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Progesterone Support in IVF Patients

Results of > 50,000 IVF treatment cycles


Dear Friends and Colleagues,

On August 20, 2009, the first survey relating to Progesterone Support in IVF Patients was posted on the website home page.

Ninety-seven units from 35 countries responded to the survey (Europe 17, South America 5, Africa 1, Far East Region 3, Asia and USA, as well as Canada 7). Of all the participating centers, the average annual treatment cycles were below 1000 cycles. Only 9 centers reported more than 1000 cycles, 3 centers more than 2000 cycles, and 2 centers treat more than 3000 cycles annually.

The first report was on approximately 25,000 treated cycles, and this current report is in the region of 51,155 treated IVF cycles. Surprisingly, there was not much difference between the results of the 25,000 and 50,000 cycles.
The survey will remain open until >100,000 treated IVF cycles will be reached.

Q: How long Progesterone needs to be administered in IVF cycles if the patient becomes pregnant?
The results represent 25,500 and 50,000 IVF cycles from 35 countries.

Criteria 25,000 cycles 50000 cycles
Until b-hCG is positive 12% 13%
Until FHR is recognized 20% 22%
Until 10-12 weeks of gestation 67% 66%

Q: What is the Progesterone you use for luteal support?
The results represent 25,500 and 50,000 IVF cycles from 35 countries.

Criteria 25,000 cycles 50000 cycles
Vaginal cream/gel 34% 34%
Vaginal capsule 28% 30%
IM Progesterone 10% 13%
hCG 7% 4%
Oral Progesterone 1% 2%
Vaginal Progesterone in combination with IM Progesterone 19% 15%
Vaginal Progesterone in combination with oral Progesterone 1% 1%
hCG in combination with any type of Progesterone 0% 1%

Comments from the participants and the Advisory Board

Hannu Martikainen
"The results are rather surprising for me. Rather many seem to use progesterone until 10-12 week of pregnancy, although,
as far as know, there is no evidence in the literature supporting this kind of practice.
Secondly, the use of intramuscular preparation must be very laborious for the patient. The same result can be obtained in a much easier way by vaginal preparations."

Ulrich Hilland
"Looking into Progesteron-substitution and the length of same only makes sense when also looking into the relationship between those values and miscarriages.

Bart Fauser
"The unique global information provided by IVF worldwide will generate new insight in IVF practice today and its clinical implications. Nothing can match the significance of big numbers and the available system provides the opportunity to perform meta-analyses based on individual patient data."

Paul Dalmeyer
"Although physiologically we stopped luteal support at fetal heart, due to increased vaginal bleeding following the discontinuation and the fear it puts into patients we have opted to continue until 12 weeks gestation".

Dr Yemini
The data about the progesterone is very useful. We have review it and have decided to gradually move from IM to Vaginal product and to treat till 9+- weeks and not till 12 weeks.


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Yours sincerely,

Prof. Zeev Shoham and Prof. Milton Leong