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Details the hormone supplements given to assist implantation i.e. luteal phase support.

Luteal phase support

Once the eggs have been removed, the follicles start to produce a hormone called progesterone.


Progesterone stimulates 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 if the woman conceived in order to assist implantation especially if you were given GnRh agonists to achieve down-regulation.There is no evidence to support continuing any form of treatment for luteal phase support beyond 8 weeks' gestation. [NICE 2013].

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

Some centers recommend adjuvant luteal phase support such as low dose aspirin, heparin, steroids and immunoglobulin in order to improve the likelihood of achieving a live birth. The use of these medications has potential risks to the treated women and Immunoglobulins are very expensive. Further research is needed to assess the efficacy of adjuvant luteal phase support treatments.

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