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

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 sever...

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Autores principales: Palomba, Stefano, Santagni, Susanna, La Sala, Giovanni Battista
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653859/
https://www.ncbi.nlm.nih.gov/pubmed/26585269
http://dx.doi.org/10.1186/s13048-015-0205-8
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author Palomba, Stefano
Santagni, Susanna
La Sala, Giovanni Battista
author_facet Palomba, Stefano
Santagni, Susanna
La Sala, Giovanni Battista
author_sort Palomba, Stefano
collection PubMed
description 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.
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spelling pubmed-46538592015-11-21 Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue? Palomba, Stefano Santagni, Susanna La Sala, Giovanni Battista J Ovarian Res Review 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. BioMed Central 2015-11-19 /pmc/articles/PMC4653859/ /pubmed/26585269 http://dx.doi.org/10.1186/s13048-015-0205-8 Text en © Palomba et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Palomba, Stefano
Santagni, Susanna
La Sala, Giovanni Battista
Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?
title Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?
title_full Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?
title_fullStr Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?
title_full_unstemmed Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?
title_short Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?
title_sort progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653859/
https://www.ncbi.nlm.nih.gov/pubmed/26585269
http://dx.doi.org/10.1186/s13048-015-0205-8
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