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Ovarian stimulation for IVF and endometrial receptivity - the missing link

Van Der Gaast, M.H., Beckers, N.G.M., Beier-Hellwig, K., Beier, H.M., Macklon, N.S. and Fauser, B.C.J.M. (2002) Ovarian stimulation for IVF and endometrial receptivity - the missing link Reproductive Biomedicine Online, 5, (3), supplement 1, pp. 36-43. (PMID:12537780).

Record type: Article

Abstract

The contemporary approach to ovarian stimulation for IVF treatment results in supraphysiological concentrations of steroids during the follicular and luteal phases of the menstrual cycle. These sex steroids act directly and indirectly to mature the endometrium, influencing receptivity for implantation. Corpus luteum function is distinctly abnormal in IVF cycles, and therefore luteal support is widely used. Various reasons may underlie the defective luteal phase, including (i) ovarian hyperstimulation per se, (ii) gonadotrophin-releasing hormone (GnRH) analogue co-treatment and (iii) the use of human chorionic gonadotrophin (HCG) to induce final oocyte maturation. The recent introduction of GnRH antagonist co-treatment for the prevention of a premature LH rise during the late follicular phase allows for different approaches to ovarian stimulation for IVF. However, a recent meta-analysis showed that implantation rates may be compromised by using GnRH antagonists in currently employed regimens. The development of endometrium receptive to embryo implantation is a complex process and may be altered by inappropriate exposure to sex steroids in terms of timing, duration and magnitude. New approaches to the assessment of endometrial receptivity are now required. Novel approaches to ovarian stimulation aimed at adjusted GnRH antagonist regimens and achieving a more physiological luteal phase endocrinology are now appearing in the literature and may represent an important step in the improvement of the overall health economics of IVF.

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Published date: 2002

Identifiers

Local EPrints ID: 185655
URI: http://eprints.soton.ac.uk/id/eprint/185655
ISSN: 1472-6483
PURE UUID: 8db0fa83-8545-4c2b-90ee-9c25118e52b0

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Date deposited: 20 May 2011 10:41
Last modified: 18 Jul 2017 11:49

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Contributors

Author: M.H. Van Der Gaast
Author: N.G.M. Beckers
Author: K. Beier-Hellwig
Author: H.M. Beier
Author: N.S. Macklon
Author: B.C.J.M. Fauser

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