Vol. 19 Suppl. 4 2009 Reproductive BioMedicine Online; www.rbmonline.com/Article/4314
on web 10 September 2009
©Published by Reproductive Healthcare Ltd., Duck End Farm, Dry Drayton, Cambridge CB23 8DB, UK
Contribution from 11th World Congress on
Controversies in Obstetrics, Gynecology and
Infertility (COGI) 'Celebration - 30 years of IVF' and
Serono Symposia International Foundation
Luteal-phase endocrinology
IE Messinis, CI Messini, K Dafopoulos
Department of Obstetrics and Gynaecology, University of Thessalia,
Medical School, 41110 Larissa, Greece
Correspondence: e-mail: messinis@med.uth.gr
Professor Ioannis E Messinis was trained in Obstetrics and Gynaecology in
Athens and in Reproductive Endocrinology in Sweden. He has worked in
Edinburgh and Aberdeen in the post of Senior Lecturer. Since 1995 he has
been Professor in Obstetrics and Gynaecology at the University of
Thessalia, Larissa, Greece and Head of the Department. His has two MD
degrees and a PhD (Aberdeen) and has been author on 150 papers in
peer-review journals and several chapters in books. He has served as an
Associate Editor of Human Reproduction and a member of the Advisory
and Executive Committees of ESHRE and currently of the Advisory
Committee of MSRM.
Abstract
The corpus luteum is formed from the pre-ovulatory follicle under the
action of the mid-cycle LH surge. LH is the main luteotrophic hormone in
women controlling luteal structure and function during the normal
menstrual cycle. Local factors, however, including progesterone are also
involved. If conception does not take place, luteolysis occurs as a
physiological apoptotic process. Human chorionic gonadotrophin, secreted
after implantation, is able to rescue the corpus luteum and extend its
lifespan. In ovulation-induction cycles, the negative feedback effect of the
ovarian steroids on the pituitary is markedly potentiated, leading to the
suppression of endogenous LH secretion during the whole menstrual cycle.
The marked suppression of LH secretion disrupts corpus luteum function
regardless of the treatment regimen.
Summary for lay readers
The corpus luteum is formed from the ovulated follicle under the influence
of the endogenous LH surge. LH is the principal hormone that stimulates
the production of progesterone and supports corpus luteum function in
women. If conception fails, regression of corpus luteum takes place, a
process named luteolysis. The causes of luteolysis in humans are not
known. Nevertheless, the function of the corpus luteum is rescued when
conception occurs by human chorionic gonadotrophin. In IVF programmes,
ovarian stimulation leads to a marked suppression of LH secretion that
disrupts corpus luteum function.