Skip to main content
Erschienen in: Gynäkologische Endokrinologie 3/2008

01.09.2008 | Leitthema

Lutealphase nach ovarieller Stimulation und Lutealphasensubstitution

verfasst von: Prof. Dr. J. Kleinstein, A.B. Brössner

Erschienen in: Gynäkologische Endokrinologie | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die kontrollierte, ovarielle Hyperstimulation mit Gonadotropinen und GnRH-Agonisten und -Antagonisten in ART-Zyklen induziert Lutealphasendefekte. Diese können erfolgreich mittels hCG (Lutealphasensupport) oder Progesteron (Lutealphasensupplementation) therapiert werden. Goldstandard ist dabei die Applikation von Progesteron auf vaginalem Wege, weil damit eine Anreicherung im Uterus bei reduzierter systemischer Wirkung mit entsprechend wenigen Nebenwirkungen erzielt wird. Der frühe Beginn der Applikation, spätestens zum Zeitpunkt des Embryotransfers, und die Extension der Anwendung bis zum sonographischen Nachweis der Intaktheit der Schwangerschaft sind Bestandteil der erfolgreichen Lutealphasensubstitution.
Literatur
1.
Zurück zum Zitat Aboulghar MA, Amin YM, Al-Inany HG et al. (2008) Prospective randomized study comparing luteal phase support for ICSI patients up to the first ultrasound compared with an additional three weeks. Hum Reprod 23: 857–862 PubMedCrossRef Aboulghar MA, Amin YM, Al-Inany HG et al. (2008) Prospective randomized study comparing luteal phase support for ICSI patients up to the first ultrasound compared with an additional three weeks. Hum Reprod 23: 857–862 PubMedCrossRef
2.
Zurück zum Zitat Andersen AN, Popovic-Todorovic B, Schmidt KT et al. (2002) Progesterone supplementation during early gestations after IVF or ICSI has no effect on the delivery rates: a randomized controlled trial. Hum Reprod 17: 357–361 CrossRef Andersen AN, Popovic-Todorovic B, Schmidt KT et al. (2002) Progesterone supplementation during early gestations after IVF or ICSI has no effect on the delivery rates: a randomized controlled trial. Hum Reprod 17: 357–361 CrossRef
3.
Zurück zum Zitat Beckers NGM, Macklon NS, Eijkemanns MJ et al. (2003) Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment. J Clin Endocrinol Metab 88: 4186–4192 PubMedCrossRef Beckers NGM, Macklon NS, Eijkemanns MJ et al. (2003) Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment. J Clin Endocrinol Metab 88: 4186–4192 PubMedCrossRef
4.
Zurück zum Zitat Cicinelli E, de Ziegler D, Buletti C et al. (2000) Direct transport of progesterone from vagina to uterus. Obstet Gynecol 95: 403–406 PubMedCrossRef Cicinelli E, de Ziegler D, Buletti C et al. (2000) Direct transport of progesterone from vagina to uterus. Obstet Gynecol 95: 403–406 PubMedCrossRef
5.
Zurück zum Zitat Daya S, Gunby J (2004) Luteal phase support in assisted reproductive cycles. The Cochrane Database of Systematic Reviews 2004, Issue 3, Art. No.: CD 004830. doi: 10.1002/14651858 Daya S, Gunby J (2004) Luteal phase support in assisted reproductive cycles. The Cochrane Database of Systematic Reviews 2004, Issue 3, Art. No.: CD 004830. doi: 10.1002/14651858
6.
Zurück zum Zitat Devroey P, Bourgain C, Macklon NS et al. (2004) Reproductive biology and IVF: ovarian stimulation and endometrial receptivity. Trends Endocrinol Metab 15: 84–90 PubMedCrossRef Devroey P, Bourgain C, Macklon NS et al. (2004) Reproductive biology and IVF: ovarian stimulation and endometrial receptivity. Trends Endocrinol Metab 15: 84–90 PubMedCrossRef
7.
Zurück zum Zitat Engmann L, Diluigi A, Schmidt D et al. (2008) The effect of luteal phase vaginal estradiol supplementation on the success of in vitro fertilization treatment: a prospective randomized study. Fertil Steril 89: 554–561 PubMedCrossRef Engmann L, Diluigi A, Schmidt D et al. (2008) The effect of luteal phase vaginal estradiol supplementation on the success of in vitro fertilization treatment: a prospective randomized study. Fertil Steril 89: 554–561 PubMedCrossRef
8.
Zurück zum Zitat Fatemi HM, Popovic-Todorovic B, Papanikolaou E et al. (2007) An update of luteal phase support in stimulated IVF cycles. Hum Reprod Update 13: 581–590 PubMedCrossRef Fatemi HM, Popovic-Todorovic B, Papanikolaou E et al. (2007) An update of luteal phase support in stimulated IVF cycles. Hum Reprod Update 13: 581–590 PubMedCrossRef
9.
Zurück zum Zitat Griesinger G, Diedrich K (2006) Die vaginale Anwendung von natürlichem Progesteron als Lutealphasenunterstützung nach IVF und Embryotransfer. Geburtsh Frauenheilk 66: 655–664 CrossRef Griesinger G, Diedrich K (2006) Die vaginale Anwendung von natürlichem Progesteron als Lutealphasenunterstützung nach IVF und Embryotransfer. Geburtsh Frauenheilk 66: 655–664 CrossRef
10.
Zurück zum Zitat Homburg R (2005) Clomiphene citrate- end of an era? A mini review. Hum Reprod 20: 2043–2051 PubMedCrossRef Homburg R (2005) Clomiphene citrate- end of an era? A mini review. Hum Reprod 20: 2043–2051 PubMedCrossRef
11.
Zurück zum Zitat Homburg R, Pap H, Brandes M et al. (2006) Endometrial biopsy during induction of ovulation with clomiphene citrate in polycystic ovary syndrome. Gynecol Endocrinol 22: 506–510 PubMedCrossRef Homburg R, Pap H, Brandes M et al. (2006) Endometrial biopsy during induction of ovulation with clomiphene citrate in polycystic ovary syndrome. Gynecol Endocrinol 22: 506–510 PubMedCrossRef
12.
Zurück zum Zitat Hutchinson-Williams KA, DeCherney AH, Lavy G et al. (1990) Luteal rescue in in vitro fertilization-embryo transfer. Fertil Steril 53: 495–501 PubMed Hutchinson-Williams KA, DeCherney AH, Lavy G et al. (1990) Luteal rescue in in vitro fertilization-embryo transfer. Fertil Steril 53: 495–501 PubMed
13.
Zurück zum Zitat Jones HW (1996) What has happened? Where are we? Hum Reprod 11 (Suppl 1): 7–24 PubMed Jones HW (1996) What has happened? Where are we? Hum Reprod 11 (Suppl 1): 7–24 PubMed
14.
Zurück zum Zitat Kleinstein J, for the Luteal Phase Study Group (2005) Efficacy and tolerability of vaginal progesterone capsules (Utrogest 200) compared with progesterone gel (Crinone 8%) for luteal phase support during assisted reproduction. Fertil Steril 83: 1641–1649 PubMedCrossRef Kleinstein J, for the Luteal Phase Study Group (2005) Efficacy and tolerability of vaginal progesterone capsules (Utrogest 200) compared with progesterone gel (Crinone 8%) for luteal phase support during assisted reproduction. Fertil Steril 83: 1641–1649 PubMedCrossRef
15.
Zurück zum Zitat Kleinstein J, Schlegelmilch R, Mazur D et al. (2002) Vergleichende Pharmakinetik von Progesteron-Kapseln und einem Progesteron-Gel nach vaginaler Anwendung. Arzneimittelforschung Drug Res 52: 615–621 Kleinstein J, Schlegelmilch R, Mazur D et al. (2002) Vergleichende Pharmakinetik von Progesteron-Kapseln und einem Progesteron-Gel nach vaginaler Anwendung. Arzneimittelforschung Drug Res 52: 615–621
16.
Zurück zum Zitat Kolibianakis EM, Albano C, Kahn J et al. (2003) Exposure to high levels of luteinizing hormone and estradiol in the early follicular phase of gonadotropin-releasing hormone antagonist cycles is associated with on reduced chance of pregnancy. Fertil Steril 79: 873–880 PubMedCrossRef Kolibianakis EM, Albano C, Kahn J et al. (2003) Exposure to high levels of luteinizing hormone and estradiol in the early follicular phase of gonadotropin-releasing hormone antagonist cycles is associated with on reduced chance of pregnancy. Fertil Steril 79: 873–880 PubMedCrossRef
17.
Zurück zum Zitat Miles RA, Paulson RB, Lobo RA et al. (1994) Pharmacokinetics and endometrial tisue levels of progesterone after administration by intramuscular or vaginal routes: a comparative study. Fertil Steril 62: 485–490 PubMed Miles RA, Paulson RB, Lobo RA et al. (1994) Pharmacokinetics and endometrial tisue levels of progesterone after administration by intramuscular or vaginal routes: a comparative study. Fertil Steril 62: 485–490 PubMed
18.
Zurück zum Zitat Mochtar MH, Hogerzeil HV, Mol BWJ (1996) Progesterone alone versus progesterone combined with hCG as luteal support in GnRHa/HMG induced IVF cycles: a randomized clinical trial. Hum Reprod 11: 1602–1605 PubMed Mochtar MH, Hogerzeil HV, Mol BWJ (1996) Progesterone alone versus progesterone combined with hCG as luteal support in GnRHa/HMG induced IVF cycles: a randomized clinical trial. Hum Reprod 11: 1602–1605 PubMed
19.
Zurück zum Zitat Mochtar MH, Van Wely M, Van der Veen F (2006) Timing luteal phase support in GnRH agonist down-regulated IVF/embryo transfer cycles. Hum Reprod 21: 905–908 PubMedCrossRef Mochtar MH, Van Wely M, Van der Veen F (2006) Timing luteal phase support in GnRH agonist down-regulated IVF/embryo transfer cycles. Hum Reprod 21: 905–908 PubMedCrossRef
20.
Zurück zum Zitat Nosarka S, Kruger T, Sieber I et al. (2005) Luteal phase support in in vitro fertilization: meta-analysis of randomized trials. Gynecol Obstet Invest 60: 67–74 PubMedCrossRef Nosarka S, Kruger T, Sieber I et al. (2005) Luteal phase support in in vitro fertilization: meta-analysis of randomized trials. Gynecol Obstet Invest 60: 67–74 PubMedCrossRef
21.
Zurück zum Zitat Penzias AS (1995) Luteal phase support. Semin Reprod Endocrinol 13: 32–38 CrossRef Penzias AS (1995) Luteal phase support. Semin Reprod Endocrinol 13: 32–38 CrossRef
22.
Zurück zum Zitat Pirard C, Donnez J, Loumaye E (2006) GnRH agonist as luteal phase support in assisted reproduction technique cycles: results of a pilot study. Hum Reprod 21: 1894–1900 PubMedCrossRef Pirard C, Donnez J, Loumaye E (2006) GnRH agonist as luteal phase support in assisted reproduction technique cycles: results of a pilot study. Hum Reprod 21: 1894–1900 PubMedCrossRef
23.
Zurück zum Zitat Schoolcraft WB, Hesla JS, Gee MJ (2000) Experience with progesterone gel for luteal support in a highly successful IVF programme. Hum Reprod 15: 1284–1288 PubMedCrossRef Schoolcraft WB, Hesla JS, Gee MJ (2000) Experience with progesterone gel for luteal support in a highly successful IVF programme. Hum Reprod 15: 1284–1288 PubMedCrossRef
24.
Zurück zum Zitat Sereepapong W, Suwajanakorn S, Triratanachat S et al. (2000) Effects of clomiphene citrate on the endometrium of regularly cycling women. Fertil Steril 73: 287–291 PubMedCrossRef Sereepapong W, Suwajanakorn S, Triratanachat S et al. (2000) Effects of clomiphene citrate on the endometrium of regularly cycling women. Fertil Steril 73: 287–291 PubMedCrossRef
25.
Zurück zum Zitat Smitz J, Deveroey P, Braeckmans P et al. (1987) Management of failed cycles in an IVF/GIFT program with the combination of a GnRH analogue and hMG. Hum Reprod 2: 309–312 PubMed Smitz J, Deveroey P, Braeckmans P et al. (1987) Management of failed cycles in an IVF/GIFT program with the combination of a GnRH analogue and hMG. Hum Reprod 2: 309–312 PubMed
26.
Zurück zum Zitat Tesarik J, Hazout A, Mendoza-Tesarik R et al. (2006) Beneficial effect of luteal phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist – and antagonist – treated ovarian stimulation cycles. Hum Reprod 21: 2572–2579 PubMedCrossRef Tesarik J, Hazout A, Mendoza-Tesarik R et al. (2006) Beneficial effect of luteal phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist – and antagonist – treated ovarian stimulation cycles. Hum Reprod 21: 2572–2579 PubMedCrossRef
27.
Zurück zum Zitat The European and Middle East Orgalutran Study Group (2001) Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation. Hum Reprod 16: 644–651 CrossRef The European and Middle East Orgalutran Study Group (2001) Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation. Hum Reprod 16: 644–651 CrossRef
28.
Zurück zum Zitat The Practice Committee of the American Society for Reproductive Medicine (2006) Use of clomiphene citrate in women. Fertil Steril 86 (Suppl 4): S198–S193 The Practice Committee of the American Society for Reproductive Medicine (2006) Use of clomiphene citrate in women. Fertil Steril 86 (Suppl 4): S198–S193
29.
Zurück zum Zitat Toner JP (2001) The luteal phase: luteal support protocols. In Gardner DK, Weissmann A, Howels CM, Shohan Z (eds) Textbook of assisted reproductive techniques. Martin Dunitz, London, pp 515–525 Toner JP (2001) The luteal phase: luteal support protocols. In Gardner DK, Weissmann A, Howels CM, Shohan Z (eds) Textbook of assisted reproductive techniques. Martin Dunitz, London, pp 515–525
30.
Zurück zum Zitat Williams SC, Oehninger S, Gibbsons WE et al. (2001) Delaying the initiation of progesterone supplementation results in decreased pregnancy rates after in vitro fertilization: a randomized prospective study. Fertil Steril 76: 1140–1143 PubMedCrossRef Williams SC, Oehninger S, Gibbsons WE et al. (2001) Delaying the initiation of progesterone supplementation results in decreased pregnancy rates after in vitro fertilization: a randomized prospective study. Fertil Steril 76: 1140–1143 PubMedCrossRef
Metadaten
Titel
Lutealphase nach ovarieller Stimulation und Lutealphasensubstitution
verfasst von
Prof. Dr. J. Kleinstein
A.B. Brössner
Publikationsdatum
01.09.2008
Verlag
Springer-Verlag
Erschienen in
Gynäkologische Endokrinologie / Ausgabe 3/2008
Print ISSN: 1610-2894
Elektronische ISSN: 1610-2908
DOI
https://doi.org/10.1007/s10304-008-0275-4

Weitere Artikel der Ausgabe 3/2008

Gynäkologische Endokrinologie 3/2008 Zur Ausgabe

Leitthema

Lutealphase

CME Weiterbildung • Zertifizierte Fortbildung

Konsensusgerechte Therapie des PCOS

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.