A survey on luteal-phase progesterone support
Luteal-phase progesterone support during stimulated IVF cycles is considered mandatory to counter luteal insufficiency that might have a negative effect on implantation. Fortunately, there have been major advancements in both luteal-phase progesterone formulations and other drug and protocol options in recent years. With the forthcoming survey of the IVF community, we would like to assess current and emerging solutions for luteal-phase support, in terms of knowledge, experience, utilization and outcomes.
- Evidence-based data from the literature
- Your personal experience
- Cost of medication
- Patients’ convenience
- Published Guidelines
- I use the same luteal support regimen for all patients
- I individualize luteal support regimens (according to each patient’s ovarian response, stimulation protocol, age, BMI, etc.)
- None of the above
- On the day of hCG administration
- On the day after hCG administration
- On the day of egg collection
- On the day after egg collection
- On the day of embryo transfer
- A few days after embryo transfer
- Other
- I do not support the luteal phase
- Until pregnancy is confirmed in a blood or urine test (week 4) or 14 days after embryo transfer
- Until the presence of a fetal heartbeat
- Until gestational week 8–10
- Until gestational week 10-12
- Until gestational week 13-15
- Longer than 16 weeks
- I do not administer progesterone
- hCG
- Vaginal progesterone
- IM progesterone
- Sub-cutaneous progesterone
- Oral progesterone
- GnRH agonist nasal spray
- A combination of the drugs/routes mentioned above
- Other
- I do not support the luteal phase
- Vaginal and IM/sub-cutaneous progesterone
- Vaginal and oral progesterone
- IM/sub-cutaneous and oral progesterone
- Vaginal, IM/sub-cutaneous, and oral progesterone
- Other
- I do not use a combination of progesterone treatments
- Vaginal progesterone in gel form (such as Crinone)
- Vaginal suppositories (such as Endometrin)
- Vaginal tablets (such as Utrogestan)
- Vaginal pessary (such as Cyclogest)
- Other
- I do not use vaginal progesterone
- Micronized progesterone (such as Utrogestan)
- Medroxyprogesterone acetate (such as Provera)
- Dydrogesterone (such as Duphaston)
- Norethisterone (such as Primolut-Nor)
- I do not use oral progesterone
- Daily progesterone in oil (Gestone, Prontogest, etc.)
- Long-acting P preparation: Hydroxyprogesterone caproate (Progesterone Retard, Proluton, etc.)
- A different interval of administration or formulation
- I do not use IM progesterone
- Yes, always
- Yes, but only in selected cases
- No, I do not use estradiol for luteal support
- Always "freeze all" with no luteal support
- "Intensive" luteal support, e.g., higher doses of progesterone and estrogen
- Low doses of hCG
- GnRH agonist nasal spray
- None of the above
- Oral
- Vaginal
- Subcutaneous
- IM
- Combined of the above drugs
- No preference
- Yes, more studies are needed
- No more studies are needed; there is already enough data in the literature to reach a decision
- Oral
- Subcutaneous
- IM
- Vaginal
- There is no need for additional data
- Yes
- No
- I do not support the luteal phase
- Yes
- No
- I do not support the luteal phase