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The effect of ovarian stimulation on luteal phase endocrinolgy-correlation with natural cycles

Thursday, 2 February, 2006 - 18:30
Campus: Brussels Health Campus
Faculty: Medicine and Pharmacy
auditorium R. Vanden Driessche
Asimina Tavaniotou
phd defence

Luteal phase is important as it is during this period of
time that embryonic implantation takes place
Currently, in the majority of the protocols used in
assisted reproduction a defective luteal phase has
been described. The aim of the present work was to
investigate luteal phase endocrinology and
regulation in different stimulation protocols in
comparison to natural cycles. The comparison of
donor unsupplemented IVF cycles stimulated with
recFSH/Ganirelix 0.25 showed a significantly shorter
luteal phase length and significantly higher steroid
concentrations in the stimulated cycles. However,
luteal phase defects might not be attributed to
GnRH antagonist administration as luteal LH levels
were similarly reduced in cycles stimulated with
HMG as well as HMG/Cetrorelix 0.25. These
differences might not be attributed to ovulatory
HCG injection as there was no difference in luteal
LH values in natural cycles with no intervention,
compared to natural cycles with ovulatory HCG
injection. High steroid concentrations observed in
stimulated cycles due to multi-follicular
development might reduce LH levels. LH values
were significantly reduced in the luteal phase in
natural cycles after IM progesterone administration
in the luteal phase than in natural cycles with no
intervention. These high steroid levels might also
affect endometrial receptivity. In stimulated cycles
endometrium was advanced in the early luteal
phase compared to the corresponding day in
natural cycles. However, clomiphene citrate
treatment has a versatile role as, LH levels remained
high in the follicular and in the luteal phase. This
might affect the dose of the antagonist needed to
prevent the LH surge as there was a great
proportion of premature LH surges with Cetrorelix
0.25. In addition, it may also question the need of
luteal phase supplementation in these cycles.