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02 April 2021, Volume 37 Issue 4 Previous Issue    Next Issue

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Formation of corpus luteum and the mechanism of luteal phase defect. 2021, 37(4): 412-414.  DOI: 10.19538/j.fk2021040102 Abstract ( )   Corpus luteum is a gland with temporary endocrine function formed after ovulation. It mainly undertakes the endocrine function of ovary and is the main source of estrogen and progesterone after ovulation. Normal luteal function is critical to maintaining ovarian cycles and early pregnancy. Luteal phase defect（LPD）refers to luteal dysplasia after ovulation and insufficient progesterone secretion，which can lead to abnormal uterine bleeding or miscarriage at early pregnancy. The incidence of LPD is high in patients with assisted reproductive technology，especially after controlled ovarian hyperstimulation and oocyte retrieval. which needs luteal phase support.

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Changes of luteal hormone secretion during pregnancy and the clinical significance. YIN Xiang-jie，LI Kun-ming 2021, 37(4): 414-417.  DOI: 10.19538/j.fk2021040103 Abstract ( )   The establishment and maintenance of a successful pregnancy requires the fine regulation of steroid hormones produced by the corpus luteum. Estrogen and progesterone play a major role in early pregnancy. The development of early pregnancy embryo needs a certain amount of estrogen to maintain，and the increase of progesterone on the basis of estrogen level provides the conditions for inducing endometrium decidualization. Insufficient production of progesterone will affect embryo implantation and growth，and eventually lead to miscarriage. Therefore，both estrogen and progesterone play an important role in maintaining endometrium decidualization in early pregnancy. At present，the clinical application of progesterone and estrogen to prevent abortion and hormone supplementation in patients with luteal insufficiency are mostly based on clinical experience，and are still lacking sufficient evidence-based medical evidence. Therefore，the supplementation of estrogen and progesterone in early pregnancy to "keep the fetus" needs to be more cautious，and unnecessary drugs should be avoided.

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Exploration of luteal phase support in different  protocols of controlled ovarian stimulation. XU Xi-ya，QUAN Song 2021, 37(4): 417-422.  DOI: 10.19538/j.fk2021040104 Abstract ( )   During the treatment with assisted reproductive technique（ART），controlled ovarian stimulation（COS）protocols are chosen depending on the patients' age，ovarian reserve，ovarian response and so on，which need to be individualized for the sake of higher efficiency and lower rate of ovarian hyperstimulation syndrome（OHSS）. As different COS protocols have different influence on the luteal function，routine luteal phase support after COS is even more important for the patients in fresh embryo transfer. Drugs of luteal phase support include hCG，progesterone，estradiol，GnRH-a and so on. In order to improve the outcome of ART，it’s necessary to study and formulate the luteal phase support scheme according to the features of different protocols of COS.

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Luteal phase support in frozen-thawed embryo transfer. ZHU Qin-ling，SUN Yun 2021, 37(4): 422-427.  DOI: 10.19538/j.fk2021040105 Abstract ( )   Optimal luteal phase support（LPS）helps the establishment of endometrium receptivity and early embryo development，and is a key factor to determine the success of pregnancy in frozen-thawed embryo transfer（FET）. Natural cycle，hormone replacement treatment cycle and mild ovarian stimulation cycle are the commonly used regimens for endometrium preparation in FET. LPS is necessary for hormone replacement treatment cycle，but whether it is needed in natural cycle and mild ovarian stimulation cycle is still controversial. Moreover，there is no unified standard for the ideal route or dose of administration in LPS，and no consensus has been reached yet on when to initiate or stop LPS. This paper reviews the latest researches of the luteal phase support according to different endometrium preparation protocols，aiming to improve the formulation and selection of luteal phase support for frozen-thawed embryo transfer.

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Role of luteal support in recurrent pregnancy loss. BAI Shi-yu，ZHANG Jian-ping 2021, 37(4): 427-431.  DOI: 10.19538/j.fk2021040106 Abstract ( )   Luteal support is widely used in the prevention and treatment of premature labor and threatened abortion，but its role in the treatment of recurrent pregnancy loss has not been uniformly understood. This article will review the role and application of luteal support in recurrent pregnancy loss，and provide references for the diagnosis and treatment of recurrent pregnancy loss.

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High-risk factors and clinical treatment of luteinized unruptured follicle syndrome. LI Song，XU Yan-wen 2021, 37(4): 431-435.  DOI: 10.19538/j.fk2021040107 Abstract ( )   Luteinized unruptured follicle syndrome（LUFS），one of the causes of female infertility，is a special phenotype of menstruation without ovulation. The mechanism of LUFS is still unclear. The possible high-risk factors include abnormal expression of hormone or local factors in ovaries that regulate the ovary cycle，mechanical factors in the pelvic cavity，as well as patient's psychological factors. Currently，no special treatment is recommended for the prevention of LUFS. High-risk factors can be dealt with to prevent LUFS，for example，high dose of hCG can be used to induce ovulation when dominant follicle is matured in patients with repeated LUFS. If LUFS occurs in natural cycle for frozen/thawed embryo transfer，luteal phase support should be strengthened or the cycle can be cancelled.

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Pros and cons of luteal phase stimulation. HUANG Jia 2021, 37(4): 435-440.  DOI: 10.19538/j.fk2021040108 Abstract ( )   Luteal phase ovarian stimulation is a new stimulation protocol in recent years. The use of progesterone during ovarian stimulation is effective to block the LH surge. There are two ways of using progesterone，as with luteal phase stimulation，or with the progestin primed ovarian stimulation. A variety of stimulation protocols are derived from these two methods. The principles of these protocols，their potential in clinical practice and their medical significance remain to be demonstrated. Their putative advantages and disadvantages are summarized here.

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Treatment for luteal phase defects with Chinese medicine. LUO Song-ping，CAO Lei 2021, 37(4): 440-443.  DOI: 10.19538/j.fk2021040109 Abstract ( )   Luteal phase defects（LPD）often contribute to advanced menstruation，hypomenorrhea，infertility and threatened abortion. The etiology and pathogenesis of LPD in TCM are mainly kidney deficiency，spleen and kidney deficiency or hepatic stagnation and kidney deficiency. The treatment is strengthening kidney and spleen，supplemented by soothing the liver and nourishing the blood. The research of our team suggests that Chinese herbal medicine prescription（CHMP）for strengthening kidney and spleen can increase the expression of progesterone receptor（PR）in endometrium or decidua and improve luteal effect. It has curative effect in regulating the menstrual function，preventing miscarriage and improving reproduction. Recently，a number of clinical and experimental studies have also found that the Chinese herbal compound for strengthening kidney and spleen and nourishing blood can effectively increase the number of ovarian antral follicles and improve ovarian reserve and function.