scholarly journals Luteal Phase in Assisted Reproductive Technology

2020 ◽  
Vol 2 ◽  
Author(s):  
Jan Tesarik ◽  
Cristina Conde-López ◽  
Maribel Galán-Lázaro ◽  
Raquel Mendoza-Tesarik
Keyword(s):  
Assisted Reproductive Technology ◽  
Luteal Phase ◽  
Secretory Activity ◽  
Reproductive Technology ◽  
Uterine Contractility ◽  
Uterine Receptivity ◽  
Increased Risk ◽  
Pituitary Secretion ◽  
Exogenous Progesterone ◽  
The One

Luteal phase (LP) is the period of time beginning shortly after ovulation and ending either with luteolysis, shortly before menstrual bleeding, or with the establishment of pregnancy. During the LP, the corpus luteum (CL) secretes progesterone and some other hormones that are essential to prepare the uterus for implantation and further development of the embryo, the function known as uterine receptivity. LP deficiency (LPD) can occur when the secretory activity of the CL is deficient, but also in cases of normal CL function, where it is caused by a defective endometrial response to normal levels of progesterone. LPD is particularly frequent in treatments using assisted reproductive technology (ART). Controlled ovarian stimulation usually aims to obtain the highest number possible of good-quality oocytes and requires the use of gonadotropin-releasing hormone (GnRH) analogs, to prevent premature ovulation, as well as an ovulation trigger to achieve timed final oocyte maturation. Altogether, these treatments suppress pituitary secretion of luteinizing hormone (LH), required for the formation and early activity of the CL. In addition to problems of endometrial receptivity for embryos, LPD also leads to dysfunction of the local uterine immune system, with an increased risk of embryo rejection, abnormally high uterine contractility, and restriction of uterine blood flow. There are two alternatives of LPD prevention: a direct administration of exogenous progesterone to restore the physiological progesterone serum concentration independently of the CL function, on the one hand, and treatments aimed to stimulate the CL activity so as to increase endogenous progesterone production, on the other hand. In case of pregnancy, some kind of LP support is often needed until the luteal–placental shift occurs. If LPD is caused by defective response of the endometrium and uterine immune cells to normal concentrations of progesterone, a still poorly defined condition, symptomatic treatments are the only available solution currently available.

Gestagens in assisted reproductive technology programs

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 76-79
Author(s):  
Anastasia G Syrkasheva ◽  
Yana A Petrosyan ◽  
Natalia V Dolgushina
Keyword(s):  
Assisted Reproductive Technology ◽  
Luteal Phase ◽  
Ovarian Hyperstimulation Syndrome ◽  
Infertility Treatment ◽  
Reproductive Technology ◽  
Art Programs ◽  
Drug Effectiveness ◽  
Essential Step ◽  
Endogenous Steroid ◽  
Endogenous Steroid Hormones

Background. Luteal phase (LP) drug support is an important step in assisted reproductive technology (ART) programs efficacy. Aim. To present up-to-date data on an efficacy of LP hormonal support during ART cycles as well as to conduct a comparative analysis of various gestagen drug effectiveness. Materials and methods. To write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, eLibrary, etc.) for the last 8 years. The review includs articles from peer-reviewed literature. Results. LP drug support becomes an essential step in infertility treatment in various ART programs. Although human chorionic gonadotropin drug injections in the posttransfer period leads to an activation of endogenous steroid hormones synthesis, exogenous hormones use is currently preferred because of not having a risk of ovarian hyperstimulation syndrome. Conclusions. The variety of progesterone drugs is accompanied by a lack of algorithms for their use in various clinical situations. Further studies are required to evaluate progesterone drugs efficacy for various subgroups of patients.

scholarly journals Assisted reproductive technology is not associated with an increased risk of pediatric cancer

2018 ◽  
Vol 110 (4) ◽  
pp. e16-e17 ◽  
Author(s):  
D. Gilboa ◽  
G. Koren ◽  
R. Katz ◽  
R. Rotem ◽  
E. Lunenfeld
Keyword(s):  
Assisted Reproductive Technology ◽  
Pediatric Cancer ◽  
Reproductive Technology ◽  
Increased Risk

Assisted Reproductive Technology and Origins of Disease: The Clinical Realities and Implications

2018 ◽  
Vol 36 (03/04) ◽  
pp. 195-203
Author(s):  
Emre Seli ◽  
Scott Morin
Keyword(s):  
Assisted Reproductive Technology ◽  
Premature Birth ◽  
Absolute Risk ◽  
Reproductive Technology ◽  
Multiple Gestation ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Monogenic Disorder ◽  
Increased Risk ◽  
Confounding Variables

AbstractThe majority of offspring born following assisted reproductive technology (ART) achieve equivalent development milestones and demonstrate comparable health as spontaneously conceived children. Yet, multiple studies have suggested offspring conceived with ART have slightly increased risk of metabolic derangements, cardiovascular disease, and malignancy. However, the associations observed in these studies often inadequately control for a variety of confounding variables, such as multiple gestation, premature birth, and low birth weight. Furthermore, many studies fail to account for the increased risk of many of these pathologies in the offspring of subfertile women in general. Lastly, the absolute risk of most of the ailments studied is extremely low. In nearly all examples, the number of women who would need to be treated to observe one additional diagnosis is substantially high. When compared with the number of couples who would have remained childless due to severe male factor infertility or would have been exposed to the risk of passing on a severe monogenic disorder, the general increased risks to ART-exposed children is very small.

The Relationship of Assisted Reproductive Technology on Perinatal Outcomes in Triplet Gestations

2018 ◽  
Vol 35 (14) ◽  
pp. 1388-1393 ◽  
Author(s):  
Jaimin Shah ◽  
Tania Roman ◽  
Oscar Viteri ◽  
Ziad Haidar ◽  
Alejandra Ontiveros ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Assisted Reproductive Technology ◽  
Distress Syndrome ◽  
Perinatal Death ◽  
Periventricular Leukomalacia ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Reproductive Technology ◽  
Increased Risk

Objective To assess whether assisted reproductive technology (ART) is associated with increased risk of adverse perinatal outcomes in triplet gestations compared with spontaneous conception. Study Design Secondary analysis of a multicenter randomized trial for the prevention of preterm birth in multiple gestations. Triplets delivered at ≥ 24 weeks were studied. The primary outcome was the rate of composite neonatal morbidity (CNM) that included one or more of the following: bronchopulmonary dysplasia, respiratory distress syndrome, necrotizing enterocolitis, culture proven sepsis, pneumonia, retinopathy of prematurity, intraventricular hemorrhage, periventricular leukomalacia, or perinatal death. Results There were 381 triplets (127 women) of which 89 patients conceived via ART and 38 patients spontaneously. Women with ART were more likely to be older, Caucasian, married, nulliparous, have higher level of education, and develop pre-eclampsia. Spontaneously conceived triplets were more likely to delivery at an earlier gestation (31.2 ± 3.5 vs 32.8 ± 2.7 weeks) (p = 0.009) with a lower birth weight (p < 0.001). After adjusting for confounders, no differences were noted in culture proven sepsis, perinatal death, CNM, respiratory distress syndrome, or Apgar score < 7 at 5 minutes. All remaining perinatal outcomes were similar. Conclusion Triplets conceived by ART had similar perinatal outcomes compared with spontaneously conceived triplets.

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