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Luteal support for ART

Satu Kuokkanen, Alex J Polotsky, Justin Chosich, Andrew P Bradford, Anna Jasinska, Tzu Phang, Nanette Santoro, Susan E Appt
UNLABELLED: Obesity and malnutrition are associated with decreased fecundity in women. Impaired reproductive capacity in obese women is often attributed to anovulation. However, obese women with ovulatory cycles also have reduced fertility, but the etiology of their impaired reproduction is only partially understood. Accumulating evidence suggests that obesity directly impairs oocyte and embryo quality as well as endometrial receptivity. In obese women, urinary progesterone metabolite excretion is decreased, but in excess of what can be explained by suppressed gonadotropin secretion, suggesting that apart from its central effect obesity may directly affect progesterone (P4) production...
August 2016: Systems Biology in Reproductive Medicine
Ravichandran Nadarajah, Hemashree Rajesh, Ker Yi Wong, Fazlin Faisal, Su Ling Yu
INTRODUCTION: Assisted reproductive techniques (ARTs) result in a deficient luteal phase, requiring the administration of exogenous progesterone intramuscularly, intravaginally or orally. Dydrogesterone, an oral retroprogesterone, has good bioavailability; it has been used in assisted reproductive cycles with outcomes comparable to those of vaginal or intramuscular progesterone. However, there are limited reviews on the use of dydrogesterone for luteal phase support in ARTs in terms of pregnancy outcomes and associated fetal anomalies...
April 19, 2016: Singapore Medical Journal
H S O Abduljabbar, S T Djamil, N N Sahly, D S Sawan, G S Ashour, A Abduljabbar
AIM: To present the authors' experience with assisted reproductive technology (ART) at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. MATERIALS AND METHODS: Retrospective analysis of data collected from the charts of 264 women who were undergoing their first cycle of ART between September 2013 and March 2014. All the women were treated with gonadotropin-releasing hormone (GnRH) antagonist protocol. For all patients, the documented data included age, infertility type, cause, and hormone profile...
2016: Clinical and Experimental Obstetrics & Gynecology
Sonia Malik, Korukonda Krishnaprasad
Role of progesterone in reproductive medicine is evolving with its suggested clinical role for the hormonal and nonhormonal actions in reproductive medicine. The main function of progesterone is to induce 'secretory' changes in endometrium that is further complimented by its immunomodulatory and anti-inflammatory actions. It positively modulates PIBF, NK cells and HOXA 10 genes for better implantation. MHRA recommends Serum Progesterone levels ≥14ng/ml in the mid-luteal phase for supporting pregnancy adequately...
February 2016: Journal of Clinical and Diagnostic Research: JCDR
A Weiss, R Beck-Fruchter, J Golan, M Lavee, Y Geslevich, E Shalev
BACKGROUND: In-vitro fertilization is a known risk factor for ectopic pregnancies. We sought to establish the risk factors for ectopic pregnancy in GnRH antagonist cycles examining patient and stimulation parameters with an emphasis on ovulation trigger. METHODS: We conducted a retrospective, cohort study of 343 patients undergoing 380 assisted reproductive technology (ART) cycles with the GnRH antagonist protocol and achieving a clinical pregnancy from November 2010 through December 2015...
2016: Reproductive Biology and Endocrinology: RB&E
Claus Yding Andersen, Helle Olesen Elbaek, Birgit Alsbjerg, Rita Jakubcionyte Laursen, Betina Boel Povlsen, Lise Thomsen, Peter Humaidan
STUDY QUESTION: Can the luteal phase support be improved in terms of efficacy, hormonal profiles and convenience as compared with today's standard care? SUMMARY ANSWER: Daily low-dose rhCG supplementation in GnRHa triggered IVF cycles can replace the traditional used luteal phase support with exogenous progesterone. WHAT IS KNOWN ALREADY: A bolus of hCG for final maturation of follicles in connection with COS may induce the risk of OHSS and the luteal phase progesterone levels rise very abruptly in the early luteal phase...
October 2015: Human Reproduction
Kobra Hamdi, Shahla Danaii, La'ya Farzadi, Sedigheh Abdollahi, Allahverdi Chalabizadeh, Somayae Abdollahi Sabet
OBJECTIVE: Several studies have shown the improving effect of heparin on the outcomes of ART. Moreover, it has been reported that adding heparin in non-thrombophilia patients with RIF is useful.The aim of this study was to evaluate the beneficial effects of heparin on ART outcomes in women with history of recurrent implantation failure (RIF) and without history of congenital or acquired thrombophilia in a randomized, controlled clinical trial (RCT). MATERIALS AND METHODS: In this study, 100 patients with a history of two or more failures in implantation in cycles of ART were randomly subdivided into two groups of study and control...
June 2015: Journal of Family & Reproductive Health
Michelle van der Linden, Karen Buckingham, Cindy Farquhar, Jan A M Kremer, Mostafa Metwally
BACKGROUND: Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin(hCG) produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques(ART), progesterone and/or hCG levels are low, so the luteal phase is supported with progesterone, hCG or gonadotropin-releasing hormone (GnRH) agonists to improve implantation and pregnancy rates. OBJECTIVES: To determine the relative effectiveness and safety of methods of luteal phase support provided to subfertile women undergoing assisted reproduction...
2015: Cochrane Database of Systematic Reviews
Céline Pirard, Ernest Loumaye, Pascale Laurent, Christine Wyns
Background. The aim of this pilot study was to evaluate intranasal buserelin for luteal phase support and compare its efficacy with standard vaginal progesterone in IVF/ICSI antagonist cycles. Methods. This is a prospective, randomized, open, parallel group study. Forty patients underwent ovarian hyperstimulation with human menopausal gonadotropin under pituitary inhibition with gonadotropin-releasing hormone antagonist, while ovulation trigger and luteal support were achieved using intranasal GnRH agonist (group A)...
2015: International Journal of Endocrinology
Bülent Gülekli, Funda Göde, Zerrin Sertkaya, Ahmet Zeki Işık
OBJECTIVE: To investigate the efficacy of low-dose gonadotropin-releasing hormone (GnRH) agonist for final oocyte maturation in females undergoing assisted reproductive treatment (ART) cycles. MATERIAL AND METHODS: Nine females undergoing ovarian stimulation in a GnRH antagonist protocol who received triptorelin 0.1 mg to trigger final oocyte maturation were included. Treatment outcomes of these patients were compared with those of controls, matched for age and oocyte number (n=14), who received 0...
2015: Journal of the Turkish German Gynecological Association
Matthew T Connell, Jennifer M Szatkowski, Nancy Terry, Alan H DeCherney, Anthony M Propst, Micah J Hill
OBJECTIVE: To summarize the available published randomized controlled trial data regarding timing of P supplementation during the luteal phase of patients undergoing assisted reproductive technology (ART). DESIGN: A systematic review. SETTING: Not applicable. PATIENT(S): Undergoing IVF. INTERVENTION(S): Different starting times of P for luteal support. MAIN OUTCOME MEASURE(S): Clinical pregnancy (PR) and live birth rates...
April 2015: Fertility and Sterility
Valerie L Baker, Christopher A Jones, Kevin Doody, Russell Foulk, Bill Yee, G David Adamson, Barbara Cometti, Gary DeVane, Gary Hubert, Silvia Trevisan, Fred Hoehler, Clarence Jones, Michael Soules
STUDY QUESTION: Is the ongoing pregnancy rate with a new aqueous formulation of subcutaneous progesterone (Prolutex(®)) non-inferior to vaginal progesterone (Endometrin(®)) when used for luteal phase support of in vitro fertilization? SUMMARY ANSWER: In the per-protocol (PP) population, the ongoing pregnancy rates per oocyte retrieval at 12 weeks of gestation were comparable between Prolutex and Endometrin (41.6 versus 44.4%), with a difference between groups of -2...
October 10, 2014: Human Reproduction
Jack Yu Jen Huang, Zev Rosenwaks
Assisted reproductive technologies (ART) encompass fertility treatments, which involve manipulations of both oocyte and sperm in vitro. This chapter provides a brief overview of ART, including indications for treatment, ovarian reserve testing, selection of controlled ovarian hyperstimulation (COH) protocols, laboratory techniques of ART including in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), embryo transfer techniques, and luteal phase support. This chapter also discusses potential complications of ART, namely ovarian hyperstimulation syndrome (OHSS) and multiple gestations, and the perinatal outcomes of ART...
2014: Methods in Molecular Biology
Saghar Salehpour, Maryam Tamimi, Nasrin Saharkhiz
BACKGROUND: Luteal phase support is mandatory in assisted reproductive technologies (ART) for optimizing outcome, so the luteal phase is supported with either progesterone, addition of estradiol to progesterone, hCG or gonadotropin releasing hormone (GnRH) agonists. Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. OBJECTIVE: To compare oral dydrogestrone with vaginal progesterone for luteal-phase support in IVF...
November 2013: Iranian Journal of Reproductive Medicine
G Lo Monte, I Piva, E Bazzan, R Marci, C Ogrin
The luteal phase is defined as the period between ovulation and either the establishment of a pregnancy or the onset of menses two weeks later. Assisted reproductive technologies (ART), and in particular controlled ovarian stimulation (COS), negatively interfere with the endocrine mechanisms normally regulating the luteal phase. Up to now, there is no generally accepted opinion as to the most appropriate therapeutic schemes for luteal phase support in ART cycles. Progesterone-based protocols are the most frequently adopted, while alternative regimens including human chorionic gonadotropin (hCG) and GnRH agonists (GnRH-a) are controversial...
December 2013: Minerva Endocrinologica
Gillian Lockwood, Georg Griesinger, Barbara Cometti
OBJECTIVE: To compare the safety, efficacy, and tolerability of subcutaneous progesterone (Prolutex, 25 mg; IBSA Institut Biochimique SA) with vaginal progesterone gel (Crinone, 8%; Merck Serono) for luteal phase support (LPS) in assisted reproduction technologies (ART) patients. DESIGN: Prospective, open-label, randomized, controlled, parallel-group, multicenter, two-arm, noninferiority study. SETTING: Thirteen European fertility clinics...
January 2014: Fertility and Sterility
Eve C Feinberg, Angeline N Beltsos, Elitsa Nicolaou, Edward L Marut, Meike L Uhler
OBJECTIVE: To compare clinical pregnancy rate (PR) and live birth rate (LBR) between Endometrin monotherapy versus Endometrin and P in oil combination therapy in assisted reproductive technology (ART) cycles. DESIGN: Retrospective analysis. SETTING: Large private practice. PATIENT(S): Patients undergoing autologous fresh IVF cycles, autologous frozen ET cycles, and fresh oocyte donor cycles were included for analysis...
January 2013: Fertility and Sterility
Ashraf Moini, Shahrzad Zadeh Modarress, Elham Amirchaghmaghi, Naeimeh Mirghavam, Soraya Khafri, Mohammad Reza Akhoond, Reza Salman Yazdi
INTRODUCTION: Luteal phase support in assisted reproductive technology (ART) cycles is still controversial. The present study was conducted to evaluate the effect of adding oral oestradiol to progesterone during ART cycles. MATERIAL AND METHODS: In this prospective case control study, infertile women under 35 years old who were candidates for IVF/ICSI cycles in Royan Institute were enrolled. A long gonadotropin-releasing hormone (GnRH) agonist protocol was used for ovarian stimulation...
February 2011: Archives of Medical Science: AMS
Michelle van der Linden, Karen Buckingham, Cindy Farquhar, Jan Am Kremer, Mostafa Metwally
BACKGROUND: Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin (hCG), which is produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques (ART) the progesterone or hCG levels, or both, are low and the natural process is insufficient, so the luteal phase is supported with either progesterone, hCG or gonadotropin releasing hormone (GnRH) agonists. Luteal phase support improves implantation rate and thus pregnancy rates but the ideal method is still unclear...
2011: Cochrane Database of Systematic Reviews
M Y Willis, A S Browne, D R Session, J B Spencer
Controlled ovarian hyperstimulation (COH) involves the administration of oral and/or injectable medications to induce ovulation in the anovulatory infertile patient, and superovulation in the ovulatory infertile patient. The different types of medication and protocols for COH are reviewed. Oral medications such as clomiphene and letrozole should be considered in most patients initially, except in the case of hypogonadotropic amenorrhea. Pregnancy rates are higher with the injectable medications, follicle stimualtion hormone (FSH) and human menopausal gonadotrpins (hMG), than oral medications; however, injectable medications have a higher risk of multiple gestation, ovarian hyperstimulation syndrome, cost and monitoring...
April 2011: Minerva Ginecologica
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