Luteal Support And Adjuvants

Luteal phase is a crucial time between the embryo transfer and confirmation of pregnancy with BHCG test. This is the time which needs support for the growing embryo. It can be supplemented with Progesterone hormone, estrogen hormone, folic acid and other medications (Low dose Heparin, Low dose aspirin, GnRH agonist etc) individualized to the need of the couple undergoing IVF cycles. Normally progesterone is initially given for a period of 14 days. This can be given either orally, vaginally, subcutaneously or intra muscularly. If after 14 days the pregnancy test is positive, we continue the progesterone for 7-8 weeks. Many units, including ours continue progesterone for 12-14 weeks of pregnancy. Estrogen in the form of estradiol valerate is continued for 9 weeks of pregnancy, especially in hormone replacement frozen thaw cycles or egg donation cycles.

In patients with repeated IVF failures we use many additional medicines such as low dose aspirin, low molecular weight heparin, steroids, oral/vaginal sildenafil, oral piroxicam, iv atosiban , iv intralipids , iv immunoglobulin IVIG etc . Many IVF groups including ours have used some of these adjuvants successfully, especially in patients with repeated IVF failures.