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

REPRODUCTIVE BIOMEDICINE ONLINE

卷:24

Review

Humaidan, Peter¹  Papanikolaou, E. G.²  Kyrou, D.²  Alsbjerg, B.³  Polyzos, N. P.⁴  Devroey, P.⁵  Fatemi, Human M.⁵ 

[1] Odense Univ Hosp, Fertil Clin, DK-5000 Odense, Denmark

[2] Aristotle Univ Thessaloniki, Assisted Reprod Unit, OB GYN Dept 1, GR-54006 Thessaloniki, Greece

[3] Skive Reg Hosp, Fertil Clin, Skive, Denmark

[4] PACMeR, Sect Obstet & Gynaecol, Athens, Greece

[5] Dutch Speaking Brussels Free Univ, Acad Hosp, Dept Reprod Med, Brussels, Belgium

关键词: GnRH agonist;    GnRH antagonist;    HCG;    IVF;    luteal phase;    ovulation induction;   

DOI  :  10.1016/j.rbmo.2011.11.001

来源: Elsevier

【 摘 要 】

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. (C) 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

Free