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What is the optimal luteal support in assisted reproductive technology?

  • Nathalie F. Wang , Leif Bungum and Sven O. Skouby EMAIL logo
Published/Copyright: February 22, 2021
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Hormone Molecular Biology and Clinical Investigation
From the journal Hormone Molecular Biology and Clinical Investigation Volume 43 Issue 2

Abstract

The need for luteal phase support in IVF/ICSI is well established. A large effort has been made in the attempt to identify the optimal type, start, route, dosage and duration of luteal phase support for IVF/ICSI and frozen embryo transfer. These questions are further complicated by the different types of stimulation protocols and ovulation triggers used in ART. The aim of this review is to supply a comprehensive overview of the available types of luteal phase support, and the indications for their use.

A review of the literature was carried out in the effort to find the optimal luteal phase support regimen with regards to pregnancy related outcomes and short and long term safety.

The results demonstrate that vaginal, intramuscular, subcutaneous and rectal progesterone are equally effective as luteal phase support in IVF/ICSI. GnRH agonists and oral dydrogesterone are new and promising treatment modalities but more research is needed. hCG and estradiol are not recommended for luteal phase support. More research is needed to establish the most optimal luteal phase support in frozen embryo transfer cycles, but progesterone has been shown to improve live birth rate in some studies. Luteal phase support should be commenced between the evening of the day of oocyte retrieval, and day three after oocyte retrieval and it should be continued at least until the day of positive pregnancy test.

So, in conclusion still more large and well-designed RCT’s are needed to establish the most optimal luteal phase support in each stimulation protocol, and especially in frozen embryo transfer.

Keywords: assisted reproductive technology; IVF/ICSI; luteal phase support; progesterone; progesterone support
Corresponding author: Sven O. Skouby, Department of Gynaecology and Obstetrics, Unit of Reproductive Medicine, Herlev/Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, DK 2730 Herlev, Denmark, Phone: +45 3868 3796, E-mail:

  1. Research funding: Authors state no funding involved.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2020-11-15
Accepted: 2021-01-16
Published Online: 2021-02-22

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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  2. Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
  3. Review Articles
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  10. Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
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  15. Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
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https://doi.org/10.1515/hmbci-2020-0081
Keywords for this article
assisted reproductive technology; IVF/ICSI; luteal phase support; progesterone; progesterone support

Articles in the same Issue

  1. Frontmatter
  2. Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
  3. Review Articles
  4. The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation
  5. A narrative review of functional outcomes following nerve-sparing surgery for deeply infiltrating endometriosis
  6. Appropriate surgical management of ovarian endometrioma: excision or drainage?
  7. Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment
  8. Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection
  9. Endometriosis at all ages: diagnostic ultrasound
  10. Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
  11. Opinion Paper
  12. Quality of life and sexual dysfunction in gynaecological cancer patients: a psychosomatic approach
  13. Review Articles
  14. Fertility preservation in women with early ovarian cancer
  15. Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
  16. Fertility preservation in borderline ovarian tumor patients and survivors
  17. Regular Issue
  18. Original Articles
  19. Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations
  20. miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma
  21. Combination therapy of calcitriol inhibits the proliferation of breast cancer cells: new concept of nonclassical function of calcitriol
  22. The change pattern in serum G protein-coupled estrogen receptor-1 (GPER1) levels during pregnancy with and without gestational diabetes mellitus
  23. Effects of Helichrysum Psudoplicatum supplementation on pruritus intensity, fatigue, quality of life and anorexia in hemodialysis patients: a randomized, double-blind placebo-controlled trial
  24. The anticancer and free radical scavenging potential of the Unani medicine Agaricus albus L.
  25. Review Articles
  26. What is the optimal luteal support in assisted reproductive technology?
  27. The relation between obesity, kisspeptin, leptin, and male fertility
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