone sulfate and estrone (a weaker estrogen). Bioavailability after oral administration is approximately 3% estradiol. Food intake does not affect this indicator.

Cmax (maximum concentration of the substance) of estradiol in serum is about 30 pg/ml, the average time to reach it is from 4 to 9 hours. 24 hours after taking Proginova, the serum level of estradiol decreases by approximately 2 times.

Estradiol binds to albumin and SHBG (sex hormone binding globulin). The free fraction of estradiol in serum is approximately 1–1.5%, and the fraction of the substance bound by SHPS is from 30 to 40%.

The apparent Vd (volume of distribution) of estradiol after a single intravenous injection is approximately 1 l/kg.

After hydrolysis of estradiol valerate, the substance undergoes biotransformation in the same ways as endogenous estradiol. Estradiol is metabolized mainly in the liver, partially in target organs, kidneys, intestines and skeletal muscles. These processes are accompanied by the formation of estrone, catechol estrogens, estriol, as well as glucuronide and sulfate conjugates of these compounds. All of them have estrogenic activity to a much lesser extent or none at all.

A certain amount of estradiol is excreted in the bile and undergoes enterohepatic recirculation. Excretion of metabolites occurs mainly in the form of glucuronides and sulfates in the urine.

The serum concentration of estradiol in the blood after repeated use is approximately 2 times higher than after a single dose. On average, this indicator can vary from 30 (minimum) to 60 (maximum) pg/l. The concentration of estrone sulfate is approximately 150 times higher than the concentration of estradiol, estrone is approximately 8 times higher. After completion of therapy, estrone and estradiol concentrations return to baseline within 2–3 days.

Indications for use

• Hormone replacement therapy (HRT) against the background of the following diseases/conditions: menopausal disorders, involutive changes in the skin and genitourinary tract, depressive states during menopause, symptoms of estrogen deficiency due to sterilization or natural menopause;
• Postmenopausal osteoporosis (prevention).

Contraindications

• Breast cancer (confirmed or suspected);
• Bleeding from the vagina of unknown etiology;
• Liver tumors (benign/malignant) currently or if there is anamnestic data;
• Hormone-dependent precancerous diseases or hormone-dependent malignant tumors (confirmed or suspected);
• Severe hypertriglyceridemia;
• Acute arterial thrombosis or thromboembolism (stroke, myocardial infarction);
• Severe liver diseases;
• High probability of developing thrombosis (venous and arterial);
• Deep vein thrombosis (with exacerbation), thromboembolism currently or in the presence of anamnestic data;
• Lactose intolerance, congenital deficiency of lactase, isomaltase/sucrase, glucose-galactose malabsorption;
• Pregnancy and lactation;
• Age up to 18 years;
• Hypersensitivity to the components of Proginova.

If any of the described conditions/diseases develop for the first time while taking Progynova, you should immediately interrupt therapy and consult a specialist.

Instructions for use of Proginova: method and dosage

Proginova should be taken orally with a small amount of liquid.

If the uterus has not been removed and the woman is still menstruating, therapy is started in combination with any gestagen in the first 5 days of the menstrual cycle. With very rare menstruation, as well as during the postmenopausal period, you can start taking Proginova at any time after excluding pregnancy.

The recommended dosage regimen is 1 tablet per day. With cyclic HRT, after 21 days (after the end of the package), you can take a break from taking the drug (usually for 7 days or less); with continuous hormone replacement therapy, Proginova is taken daily without a break.

With cyclic combined HRT, gestagen is recommended to be taken every 4 weeks for 10-14 days, with continuous combined HRT - simultaneously with each estrogen tablet.

It is recommended to take Proginova at the same time, but the time of day does not affect the effectiveness of the drug. If a single dose is missed, the pill should be taken within the next 12-24 hours. If therapy is interrupted for a longer period, bleeding may develop.

Side effects

Possible adverse reactions (≥1/10 – often; ≥1/10 00 and<1/10 – нечасто; <1/1000 – редко):

• Central nervous system: often – headache; infrequently - dizziness; rarely – migraine;
• Reproductive system: often - uterine, vaginal bleeding, incl. spotting bleeding; uncommon – pain in the mammary glands, increased sensitivity of the mammary glands; rarely – symptom complex of premenstrual syndrome, dysmenorrhea, breast enlargement, vaginal discharge;
• Cardiovascular system: infrequently – palpitations;
• Immune system: uncommon – hypersensitivity reactions;
• Musculoskeletal system: rarely – muscle spasms;
• Digestive system: often – abdominal pain, nausea; uncommon – dyspepsia; rarely – bloating, vomiting;
• Skin: often – rash, itching; uncommon – erythema nodosum, urticaria; rarely – hirsutism, acne;
• Metabolism: often – change (decrease or increase) in body weight;
• Organ of vision: infrequently - visual impairment; rarely – intolerance to contact lenses (unpleasant sensations when wearing them);
• Mental health: infrequently – decreased mood; rarely – anxiety, change (increase or decrease) in libido;
• General: uncommon – swelling; rarely – weakness.

In rare cases, when taking Progynova, it is possible to develop thromboembolism and deep vein thrombosis, as well as benign, and even less often, malignant liver tumors (in some cases this led to intra-abdominal bleeding, which is life-threatening).

With prolonged monotherapy, the likelihood of endometrial cancer or hyperplasia increases. When taking Progynova for several years, an increase in the relative risk of breast cancer has been established.

In some women, taking the drug may lead to the development of cholelithiasis.

There is limited data indicating an increased likelihood of dementia in patients starting Progynova after age 65 years.

In some cases, chloasma may develop, especially in women with a history of chloasma during pregnancy. In the presence of hereditary forms of angioedema, Proginova can cause or worsen the signs of angioedema.

Overdose

When accidentally taking Proginova at a dose many times higher than the daily therapeutic dose, the risk of developing serious acute adverse reactions has not been identified.

Possible symptoms: vomiting, nausea, vaginal bleeding.

Therapy: symptomatic. There is no specific antidote.

special instructions

If there are several risk factors for the development of thrombosis or a high degree of severity of one of the risk factors, the likelihood of mutually enhancing the effect of these factors and the prescribed therapy on the development of thrombosis must be taken into account. The total value of existing risk factors in such cases increases. If there is a high probability of risk, Proginova should not be taken.

Before prescribing a treatment course, as well as regularly during therapy (at least once every six months), it is necessary to carry out the necessary studies, including examination of the mammary glands, gynecological examinations, measurement of blood pressure and others; in the presence of prolactinoma, a medical examination (including periodic determination of prolactin concentration ).

Women who have the following conditions/diseases need careful medical supervision:

• Endometriosis (currently or if there is a history of indications);
• Uterine fibroids;
• Jaundice during previous pregnancy or previous use of sex hormones;
• Epilepsy;
• Diseases of the liver or gall bladder (prescription of Proginova after hepatitis is possible no earlier than six months (after normalization of liver function indicators));
• Arterial hypertension;
• Diabetes;
• Chloasma currently or in the past (prolonged exposure to the sun or ultraviolet radiation should be avoided);
• Chorea;
• Systemic lupus erythematosus;
• Benign diseases of the mammary glands (mastopathy);
• Migraine;
• Bronchial asthma;
• Porphyria;
• Increased levels of triglycerides in the blood;
• Otosclerosis;
• Increased risk of venous thrombosis (the risk increases with age, as well as with excess body weight, varicose veins, and family history of thrombosis).

The risk of deep vein thrombosis may be briefly increased by surgery, prolonged immobility, or serious injury. When planning surgical interventions or operations, you need to inform your doctor in advance about taking the drug (4-6 weeks in advance).

Proginova should not be used to prevent heart attack or stroke.

During therapy, it is necessary to take into account the likelihood of developing the following diseases:

• Endometrial cancer: the risk increases with long-term monotherapy. If the uterus is preserved, the combined use of Proginova with gestagens is necessary. If you experience frequent irregular or breakthrough bleeding, you should consult a specialist;
• Breast cancer (BC): the relative risk increases with increasing duration of estrogen monotherapy. During the first few years after stopping HRT, the increased risk gradually decreases to normal levels. HRT can increase the mammographic density of the mammary glands, which in some cases can negatively affect the X-ray detection of breast cancer (it is possible to use other research methods for screening for breast cancer);
• Ovarian cancer: Long-term (longer than 10 years) estrogen replacement therapy (ERT) slightly increases the risk of developing ovarian cancer;
• Liver tumors: a connection with ongoing HRT has not been proven. If you develop unusual sensations in the upper abdomen that do not go away within a short period of time, you should consult a specialist.

If one of the following conditions occurs, you should interrupt therapy and consult a doctor:

• Exacerbation of existing migraine;
• New migraine attack (characterized by nausea and throbbing headache, preceded by visual impairment);
• Sudden hearing or vision problems;
• any unusually frequent or unusually severe headaches;
• Inflammation of the veins (phlebitis).

Also, the reason for stopping taking Proginova is thrombosis or suspicion of it. Signs of possible thrombosis include coughing up blood, loss of consciousness, unusual pain or swelling in the legs or arms, or sudden shortness of breath.

If jaundice develops or pregnancy occurs, therapy should be discontinued.

Before conducting laboratory tests, you must warn your doctor about taking Proginova, since therapy may affect the results of some of them.

Proginova should not be taken for contraceptive purposes (the use of non-hormonal methods other than temperature and calendar is recommended). If pregnancy is suspected, the drug should be suspended (until it is ruled out).

Women over the age of 65 should consult a specialist before taking Progynova (due to data indicating an increased likelihood of developing dementia).

Use during pregnancy and lactation

According to the instructions, Proginova is not prescribed during pregnancy/lactation.

If pregnancy is detected during therapy, the drug is discontinued.

Use in childhood

Proginova therapy is contraindicated in patients under 18 years of age.

For impaired renal function

There is no need to adjust the dose in patients with impaired renal function.

For liver dysfunction

Contraindications to taking Progynova are benign/malignant liver tumors, including a family history, and severe liver disease.

Drug interactions

Before starting HRT, the use of hormonal contraceptives should be interrupted. If necessary, the woman is prescribed non-hormonal contraceptives.

When Progynova is used simultaneously with certain drugs/substances, the following effects may occur:

• Alcohol: increased circulating estradiol levels;
• Some types of antibiotics (tetracycline and penicillin groups): decreased estradiol levels;
• Drugs that induce liver enzymes (some anticonvulsants and antimicrobial drugs): increase the clearance of sex hormones and reduce their clinical effectiveness;
• Oral antidiabetic agents, insulin: changes in the need for them (due to the effect of HRT on glucose tolerance);
• Substances that undergo significant conjugation (paracetamol): increased bioavailability of estradiol.

Analogues

Analogues of Proginova are: Ethinyl estradiol, Folliculin, Ovipol Clio, Sinestrol, Estrovagin, Elvagin, Kolpotrofin, Esterlan, Pauzogest, Estrocad, Klimen, Ovestin.

Terms and conditions of storage

Keep out of the reach of children under normal conditions.

Shelf life – 5 years.

Proginova is a hormonal drug containing synthetic estrogens, identical to natural estradiol, which is normally produced by the ovaries. The lack of this hormone in the body leads to problems with conceiving and bearing a child. When planning pregnancy, Proginova helps improve fertility and normalize the functioning of the woman’s reproductive system.

Experts do not recommend using this drug for self-treatment, since the result of such therapy can be dangerous. This recommendation primarily applies to women dreaming of pregnancy. Uncontrolled use of the drug Proginova can worsen the condition of hormonal levels and the reproductive system.

When planning pregnancy, Proginova is prescribed for hormone replacement treatment for women suffering from severe estrogen deficiency in the body. This condition may be accompanied by the following pathologies:

• infertility caused by lack of ovulation and/or inadequate growth of the endometrium;
• chronic miscarriage;
• post-term pregnancy;
• weakness of labor;
• hirsutism detected against the background of polycystic ovary syndrome;
• primary or secondary amenorrhea;
• scanty menstruation, indicating the extinction of ovarian function.

The drug is used in gynecology and in other situations. In particular, when planning a pregnancy through an IVF program, resection of one or both ovaries, or the presence of a tumor in the breast (breast cancer). Proginova is also used to suppress lactation, to normalize hormonal levels and prevent osteoporosis during menopause.

How does the drug affect the female body?

The drug Proginova, prescribed in case of menopause, eliminates the pronounced clinical picture of this condition: it reduces heartbeat, relieves attacks of excessive sweating, dizziness and weakness, normalizes sleep and mood, and fights signs of osteoporosis.

In addition, when entering the body, the drug has a positive effect on the condition of the mucous membranes and skin, promoting their regeneration. Thanks to this, the dermis is strengthened, the process of wrinkle formation slows down, and the level of collagen in the skin increases.

The drug is based on estradiol valerate, a synthetic estrogen that replaces the female body’s own estradiol. The lack of this hormone negatively affects a woman’s reproductive functions, preventing conception, implantation and pregnancy.

As a result of taking the drug Proginova when planning pregnancy, a woman of reproductive age does not experience suppression of her own ovulatory function, the synthesis of her own estrogens continues. The noticeable externally beneficial effect of estrogen on the skin of women who want to become pregnant plays another role - it qualitatively improves the condition of the inner layer of the uterus (endometrium).

All this, in the absence of other health problems, allows a woman to conceive a child in the next menstrual cycle. A wide range of activities of this hormonal drug helps to cope with various female diseases.

Contraindications

Proginov cannot be called a harmless drug, so it is prohibited for a number of conditions. List of contraindications for use:

• diabetes;
• heart and vascular diseases;
• thrombophlebitis, thrombosis and thromboembolic pathology in the active phase;
• liver and gallbladder diseases;
• neoplasms of various origins (except breast cancer);
• endometriosis;
• young age (under 18 years old);
• lactation;
• undiagnosed uterine bleeding.

Proginova is not prescribed together with other hormone-containing drugs containing estradiol. Because excess estrogen in the female body leads to migraines, nausea, vomiting and dizziness.

Features of admission when planning pregnancy

The drug Proginova is used frequently and successfully when planning pregnancy. It is usually prescribed in the following cases:

• chronic estrogen deficiency in the body;
• the need to build up the endometrium;
• improving blood supply to the placenta;
• preparation for IVF;
• spontaneous miscarriages in the past.

The main cause of female infertility or spontaneous abortion is often insufficient thickness of the endometrial layer. Proginova improves its growth, and therefore the fertilized egg has a greater chance of attaching to the uterine wall and continuing its development.

The synthetic estradiol contained in the drug restores and stabilizes the hormonal levels of a woman’s body, which allows eliminating many disorders and pathologies from a gynecological point of view. Estrogens activate the functions of the ovaries; after discontinuation of the drug, most women experience normal ovulation, which contributes to successful conception in the first cycle.

After treatment with Proginova, the condition of the endometrium improves markedly. A normal level of estrogen in the body also helps to cope with nervous system disorders and systematic migraines. The drug Proginova is usually included in the list of medications required to be taken before the IVF procedure.

Dosage regimens

The drug is taken regardless of food intake at the same time of day. It is advisable to swallow the tablet whole with a small amount of water. It is not recommended to crush or chew the drug.

The regimen for taking Proginov when planning pregnancy is carried out in two types: continuous and cyclic. A continuous regimen means that the patient takes one tablet of the drug daily until it runs out. Then, without any interruption, begin the next package of the drug.

The cyclic scheme involves taking Proginov daily until the end of the package - 21 days. Next, a 7-day break is required, after which the intake is resumed.

Less often, doctors resort to a combined regimen of Proginov. Its peculiarity is the prescription of an additional drug containing a gestagen. Typically, this scheme looks like this: a woman takes both drugs for 2 weeks, then takes a break for 4 weeks. The course of treatment is adjusted by the doctor.

It is important to remember that errors and omissions made during treatment with this drug can cause bleeding from the genital tract.

If pregnancy occurs while taking Proginov, you need to continue taking the pills for the first 8 weeks. This is especially true for women who have experienced failures during previous pregnancies - miscarriages in early gestation.

The drug Proginova supports the ongoing pregnancy, saturating the developing placenta with blood and oxygen, successfully preventing its rejection. Starting from the 7th week of pregnancy, the drug is discontinued gradually; you cannot stop drinking it suddenly - spontaneous abortion may occur. In some cases, doctors prescribe taking Proginov before the 15th week of gestation.

In what cases does pregnancy not occur after taking it?

The absence of pregnancy after completing the full course of treatment with the drug usually means that:

1. A woman’s body does not perceive Proginov’s components as a medicine.
2. The woman suffers from gynecological and endocrine disorders.

In both cases, the effectiveness of Proginova when planning pregnancy will be minimal. It is necessary to conduct a more thorough examination, cure existing pathologies and only then start taking the drug. Or initially replace Proginov with a drug to which in a particular case there will be greater sensitivity.

Side effects

Any hormonal drug, including Proginova, can lead to side effects. The main ones are:

• periodic pain in the lower abdomen;
• heaviness in the stomach, flatulence;
• intestinal colic;
• suppression of libido;
• amenorrhea;
• enlargement and increased sensitivity of the mammary glands;
• growth of tumors in the breast;
• sudden changes in blood pressure;
• tachycardia;
• headaches, dizziness;
• easy fatigue;
• apathy;
• rash on the skin;
• sudden weight gain;
• intolerance to contact lenses.

"Proginova" is a hormonal drug containing estrogens and estradiol valerate, a synthetic analogue of the female ovarian hormone estradiol. The effect of the drug is based on improving blood circulation in the placenta, which reduces the likelihood of miscarriage. At the same time, Proginova does not suppress ovulation and does not interfere with the production of hormones in the female body.

When planning pregnancy, the drug "Proginova" is prescribed:

• if necessary, increase the endometrium so that the fetus “takes root”;
• with low estrogen levels;
• in cases where previous pregnancies were terminated;
• to improve blood supply to the placenta;
• at the stage of preparation for IVF

One of the reasons for infertility or interrupted pregnancies may be a thin endometrium - the tissue of the inner cavity of the uterus. Thin and insufficiently dense endometrium does not allow the fertilized egg to attach to the wall of the uterus and stay firmly there for a sufficient time: in the first case, pregnancy does not occur, in the second, it is interrupted.

“Growing” a dense layer of the endometrium is especially important before the IVF procedure to help the uterus preserve the implanted egg.

Taking the drug "Proginova" makes the endometrium thicker and gives a chance for a successful pregnancy.

How to take Proginova when planning pregnancy?

Taking the drug "Proginova" is designed for 21 days. The first pill is taken in the first five days of the menstrual cycle or on any day if there is no menstrual cycle.

There are two regimens for taking the drug: cyclic and continuous.

• Cyclic use of the drug "Proginova"

The drug is taken daily, one tablet for 21 days, after which a seven-day break is taken. On the eighth day, the next dosage cycle begins, again lasting 21 days.

• Continuous use of the drug "Proginova"

The drug is taken for 21 days, and from the 22nd day, without a break, a new cycle of administration begins.

The drug regimen is selected by the woman’s attending physician.

Pregnancy often occurs after the first course of treatment with the drug.

If pregnancy does not occur after taking Proginova:

• a woman may have diseases of the pelvic organs or endocrine disorders;
• her body is not sensitive to this drug.

The drug "Proginova" is very effective when planning pregnancy, but there are a number of contraindications for its use.

Proginova should not be taken:

• during pregnancy more than eight weeks;
• during breastfeeding;
• simultaneously with other estrogen-containing drugs, including contraceptives;
• for vaginal bleeding;
• for tumor neoplasms, diseases of the liver, gallbladder, pancreas, diabetes mellitus, lactase deficiency, tendency to thrombus formation.

Before prescribing the Proginova hormone, the doctor will conduct a full examination of the woman and decide whether this drug is suitable for her. If it cannot be used or is ineffective, the doctor will prescribe other hormonal medications that will help bring the long-awaited moment of conception closer and carry a healthy child.

Artificial insemination cannot take place as easily and quickly as the natural process of conceiving a child. Moreover, even a successful one is not a guarantee of a successful pregnancy outcome. Almost always, pregnancy after IVF requires special medical support. The drug proginova during IVF is often prescribed to women to maintain hormonal levels. Its active ingredient is, which plays an important role in planning pregnancy. In the absence of this hormone, a woman not only suffers from a “bouquet” of various health disorders, but also cannot become pregnant.

Proginova refers to those containing estrogens. The drug contains an artificial hormone identical to the natural hormone of the female ovaries. In the body, the drug is converted into.

Proginova ideally replaces the lack of normal hormones that occurs in women during various periods (with natural or artificial menopause). In modern gynecology, Proginov tablets are prescribed for the successful conception of a baby. This remedy serves as an additional source of estrogen, causing women's ovaries to work more intensely and produce sex hormones.

This drug is prescribed in the following cases:

• For problems conceiving a child for women with too thin endometrium (to thicken and strengthen it). For conception, the thickness of the endometrium should not be less than 7-10 mm. With a thin endometrium (4-5 mm), it is impossible for the egg to attach, so pregnancy does not occur. The drug prepares the endometrial layer to react to.
• In the absence of ovulation. The drug ensures full ovulation if it was absent before treatment.
• With several failed pregnancies.
• With critically low estradiol levels. This hormone deficiency prevents the egg from leaving the follicle.
• After IVF as a supporting agent for better engraftment of the implanted embryo.

Thus, Proginova gives a chance to infertile couples and solves many problems that prevent women from getting pregnant.

Proginova when planning pregnancy

For many women, Progynova is an excellent alternative to using potent hormones.

During IVF, this drug prepares the female body for pregnancy. Unlike most similar drugs, Proginova has a very gentle and gentle effect on the female body. This drug suppresses the functioning of the ovaries and artificially ensures hormonal stability.
By stabilizing estrogen levels, this remedy also eliminates all complications caused by hormonal imbalance. Thus, Proginova contributes to:

• stable hormonal levels, independent of unfavorable external factors (stress, colds, chronic illnesses);
• preventing abortion or miscarriage;
• improvement of placental blood circulation;
• prevention of placental abruption.

The drug Proginova not only protects the body of expectant mothers from complications, but also guarantees the preservation of pregnancy and fetal viability.

The instructions indicate that Proginova should not be prescribed during pregnancy (at any stage). However, in practice, it is often this drug that accompanies pregnancy. This may be necessary when:

1. decrease in estrogen levels (up to 8 weeks of pregnancy);
2. post-term pregnancy or weak labor.

The influence of Proginov on the functions of the female body

A woman needs to be prepared for the fact that this medicine will affect the functioning of her female organs. When taking it, the female body can react like this:

• usually become painful and profuse.
• The effect of Proginov on ovulation in different women may be different. The medicine may not change the ovulation process in any way or may suppress it. After discontinuation of the drug, the quality of ovulation always improves. Even if a woman did not ovulate before therapy, they appear after stopping the medication. This promotes a rapid pregnancy process.
• At the same time, endometrial recipes are growing more actively. The uterus becomes ready for the introduction of progesterone in the second half of the cycle. It is at this time that it responds well to progesterone. In this case, the inner layer of the uterus becomes ideally suited for the attachment of the fertilized egg and pregnancy (with the required size, thickness and blood supply).
• The drug significantly affects a woman’s mammary glands. It causes the ducts to become denser and promotes the growth of their cells. Such transformations contribute to good lactation in the mammary glands after childbirth. Estrogens cause the breasts to enlarge, become swollen, firm and painful to the touch. However, such changes disappear after discontinuation of the drug.

For whom the drug is contraindicated

Proginova is a hormonal drug. The effect of this medicine on the female body is quite serious. It cannot be used alone.

Before taking the drug, the doctor must perform a high-quality gynecological examination of the woman, find out everything about the presence of chronic diseases, examine the breasts, monitor blood pressure and sugar levels, and take a smear on a hormonal mirror (colpocytodiagnosis).

The drug is not prescribed for:

• hypersensitivity to the drug or its individual intolerance;
• children under 18 years of age;
• pregnancy (unless the doctor thinks otherwise);
• bleeding;
• suspected breast cancer;
• states of acute thrombosis (myocardial infarction, stroke);
• thrombosis of the veins of the extremities;
• intolerance to sugar-containing products;
• vaginal and vaginal bleeding;
• breastfeeding;
• disorders of fat metabolism;
• severe ailments of the liver and gall bladder;
• thromboembolism;
• pancreatitis;
• complicated diabetes;
• lactose deficiency;
• bleeding;
• anemia;
• malignant tumors (especially estrogen-dependent ones).

The medicine is prescribed with extreme caution in the following cases:

• hypertension;
• diabetes mellitus;
• endometriosis;
• mastopathy;
• pathologies of the gallbladder or liver;
• epilepsy;
• bronchial asthma;
• migraine;
• systemic lupus erythematosus;
• minor chorea;
• uterine fibroids;
• hyperbilirubinemia.

Side effects

The drug Proginova has a mild effect (compared to other hormonal drugs). However, when taking and prescribing a medicine, it is necessary to take into account all the nuances of its effect on the body, carefully studying all the side effects.

Side effects when taking the drug may include:

1. cardiovascular system: pain, palpitations;
2. digestive organs: abdominal pain, diarrhea, vomiting or nausea;
3. nervous system: headache or dizziness, visual disturbances, anxiety, depressive symptoms, decreased libido;
4. immune system: allergic manifestations;
5. metabolism: increase or decrease in body weight;
6. skin: rashes or itching, acne, urticaria, excess hair growth (hirsutism);
7. genitourinary system: soreness of the mammary glands or their enlargement, spotting, uterine bleeding, menstrual irregularities (shortening, lengthening, change in the volume of discharge), symptoms of PMS.

Rare side effects

Other manifestations when using Proginov may be: Quincke's edema, weakness, muscle pain or spasms, thrombosis, venous edema, cholelithiasis, pressure changes, jaundice, chloasma (pigmented areas).

In very rare cases, there are cases of benign or malignant degeneration of the liver.

There is evidence of an increased risk of senile dementia when using this medicine (in women over 65 years of age).

If side effects occur, it is important for a woman to consult with her gynecologist about the possibility of further treatment with this drug.

It is urgent to consult a doctor if patients experience:

• loss of consciousness;
• coughing up blood;
• visual or hearing disorders;
• jaundice;
• severe lack of air;
• severe swelling or pain in the limbs.

Why is Proginova prescribed for IVF?

Proginova for IVF is prescribed to women who need replacement therapy during pregnancy. The need to use the drug is decided by a fertility specialist. There are such nuances of using the drug:

• Proginova is often prescribed along with ovarian stimulation during puncture. The administration of the drug continues during the period of implantation of embryos into the woman’s uterus. This is done before positive tests confirm pregnancy (hCG or ultrasound examination). If pregnancy does not occur, the doctor has the right to stop or stop taking the medication.
• After pregnancy, the drug is administered for at least 8-10 weeks. The introduction of Proginov during the period of bearing a baby replaces the important hormonal functions of the corpus luteum and ovaries, which do not work in many pathologies. And only after 10 weeks of pregnancy there is no need for hormonal support and the medicine is discontinued.

Reception scheme

The medicine is taken according to very simple regimens. One tablet of the drug contains the daily dose of estradiol. The tablets are usually taken 1 tablet daily at the same time (regardless of meals) as a whole, washed down with the required amount of water. The package contains 21 tablets, just enough for a course of treatment.

There are 2 treatment regimens with this drug:

1. Continuous: the medicine is taken for 3 weeks, one tablet at a time. The next package of the drug is started to be taken without any interruption.
2. Cyclic: the drug is also taken 1 tablet daily. After a 21-day course, there is a break in taking pills for 7 days.
3. In addition to the generally accepted regimens, the doctor may suggest his own regimen for taking the medication. In this case, options for taking tablets from 1/8 to 2 tablets 1-3 times a day are possible.

In any situation, the hormonal treatment regimen is determined by the doctor.

About some nuances of application

The drug Proginova is usually prescribed during the 8-10th week of pregnancy under the IVF protocol. This technique allows you to maintain a stable level of estrogen in the body.

The peculiarity of IVF pregnancies is the risk of their termination in the first few weeks after implantation of the embryo.

• Many specialists adjust the dosage of the drug using ultrasound, when the growth of follicles and endometrium is clearly visible.
• It is necessary to plan a convenient time at which the woman can take these pills daily.
• If a woman misses a dose of medication, it is important to take the next pill as quickly as possible. The unused tablet must be destroyed. Further, the dosage regimen is not changed.
• If a woman takes a break from taking the drug for more than a day, uterine bleeding may occur.
• When taking Proginov, other hormone-containing drugs are selected especially carefully.
• To make hormonal therapy more effective, other similar drugs are often used in parallel with Proginova.
• Most often, the drug is used for at least 3 months. With this course, the effect of treatment is maximum.
• Women are not recommended to stop taking Proginova even at the first sign of miscarriage. The drug allows you to consolidate pregnancy and help eliminate bleeding. In such situations, the doctor may even recommend increasing the dose of this medicine.
• After 10 weeks of taking Proginov, with a successful pregnancy, the body should independently begin to produce its own estrogen. It is at this time that the drug is most often discontinued.
• There are two drugs on the market with a similar name: Proginova and Cyclo-proginova. Despite the similarity in name, these are completely different drugs. They have different compositions and indications for use. To maintain pregnancy during IVF, only Proginova is used.
• Cyclo-proginova is used in women during menopause. The purpose of using this drug is the need to eliminate negative manifestations during menopause. This drug is not used for maintenance hormonal therapy during IVF.

Features of drug withdrawal

If pregnancy occurs, then this medicine has played a role and must be discontinued. However, this is done no earlier than 8-9 weeks of pregnancy. Only during this period the placenta is already formed and supports the development of the fetus.

The medication is usually discontinued completely by 15 weeks of pregnancy. After this period, the drug may harm the development of the fetus. This can be especially negative when carrying boys.

Abrupt withdrawal of the drug can cause spontaneous miscarriage.

Proginov is discontinued gradually to avoid the threat of miscarriage. The doctor may use various schemes to reduce the dosage of the medicine (by a quarter, half or whole tablet over three days).

Usually they try to start withdrawing the medication with one quarter of the tablet. If the body tolerates it normally, then after 3 days half the tablet is removed, and after another 3 days the whole tablet is removed.

Compatibility with other drugs

When taken orally, only 3% of the estradiol from the drug is absorbed.

Many doctors prescribe gestagen in parallel with this drug (usually for 10 days). This scheme reduces the possibility of complications during hormone therapy (adenocarcinoma, hyperplasia, etc.)

You cannot independently combine the medicine with other estrogen-containing drugs (including oral contraceptives).

The drug may affect blood glucose levels in diabetics. Therefore, it is important to monitor these indicators when treating diabetes.

The effect of this medication is reduced by concomitant use of drugs for epilepsy (barbiturates, etc.), antibiotics, and antituberculosis drugs.