Luteal phase support in assisted reproduction: United Kingdom survey

Objective: Probing practices of luteal phase support in assisted reproductive technology (ART) centers in U.K.
Materials and methods: A question survey was conducted via the recognized centre by the HFEA (Human Fertilization Embryology Authority) registry for year 2005. Questions covered importance, optimal hormone for luteal support and optimal route and length of progesterone and human chorionic gonadotrophin (hCG) administration for women undergoing assisted reproductive technologies.
Main outcome measures: The main outcome measures were importance, optimal hormone, and optimal route, dose, length of progesterone, estrogen and hCG administration.
Results: 82 centers licensed for in vitro fertilization / Donor insemination (IVF/DI) acknowledge receiving the survey. Of those, 69 centers perform in vitro fertilization / intra cytoplasmic sperm injection (IVF/ICSI). 60 (87%) centers replied. Luteal support was very important in 65% and important in 31%. 97% used it in long down regulation protocol. The routine use of luteal support following controlled ovarian hyperstimulation (COH) with all stimulated cycles was 80.6%. HCG was behind the progesterone in its use in this survey. Cyclogest (progesterone pessaries) was the first choice of those selected as a preference in 55%. 92% of IVF/ICSI centers that responded to the questionnaire use cyclogest. The commonest dose used is 400 mg twice daily (BD). The other leaders are intramuscular progesterone (42%), hCG (38%), and vaginal progesterone gel (25%). The common practice is to start luteal support from the day of oocyte collection (48%) and 48% centers continue support until 12 weeks gestation.
Conclusion:Luteal phase support in ART is regarded as important by majority of specialist centre. Cyclogest is the most widely used luteal phase support.