title: Luteal phase support for in vitro fertilization-embryo transfer--present and future methods to improve successful implantation.
abstract: OBJECTIVE
  To present reasons for luteal phase deficiency when taking controlled ovarian hyperstimulation (COH) for purposes of inducing multiple oocytes for in vitro fertilization (IVF), and to suggest strategies to overcome the defect.
  
  
  METHODS
  Treatment options presented include luteal phase support with human chorionic gonadotropin (hCG) injection, progesterone, estradiol, gonadotropin releasing hormone agonists, cytokines, e.g., granulocyte colony stimulating factor, and lymphocyte immunotherapy.
  
  
  RESULTS
  hCG and progesterone produce the best results and are comparable or at best a slight edge to hCG but the latter is associated with too high a risk for ovarian hyperstimulation syndrome. Vaginal progesterone is the most efficacious with the least side-effects.
  
  
  CONCLUSIONS
  Better methods are needed to adequately assess full correction of the luteal phase defect. In some cases the luteal phase defect associated with COH is not correctable and FSH stimulation should be reduced or all embryos frozen and defer transfer to an artificial estrogen progesterone or natural cycle.
authors: J H
authors: JH
authors: Check
mesh_terms: D003338:Corpus Luteum / Q000502:physiology*; D003340:Corpus Luteum Maintenance / Q000502:physiology; D016207:Cytokines / Q000627:therapeutic use; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects* / Q000502:physiology*; D054315:Oocyte Retrieval; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D011247:Pregnancy; D011374:Progesterone / Q000627:therapeutic use; D011372:Progestins / Q000627:therapeutic use
chemical_list: D016207:Cytokines; D011372:Progestins; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone