Luteal-phase deficiency in infertility management is typically addressed with what in ART cycles?

• A. Increased estrogen therapy during the follicular phase
• B. Extended ovarian stimulation without luteal support
• C. Creatively adjusting GnRH agonist therapy
• D. Luteal-phase support with progesterone in ART cycles

Answer: (D)

In ART cycles, the luteal phase often becomes insufficient because ovarian stimulation and the use of GnRH analogs suppress natural LH and corpus luteum function, leading to low endogenous progesterone. Providing luteal-phase support with progesterone replenishes this deficiency, ensuring the endometrium remains in a receptive, secretory state for implantation and early pregnancy maintenance. Progesterone support can be given vaginally, orally, or by injection and is a standard part of IVF/ART protocols to improve implantation and pregnancy rates. Other options don’t directly fix the deficient progesterone environment: increasing estrogen in the follicular phase doesn’t address luteal function, extending stimulation without luteal support worsens the deficit, and simply adjusting GnRH agonist therapy doesn’t provide the necessary luteal backing.