Greenbaum Shirley, Athavale Ahlad, Hershko Klement Anat, Bentov Yaakov
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Front Reprod Health. 2022 Jul 19;4:919948. doi: 10.3389/frph.2022.919948. eCollection 2022.
Luteal phase support (LPS) has become an essential component of IVF protocols following both fresh and frozen embryo transfers, yet there is still controversy with regards to the optimal protocol of LPS to enhance treatment outcome.
A search PubMed for all the selected topics was limited to publications from the past 10 years and to English language. We subsequently searched the reference lists of retrieved articles. Where available, RCTs were chosen over non-randomized studies. Here we provide an updated review of the current literature on various issues relating to LPS, in both fresh and frozen embryo transfers. The timing of LPS initiation as well as the route of administration and dosing are discussed for both fresh and frozen transfers. A separate discussion for frozen thawed embryo transfer in natural cycles and non-ovulatory cycles is presented.
We present data that supports the use of Progesterone LPS in fresh and frozen embryo transfers. No benefits were found to the addition of hCG or estradiol to progesterone LPS in fresh transfers, however GnRH agonist may have a role. IM Progesterone was not advantageous over vaginal progesterone in fresh transfers but was superior in frozen transfers. The timing of LPS introduction, the interval to embryo transfer, as well as the serum concentration of progesterone, have significant effects on the success of the treatment.
黄体期支持（LPS）已成为新鲜胚胎移植和冷冻胚胎移植后体外受精方案的重要组成部分，但关于LPS的最佳方案以提高治疗效果仍存在争议。
在PubMed上搜索所有选定主题，仅限于过去10年的出版物且为英文。随后我们检索了检索到的文章的参考文献列表。如有随机对照试验（RCT），则优先于非随机研究。在此，我们对当前关于新鲜胚胎移植和冷冻胚胎移植中与LPS相关的各种问题的文献进行了更新综述。讨论了新鲜移植和冷冻移植中LPS开始的时间以及给药途径和剂量。还对自然周期和无排卵周期中冷冻解冻胚胎移植进行了单独讨论。
我们提供的数据支持在新鲜胚胎移植和冷冻胚胎移植中使用黄体酮进行LPS。在新鲜移植中，向黄体酮LPS中添加人绒毛膜促性腺激素（hCG）或雌二醇未发现有任何益处，然而促性腺激素释放激素（GnRH）激动剂可能起作用。在新鲜移植中，肌肉注射黄体酮并不优于阴道用黄体酮，但在冷冻移植中更具优势。LPS引入的时间、至胚胎移植的间隔以及黄体酮的血清浓度，对治疗的成功有显著影响。
