Luteal support sounded the success of the test tube baby horn – Sohu health-jiqingwuyuetian

Luteal support: blowing "test tube baby" the success of horn – Sohu health Wang Huan, Wang Bin, Zhu Liang, the PLA No.306 Hospital, Center for reproductive medicine brand quality management office editor of corpus luteum after ovulation follicle formation rich vein temporary endocrine glands, is the main source of steroid hormones. During the menstrual period of endogenous luteinizing hormone (LH) peak under induction of mature follicles from egg cells, follicular wall after ovulation, the residual subsidence of basement membrane integrity, follicle loss, tissue remodeling, vascular invasion of theca granulosa cells, neovascularization, and ultimately into full luteal tissue capillary network. Luteal phase for Jones was first proposed in 1949, refers to the luteal dysplasia after ovulation, luteal progesterone secretion is insufficient or premature degradation, resulting in decreased endometrial secretory response; clinical to endometrial development and embryonic development are not synchronized as the main feature, and is closely related to infertility or abortion, its etiology is still unclear. There is no uniform and accurate diagnostic criteria for the diagnosis of luteal insufficiency. In the natural menstrual cycle, the incidence rate of luteal insufficiency in reproductive age women was 3% ~ 10%. In superovulation cycles, due to the number of corpus luteum and development, synthesis and secretion of supraphysiologic amounts of estrogen and progesterone, negative feedback inhibition of the hypothalamic pituitary axis, inhibit the secretion of LH, thus causing luteal insufficiency, the occurrence rate is almost 100%. In the course of IVF treatment, it is hoped that many mature follicles can be obtained at the same time of ovulation induction, which can inhibit the secretion of luteinizing hormone and improve the function of corpus luteum. During the course of oocyte retrieval, follicle aspiration can decrease the hormone level in luteal phase, leading to the decline of luteal function, the decrease of pregnancy rate and the increase of abortion rate. While the use of hormone replacement cycle of frozen thawed embryo transfer, due to the distance take eggs for a period of time, the patients did not own luteal function, therefore enough luteal support is directly related to the success of the final pregnancy. Commonly used drugs for luteal support: in assisted reproductive technology, human chorionic gonadotropin (human chorionic gonadotropin, hCG) or progesterone is often used to support luteal function. Because hCG has increased the risk of ovarian hyperstimulation syndrome, the use of progesterone. Luteal support requires the use of natural progesterone to reduce the impact on the fetus. Usually after embryo transfer is started, to the end of 14 days of pregnancy, if successful pregnancy, you need to continue to support luteal 2-3 month of pregnancy the fetus is stable so far. The route of luteal support: 1. Oral administration. Oral progesterone formulations including micronized progesterone capsules and dydrogestrone, there are first pass effect, effective components of most of the liver metabolism decomposition, low bioavailability, reproductive field seldom used for luteal support after embryo transfer. 2, muscle injection. Oil formulations of progesterone, absorbed rapidly after muscle injection, no liver first pass effect, high bioavailability, after intramuscular injection of blood progesterone concentrations were significantly increased, blood concentration of 6 ~ 8h.相关的主题文章: