Between embryo transfer and BHCG test confirmation of pregnancy, the luteal phase is critical. This is the time when the developing embryo needs Luteal Support & Adjuvants. It can be supplemented with progesterone, estrogen, folic acid, and other drugs based on the needs of the IVF partner.
During the Luteal Support & Adjuvants, progesterone is usually given over a 14-day period at first. Orally, vaginally, subcutaneously, or intramuscularly are all options. If the pregnancy test comes back positive after 14 days, the progesterone will be continued for another 7-8 weeks. Many units, like ours, use progesterone for the entire pregnancy (12-14 weeks). During hormone replacement freeze thaw cycles or embryo transfer cycles, estrogen in the form of estradiol valerate is continued until 9 weeks of pregnancy.
Experts employ a variety of extra medications in patients who have had several IVF failures, including low-dose aspirin, low-molecular-weight heparin, steroids, oral/vaginal sildenafil, and others during the Luteal Support & Adjuvants. Many IVF clinics, including ours, have had success with some of these adjuvants, especially in individuals who have had many IVF failures.
The effect of Luteal Support & Adjuvants on pregnancy rate is unaffected by whether progesterone support was initiated at hCG injection, oocyte retrieval, or ET. There is no clarity on how long luteal support should last. Traditionally, progesterone is given for 8-10 weeks after a positive pregnancy test; however, there was no difference in outcomes when progesterone was given for 8 weeks or discontinued immediately after a successful pregnancy.
Research suggests that Luteal Support & Adjuvants should be included in any regulated hyperstimulation strategy. HCG is the same as progesterone deficiency, but it's linked to a higher risk of hyperstimulation syndrome. Intramuscular progesterone appears to increase the likelihood of conception; nevertheless, the negative effects of intramuscular progesterone make local vaginal progesterone cream or suppository the most popular type used by patients.