title: Treatment of luteal phase defects in assisted reproduction.
abstract: Abnormal luteal function is a common issue in assisted reproduction techniques associated with ovarian stimulation probably due to low levels of LH in the middle and in the late luteal phase. This defect seems to be associated with supraphysiological steroid levels at the end of follicular phase. The luteal phase insufficiency has not got a diagnostic test which has proven reliable in a clinical setting. Luteal phase after ovarian stimulation becomes shorter and insufficient, resulting in lower pregnancy rates. Luteal phase support with progesterone or hCG improves pregnancy outcomes and no differences are found among different routes of administration. However, hCG increases the risk of ovarian hyperstimulation syndrome. In relation to the length of luteal support, the day of starting it remains controversial and it does not seem necessary to continue once a pregnancy has been established. After GnRHa triggering ovulation, intensive luteal support or hCG bolus can overcome the defect in luteal phase, but more studies are needed to show the LH utility as support.
authors.affiliation: IVI Vigo, Reproductive Medicine Unit, Vigo, Spain. elkin.munoz@ivi.es
authors.forename: Elkin
authors.initials: E
authors.lastname: Muñoz
authors.forename: Esther
authors.initials: E
authors.lastname: Taboas
authors.forename: Susana
authors.initials: S
authors.lastname: Portela
authors.forename: Jesús
authors.initials: J
authors.lastname: Aguilar
authors.forename: Iria
authors.initials: I
authors.lastname: Fernandez
authors.forename: Luis
authors.initials: L
authors.lastname: Muñoz
authors.forename: Ernesto
authors.initials: E
authors.lastname: Bosch
mesh_terms: D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use; D004958:Estradiol / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D008183:Luteal Phase / Q000187:drug effects / Q000502:physiology*; D016471:Ovarian Hyperstimulation Syndrome / Q000188:drug therapy*; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; C083781:LHRH, Ala(6)-Gly(10)-ethylamide-