Duration of progesterone-in-oil support after in vitro fertilization and embryo transfer: a randomized, controlled trial

Early progesterone cessation after in vitro fertilization/intracytoplasmic sperm injection: a randomized, controlled trial

“…Live birth rate was also similar in both groups. Our experience is in line with other studies supporting this concept even at an earlier stage (5,16,21,22), although evidence is still limited.…”

“…Our study confirms findings of the four previously published randomized trials on this topic (5,16,21,22), establishing a noninferiority cycle outcome if P withdrawal is implemented after the gestational sac is visible by transvaginal ultrasound. However, the main limitation of our results regarding adoption in general IVF practice is the limited experience with this approach in patients whose luteal phase may behave differently, such as those with advanced maternal age or endometriosis.…”

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

“…These studies had significant patient numbers with over 900 participants in total; however only two were prospective trials (Prietl et al, 1992;Schmidt et al, 2001;Nyboe Andersen et al, 2002). More recently, Kyrou et al (2011) and Goudge et al (2010) reported fi ndings consistent with these earlier studies. Clinical trials by Aboulghar et al (2008) and Kohls et al (2012) suggested luteal support beyond the fi rst viable ultrasound was unnecessary (Aboulghar et al, 2008;Kohls et al, 2012).…”

“…It is unclear why these changes had occurred between surveys. Whilst there has been growing evidence to suggest prolonged progesterone supplementation may be unnecessary (Schmidt et al, 2001;Nyboe Andersen et al, 2002;Proctor et al, 2006;Aboulghar et al, 2008;Goudge et al, 2010;Kyrou et al, 2011), we suspect that clinicians continue to argue that this evidence still remains to be substantiated in larger clinical trials. Whilst putative attempts to reduce the duration of treatment have been observed, these reduction are minimal and do not concur with the emerging evidence.…”

Progesterone supplementation after oocyte retrieval: how long is it really needed?

“…The study of Kohls et al in the current issue in which patients discontinued micronized vaginal P at either 5 or 8 weeks' gestation without effect on pregnancy outcome (although the early cessation group did experience more vaginal bleeding) is consistent with other recent reports (4). Gouge et al (5) compared two groups of patients undergoing IVF with IM P support. In group 1, patients received injections for 6 weeks; in group 2 for only 11 days with P supplementation starting on day of transfer in group 2.…”