The curious case of premature luteinization

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization
• Clinical Obstetrics and Gynecology

Background:

• Premature luteinization (PL) occurs in 12.3-46.7% of fresh IVF cycles.
• PL is linked to reduced success rates in assisted reproductive technologies.
• Despite its clinical impact, PL lacks a clear definition and understanding.

Purpose of the Study:

• To provide a comprehensive overview of premature luteinization.
• To re-evaluate fundamental aspects of PL, including pathogenesis and clinical implications.
• To identify areas for future research and standardization in PL studies.

Main Methods:

• A comprehensive literature search was performed in major databases (PubMed, Embase, Medline) from 1978 to January 2018.
• References of relevant studies were cross-checked.
• Meeting proceedings from key reproductive societies were hand-searched.

Main Results:

• The review discusses the pathogenesis, definition, measurement techniques, clinical effects, and management of PL.
• Controversies surrounding PL are highlighted, with suggestions for future research directions.
• The need for a re-evaluation of PL from its fundamental aspects is emphasized.

Conclusions:

• Standardization of terminology, progesterone cut-offs, and measurement methods is essential for scientific dialogue on PL.
• Future research should explore tailored approaches for specific patient profiles.
• Continuous progesterone monitoring may offer better insights than single measurements; RCTs are needed to confirm optimal PL management strategies.