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Human Reproduction, Vol. 3, No. suppl_2, pp. 43-52, 1988
© 1988 European Society of Human Reproduction and Embryology

The influence of stimulation regimes and luteal phase support on the outcome of IVF

M.C. MacNamee, R.G. Edwards1 and C.M. Howles2

Bourn Hall Clinic Bourn, Cambridge CB3 7TR, UK 1 Physiological Laboratory Downing Street, Cambridge CB2 3EG, UK 2 Serono Laboratories (UK) Ltd 2 Tewin Court, Welwyn Garden City, Herts AL7 1AU, UK

Successful in-vitro fertilization (IVF) requires the generation of a number of healthy embryos and adequate priming and maintenance of a receptive endometrium. Both of these factors are influenced by ovarian stimulation regimes and are responsive to endocrine manipulation. Detailed analysis of follicular phase patterns of hormone secretion have established an inverse relationship between luteinizing hormone (LH) and egg/embryo quality which is not discernible on microscopic examination. The advent and extensive use of LHRH agonists in ovarian stimulation has gone some way towards optimizing embryo fitness by suppressing LH secretion and this has exposed the endometrial contribution to a failure of implantation to closer examination. The supraphysiological production of oestradiol and progesterone from the large numbers of follicles developed during ovarian stimulation cannot be without effect on the endometrium. Data presented in this brief review show how our understanding of ovarian stimulation and its influence on the outcomes of IVF has advanced and highlights the opportunities for manipulation of the endometrium to encourage implantation.

Key words: luteinizing hormone/follicular phase/luteal phase/LHRH agonists

Submitted on June 6, 1988; accepted on July 12, 1988.


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