Hi,
  I had a successful IVF and am now pregnant with one child. I was told to take all of the following until the 12th week:
        3 progesterone pills orally 3 times per day (each pill 100 mg)
        3 estrogen pills orally 3 times per day (each pill 2 mg)
        1 progesterone gel vaginal suppository (Crinone 8%) 1 time per day
        1 prednison pill per day (5 mg)
  I had the IVF done in another city and the above instructions were given by the doctor who did the IVF. Since returning home I have been under the care of a regular OBGYN, who is not a fertility specialist. Due to a miscommunication between my hometown OBGYN and myself, I began taking the oral progesterone pills twice per day instead of three times per day starting at Week 9 Day 5, and then I began taking the estrogen pills twice per day instead of three times per day starting at Week 10 Day 2.
  I am now at 11 weeks. Do you think that the fetus will be harmed by this? I am very worried that it will not develop normally, and I can’t sleep at night. This was nobody’s fault, I am just worried about my baby.
  Thank you for taking the time to answer this question, I really appreciate it.
  Rebecca

Dear Rebecca,
Please rest assured that your fetus should not be harmed by the tapering of hormones in your 9th week, and in fact many REs begin to taper or wean their patients off of exogenous (external) hormone supplementation before then. The traditional studies demonstrate that the placenta is functional as an endocrine (hormone producing) unit by 8 wks gestation. Your progesterone and estrogen supplementation into 12 wks is primarily meant to prevent unforeseen dips in your levels due to disruption of the corpus lutem (ovulation site) after egg retrieval, and at the time of the shift from your ovaries producing hormones to your placenta. And you were still on plenty of both the estrogen and supplementation even after your inadvertant taper!

Dear Dr. Chang,
  Thanks so much for your reply. Can I be a bit paranoid and ask one more question? Does this hold true also for situations where a donor egg was used, because you mentioned that supplementation into the 12th week was meant to avoid dips in level due to disruption of the ovaries at the egg retrieval site, however I was given a shot of Lupron a few weeks prior to the IVF which they said was to “shut my ovaries down”, so when you mentioned about the transfer of hormone producing responsibility from the ovaries to the placenta, are my ovaries not doing anything and am I therefore totally dependent on the pills? My guess is you’re probably going to say that two pills per day is enough since the placenta is starting to ramp up production, but I just wanted to make sure. Thanks again!