IVF procedure

Luteal phase support

Once the eggs have been removed, the follicles start to produce a hormone called progesterone to stimulate the endometrium and prepare it for implantation. In addition, it reduces uterine contractions. However, the amount of progesterone produced by the follicles is usually not enough to support the lining of the uterus. Hormone supplements are usually given for two weeks or longer to assist implantation especially if you were given GnRh agonists to achieve down-regulation.

The choice for luteal phase lies between intramuscular hCG injections and progesterone. While hCG may result in higher pregnancy rates, there is an increased likelihood for OHSS (ovarian hyperstimulation syndrome) and for this reason routine use of hCG is not recommended. There are different forms of progesterone to choose from.

• Daily intamuscular injections e.g. gestone
• Daily vaginal pessaries e.g. cyclogest. These are mounted in wax, which melts as progesterone is absorbed causing discharge. It may be necessary to wear a panty liner.
• Daily vaginal tablets e.g. utrogestan
• Daily vaginal gel e.g. crinone

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