IVF Research Today is a free monthly online journal that collates and summarizes the latest research about IVF, including details on in vitro fertilization, infertility, treatment, procedure, pregnancy, success rates.

Luteal supplementation in in vitro fertilization: more questions than answers.

Hubayter ZR, Muasher SJ

Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

OBJECTIVE: To update clinicians on different regimens of luteal phase supplementation in IVF-stimulated cycles and to identify areas that need further research in this subject. DESIGN: Literature review and critical analysis of published studies on luteal phase supplementation during the last 20 years. CONCLUSION(S): Luteal phase supplementation in IVF-stimulated cycles, both in gonadotropin releasing hormone agonist and antagonist protocols, is considered an essential requirement for optimal success rates. The date of initiation and discontinuation of supplemented hormones is not adequately studied in the literature. In most major controlled and randomized studies, there are no significant differences in success rates with progesterone supplementation alone, progesterone and estradiol, progesterone and human chorionic gonadotropin, and human chorionic gonadotropin alone. Success rates seem similar with intramuscular and vaginal progesterone administration with patient preference for the vaginal route. The optimal dose of progesterone has not been studied in a scientific way in the literature. The use of gonadotropin releasing hormone agonists for luteal phase supplementation in antagonist cycles appears to be promising, and is worthy of further investigation.

Published 14 April 2008 in Fertil Steril, 89(4): 749-58.
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Articles on IVF published 14 April 2008:

Birth of a healthy boy after fertilization of cryopreserved oocytes with cryopreserved testicular spermatozoa from a man with nonmosaic Klinefelter syndrome.   Fertil Steril, 89(4): 991.e5-7.

OBJECTIVE: To report the first birth with frozen spermatozoa and frozen oocytes in a case of nonmosaic Klinefelter syndrome. DESIGN: Case report. SETTING: Private IVF clinics and a university hospital. PATIENT(S): A 32-year-old woman and a 33-year-old man. INTERVENTION(S): Testicular sperm extraction and cryopreservation, oocyte recovery and cryopreservation, intracytoplasmic sperm injection. MAIN OUTCOME MEASURE(S): Assessment of fertilization and chromosomal analysis of newborn child. ... [Abstract] [Full-text]

Vitrification of preimplantation genetically diagnosed human blastocysts and its contribution to the cumulative ongoing pregnancy rate per cycle by using a closed device.   Fertil Steril, 89(4): 840-6.

OBJECTIVE: To evaluate the survival rate and clinical results of our vitrification procedure on preimplantation genetic diagnosis (PGD) blastocysts and to calculate its actual contribution to the reproductive outcome per cycle. DESIGN: Retrospective clinical study. SETTING: University Institute IVI, Valencia, Spain. PATIENT(S): Patients who requested cryotransfer of surplus PGD blastocysts after failed fresh elective transfer. INTERVENTION(S): Retrospectively collected data during 2 years of ... [Abstract] [Full-text]

The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles.   Fertil Steril, 89(4): 832-9.

OBJECTIVE: To examine the relationship between endometrial thickness and outcome of medicated frozen-thawed embryo replacement (FER) cycles. DESIGN: A retrospective observational study. SETTING: Assisted conception unit at a university hospital. PATIENT(S): All patients who underwent an FER cycle between 1997 and April 2006 and met the inclusion criteria. INTERVENTION(S): For endometrial preparation, a daily dose of 6 mg of oral E(2) valerate was started on menstrual day 1, and P pessaries (800 ... [Abstract] [Full-text]

Do sperm DNA integrity tests predict pregnancy with in vitro fertilization?   Fertil Steril, 89(4): 823-31.

OBJECTIVE: To evaluate the predictive value of sperm DNA integrity tests for pregnancy from in vitro fertilization treatment. DESIGN: Systematic review and meta-analysis. SETTING: Studies from infertility centers. PATIENT(S): Infertile couples undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment. INTERVENTION(S): Sperm DNA integrity tests before IVF and ICSI cycles. MAIN OUTCOME MEASURE(S): Diagnostic test properties for sperm DNA integrity tests with ... [Abstract] [Full-text]

Successful delivery after the transfer of embryos obtained from a cohort of incompletely in vivo matured oocytes at retrieval time.   Fertil Steril, 89(4): 991.e1-4.

OBJECTIVE: To report a case of successful delivery of a healthy baby after intracytoplasmic sperm injection (ICSI) in a patient with no mature oocytes at the time of oocyte retrieval. DESIGN: Case report. SETTING: Department of Reproductive Medicine. PATIENT: After a controlled ovarian hyperstimulation cycle, a total of seven immature oocytes were collected. INTERVENTION(S): Medical management. MAIN OUTCOME MEASURE(S): The timing of polar body extrusion was checked every 2 hours, and ICSI was ... [Abstract] [Full-text]

The predictive value for in vitro fertility delivery rates is greatly impacted by the method used to select the threshold between normal and elevated basal follicle-stimulating hormone.   Fertil Steril, 89(4): 868-78.

OBJECTIVE: To evaluate the predictive accuracy of different methodologies for selecting a basal FSH threshold level that prognosticates live birth after IVF. DESIGN: Retrospective. SETTING: Academic private practice. PATIENT(S): Eight thousand nineteen patients who had their basal FSH levels determined by the program's endocrinology laboratory. INTERVENTION(S): Thresholds between normal and elevated basal FSH levels were calculated by using six different methodologies. MAIN OUTCOME MEASURE(S): ... [Abstract] [Full-text]

Failed fertilization after ICSI and spermiogenic defects.   Fertil Steril, 89(4): 892-8.

OBJECTIVE: To evaluate the relationship between late spermiogenic events, including histone-protamine replacement, acrosome integrity, and sperm morphology, with fertilization rate after intracytoplasmic sperm injection (ICSI). DESIGN: Prospective study. SETTING: Isfahan Fertility and Infertility Center, Royan Institute, Tehran, Iran. PATIENT(S): Semen samples from 68 infertile couples undergoing ICSI at Isfahan Fertility and Infertility center were assessed during this study. INTERVENTION(S): ... [Abstract] [Full-text]

Articles on IVF published 14 March 2008:

Oxidative stress impairs oocyte quality and melatonin protects oocytes from free radical damage and improves fertilization rate.   J Pineal Res, 44(3): 280-7.

We investigated the relationship between oxidative stress and poor oocyte quality and whether the antioxidant melatonin improves oocyte quality. Follicular fluid was sampled at oocyte retrieval during in vitro fertilization and embryo transfer (IVF-ET). Intrafollicular concentrations of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in women with high rates of degenerate oocytes were significantly higher than those with low rates of degenerate oocytes. As there was a negative correlation between ... [Abstract] [Full-text]

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