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Luteal phase support in assisted reproductive technology.

Akanksha Garg1,2, Agata P Zielinska1,2, Arthur C Yeung1,2

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Luteal phase support in in vitro fertilization (IVF) is crucial but poorly understood. This review clarifies progesterone

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Area of Science:

  • Reproductive Endocrinology
  • In Vitro Fertilization
  • Embryology

Background:

  • Infertility affects 1 in 6 couples, with IVF being a common treatment.
  • IVF ovarian stimulation disrupts the natural luteal phase, impairing implantation and pregnancy.
  • Current luteal phase support protocols lack clear optimal parameters.

Purpose of the Study:

  • To review existing evidence on luteal phase support in IVF.
  • To identify uncertainties and future research directions in optimizing progesterone supplementation.
  • To inform evidence-based protocols for luteal phase support.

Main Methods:

  • Literature review of physiological luteal phase and IVF-induced alterations.
  • Evaluation of hormonal triggers' impact on luteal phase support needs.
  • Analysis of endometrial receptivity markers and progesterone pharmacokinetics.

Main Results:

  • Supraphysiological ovarian stimulation in IVF leads to a dysfunctional luteal phase.
  • Hormonal triggers for oocyte maturation influence the required luteal phase support.
  • Understanding endometrial transformation and progesterone's role is key to optimizing support.

Conclusions:

  • Luteal phase support with progesterone is essential in IVF but requires further optimization.
  • Clarifying optimal timing, dosage, route, and duration of progesterone is critical.
  • Future research should focus on personalized luteal phase support strategies.