The Luteal Phase Defect: The Relative Frequency of, and Encouraging Response to, Treatment with Vaginal Progesterone

Rosenberg, Sanford M.; Luciano, Anthony A.; Riddick, Daniel H.

doi:10.1016/s0015-0282(16)44831-4

Cited by 83 publications

(5 citation statements)

References 9 publications

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“…Whether luteal support is required for FET during natural cycles remains controversial [7,[20][21][22]. Previous studies suggested that the corpus luteum, produced by spontaneous ovulation, can maintain embryo implantation [23]. But luteal insu ciency may lead to implantation failure and abortion [24], a previous report showed that in infertile patients, the incidence of luteal insu ciency was 3.7%-20%.…”

Section: Discussionmentioning

confidence: 99%

Does the addition of luteal function support drug benefit pregnancy and perinatal outcome in modified natural cycle frozen thawed embryo transfer in women under the age of 35- year-old?

Zhang

Ren

et al. 2022

Preprint

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Background:In the freeze-thaw embryo transfer, the use of best luteal phase support protocols is continuously being discussed, especially in the natural cycles. Previous comparisons of luteal phase support protocols in natural cycles focused on pregnancy outcome, with less attention to perinatal outcome. Thus, convincing conclusion about which protocol is more appropriate could not be drawn. At the same time, with increasing luteal support drugs, the benefit of using these drugs also needs evidence. Methods: The clinical data of 3658 mNC-FET cycles in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 with the participants’ age of less than or equal to 35 years old，were retrospectively analyzed. The cycles were divided into three groups based on luteal phase support protocols used. The patients received a combination of progesterone soft capsule and dydrogesterone in the group A (882 cycles), the patients received dydrogesterone in the group B (627cycles), and the patients received a combination of progesterone vaginal sustained-release gel and dydrogesterone in the group C (2149 cycles). Pregnancy and perinatal outcomes in the group A, group B, and group C were compared. Results: HCG positive rate, clinical pregnancy rate, and implantation rate were higher in the group B than in the groups A and C （67.30% vs. 57.37% and 61.05%; 64.43% vs. 55.67 % and 57.88 %; 54.83 % vs 42.70 % and 45.92 %）. The 12-week pregnancy rate and live birth rate in the group B were higher than those in the group A （56.30% vs. 49.55%；53.26% vs. 46.83%）. There were no significant differences in newborn weight, premature delivery rate, pregnancy complications rate, and incidence of birth defects among the three groups. Logistic regression analyses showed that three different luteal phase support regimens were not associated with live birth rate （0R 95% CI B VS. A=1.23，P=0.056；0R 95%CI B VS. A=1.07，P=0.374）. Conclusions: In the mNC-FET cycle, patients younger than or equal to 35 years of age, who chose dydrogesterone alone as luteal support drug, had no difference in live birth rate and perinatal outcome between progesterone soft capsules or progesterone vaginal sustained-release gel combined with dydrogesterone, but the outcome still needs to be confirmed by large sample prospective studies.

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Section: Discussionmentioning

confidence: 99%

Does the addition of luteal function support drug benefit pregnancy and perinatal outcome in modified natural cycle frozen thawed embryo transfer in women under the age of 35- year-old?

Zhang

Ren

et al. 2022

Preprint

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“…Progesterone administration is required in HRT cycles because no endogenous P is produced, but nothing is known about the effect of LPS in true or modified natural FET cycles [ 48 , 85 ]. ( Table 2 ) Luteal phase defect is thought to be uncommon in cycles involving spontaneous ovulation because the resulting corpus luteum is thought to provide all that is needed for embryo implantation [ 86 ]. However, some women undergoing fertility treatment may not produce enough progesterone.…”

Section: Methodsmentioning

confidence: 99%

Preparation of the endometrium for frozen embryo transfer: an update on clinical practices

Zhang¹,

Xiao²,

Gao³

et al. 2023

Reprod Biol Endocrinol

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Over the past decade, the application of frozen-thawed embryo transfer treatment cycles has increased substantially. Hormone replacement therapy and the natural cycle are two popular methods for preparing the endometrium. Hormone replacement therapy is now used at the discretion of the doctors because it is easy to coordinate the timing of embryo thawing and transfer with the schedules of the in-vitro fertilization lab, the treating doctors, and the patient. However, current results suggest that establishing a pregnancy in the absence of a corpus luteum as a result of anovulation may pose significant maternal and fetal risks. Therefore, a ‘back to nature’ approach that advocates an expanded use of natural cycle FET in ovulatory women has been suggested. Currently, there is increasing interest in how the method of endometrial preparation may influence frozen embryo transfer outcomes specifically, especially when it comes to details such as different types of ovulation monitoring and different luteal support in natural cycles, and the ideal exogenous hormone administration route as well as the endocrine monitoring in hormone replacement cycles. In addition to improving implantation rates and ensuring the safety of the fetus, addressing these points will allow for individualized endometrial preparation, also as few cycles as possible would be canceled.

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“…Using a threshold of 10 ng/ml during the mid-luteal phase of natural cycles (133), a luteal phase defect was reported in 8% of normo-ovulatory subfertile women (134). To our knowledge, until now, only one study reported the impact of serum P 4 one day prior to warmed blastocyst transfer in t-NC cycles (135).…”

Section: Rescue Protocolmentioning

confidence: 99%

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

et al. 2021

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Despite the worldwide increase in frozen embryo transfer, the search for the best protocol to prime endometrium continues. Well-designed trials comparing various frozen embryo transfer protocols in terms of live birth rates, maternal, obstetric and neonatal outcome are urgently required. Currently, low-quality evidence indicates that, natural cycle, either true natural cycle or modified natural cycle, is superior to hormone replacement treatment protocol. Regarding warmed blastocyst transfer and frozen embryo transfer timing, the evidence suggests the 6th day of progesterone start, LH surge+6 day and hCG+7 day in hormone replacement treatment, true natural cycle and modified natural cycle protocols, respectively. Time corrections, due to inter-personal differences in the window of implantation or day of vitrification (day 5 or 6), should be explored further. Recently available evidence clearly indicates that, in hormone replacement treatment and natural cycles, there might be marked inter-personal variation in serum progesterone levels with an impact on reproductive outcomes, despite the use of the same dose and route of progesterone administration. The place of progesterone rescue protocols in patients with low serum progesterone levels one day prior to warmed blastocyst transfer in hormone replacement treatment and natural cycles is likely to be intensively explored in near future.

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The Luteal Phase Defect: The Relative Frequency of, and Encouraging Response to, Treatment with Vaginal Progesterone

Cited by 83 publications

References 9 publications

Does the addition of luteal function support drug benefit pregnancy and perinatal outcome in modified natural cycle frozen thawed embryo transfer in women under the age of 35- year-old?

Does the addition of luteal function support drug benefit pregnancy and perinatal outcome in modified natural cycle frozen thawed embryo transfer in women under the age of 35- year-old?

Preparation of the endometrium for frozen embryo transfer: an update on clinical practices

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

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