Luteal phase support in assisted reproductive technologies: a comprehensive review

Abstract

Luteal phase defect (LPD) is a condition with insufficient endogenous progesterone for maintenance of functional secretory endometrium, normal embryo implantation, and growth. In today’s era, there is a lot of complex research with wide diversity with respect to LPD and its treatment. With such diversity and complexity of research data, we hereby did this review to address the pathophysiology of LPD and the role of luteal phase support in assisted reproductive cycles based on available scientific evidence in a simplified manner. An electronic search of Pubmed, Scopus, Embase, and Google Scholar was performed for LPD, luteal phase support, and assisted reproductive technologies. There is no valid diagnostic test for LPD. Prompt identification and treatment of underlying factors is the preferred approach. In assisted reproductive cycles, the luteal phase is usually abnormal and luteal phase support in form of exogenous progesterone with or without estrogen or hCG and GnRH agonists, which enhance endogenous progesterone release have a significant effect on successful reproductive outcomes. The choice of drug is dependent upon the patient’s characteristics and type of ongoing treatment. It should be started on the day of oocyte retrieval or till the day 3 postretrieval and to be continued till a positive pregnancy test at least.