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Treatment methods & how they work
There are different approaches to luteal phase support (LPS) depending on whether you are undergoing assisted reproductive technology (ART) or not.1
The following sections will discuss the most common treatment approaches for individuals requiring LPS, including those who may have luteal phase deficiency, as well as those undergoing ART.
Therapeutic treatments
Progesterone
Progesterone is a common treatment option for luteal phase support (LPS) in both luteal phase deficiency (LPD) and ART.1 There is no published evidence demonstrating that progesterone improves pregnancy rates in women with LPD in natural cycles; however, it is still widely used.1
Types of progesterone methods include:1
- Oral capsules
- Tablets to dissolve under the tongue
- Intramuscular injection
- Rectal suppository
- Vaginal suppository
- Cream applied to the vagina
Ultimately, you can discuss which method of progesterone supplementation is best for you and can be easily implemented into your lifestyle for the appropriate treatment duration.
There is evidence to suggest that LPS with progesterone is not required beyond a positive pregnancy test.2 However, some protocols may extend progesterone supplementation to weeks 5–7 of pregnancy, but no longer than week 12.2
Gonadotropin-releasing hormone (GnRH)
GnRH is used in combination with progesterone supplementation for women and birthing people undergoing ART. It is administered as a single dose 5–6 days after egg retrieval. It is believed to support the luteal phase by helping produce luteinising hormone, which is responsible for ovulation and formation of the corpus luteum required for progesterone production.1
Ovarian stimulation
In most women and birthing people with LPD, clinicians aim to stimulate the ovaries to improve corpus luteum function.3 Agents such as clomiphene citrate (CC), letrozole, or injectable gonadotropins may be prescribed.1
The aim of ovarian stimulation in IVF or ICSI is to help the ovaries grow more than one mature egg in a single cycle. In a natural cycle, the body usually develops just one egg. During fertility treatment, having several mature eggs increases the chances of creating healthy embryos and improves the overall likelihood of a successful pregnancy.3