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Review
. 2022 Jan 22;19(1):19.
doi: 10.1186/s12978-021-01320-7.

Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review

Jing Zhao  1   2 , Jie Hao  1   2 , Yanping Li  3   4
Affiliations
Review

Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review

Jing Zhao et al. Reprod Health. .

Abstract

Background: Luteal phase support (LPS) is an important part of assisted reproductive technology (ART), and adequate LPS is crucial for embryo implantation. At present, a great number of studies have put emphasis on an individualized approach to controlled ovarian stimulation (COS) and endometrium preparation of frozen- thawed embryo transfer (FET); However, not much attention has been devoted to the luteal phase and almost all ART cycles used similar LPS protocol bases on experience.

Main body: This review aims to concisely summarize individualized LPS protocols in fresh embryo transfer cycles with hCG trigger or GnRH-a trigger. The PubMed and Google Scholar databases were searched using the keywords: (luteal phase support or LPS) AND (assisted reproductive technology or ART or in vitro fertilization or IVF). We performed comprehensive literature searches in the English language describing the luteal phase support after ART, since 1978 and ending in May 2019. Recent studies have shown that many modified LPS programs were used in ART cycle. In the cycle using hCG for final oocyte maturation, the progesterone with or without low dose of hCG may be adequate to maintain pregnancy. In the cycle using GnRH-a for trigger, individualized low dose of hCG administration with or without progesterone was suggested. The optimal timing to start the LPS would be between 24 and 72 h after oocyte retrieval and should last at least until the pregnancy test is positive. Addition of E2 and the routes of progesterone administration bring no beneficial effect on the outcomes after ART.

Conclusions: Individualized LPS should be applied, according to the treatment protocol, the patients' specific characteristics, and desires.

Keywords: Assisted reproductive technology; Individualized luteal phase support; Progesterone.

Plain language summary

Luteal phase support (LPS) is an important part of assisted reproductive technology (ART). In the cycle using hCG for final oocyte maturation, the progesterone with or without low dose of hCG may be adequate to maintain pregnancy. In the cycle using GnRH-a for trigger, individualized low dose of hCG administration with or without progesterone was suggested. The optimal timing to start the LPS would be between 24 and 72 h after oocyte retrieval and should last at least until the pregnancy test is positive. Addition of E2 and the routes of progesterone administration bring no beneficial effect on the outcomes after ART. Individualized LPS should be applied, according to the treatment protocol, the patients’ specific characteristics, and desires.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Optimal initiation and duration of LPS. The optimal initiation of LPS should be between 24 and 72 h after oocyte retrieval; the duration of LPS should at least last to pregnancy test is positive. OPU oocyte pick-up, ET embryo transfer, LPS luteal phase support
See this image and copyright information in PMC

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