After undergoing a full set of examinations, ovulation promotion, egg retrieval, and fertilization to form embryos, test-tube patients finally ushered in the most important moment-embryo transfer, which is becoming a mother-to-be. A key step. This
stage luteal support treatment is the final battle to defend the city of IVF. Let us understand how to fight this battle together.
After the follicle matures and ovulates, the residual follicular wall collapses, and tissue remodeling and differentiation forms a capillary-rich cell mass with endocrine functions. The main function of corpus luteum is
Synthetic steroid hormones include progesterone, which is indispensable for the establishment and maintenance of pregnancy, and estrogen, which is important for maintaining progesterone and promoting normal endometrial secretion and transformation. Positive
Normal luteal function is necessary to maintain pregnancy outcome.
During the egg retrieval process, the puncture needle enters the follicular cavity. While sucking the follicles with negative pressure, a large number of granulosa cells are also extracted, resulting in the reduction of the effective components of the corpus luteum, thereby triggering the corpus luteum function
Incomplete.
For patients undergoing freeze-thawed embryo transfer using the artificial cycle protocol, estrogen replacement is used to prepare the endometrium, which inhibits the development of their own follicles, resulting in loss of their own corpus luteum function and transformation of the endometrium
Activation, embryo implantation, and maintenance of early pregnancy are completely dependent on exogenous progesterone.
Therefore, test-tube patients are prone to insufficient luteal function, and luteal support treatment is extremely necessary to improve pregnancy outcomes. Luteal support is like farmers fertilizing soil while farming, which requires
Only by "taking good care" can the land be more fertile and more suitable for seed germination and growth.
3. How to choose luteal support drugs?
Overall, there are three types: oral, vaginal and intramuscular. Commonly used drugs are:
In fact, in our corpus luteal support program, doctors will choose individualized medication based on clinical practice experience and the assisted pregnancy status of different patients. Not everyone uses the same type and dose
amount of drug. Generally, two drugs will be selected to be used in combination to complement each other's advantages and improve the effect while reducing adverse reactions.
No need! When using vaginal medication, the progesterone level reflected in the blood is much lower than its local concentration in the uterus, while oral didrogone cannot detect its concentration in the blood at all. "Lutea
Consensus on Support and Progesterone Supplement clearly states that the doses of drugs administered in all luteal support regimens are sufficient, and not all luteal support will manifest as elevated serum progesterone levels. Due to
In this case, it is only recommended to measure blood hCG levels to determine the activity of pregnant villi. Ultrasound is used to detect embryonic development, and there is no need to monitor serum progesterone levels and changes.
Usually, luteal support is used until 10 - 12 weeks of pregnancy. Why this time? Because after 7 to 9 weeks of pregnancy, the placenta gradually forms and produces enough estrogen and progesterone to maintain a normal pregnancy.
Therefore, the longer the luteal support is not the better. If the B-ultrasound shows that the baby is developing normally, the dose will be gradually reduced until the drug is stopped around 8 - 9 weeks of pregnancy. After that, the baby will rely on the female supply provided by his own placenta
Progestogen is completely self-sufficient.
