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

Kohls, Graciela; Ruiz, Francisco; Martínez, María del Mar Fernández; Hauzman, Erik; Fuente, Gabriel de la; Pellicer, António; Garcia-Velasco, Juan A.

doi:10.1016/j.fertnstert.2012.05.046

Cited by 42 publications

(61 citation statements)

References 24 publications

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“…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). A recent meta-analysis of randomised controlled trials found no difference in on-going pregnancy rates, miscarriage rates or live birth rates comparing early cessation of luteal support compared with prolonged support (Liu et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, whilst there is global agreement that luteal support is essential, there is no consensus on the optimum duration of luteal support. Importantly, some studies have recently suggested that luteal support can be safely withdrawn at the time of biochemical pregnancy confi rmation, (Mochtar et al, 1996;Schmidt et al, 2001;Nyboe Andersen et al, 2002) while others have recommended withdrawal at 5 weeks gestation (Kohls et al, 2012), at fi rst ultrasound (Aboulghar et al, 2008), up to 8 weeks gestation (Polson et al, 1992;Miles et al, 1994) or up to 12 weeks gestation (Smitz et al, , 1992Van Steirteghem et al, 1988;Ludwig & Diedrich, 2001).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Russell¹,

Kingsland²,

Alfirević³

et al. 2014

Human Fertility

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Russell¹,

Kingsland²,

Alfirević³

et al. 2014

Human Fertility

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show abstract

“…case of pregnancy is still common practice in the majority of IVF centres around the world [19], despite potential hazards and increasing knowledge about a missing negative effect when it is stopped at the time of a positive pregnancy test [20,21]. The results of a recent prospective study have additionally supported the practice of early cessation of LPS in pregnant patients following IVF/ICSI [22]. Our data further indicate a discriminatory potential of E2 and P in the mid-luteal phase for CC-OG as compared with CC-MC; the best discriminatory capacity is given for P on ET þ 7 with 66.7% of patients correctly determined as ongoing pregnant (CC-OG) and 92.3% as not (NC) or not ongoing pregnant (CC-MC) at a threshold of 126 nmol/l.…”

Section: Discussionmentioning

confidence: 99%

Serum estradiol and progesterone in the mid-luteal phase predict clinical pregnancy outcome in IVF/ICSI cycles

Sonntag

Loebbecke

Nofer

et al. 2013

Gynecological Endocrinology

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In this prospective study, we tested the hypothesis if E2 and P serum levels significantly differ during the luteal phase following in vitro-fertilization/intracytoplasmic sperm injection (IVF/ICSI) therapy in conception (CC) versus non-conception (NC) cycles, and their potential in the prediction of pregnancy at the earliest point in time. Serum was sampled from the day of embryo transfer (ET) and throughout the luteal phase until ET + 14 from patients consecutively enrolling for IVF/ICSI therapy. The luteal phase was supported by vaginal P suppositories only, clinical pregnancies were detected by ultrasound and followed up until the 20th week. Overall pregnancy rate was 30.9% constituting the two study groups of CC (n = 22) and NC cycles (n = 49). Significantly, higher E2 (3326 ± 804 versus 1072 ± 233 pmol/l, p = 0.014) and P (244 ± 68 versus 73 ± 10 nmol/l, p = 0.023) were present in CC versus NC from as early as ET + 7. In the CC group, patients with ongoing pregnancies (CC-OG) as compared with miscarriages (CC-MC) had significantly higher E2 and P from ET + 7, predicting ongoing pregnancy in receiver operator characteristics analysis.

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“…However, there was substantially more bleeding in the group discontinuing treatment at 5 weeks. 324 Given the anxiety first trimester bleeding causes patients, treatment beyond 5 weeks seems reasonable.…”

Section: Luteal Phase Support In Fresh Embryo Transfersmentioning

confidence: 99%

Assisted Reproduction

Ginsburg¹,

Racowsky²

2014

Yen &Amp; Jaffe's Reproductive Endocrinology

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

Cited by 42 publications

References 24 publications

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

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

Serum estradiol and progesterone in the mid-luteal phase predict clinical pregnancy outcome in IVF/ICSI cycles

Assisted Reproduction

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