title: Duration of luteal support after IVF is important, so why is there no consistency in practice? The results of a dynamic survey of practice in the United Kingdom.
abstract: Luteal support is considered as an essential component of IVF treatment following ovarian stimulation and embryo transfer. Several studies have consistently demonstrated a benefit of luteal support compared with no treatment and whilst a number of preparations are available, no product has been demonstrated as superior. There is an emerging body of evidence which suggests that extension of luteal support beyond biochemical pregnancy does not confer a benefit in terms of successful pregnancy outcome. We performed two surveys separated by 5 years of practice evolution, with the latter reporting on the use of luteal support in all IVF clinics in the UK. All clinics reported utilising luteal support with the majority favouring the use of Cyclogest 400 mg twice daily. In contrast, there was no consensus on the optimal duration of luteal support. Whilst 24% of clinics withdrew luteal support at biochemical confirmation of pregnancy, 40% continued treatment until 12 weeks gestation. Several clinics even extended luteal support beyond 12 weeks gestation. We observed no difference in practice based on the size of the IVF unit or treatment funding source. Although there was some change in practice between surveys in many clinics, there was no uniformity in the direction of change.
authors.affiliation: Hewitt Fertility Centre for Reproductive Medicine, Liverpool Women's NHS Foundation Trust Hospital , Liverpool , UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Russell
authors.forename: Charles
authors.initials: C
authors.lastname: Kingsland
authors.forename: Zarko
authors.initials: Z
authors.lastname: Alfirevic
authors.forename: Rafet
authors.initials: R
authors.lastname: Gazvani
mesh_terms: D000328:Adult; D003340:Corpus Luteum Maintenance / Q000187:drug effects*; D004334:Drug Administration Schedule; D046149:Embryo Culture Techniques; D004624:Embryo Transfer; D019317:Evidence-Based Medicine; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000494:pharmacology*; D005307:Fertilization in Vitro; D019538:Health Care Surveys; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D010062:Ovulation Induction; D010818:Practice Patterns, Physicians' / Q000639:trends; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011374:Progesterone / Q000008:administration & dosage / Q000494:pharmacology*; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D006113:United Kingdom
chemical_list: D005300:Fertility Agents, Female; D011374:Progesterone
keywords: IVF; luteal phase deficiency; luteal support; progesterone