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Luteal Phase Defect (LPD): A necessary tool in assisted reproductive techniques

In Luteal Phase Defect (LPD), endogenous progesterone is insufficient to maintain a functional secretory endometrium and also inhibit embryo growth and implant. In 1960, it was estimated that 20 million pregnancies were exposed to Dydrogesterone in utero. LOTUS I and LOTUS II two major multicenter Phase III studies were conducted on patients who were planning to undergo Fertilization (IVF) with or without Intracytoplasmic Sperm Injection (ICSI). The result of both studies shows that Dydrogesterone was non-inferior to micronized vaginal progesterone, which was the presence of fetal heartbeats at 12 weeks of gestation. Progesterone which can be administered either by oral preparation, vaginal administration along with optimal use of estrogen and Gonadotropin-Releasing Hormon (GnRH) agonist drugs is used in the treatment of LPD. Studies have suggested the use of Dydrogesterone in fresh IVF cycles and Luteal Phase Support (LPS) is continued till 10–12 weeks. However, it may be stopped at the time of β-hCG becoming positive or visualization of a fetal heartbeat.