{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:11:10Z","timestamp":1789621870529,"version":"build-2803163510"},"reference-count":37,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T00:00:00Z","timestamp":1656720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Gedeon Richter and the Zealand Health Region"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Supraphysiological sex steroid levels at the follicular-luteal phase transition are implicated as the primary cause of luteal insufficiency after ovarian stimulation (OS) for in vitro fertilization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to determine the impact of suppressing estradiol levels during OS of multiple dominant follicles on the unsupported luteal phase and markers of endometrial maturation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>At 2 university hospitals, 25 eligible egg donors were randomized to undergo OS using exogenous gonadotropins with or without adjuvant letrozole 5 mg\/day. Final oocyte maturation was triggered with a GnRH agonist. No luteal support was provided. The primary outcome was the duration of the luteal phase. Secondary outcomes were luteal phase hormone profiles and the endometrial transcriptomic signature 5 days after oocyte pick up (OPU\u2005+\u20055).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median (interquartile range [IQR]) luteal phase duration was 8.0 (6.8-11.5) days compared with 5.0 (5.0-6.8) days in the intervention and control group, respectively (P\u2005&amp;lt;\u20050.001). Estradiol levels were effectively suppressed in the letrozole group with a median of 0.86 (0.23-1.24) nmol\/L at OPU compared to 2.82 (1.34-3.44) nmol\/L in the control group. Median (IQR) progesterone levels at OPU\u2005+\u20055 were 67.05 (15.67-101.75) nmol\/L in the letrozole group vs 2.27 (1.05-10.70) nmol\/L in the control group (P\u2005&amp;lt;\u20050.001). In the letrozole group, 75% of participants revealed endometrial transcriptomic signatures interpreted as post-receptive. In the control group, 40% were post-receptive and 50% noninformative.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Suppressing estradiol levels in the follicular phase with adjuvant letrozole significantly reduces the disruption of the unsupported luteal phase after OS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgac409","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T15:36:45Z","timestamp":1656776205000},"page":"e3633-e3643","source":"Crossref","is-referenced-by-count":7,"title":["The Impact of Suppressing Estradiol During Ovarian Stimulation on the Unsupported Luteal Phase: A Randomized Controlled Trial"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-8389","authenticated-orcid":false,"given":"Marianne","family":"Dreyer Holt","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Fertility Clinic and ReproHealth Consortium, Zealand University Hospital , Lykkeb\u00e6kvej 14, 4600 K\u00f8ge , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven Olaf","family":"Skouby","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Fertility Clinic, Herlev University Hospital , Borgmester Ib Juuls Vej 1, 2730 Herlev , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie S\u00f8derhamn","family":"B\u00fclow","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Fertility Clinic, Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Lis Mikkelsen","family":"Englund","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Fertility Clinic and ReproHealth Consortium, Zealand University Hospital , 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