Abstract
In the United Kingdom, between 2012 and 2017 the annual number of frozen-thawed embryo replacement (FER) cycles doubled, while fresh cycles declined. With FER now accounting for 34% of IVF cycles, the aim of this UK-wide survey of IVF clinics was to determine current trends in the management of FER. A senior clinician in each of the 84 UK IVF clinics was asked to complete an online survey between September 2018 and February 2019 focussing on their clinic’s first-line protocols for FER. Sixty-five clinics (77%) responded, accounting for approximately 24,419 FER cycles annually. In ovulatory women, 69% of clinics favour medicated, 26% natural cycle and 5% modified natural cycle FER. In medicated FER, 61% of clinics undertake blastocyst transfer on the sixth day of progesterone administration, 21% on the fifth, 13% on the seventh, 3% on the fourth and 2% on the third. The preferred route of progesterone in medicated FER is vaginal, favoured by 82% of clinics. For pituitary suppression, 55% of clinics favour GnRH-agonist, 11% GnRH-antagonist and 34% oestrogen-only. In natural cycle FER, 31% always, 44% sometimes and 25% never give supplementary luteal support. In summary, the results illustrate wide variation in practice and highlight key research priorities.
Acknowledgement
The authors thank all those who took the time to complete the survey.
Disclosure statement
No potential conflict of interest was reported by the authors.