Luteal Support and Risk of Ovarian Hyperstimulation in Assisted Reproduction (A Review)

Background. Gonadotropin-releasing hormone agonist as an ovulation trigger effectively reduces the ovarian hyperstimulation risk in in vitro fertilisation protocols, at the same time requiring an effective luteal phase support in embryo transfer cycles.

Objectives. A review of modern approaches to luteal support after the ovulation trigger switch in in vitro fertilisation/intracytoplasmic sperm injection protocols; assessment of feasibility and safety of gonadotropin-releasing hormone agonist in the post-transfer period.

Methods. Literature sources were mined in the PubMed, eLibrary, Web of Science, Cochrane Library, Cyberleninka databases at a depth of 10 years. The query keywords were: gonadotropin-releasing hormone agonist, luteal phase support, ovulation trigger, in vitro fertilisation, ovarian hyperstimulation syndrome.

Results. The review included 35 records selected from the 96 analysed total. The analysis reveals a sensible efficiency of gonadotropin-releasing hormone agonist for the luteal phase support, improved success of in vitro fertilisation/intracytoplasmic sperm injection and embryo transfer strategies, improved pregnancy outcomes. Microdosing of chorionic gonadotropin to supplement standard progesterone luteal support also improves the pregnancy outcome rate in assisted reproduction, however, at the risk of late ovarian hyperstimulation syndrome and should be applied with caution.

Conclusion. Administration of gonadotropin-releasing hormone agonist for luteal support may improve pregnancy outcomes in in vitro fertilisation/intracytoplasmic sperm injection protocols in patients with the ovarian hyperstimulation risk after the ovulation trigger switch. Nevertheless, further research is necessary into the efficacy and safety of gonadotropin-releasing hormone agonist for luteal support in embryo transfer cycles.

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