The effect of controlled ovarian hyperstimulation (COH) on uterine receptivity
Infertility is a condition affecting approximately 10-15% of reproductive age couple. Although in 1978 the first baby was born from in vitro fertilization in a normal cycle with developing of IVF procedures, nowadays there are many protocols that we use for controlled ovarian hyperstimulation in order to increase the pregnancy rate. Although these gonadotropins produce many oocytes, but changing of hormonal pattern in these women, alter the endometrial receptivity. On the other hand, there are inadequate researches about it and after 50 years of gonadotropin administration, lack of understanding of consecutive steps leading to embryonic implantation, remains. The endometrial changes that were occurred during controlled ovarian hyperstimulation may compromise implantation, for example supra physiologic level of estradiol, progesterone or increasing of the expression of some apoptosis related genes. As well as many of these protocols produce luteal phase defect that needs support of this phase with some drugs like HCG or progesterone. In this lecture, we will speak about these drugs and things that we should do.