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Chapter 4 - Individualized Luteal Phase Support

Published online by Cambridge University Press:  12 February 2021

Human M. Fatemi
IVI Middle East Fertility Clinic, Abu Dhabi, UAE
Barbara Lawrenz
IVI Middle East Fertility Clinic, Abu Dhabi, UAE
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In ovarian stimulation cycles for IVF/ICSI, a defective luteal phase occurs in almost all patients as a result of the multifollicular development and supraphysiological hormonal levels, which inhibit the LH secretion by the pituitary via negative feedback actions at the level of the hypothalamic-pituitary axis. Progesterone is crucial to induce secretory transformation of the endometrium after previous estrogenization, a process which will finally result in a receptive endometrium. Consequently, luteal phase support (LPS) represents an essential part of ART treatment in case of a planned fresh embryo transfer, as it is crucial to counterbalance the luteal phase insufficiency.

Individualized In-Vitro Fertilization
Delivering Precision Fertility Treatment
, pp. 39 - 49
Publisher: Cambridge University Press
Print publication year: 2021

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Filicori, M, Santoro, N, Merriam, GR, et al. Characterization of the physiological pattern of episodic gonadotropin secretion throughout the human menstrual cycle. J Clin Endocrinol Metab 1986;62:11361144.CrossRefGoogle ScholarPubMed
Kolibianakis, EM, Devroey, P. The luteal phase after ovarian stimulation. Reprod Biomed Online 2002a;5:2635.CrossRefGoogle ScholarPubMed
Fatemi, HM. The luteal phase after 3 decades of IVF: what do we know? Reprod Biomed Online 2009;19(Suppl 4):4331.CrossRefGoogle ScholarPubMed
Ludwig, M, Doody, KJ, Doody, KM. Use of recombinant human chorionic gonadotropin in ovulation induction. Fertil Steril 2003;79(5):10511059.Google Scholar
Gonen, Y, Balakier, H, Powell, W, et al. Use of gonadotropin-releasing hormone agonist to trigger follicular maturation for in vitro fertilization. J Clin Endocrinol Metab 1990;71:918922.CrossRefGoogle ScholarPubMed
Tannus, S, Burke, Y, McCartney, CR, et al. GnRH-agonist triggering for final oocyte maturation in GnRH-antagonist IVF cycles induces decreased LH pulse rate and amplitude in early luteal phase: a possible luteolysis mechanism. Gynecol Endocrinol 2017. [Epub ahead of print]CrossRefGoogle Scholar
Fatemi, HM, Polyzos, NP, van Vaerenbergh, I, et al. Early luteal phase endocrine profile is affected by the mode of triggering final oocyte maturation and the luteal phase support used in recombinant follicle-stimulating hormone–gonadotropin-releasing hormone antagonist in vitro fertilization cycles. Fertil Steril 2013;100:742747.CrossRefGoogle ScholarPubMed
Lawrenz, B, Garrido, N, Samir, S, et al. Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation. PLoS One 2017;12(5):e0176600.CrossRefGoogle ScholarPubMed
Devroey, P, Polyzos, NP, Blockeel, C. An OHSS-free clinic by segmentation of IVF treatment. Hum Reprod 2011;26:25932597.Google Scholar
Simon, C, Martın, JC, Pellicer, A. Paracrine regulators of implantation. Baillieres Best Pract Res Clin Obstet Gynaecol 2000;14:815826.CrossRefGoogle ScholarPubMed
Psychoyos, A. Hormonal control of ovoimplantation. Vitam Horm 1973;31:201256.CrossRefGoogle ScholarPubMed
Giudice, LC. Genes associated with embryonic attachment and implantation and the role of progesterone. J Reprod Med 1999;44:165171.Google ScholarPubMed
Kodaman, P, Taylor, H. Hormonal regulation of implantation. Obstet Gynecol Clin N Am 2004;31:745766.CrossRefGoogle ScholarPubMed
Díaz-Gimeno, P, Horcajadas, JA, Martínez-Conejero, JA, et al. A genomic diagnostic tool for human endometrial receptivity based on the transcriptomic signature. Fertil Steril 2011;95(1):5060.CrossRefGoogle ScholarPubMed
Jordan, J, Craig, K, Clifton, DK, et al. Luteal phase defect: the sensitivity and specificity of diagnostic methods in common clinical use. Fertil Steril 1994;62(1):5462.CrossRefGoogle ScholarPubMed
Jones, GES. Some new aspects of management of infertility. JAMA 1979;141:1123.Google Scholar
Practice Committee of the American Society for Reproductive Medicine. Current clinical irrelevance of luteal phase deficiency: a committee opinion. Fertil Steril 2015;103:e2733.CrossRefGoogle Scholar
Devroey, P, Palermo, G, Bourgain, C, et al. Progesterone administration in patients with absent ovaries. Int J Fertil 1989;34:188193.Google ScholarPubMed
Griesinger, G, Blockeel, C, Tournaye, H. Oral dydrogesterone for luteal phase support in fresh in vitro fertilization cycles: a new standard? Fertil Steril 2018;109(5):756762.CrossRefGoogle ScholarPubMed
Andersen, CY, Fischer, R, Giorgione, V, et al. Micro-dose hCG as luteal phase support without exogenous progesterone administration: mathematical modelling of the hCG concentration in circulation and initial clinical experience. J Assist Reprod Genet 2016;33(10):13111318.Google Scholar
van der Linden, M, Buckingham, K, Farquhar, C, et al. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev 2015;7(7):CD009154.Google Scholar
Humaidan, P, Bredkjaer, HE, Bungum, L, et al. GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study. Hum Reprod 2005;20:12131220.Google Scholar
Kol, S, Breyzman, T, Segal, L, et al. “Luteal coasting” after GnRH agonist trigger – individualized, HCG-based, progesterone-free luteal support in “high responders”: a case series. RBMonline 2015;31:747751.Google ScholarPubMed
Lawrenz, B, Samir, S, Garrido, N, et al. Luteal coasting and individualization of human chorionic gonadotropin dose after gonadotropin-releasing hormone agonist triggering for final oocyte maturation – a retrospective proof-of-concept study. Front Endocrinol (Lausanne) 2018;15(9):33.CrossRefGoogle Scholar
Connell, MT, Szatkowski, JM, Terry, N, et al. Timing luteal support in assisted reproductive technology: a systematic review. Fertil Steril 2015;103:939946.CrossRefGoogle ScholarPubMed
Nyboe, AA, Popovic-Todorovic, B, Schmidt, KT, et al. Progesterone supplementation during early gestations after IVF or ICSI has no effect on the delivery rates: a randomized controlled trial. Hum Reprod 2002;17:357361.CrossRefGoogle Scholar

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