Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot 76100, Israel.
Reprod Biomed Online. 2012 Aug;25(2):139-45. doi: 10.1016/j.rbmo.2012.04.005. Epub 2012 Apr 22.
This worldwide web-based survey compared the clinical practice for luteal-phase supplementation (LPS) in stimulated IVF cycles to the current evidence-based literature. Eighty-four treatment centres in 35 countries, representing a total of 51,155 IVF cycles/year, responded. Vaginal progesterone alone was used for LPS in 64% of cycles and in another 16% of cycles in combination with either i.m. (15%) or oral progesterone (1%). As a single agent, i.m. progesterone was used in 13% of cycles, oral progesterone in another 2% and human chorionic gonadotrophin (HCG) was still used in 5% of cycles. Progesterone was administered until 10-12 weeks' gestation in 67% of cycles and in 22% and 12% it was discontinued when fetal heart pulsations are recognized or until βHCG was positive, respectively. In conclusion, in almost two-thirds of the assisted cycles represented in this survey, vaginal administration of progesterone is preferred for LPS. Nevertheless, despite the available literature on the disadvantages of oral progesterone, i.m. progesterone and HCG for LPS, these agents are still used routinely by many practitioners. Furthermore, although there is no firm evidence to support the continuation of LPS until 10-12 weeks' gestation, this practice is used in the majority of IVF cycles worldwide.
这项基于互联网的全球调查比较了在刺激体外受精 (IVF) 周期中黄体期补充 (LPS) 的临床实践与当前基于证据的文献。来自 35 个国家的 84 个治疗中心，共代表了 51155 个 IVF 周期/年，做出了回应。64%的周期单独使用阴道孕酮进行 LPS，另外 16%的周期与肌肉内 (15%) 或口服孕酮 (1%) 联合使用。作为单一药物，13%的周期使用肌肉内孕酮，另外 2%的周期使用口服孕酮，还有 5%的周期使用人绒毛膜促性腺激素 (hCG)。在 67%的周期中，孕酮一直用到 10-12 周妊娠，在 22%和 12%的周期中，分别在胎儿心跳可识别或β hCG 阳性时停止使用。总之，在这项调查中代表的近三分之二的辅助周期中，更倾向于阴道给予孕酮进行 LPS。然而，尽管有关于 LPS 时口服孕酮、肌肉内孕酮和 hCG 的缺点的可用文献，但许多从业者仍常规使用这些药物。此外，尽管没有确凿的证据支持 LPS 一直持续到 10-12 周妊娠，但这种做法在全球大多数 IVF 周期中仍被广泛采用。
