The early luteal phase administration of estrogen and progesterone does not induce premature luteolysis in normo-ovulatory women

Beckers, Nicole G. M., Platteau, Peter, Eijkemans, Marinus J., Macklon, Nicholas S., de Jong, Frank H., Devroey, Paul and Fauser, Bart C. J. M. (2006) The early luteal phase administration of estrogen and progesterone does not induce premature luteolysis in normo-ovulatory women. European journal of endocrinology, 155 (2), 355-363. (doi:10.1530/eje.1.02199). (PMID:16868151)

Abstract

Objective: The luteal phase after ovarian hyperstimulation for in vitro fertilization (IVF) is insufficient.
Therefore, luteal phase supplementation is routinely applied in IVF. It may be postulated that
premature luteolysis after ovarian hyperstimulation is due to supraphysiological steroid levels in the
early luteal phase. In the present study, high doses of steroids are administered after the LH surge in
normo-ovulatory volunteers in order to investigate whether this intervention gives rise to endocrine
changes and a shortening of the luteal phase.
Design: Randomized controlled trial.
Methods: Forty non-smoking, normal weight women, between 18 and 37 years of age, with a regular
menstrual cycle (24–35 days), received either high dosages of estradiol (E2), progesterone (P), E2CPor
no medication. Blood sampling was performed every other day from the day of the LH surge until LHC
14. Duration of the luteal phase and endocrine profiles were the main study outcomes.
Results: Early luteal phase steroid concentrations achieved by exogenous administration were
comparable with levels observed following ovarian hyperstimulation for IVF. No difference in the luteal
phase length was observed comparing all groups. However, a significant decrease in LH levels could be
observed 6 days after the mid-cycle LH surge (P!0.001) in women receiving P, resulting in accelerated
decrease of inhibin A production by the corpus luteum (PZ0.001).
Conclusion: The present intervention of high-dose steroid administration shortly after the LH surge
failed to induce a premature luteolysis regularly in cyclic women. It seems that the induced transient
suppression in LH allowed for a timely recovery of corpus luteum function. Other additional factors
may be held responsible for the distinct reduction in luteal phase length observed after ovarian
hyperstimulation for IVF.

This record has no associated files available for download.

Contributors

Download statistics