Date: {{$ActivityAssignDate}}

Dear Dr. {{$doctorName}},

Subject: To understand the role of natural progesterone for prevention of spontaneous preterm delivery and as luteal phase support during assisted reproductive technology in real-life clinical practice.

Spontaneous preterm birth is the single most important cause of perinatal morbidity and mortality. The rate is increasing world-wide with a great disparity between low, middle and high income countries. It has been estimated that the cost of neonatal care for preterm babies is more than 4 times that of a term neonate admitted into the neonatal care. Furthermore, there are high costs associated with long-term morbidity in those who survive the neonatal period. Interventions to stop delivery once preterm labor starts are largely ineffective hence the best approach to reducing the rate and consequences is prevention. This is either primary (reducing or minimizing factors associated with preterm birth prior to and during pregnancy) or secondary - identification and amelioration (if possible) of factors in pregnancy that are associated with preterm labor.

Following continued development, assisted reproductive technology (ART) procedures now have enormous potential as a tool for treating infertility. Success rates in ART are dependent on both medical management and patient characteristics. Personalized management strategies have been proposed to optimize efficacy and safety outcomes. Furthermore, a personalized approach, encompassing shared decision-making between patients and clinicians, could help to alleviate the psychological burden associated with treatment. Such strategies may have the added benefit of reducing discontinuation rates.

We have planned this survey to understand the role of natural progesterone for prevention of spontaneous preterm delivery and as luteal phase support during assisted reproductive technology in real-life clinical practice.

We invite you to participate in this survey by responding to the survey questions and sharing your opinion on the role of natural progesterone for prevention of spontaneous preterm delivery and as luteal phase support during assisted reproductive technology in your routine clinical practice.

We trust you and we are partners in ensuring safe and effective drug therapy. In that spirit we hope you will consent to participate in this survey.