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Luteal support is the administration of medication, generally progesterone, progestins, hCG or GnRH agonists, to increase the success rate of implantation and early embryogenesis, thereby complementing and/or supporting the function of the corpus luteum. It can be combined with for example in vitro fertilization and ovulation induction.
Data on breast safety with vaginal progesterone are scarce. [126] The Early versus Late Intervention Trial with Estradiol (ELITE) was a randomized controlled trial of about 650 postmenopausal women who used estradiol and 45 mg/day cyclic vaginal progesterone. [126] [132] Incidence of breast cancer was reported as an adverse effect.
Progesterone plays a vital role in making the endometrium receptive to implantation of the embryo and supportive of early pregnancy. High levels of progesterone inhibit the follicular growth. The increase in estrogen and progesterone also lead to increased basal body temperature during the luteal phase. [3]
At the same time progesterone affects the vaginal epithelium and cervical mucus, making it thick and impenetrable to sperm. Progesterone is anti-mitogenic in endometrial epithelial cells, and as such, mitigates the tropic effects of estrogen. [55] If pregnancy does not occur, progesterone levels will decrease, leading to menstruation. Normal ...
For example, progesterone (or sometimes dydrogesterone or hydroxyprogesterone caproate) is used for luteal support in in-vitro fertilization protocols. [42] Certain progestogens are used to support pregnancy, including progesterone, hydroxyprogesterone caproate, dydrogesterone, and allylestrenol.
Progesterone also causes decreased motility of the ureters, which can lead to stasis of the urine and hence an increased risk of urinary tract infection. [6] Pregnancy alters the vaginal microbiota with a reduction in species/genus diversity. [34] Physiological hydronephrosis may appear from six weeks. [35]
The only progestogens currently used during pregnancy (e.g., for luteal support in IVF protocols or for prevention of preterm birth in pregnant women with a history of at least one spontaneous preterm birth) are: progesterone, hydroxyprogesterone caproate, dydrogesterone, and allylestrenol. [6]
Healthy pregnancy results in a dense CMP which protects the uterine cavity from infection. [1] Elevated progesterone plasma levels induce cervical mucus to form a more viscous plug called the CMP. [7] One of the most common causes of preterm birth is inflammation induced by the changes in vaginal bacterial flora. [8]
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