Luteal Phase Support – Refining Protocols for Better ART Outcomes
On 12 September 2025, I had the privilege of speaking at the Gunasheela Hospital Golden Jubilee Conference – “Pushing the Frontiers in Infertility”, Bangalore. My session focused on Luteal Phase Support (LPS): Various Protocols, a cornerstone of ART success.
Key Insights:
• When to start progesterone: Evidence supports initiating between oocyte pickup and day 3 in fresh cycles. In frozen cycles, timing must align with embryo stage and endometrial priming.• European vs American concepts: European style couples GnRHa trigger with low-dose hCG “rescue,” while the American approach relies solely on exogenous steroids. Each has a place depending on OHSS risk.
• Individualization matters: Serum progesterone thresholds, BMI effects, and patient comfort influence real-world outcomes. Rescue strategies with IM/SC progesterone can normalize live birth rates in women with low luteal P.
• Practical pearls for Indian/Asian practice: Vaginal progesterone remains the workhorse; dydrogesterone offers convenience and strong trial evidence; SC progesterone is a valuable alternative for select patients.
• Practical pearls for Indian/Asian practice: Vaginal progesterone remains the workhorse; dydrogesterone offers convenience and strong trial evidence; SC progesterone is a valuable alternative for select patients.
In summary:
LPS is essential but not uniform. Timing, adequate exposure, personalization for high-risk groups, and balancing safety with patient comfort are the guiding principles.
I am grateful to Gunasheela Hospital for this opportunity and to colleagues for engaging discussions that push our field forward.