title: Worldwide survey of IVF practices: trigger, retrieval and embryo transfer techniques.
abstract: OBJECTIVE
  To identify common and varying practice patterns used by in vitro fertilization (IVF) providers from a broadly distributed, worldwide survey. Specific information regarding clinical IVF practices involving the oocyte maturation triggering, oocyte retrieval and embryo transfer was elicited.
  
  
  METHODS
  This is an internet-based questionnaire study of IVF practices throughout the world. We used 26 multiple choice questions regarding common clinical practices. The data reported are weighted based on the number of IVF cycles performed at the specific IVF center, represented by a single respondent.
  
  
  RESULTS
  Surveys were completed from 359 centers in 71 countries throughout the world. The most common practice patterns (defined as ≥75 % of IVF cycles) identified included: use of human chorionic gonadotropin (hCG) for trigger with an antagonist protocol, no routine patient monitoring from hCG trigger to oocyte retrieval, timing oocyte retrieval 34-37 h following oocyte maturing trigger, use of a single lumen retrieval needle, no routine tests following oocyte retrieval prior to patient discharge and use of ultrasound assistance with embryo transfer.
  
  
  CONCLUSIONS
  This is the largest and most diversely represented survey of specific IVF practices addressing oocyte maturation triggers, oocyte retrieval and embryo transfers. Several uniform practice patterns were identified that can be correlated with evidence-based medicine; however, we identified multiple variable practice patterns which is likely the result of the absence of definitive evidence to guide IVF practitioners. The results of this survey allow IVF providers to compare their specific practice patterns with those of a global diverse population of IVF providers.
authors.affiliation: Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, Falls Concourse, 10751 Falls Road, Suite 280, Lutherville, MD, 21093, USA, ktobler1@jhmi.edu.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Tobler
authors.forename: Yulian
authors.initials: Y
authors.lastname: Zhao
authors.forename: Ariel
authors.initials: A
authors.lastname: Weissman
authors.forename: Abha
authors.initials: A
authors.lastname: Majumdar
authors.forename: Milton
authors.initials: M
authors.lastname: Leong
authors.forename: Zeev
authors.initials: Z
authors.lastname: Shoham
mesh_terms: D006063:Chorionic Gonadotropin / Q000652:urine; D004624:Embryo Transfer / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000706:statistics & numerical data; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors; D006801:Humans; D054315:Oocyte Retrieval / Q000379:methods / Q000706:statistics & numerical data; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012102:Reproductive Control Agents / Q000008:administration & dosage; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D018084:Ultrasonography, Interventional
chemical_list: D006063:Chorionic Gonadotropin; D012102:Reproductive Control Agents; D007987:Gonadotropin-Releasing Hormone