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The luteal phase after GnRH-agonist triggering of ovulation: present and future perspectives.

Abstract：

:In stimulated IVF/intracytoplasmic sperm injection cycles, the luteal phase is disrupted, necessitating luteal-phase supplementation. The most plausible reason behind this is the ovarian multifollicular development obtained after ovarian stimulation, resulting in supraphysiological steroid concentrations and consecutive inhibition of LH secretion by the pituitary via negative feedback at the level of the hypothalamic-pituitary axis. With the introduction of the gonadotrophin-releasing hormone-(GnRH) antagonist, an alternative to human chorionic gonadotrophin triggering of final oocyte maturation is the use of GnRH agonist (GnRHa) which reduces or even prevents ovarian hyperstimulation syndrome (OHSS). Interestingly, the current regimens of luteal support after HCG triggering are not sufficient to secure the early implanting embryo after GnRHa triggering. This review discusses the luteal-phase insufficiency seen after GnRHa triggering and the various trials that have been performed to assess the most optimal luteal support in relation to GnRHa triggering. Although more research is needed, GnRHa triggering is now an alternative to HCG triggering, combining a significant reduction in OHSS with high ongoing pregnancy rates.

journal_name

Reprod Biomed Online

journal_title

Reproductive biomedicine online

authors

Humaidan P,Papanikolaou EG,Kyrou D,Alsbjerg B,Polyzos NP,Devroey P,Fatemi HM

doi

10.1016/j.rbmo.2011.11.001

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

134-41

issue

2

eissn

1472-6483

issn

1472-6491

pii

S1472-6483(11)00603-1

journal_volume

24

pub_type

杂志文章,评审

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