In a patient undergoing IVF-ET, the luteal phase is supported primarily because:

• A Exogenous progesterone prevents ovarian hyperstimulation
• B GnRH agonist/antagonist downregulation impairs endogenous LH secretion, causing premature corpus luteum demise ✓
• C The transferred embryo requires progesterone to prevent implantation failure due to endometrial polyps
• D Aspiration of follicles removes all luteinised granulosa cells, abolishing corpus luteum function

Explanation

Luteal phase deficiency in IVF cycles results from GnRH agonist/antagonist suppression of pituitary LH secretion, which is necessary to sustain the corpus luteum after oocyte retrieval. Without exogenous luteal support (progesterone, with or without estradiol), premature corpus luteum regression leads to inadequate endometrial preparation for implantation. Oocyte aspiration also removes luteinised granulosa cells, compounding the deficit. Progesterone supplementation is therefore mandatory in all stimulated IVF cycles.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.