Luteal supplementation in in vitro fertilization: more questions than answers

• Published in: Fertility and sterility Vol. 89; no. 4; pp. 749 - 758
• Main Authors: Hubayter, Ziad R., Muasher, Suheil J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2008; Elsevier Science
• Subjects: Biological and medical sciences; Chorionic Gonadotropin - administration & dosage; Dosage Forms; Dose-Response Relationship, Drug; Drug Administration Routes; Drug Administration Schedule; Drug Therapy, Combination; estradiol; Estradiol - administration & dosage; Female; Fertility Agents, Female - administration & dosage; Fertilization in Vitro - methods; Gonadotropin-Releasing Hormone - agonists; Gonadotropin-Releasing Hormone - antagonists & inhibitors; gonadotropin-releasing hormone agonists and antagonists; Gynecology. Andrology. Obstetrics; Hormone Antagonists - administration & dosage; human chorionic gonadotropin; Humans; in vitro fertilization; Infertility, Female - therapy; Internal Medicine; Luteal Phase - drug effects; Luteal phase supplementation; Medical sciences; Obstetrics and Gynecology; Patient Compliance; Patient Satisfaction; Pregnancy; Pregnancy Rate; progesterone; Progesterone - administration & dosage; Treatment Outcome; in vitro fertilization; Luteal phase supplementation; gonadotropin-releasing hormone agonists and antagonists; human chorionic gonadotropin; progesterone; estradiol; Human; Agonist; gonadotropin releasing hormone agonists and antagonists; Gynecology; Estrogen; Gonadotropin RH; Assisted procreation; Estradiol; Obstetrics; Progestagen; In vitro fertilization embryo transfer; Protein hormone; Luteal phase; Chorionic gonadotrophin; Antagonist; Progesterone; Supplementation; Sex steroid hormone; progesterone estradiol
• ISSN: 0015-0282; 1556-5653; 1556-5653
• DOI: 10.1016/j.fertnstert.2008.02.095

To update clinicians on different regimens of luteal phase supplementation in IVF-stimulated cycles and to identify areas that need further research in this subject. Literature review and critical analysis of published studies on luteal phase supplementation during the last 20 years. Luteal phase supplementation in IVF-stimulated cycles, both in gonadotropin releasing hormone agonist and antagonist protocols, is considered an essential requirement for optimal success rates. The date of initiation and discontinuation of supplemented hormones is not adequately studied in the literature. In most major controlled and randomized studies, there are no significant differences in success rates with progesterone supplementation alone, progesterone and estradiol, progesterone and human chorionic gonadotropin, and human chorionic gonadotropin alone. Success rates seem similar with intramuscular and vaginal progesterone administration with patient preference for the vaginal route. The optimal dose of progesterone has not been studied in a scientific way in the literature. The use of gonadotropin releasing hormone agonists for luteal phase supplementation in antagonist cycles appears to be promising, and is worthy of further investigation.