Understanding IVF Pessaries: What They Are and How They Help
If you’ve begun your fertility journey, you’ve probably heard your doctor mention the term “pessaries.” For many people undergoing in vitro fertilization (IVF), this can be a new and unfamiliar part of treatment. So, what are IVF pessaries, and why are they prescribed during the process?
IVF pessaries play a crucial role in supporting the early stages of pregnancy after embryo transfer. They deliver hormones, most commonly progesterone, directly to the uterus, helping the body maintain the right conditions for embryo implantation and growth.
This guide will explain what IVF pessaries are, how they work, how to use them correctly, and what side effects to expect.
What Are IVF Pessaries?
IVF pessaries are small, solid, or capsule-like medications inserted into the vagina, where they dissolve and release hormones directly into the bloodstream.
The main purpose of these pessaries is to supplement progesterone, a hormone that plays a vital role in preparing and maintaining the uterine lining for pregnancy.
During a natural menstrual cycle, progesterone levels rise after ovulation to help the uterine lining thicken. However, in IVF, because the ovaries are artificially stimulated and eggs are collected, the body’s natural hormone production may be temporarily disrupted.
That’s where progesterone pessaries come in: they provide essential hormonal support to ensure the uterus remains ready for the embryo to implant successfully.
Why Are Pessaries Used in IVF?
Progesterone is one of the most important hormones for a healthy pregnancy. In IVF cycles, pessaries are prescribed after egg retrieval or embryo transfer to help the uterus maintain a stable, pregnancy-friendly environment.
Here’s why they’re essential:
- Support for the uterine lining: Pessaries ensure the endometrium stays thick and receptive for implantation.
- Prevention of early miscarriage: Maintaining progesterone levels reduces the risk of early pregnancy loss.
- Improved implantation rates: Research shows that progesterone supplementation can enhance the chances of successful embryo attachment.
Doctors may prescribe pessaries alongside, or instead of, progesterone injections or gels, depending on the patient’s preference, comfort, and medical history.
How IVF Pessaries Work
Once inserted, the pessary dissolves inside the vagina, and the progesterone is absorbed directly into the bloodstream and nearby uterine tissues.
Because the hormone is delivered close to the uterus, it bypasses the liver, which makes absorption more efficient than oral tablets. This local absorption also reduces some of the systemic side effects that can occur with injections.
Patients typically start using pessaries after the egg retrieval or embryo transfer phase, continuing daily until the pregnancy test and sometimes for several weeks into early pregnancy if conception occurs.
How to Use IVF Pessaries Correctly
Using pessaries can feel awkward at first, but with proper technique, they become a simple part of the daily routine.
Here’s how to use them:
- Wash your hands thoroughly before and after insertion.
- Lie down or stand with one leg raised for easier access.
- Insert the pessary gently into the vagina as far as it will comfortably go, using your finger or an applicator if provided.
- Remain lying down for about 10–15 minutes afterward to help absorption.
- Wear a panty liner if needed, some residue or mild discharge is normal.
Most doctors recommend inserting the pessary once or twice a day, usually morning and evening. Always follow your clinic’s specific instructions on dosage and timing.
Common Side Effects of IVF Pessaries
Like all medications, pessaries can have side effects, but most are mild and manageable. Because they are used locally, they typically cause fewer systemic effects compared to injections or oral pills.
Here are the most common side effects:
1. Vaginal Discomfort or Itching
Some people experience mild irritation or itching after insertion. This is often due to the base ingredients used in the pessary rather than the progesterone itself.
How to manage the situation:
- Wear breathable cotton underwear.
- Avoid using perfumed soaps or douches.
- If irritation persists, talk to your doctor about switching brands.
2. Vaginal Discharge
A white or creamy discharge is common and is usually just residue from the dissolved pessary. It’s not a sign of infection.
Tip: Wearing a panty liner can help you stay comfortable and clean.
3. Mild Abdominal Bloating or Cramps
Progesterone can cause mild bloating or period-like cramps as the body adjusts. These symptoms are normal and temporary.
How to manage cramps:
- Stay hydrated.
- Avoid high-sodium foods.
- Gentle stretching or light walks can help relieve discomfort.
4. Breast Tenderness or Mood Changes
Since progesterone affects hormone levels, some people notice breast sensitivity, fatigue, or mood swings similar to premenstrual symptoms.
These are temporary and often subside once hormone levels stabilize.
Advantages of Using Pessaries in IVF
Pessaries are a preferred method of progesterone delivery for many IVF patients because they offer several advantages:
- Painless application: No needles or injections are required.
- Efficient absorption: Hormone delivery is localized to the uterus, improving effectiveness.
- Fewer systemic side effects: Compared to oral or injectable forms.
- Ease of use: Can be self-administered at home.
Your fertility doctor may choose pessaries over other forms of progesterone based on comfort, tolerance, and treatment goals.
What to Expect While Using IVF Pessaries
You’ll likely begin pessary use shortly after egg retrieval or embryo transfer, continuing until your pregnancy test about two weeks later. If your test is positive, your doctor may advise continuing the pessaries for 8–12 weeks to support early pregnancy until the placenta takes over hormone production.
During this time, it’s normal to experience mild side effects. However, if you notice heavy bleeding, severe pain, or signs of infection (such as foul-smelling discharge), contact your fertility clinic right away.
Can I Miss a Dose?
If you forget to insert a pessary, take it as soon as you remember, unless it’s almost time for your next dose. Do not double up. Consistency is key for maintaining hormone levels, so set reminders if needed.
Missing multiple doses can affect uterine support and potentially reduce implantation chances, so always follow your doctor’s schedule closely.
Final Thoughts
IVF pessaries are a simple yet powerful part of fertility treatment. They help create the ideal environment for an embryo to implant and thrive by maintaining optimal progesterone levels.
While minor side effects can occur, they are manageable and far outweighed by the benefits they provide during this crucial phase of IVF.
Remember, your fertility team is there to guide you through every step from correct usage to managing any discomfort along the way.
At The Bridge Clinic, our IVF specialists offer personalized treatment plans, including detailed guidance on medication use, such as pessaries. We ensure you’re comfortable, informed, and supported throughout your journey to parenthood.
Contact The Bridge Clinic today to schedule a consultation and learn how our expert team can help you achieve a successful IVF experience.
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