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Luteal Support: What to Use When?

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Principles and Practice of Controlled Ovarian Stimulation in ART

Abstract

Supraphysiological hormonal profiles are the cause of luteal defect observed in stimulated IVF cycles. Hence it is essential to support the luteal phase in stimulated cycles for which different forms of support are available. Progesterone and human chorionic gonadotropins (hCGs) so far have been the ideal supports for pregnancy. HCG results in higher incidence of ovarian hyperstimulation. Luteal phase support with progesterone results in increase in implantation and pregnancy rates. For now, progesterone seems to be the best option as luteal phase support. Oral progesterone is associated with reduced bioavailablity. Vaginal progesterone is associated with increased at-site concentration.

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References

  1. Zhao Y, Zacur H, Cheadle C, Ning N, Fan J, Vlahos NF. Effect of luteal-phase support on endometrial microRNA expression following controlled ovarian stimulation. Reprod Biol Endocrinol. 2012;6(10):72.

    Article  Google Scholar 

  2. Miyake A, Aono T, Kinugasa T, Tanizawa O, Kurachi K. Suppression of serum levels of luteinizing hormone by short- and long-loop negative feedback in ovariectomized women. J Endocrinol. 1979;80(3):353–6.

    Article  CAS  PubMed  Google Scholar 

  3. Fauser BC, Devroey P. Reproductive biology and IVF: ovarian stimulation and luteal phase consequences. Trends Endocrinol Metab. 2003;14(5):236–42.

    Article  CAS  PubMed  Google Scholar 

  4. Jones GS. Luteal phase defect: a review of pathophysiology. Curr Opin Obstet Gynecol. 1991;3(5):641–8.

    Article  CAS  PubMed  Google Scholar 

  5. Beckers NG, Macklon NS, Eijkemans MJ, Ludwig M, Felberbaum RE, Diedrich K, et al. Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment. J Clin Endocrinol Metab. 2003;88(9):4186–92.

    Article  CAS  PubMed  Google Scholar 

  6. Bulletti C, de Ziegler D. Uterine contractility and embryo implantation. Curr Opin Obstet Gynecol. 2006;18(4):473–84. Review.

    Article  PubMed  Google Scholar 

  7. Kleinstein J. Efficacy and tolerability of vaginal progesterone capsules (Utrogest 200) compared with progesterone gel (Crinone 8%) for luteal phase support during assisted reproduction. Fertil Steril. 2005;83(6):1641–9.

    Article  CAS  PubMed  Google Scholar 

  8. Chakravarty BN, Shirazee HH, Dam P, Goswami SK, Chatterjee R, Ghosh S. Oral dydrogesterone versus intravaginal micronised progesterone as luteal phase support in assisted reproductive technology (ART) cycles: results of a randomized study. J Steroid Biochem Mol Biol. 2005;97(5):416–20.

    Article  CAS  PubMed  Google Scholar 

  9. Pritts EA, Atwood AK. Luteal phase support in infertility treatment: a meta-analysis of the randomized trials. Hum Reprod. 2002;17:2287–99.

    Article  CAS  PubMed  Google Scholar 

  10. Cicinelli E, Schonauer LM, Galantino P, Matteo MG, Cassetta R, Pinto V. Mechanisms of uterine specificity of vaginal progesterone. Hum Reprod. 2000;15 Suppl 1:159–65.

    Article  CAS  PubMed  Google Scholar 

  11. de Ziegler D, Seidler L, Scharer E, Bouchard P. Non-oral administration of progesterone: experiences and possibilities of the transvaginal route. Schweiz Rundsch Med Prax. 1995;84(5):127–33.

    Google Scholar 

  12. Zarutskie PW, Phillips JA. A meta-analysis of the route of administration of luteal phase support in assisted reproductive technology: vaginal versus intramuscular progesterone. Fertil Steril. 2009;92(1):163–9.

    Article  CAS  PubMed  Google Scholar 

  13. Ludwig M, Schwartz P, Babahan B, Katalinic A, Weiss JM, Felberbaum R, Al-Hasani S, Diedrich K. Luteal phase support using either Crinone 8% or Utrogest: results of a prospective, randomized study. Eur J Obstet Gynecol Reprod Biol. 2002;103(1):48–52.

    Article  CAS  PubMed  Google Scholar 

  14. Honda T, Fujiwara H, Yamada S, Fujita K, Nakamura K, Nakayama T, et al. Integrin a5 is expressed on human luteinizing granulosa cells during corpus luteum formation, and its expression is enhanced by human chorionic gonadotrophin in vitro. Mol Hum Reprod. 1997;3(11):979–84.

    Article  CAS  PubMed  Google Scholar 

  15. Buvat J, Marcolin G, Guittard C, Dehaene JL, Herbaut JC, Louvet AL. [Luteal support after administration of an LHRH analog for in vitro fertilization]. Superiority of vaginal progesterone in comparison with oral progesterone. Presse Med. 1990;19(11):527.

    CAS  PubMed  Google Scholar 

  16. Araujo Jr E, Bernardini L, Frederick JL, Asch RH, Balmaceda JP. Prospective randomized comparison of human chorionic gonadotropin versus intramuscular progesterone for luteal-phase support in assisted reproduction. J Assist Reprod Genet. 1994;11(2):74–8.

    Article  PubMed  Google Scholar 

  17. van der Linden M, Buckingham K, Farquhar C, Kremer JAM, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2011;(10):CD009154. doi:10.1002/14651858.CD009154.pub2.

  18. Kolibianakis EM, Venetis CA, Papanikolaou EG, Diedrich K, Tarlatzis BC. Estrogen addition to progesterone for luteal phase support in cycles stimulated with GnRH analogues and gonadotrophins for IVF: a systematic review and meta-analysis. Hum Reprod. 2008;23(6):1346–54.

    Article  CAS  PubMed  Google Scholar 

  19. Gelbaya TA, Kyrgiou M, Tsoumpou I, Nardo LG. The use of estradiol for luteal phase support in in vitro fertilization/intracytoplasmic sperm injection cycles: a systematic review and meta-analysis. Fertil Steril. 2008;90(6):2116–25.

    Article  PubMed  Google Scholar 

  20. Bueno MJ, Pérez de Castro I, Malumbres M. Control of cell proliferation pathways by microRNAs. Cell Cycle. 2008;7(20):3143–8.

    Article  CAS  PubMed  Google Scholar 

  21. Tesarik J, Hazout A, Mendoza-Tesarik R, Mendoza N, Mendoza C. Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles. Hum Reprod. 2006;21(10):2572–9.

    Article  CAS  PubMed  Google Scholar 

  22. Oliveira JB, Baruffi R, Petersen CG, Mauri AL, Cavagna M, Franco Jr JG. Administration of single-dose GnRH agonist in the luteal phase in ICSI cycles: a meta-analysis. Reprod Biol Endocrinol. 2010;8:107.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Kyrou D, Kolibianakis EM, Fatemi HM, Tarlatzi TB, Devroey P, Tarlatzis BC. Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: a systematic review and meta-analysis. Hum Reprod Update. 2011;17(6):734–40.

    Article  CAS  PubMed  Google Scholar 

  24. Pirard C, Donnez J, Loumaye E. GnRH agonist as novel luteal support: results of a randomized, parallel group, feasibility study using intranasal administration of buserelin. Hum Reprod. 2005;20(7):1798–804.

    Article  CAS  PubMed  Google Scholar 

  25. Griesinger G, Franke K, Kinast C, Kutzelnigg A, Riedinger S, Kulin S, et al. Ascorbic acid supplement during luteal phase in IVF. J Assist Reprod Genet. 2002;19(4):164–8.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Ubaldi F, Rienzi L, Ferrero S, Anniballo R, Iacobelli M, Cobellis L, Greco E. Low dose prednisolone administration in routine ICSI patients does not improve pregnancy and implantation rates. Hum Reprod. 2002;17(6):1544–7.

    Article  CAS  PubMed  Google Scholar 

  27. Okuda K, Miyamoto Y, Skarzynski DJ. Regulation of endometrial prostaglandin F(2alpha) synthesis during luteolysis and early pregnancy in cattle. Domest Anim Endocrinol. 2002;23(1–2):255–64.

    Article  CAS  PubMed  Google Scholar 

  28. Wada I, Hsu CC, Williams G, Macnamee MC, Brinsden PR. The benefits of low-dose aspirin therapy in women with impaired uterine perfusion during assisted conception. Hum Reprod. 1994;9(10):1954–7.

    CAS  PubMed  Google Scholar 

  29. Hurst BS, Bhojwani JT, Marshburn PB, Papadakis MA, Loeb TA, Matthews ML. Low-dose aspirin does not improve ovarian stimulation, endometrial response, or pregnancy rates for in vitro fertilization. J Exp Clin Assist Reprod. 2005;2:8.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Geva E, Amit A, Lerner-Geva L, Yaron Y, Daniel Y, Schwartz T, et al. Prednisone and aspirin improve pregnancy rate in patients with reproductive failure and autoimmune antibodies: a prospective study. Am J Reprod Immunol. 2000;43(1):36–40.

    Article  CAS  PubMed  Google Scholar 

  31. Takasaki A, Tamura H, Taniguchi K, Asada H, Taketani T, Matsuoka A, et al. Luteal blood flow and luteal function. J Ovarian Res. 2009;2:1.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Sher G, Fisch JD. Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. Fertil Steril. 2002;78(5):1073–6.

    Article  PubMed  Google Scholar 

  33. Baruffi R, Mauri AL, Petersen CG, Felipe V, Franco Jr JG. Effects of vaginal progesterone administration starting on the day of oocyte retrieval on pregnancy rates. J Assist Reprod Genet. 2003;20(12):517–20.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Mochtar MH, Van Wely M, Van der Veen F. Timing luteal phase support in GnRH agonist down-regulated IVF/embryo transfer cycles. Hum Reprod. 2006;21(4):905–8.

    Article  CAS  PubMed  Google Scholar 

  35. Schmidt KL, Ziebe S, Popovic B, Lindhard A, Loft A, Andersen AN. Progesterone supplementation during early gestation after in vitro fertilization has no effect on the delivery rate. Fertil Steril. 2001;75(2):337–41.

    Article  CAS  PubMed  Google Scholar 

  36. Nyboe AA, Popovic-Todorovic B, Schmidt KT, Loft A, Lindhard A, Hojgaard A, Ziebe S, Hald F, Hauge B, Toft B. Progesterone supplementation during early gestations after IVF or ICSI has no effect on the delivery rates: a randomized controlled trial. Hum Reprod. 2002;17(2):357–61.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Nova IVI Fertility Clinics, New Delhi, Delhi, India

    Sandeep Talwar MBBS, DNB

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  1. Sandeep Talwar MBBS, DNB
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Correspondence to Sandeep Talwar MBBS, DNB .

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Editors and Affiliations

  1. Director, IVF & Reproductive Medicine, Department of Obstetrics and Gynecology, MAX Multispecialty Hospitals, New Delhi, India

    Surveen Ghumman

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© 2015 Springer India

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Talwar, S. (2015). Luteal Support: What to Use When?. In: Ghumman, S. (eds) Principles and Practice of Controlled Ovarian Stimulation in ART. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1686-5_22

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  • DOI: https://doi.org/10.1007/978-81-322-1686-5_22

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-1685-8

  • Online ISBN: 978-81-322-1686-5

  • eBook Packages: MedicineMedicine (R0)

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