The Endometrium During And After Ovarian Hyperstimulation And The Role Of Segmentation Of Infertility Treatment

Publication date: Available online 13 September 2018Source: Best Practice & Research Clinical Endocrinology & MetabolismAuthor(s): Jorge Rodriguez-Purata, Nikolaos P. PolyzosAbstractControlled ovarian hyperstimulation (COH) is a key part of assisted reproductive technologies (ART) that resulted in a substantial increase in pregnancy rates from in vitro fertilization (IVF). However, in spite of the clear benefit of COH on an increase in the number of follicles and the number of oocytes retrieved, allowing for extended embryo culture and enabling the selection of the best quality embryo for transfer, several reports has shown that the supraphysiological hormonal levels may indeed have a detrimental effect on the endometrial level. The current article revises the pathophysiological mechanisms through which ovarian stimulation may negatively affect endometrial receptivity. In addition, the evidence is analyzed explaining how segmentation of IVF treatment may allow us to overcome the deleterious effects of hyperstimulation on endometrial receptivity. Deferred embryo transfer may be performed in a more physiologic uterine environment in a subsequent cycle, improve endometrial receptivity, decrease uterine contractility, diminishes the impact of premature luteinization and allow individualized stimulation according to the level of response.
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research