Progesterone administration for luteal phase deficiency in human reproduction: An old or new issue?

Stefano Palomba, Susanna Santagni, Giovanni Battista La Sala

Research output: Contribution to journalArticle

Abstract

Luteal phase deficiency (LPD) is described as a condition of insufficient progesterone exposure to maintain a regular secretory endometrium and allow for normal embryo implantation and growth. Recently, scientific focus is turning to understand the physiology of implantation, in particular the several molecular markers of endometrial competence, through the recent transcriptomic approaches and microarray technology. In spite of the wide availability of clinical and instrumental methods for assessing endometrial competence, reproducible and reliable diagnostic tests for LPD are currently lacking, so no type-IA evidence has been proposed by the main scientific societies for assessing endometrial competence in infertile couples. Nevertheless, LPD is a very common condition that may occur during a series of clinical conditions, and during controlled ovarian stimulation (COS) and hyperstimulation (COH) programs. In many cases, the correct approach to treat LPD is the identification and correction of any underlying condition while, in case of no underlying dysfunction, the treatment becomes empiric. To date, no direct data is available regarding the efficacy of luteal phase support for improving fertility in spontaneous cycles or in non-gonadotropin induced ovulatory cycles. On the contrary, in gonadotropin in vitro fertilization (IVF) and non-IVF cycles, LPD is always present and progesterone exerts a significant positive effect on reproductive outcomes. The scientific debate still remains open regarding progesterone administration protocols, specially on routes of administration, dose and timing and the potential association with other drugs, and further research is still needed.

Original languageEnglish
Article number77
JournalJournal of Ovarian Research
Volume8
Issue number1
DOIs
Publication statusPublished - Nov 19 2015

Keywords

  • ART
  • Endometrium
  • Implantation
  • Luteal phase deficiency
  • Progesterone

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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