Skip to main content

Luteal Phase Support in ART Treatments

  • Protocol
  • First Online:

Part of the book series: Methods in Molecular Biology ((MIMB,volume 1154))

Abstract

In a normal spontaneous menstrual cycle, the luteal phase is characterized by the production and secretion of estradiol (E) and progesterone (P) from the corpus luteum (CL) in an episodic manner. The steroidogenesis of the CL is dependent on continued tonic luteinizing hormone (LH) secretion (Fritz and Speroff, Clinical gynecologic endocrinology and infertility, 8th edn. Wolters Kluwer, Lippincott Williams & Wilkins, Philadelphia, 2011). The dependence of the CL was further supported by the prompt luteolysis that followed the administration of GnRH analogues or withdrawal of GnRH when ovulation has been induced by the administration of pulsatile GnRH (Hutchison and Zeleznik, Endocrinology 115:1780–1786, 1984; Fraser et al., Hum Reprod 12:430–435, 1997). Progesterone concentrations normally rise sharply after ovulation, reaching a peak approximately 8 days after the LH surge. Since the secretion of E and P during the luteal phase is episodic and correlates closely with LH pulses, relatively low mid-luteal progesterone levels can be found in the course of a totally normal luteal phase (Fritz and Speroff, Clinical gynecologic endocrinology and infertility, 8th edn. Wolters Kluwer, Lippincott Williams & Wilkins, Philadelphia, 2011).

This is a preview of subscription content, log in via an institution.

Buying options

Protocol
USD   49.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Springer Nature is developing a new tool to find and evaluate Protocols. Learn more

References

  1. Fritz MA, Speroff L (2011) Clinical gynecologic endocrinology and infertility, 8th edn. Wolters Kluwer, Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  2. Edwards RG, Steptoe PC, Purdy JM (1980) Establishing full-term human pregnancies using cleaving embryos grown in vitro. Br J Obstet Gynaecol 87(9):737–756

    Article  PubMed  CAS  Google Scholar 

  3. Check JH et al (1987) The efficacy of progesterone in achieving successful pregnancy: I. Prophylactic use during luteal phase in anovulatory women. Int J Fertil 32(2):135–138

    PubMed  CAS  Google Scholar 

  4. Check JH, Chase JS, Nowroozi K, Nazari A (1989) Ovulation induction and pregnancies in women with ovarian failure (reversing menopause). In: Parthenon publishing, recent developments in fertility & sterility, proceedings of the XIII World Congress on fertility and sterility, Marrakesh, October 1989, vol 6. pp 43–47

    Google Scholar 

  5. Kerin JF et al (1981) Human luteal phase function following oocyte aspiration from the immediately preovular graafian follicle of spontaneous ovular cycles. Br J Obstet Gynaecol 88(10):1021–1028

    Article  PubMed  CAS  Google Scholar 

  6. Tavaniotou A, Devroey P (2003) Effect of human chorionic gonadotropin on luteal luteinizing hormone concentrations in natural cycles. Fertil Steril 80(3):654–655

    Article  PubMed  Google Scholar 

  7. Smitz J et al (1992) Pituitary gonadotrophin secretory capacity during the luteal phase in superovulation using GnRH-agonists and HMG in a desensitization or flare-up protocol. Hum Reprod 7(9):1225–1229

    PubMed  CAS  Google Scholar 

  8. Albano C et al (1998) The luteal phase of nonsupplemented cycles after ovarian superovulation with human menopausal gonadotropin and the gonadotropin-releasing hormone antagonist Cetrorelix. Fertil Steril 70(2):357–359

    Article  PubMed  CAS  Google Scholar 

  9. Fauser BC, Devroey P (2003) Reproductive biology and IVF: ovarian stimulation and luteal phase consequences. Trends Endocrinol Metab 14(5):236–242

    Article  PubMed  CAS  Google Scholar 

  10. Gardner DK, Weissman A, Howles CM, Shoham Z (eds) (2009) Textbook of assisted reproductive techniques laboratory and clinical perspectives, 3rd edn. Martin Dunitz, London

    Google Scholar 

  11. Leeton J, Trounson A, Jessup D (1985) Support of the luteal phase in in vitro fertilization programs: results of a controlled trial with intramuscular Proluton. J In Vitro Fert Embryo Transf 2(3):166–169

    Article  PubMed  CAS  Google Scholar 

  12. Daya S, Gunby J (2004) Luteal phase support in assisted reproduction cycles. Cochrane Database Syst Rev (3):CD004830

    Google Scholar 

  13. van der Linden M et al (2011) Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev (10):CD009154

    Google Scholar 

  14. Bourgain C et al (1990) Effects of natural progesterone on the morphology of the endometrium in patients with primary ovarian failure. Hum Reprod 5(5):537–543

    PubMed  CAS  Google Scholar 

  15. Zarutskie PW, Phillips JA (2009) A meta-analysis of the route of administration of luteal phase support in assisted reproductive technology: vaginal versus intramuscular progesterone. Fertil Steril 92(1):163–169

    Article  PubMed  CAS  Google Scholar 

  16. Bouckaert Y et al (2004) Acute eosinophilic pneumonia associated with intramuscular administration of progesterone as luteal phase support after IVF: case report. Hum Reprod 19(8):1806–1810

    Article  PubMed  CAS  Google Scholar 

  17. Costabile L et al (2001) A prospective randomized study comparing intramuscular progesterone and 17alpha-hydroxyprogesterone caproate in patients undergoing in vitro fertilization-embryo transfer cycles. Fertil Steril 76(2):394–396

    Article  PubMed  CAS  Google Scholar 

  18. Pritts EA, Atwood AK (2002) Luteal phase support in infertility treatment: a meta-analysis of the randomized trials. Hum Reprod 17(9):2287–2299

    Article  PubMed  CAS  Google Scholar 

  19. Devroey P et al (1989) Progesterone administration in patients with absent ovaries. Int J Fertil 34(3):188–193

    PubMed  CAS  Google Scholar 

  20. Smitz J et al (1992) A prospective randomized comparison of intramuscular or intravaginal natural progesterone as a luteal phase and early pregnancy supplement. Hum Reprod 7(2):168–175

    PubMed  CAS  Google Scholar 

  21. Miles RA et al (1994) Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertil Steril 62(3):485–490

    PubMed  CAS  Google Scholar 

  22. De ZD (1995) Hormonal control of endometrial receptivity. Hum Reprod 10(1):4–7

    Google Scholar 

  23. Roman E et al (2000) Analysis of the bleeding pattern in assisted reproduction cycles with luteal phase supplementation using vaginal micronized progesterone. Hum Reprod 15(7):1435–1439

    Article  PubMed  CAS  Google Scholar 

  24. Gurbuz B et al (2003) Bleeding patterns in women using intramuscular progesterone for luteal support in in-vitro fertilisation cycles. J Obstet Gynaecol 23(3):267–270

    Article  PubMed  CAS  Google Scholar 

  25. Zegers-Hochschild F et al (2000) Prospective randomized trial to evaluate the efficacy of a vaginal ring releasing progesterone for IVF and oocyte donation. Hum Reprod 15(10):2093–2097

    Article  PubMed  CAS  Google Scholar 

  26. Mochtar MH, Van Wely M, Van der Veen F (2006) Timing luteal phase support in GnRH agonist down-regulated IVF/embryo transfer cycles. Hum Reprod 21(4):905–908

    PubMed  CAS  Google Scholar 

  27. Nyboe Andersen A et al (2002) Progesterone supplementation during early gestations after IVF or ICSI has no effect on the delivery rates: a randomized controlled trial. Hum Reprod 17(2):357–361

    Article  PubMed  CAS  Google Scholar 

  28. Aboulghar MA et al (2008) Prospective randomized study comparing luteal phase support for ICSI patients up to the first ultrasound compared with an additional three weeks. Hum Reprod 23(4):857–862

    Article  PubMed  Google Scholar 

  29. Fatemi HM et al (2006) Addition of estradiol to progesterone for luteal supplementation in patients stimulated with GnRH antagonist/rFSH for IVF: a randomized controlled trial. Hum Reprod 21(10):2628–2632

    Article  PubMed  CAS  Google Scholar 

  30. Fatemi HM et al (2007) The luteal phase of recombinant follicle-stimulating hormone/gonadotropin-releasing hormone antagonist in vitro fertilization cycles during supplementation with progesterone or progesterone and estradiol. Fertil Steril 87(3):504–508

    Article  PubMed  CAS  Google Scholar 

  31. Kolibianakis EM et al (2008) Estrogen addition to progesterone for luteal phase support in cycles stimulated with GnRH analogues and gonadotrophins for IVF: a systematic review and meta-analysis. Hum Reprod 23(6):1346–1354

    Article  PubMed  CAS  Google Scholar 

  32. Var T et al (2011) A comparison of the effects of three different luteal phase support protocols on in vitro fertilization outcomes: a randomized clinical trial. Fertil Steril 95(3):985–989

    Article  PubMed  Google Scholar 

  33. Humaidan P, Kol S, Papanikolaou EG, on behalf of the “the Copenhagen GnRH Agonist Triggering Workshop Group” (2011) GnRH agonist for triggering of final oocyte maturation: time for a change of practice? Hum Reprod Update 17(4):510–524

    Article  PubMed  CAS  Google Scholar 

  34. Griesinger G et al (2006) GnRH agonist for triggering final oocyte maturation in the GnRH antagonist ovarian hyperstimulation protocol: a systematic review and meta-analysis. Hum Reprod Update 12(2):159–168

    Article  PubMed  CAS  Google Scholar 

  35. Eldar-Geva T et al (2007) Similar outcome for cryopreserved embryo transfer following GnRH-antagonist/GnRH-agonist, GnRH-antagonist/HCG or long protocol ovarian stimulation. Reprod Biomed Online 14(2):148–154

    Article  PubMed  Google Scholar 

  36. Engmann L et al (2008) The use of gonadotropin-releasing hormone (GnRH) agonist to induce oocyte maturation after cotreatment with GnRH antagonist in high-risk patients undergoing in vitro fertilization prevents the risk of ovarian hyperstimulation syndrome: a prospective randomized controlled study. Fertil Steril 89(1):84–91

    Article  PubMed  CAS  Google Scholar 

  37. Hutchison JS, Zeleznik AJ (1984) The rhesus monkey corpus luteum is dependent on pituitary gonadotropin secretion throughout the luteal phase of the menstrual cycle. Endocrinology 115(5):1780–1786

    Article  PubMed  CAS  Google Scholar 

  38. Fraser HM et al (1997) Initiation of high dose gonadotrophin-releasing hormone antagonist treatment during the late follicular phase in the macaque abolishes luteal function irrespective of effects upon the luteinizing hormone surge. Hum Reprod 12(3):430–435

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zeev Shoham M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this protocol

Cite this protocol

Or, Y., Vaisbuch, E., Shoham, Z. (2014). Luteal Phase Support in ART Treatments. In: Rosenwaks, Z., Wassarman, P. (eds) Human Fertility. Methods in Molecular Biology, vol 1154. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0659-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-0659-8_10

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-0658-1

  • Online ISBN: 978-1-4939-0659-8

  • eBook Packages: Springer Protocols

Publish with us

Policies and ethics