What is the luteal phase?
Healthy women of reproductive age develop one egg every month during their menstrual period. The egg that is produced reaches a certain maturity and then cracks, and pregnancy is established and maintained by the hormones secreted by a structure called the corpus luteum, which is formed by other cells in the body within the ovary. The placenta, which is created between the mother and the baby to ensure the development of the baby throughout pregnancy and is commonly called the baby's partner, continues to secrete hormones and create the nutrients needed for the baby's development until it begins to do its job by the ovaries. The vast majority of conditions commonly known as miscarriages are caused by the structure called the corpus luteum not being able to fulfill its duties as required.
The luteal phase is the period when hormones fulfill their duties after the expectant mother ovulates during her menstrual period and the foundations of pregnancy are laid. Especially in in vitro fertilization applications and in cases where the pregnancy is monitored as it should be, since the situations where luteal phase support is required are detected, great steps are being taken in terms of ending the pregnancy with a live birth without miscarriage.
In what situations is IVF and luteal phase support necessary?
Unlike normal pregnancies, IVF In treatments, as a result of stimulation of the ovaries with needles etc., the necessary hormones are not secreted in the corpus luteum event and the baby's development cannot be ensured until the placenta is formed, and the pregnancy cannot be sustained. Since the eggs are cracked by external intervention, the luteal phase hormones decrease and cannot fulfill their function due to the pressure exerted on the brain by the estrogen hormone, which is suddenly secreted more. Therefore, hormone support should be applied during the luteal phase period to ensure sufficient secretion of hormones after intervention on more than one egg in in vitro fertilization applications.
Which hormone is used and how during the luteal phase?
Another issue that is at least as important as the cracking of the eggs and the sufficient secretion of hormones during pregnancy and the establishment of the beginning of pregnancy on a solid foundation is the attachment of the embryo to the uterine wall. After the egg and sperm cells unite and are fertilized, the embryo falls into the uterus from the fallopian tubes and after attaching to the uterine wall here, the baby continues its development in the amniotic sac formed by the mother's body. One of the most important factors for the attachment of the embryo to the uterine wall is the progesterone hormone. Therefore, progesterone-containing drugs should be used during the luteal phase . Progesterone-containing drugs are administered to the body in many different ways, including vaginally, with intramuscular injections, rectally and orally. Hormone supplements applied during the luteal phase of in vitro fertilization are generally applied vaginally today. Vaginal applications are preferred because they are easier and painless than others. The most commonly used application after vaginal applications is intramuscular infection.
The most important time to start hormone supplementation during the luteal phase is when the eggs are collected. During this period, hormone supplementation alone will not be enough, and patients are informed about the medications they will use and the points they will pay attention to after the OPU procedure. The reason for this application is that drug treatments after the luteal phase directly affect pregnancy.
What does vaginal bleeding indicate during the luteal phase?
Bleeding following embryo transfer in IVF treatments is a concern for expectant mothers and specialists. The occurrence of this bleeding after embryo transfer and before the pregnancy test indicates that a miscarriage may be due to a lack of hormones. However, if we consider the percentage of probability and the certainty of the evidence, it would be wrong to call this the only factor that causes miscarriage . It is not only hormone deficiency, but also vaginal bleeding during pregnancy, and bleeding that occurs during the attachment of the embryo to the uterine wall, which is called menstruation.
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