Orvieto · Frontiers in endocrinology 2021 · Delphi consensus study · n=35

Optimising Follicular Development, Pituitary Suppression, Triggering and Luteal Phase Support During Assisted Reproductive Technology: A Delphi Consensus.

Cited 50 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Delphi expert consensus panel without primary experimental or trial data

PubMed 34040586 · doi:10.3389/fendo.2021.675670 · record verified 2026-08-26

What was done

A Delphi consensus process was conducted to evaluate expert opinions on assisted reproductive technology (ART). Ten experts and a Scientific Coordinator drafted and refined clinical statements, which were then distributed via an online survey to 35 international experts. Consensus was predefined as >66% agreement or disagreement on each statement across four domains: follicular stimulation, pituitary suppression, oocyte triggering, and luteal-phase support.

What was found

Consensus (>66%) was reached on all 18 developed statements. Key agreements included: recombinant human FSH (r-hFSH) alone is sufficient for normogonadotropic women under 35 years; r-hFSH plus r-hLH improves pregnancy rates over human menopausal gonadotropin in severe gonadotropin deficiency; GnRH antagonists lower OHSS and cycle cancellation rates compared to agonists; hCG remains the standard trigger in fresh cycles, while GnRH agonist triggering is recommended for women at risk of OHSS; and vaginal progesterone represents the gold standard for luteal-phase support. Specific voting percentages and numerical effect sizes were not reported in the abstract.

Why it matters

This consensus provides structured clinical guidance from international specialists to standardize key treatment steps in ART cycles where empirical trial evidence may be varied or nuanced.

Limits

The findings represent expert opinion rather than primary clinical trial data. Specific consensus percentages, vote distributions, and effect sizes are absent from the abstract. The panel was limited to 35 surveyed experts, introducing potential geographical and practice-pattern selection bias.

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