Title:Treatment of Luteal Phase Defects in Assisted Reproduction
Volume: 14
Issue: 8
Author(s): Elkin Munoz, Esther Taboas, Susana Portela, Jesus Aguilar, Iria Fernandez, Luis Munoz and Ernesto Bosch
Affiliation:
Keywords:
Assisted reproduction treatments, GnRH agonist triggering, hCG, LH, luteal phase support, progesterone.
Abstract: Abnormal luteal function is a common issue in assisted reproduction techniques associated with ovarian stimulation
probably due to low levels of LH in the middle and in the late luteal phase. This defect seems to be associated with
supraphysiological steroid levels at the end of follicular phase. The luteal phase insufficiency has not got a diagnostic test
which has proven reliable in a clinical setting. Luteal phase after ovarian stimulation becomes shorter and insufficient, resulting
in lower pregnancy rates. Luteal phase support with progesterone or hCG improves pregnancy outcomes and no
differences are found among different routes of administration. However, hCG increases the risk of ovarian hyperstimulation
syndrome. In relation to the length of luteal support, the day of starting it remains controversial and it does not seem
necessary to continue once a pregnancy has been established. After GnRHa triggering ovulation, intensive luteal support
or hCG bolus can overcome the defect in luteal phase, but more studies are needed to show the LH utility as support.
