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Related Experiment Videos

Luteal phase after ovarian hyperstimulation.

I E Messinis, A Templeton, D T Baird

    British Journal of Obstetrics and Gynaecology
    |April 1, 1987
    PubMed
    Summary
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    Superovulation treatments using clomiphene with gonadotropins (hMG or FSH) disrupted the luteal phase in women undergoing in-vitro fertilization. Higher estrogen levels correlated with shorter luteal phases and lower progesterone levels.

    Area of Science:

    • Reproductive Endocrinology
    • In-Vitro Fertilization (IVF)

    Background:

    • The luteal phase is crucial for successful implantation in assisted reproductive technologies.
    • Superovulation protocols aim to increase oocyte yield but can potentially impact luteal phase function.

    Purpose of the Study:

    • To investigate the impact of different superovulation protocols on luteal phase function in women undergoing IVF.
    • To determine if combination therapies (clomiphene with hMG or FSH) affect luteal phase hormonal profiles and duration compared to clomiphene alone.

    Main Methods:

    • 17 women with normal menstrual cycles and tubal infertility were studied during an IVF program.
    • Three superovulation regimens were used: clomiphene alone, clomiphene plus pulsatile human menopausal gonadotrophin (hMG), and clomiphene plus pulsatile follicle stimulating hormone (FSH).

    Related Experiment Videos

  • Follicle aspiration occurred 34-36 hours post-LH surge; urinary estrogen and pregnanediol levels, and luteal phase duration were measured.

    • Main Results:

    • Combination treatments (clomiphene/hMG or clomiphene/FSH) resulted in significantly higher urinary estrogen levels during the early luteal phase.
    • These combination treatments also led to a significantly shorter luteal phase duration and lower luteal levels of urinary pregnanediol (a progesterone metabolite).
    • A significant negative correlation was observed between mid-luteal pregnanediol levels/luteal phase duration and estrogen levels (urinary and plasma) during both follicular and luteal phases.

    Conclusions:

    • Superovulation with clomiphene combined with hMG or FSH disrupts normal luteal phase function in IVF cycles.
    • Elevated circulating estrogen levels associated with these combination therapies appear to be responsible for the impaired luteal function.
    • This disruption may negatively affect implantation and pregnancy rates in IVF patients.