Albert Irkaliev: Have We Underestimated the Corpus Luteum in Frozen Embryo Transfer?
Albert Irkaliev, Reproductologist at SILK Medical, shared on LinkedIn:
“Have we underestimated the corpus luteum in frozen embryo transfer?
In reproductive medicine, we often focus on one primary objective: creating a receptive endometrium and achieving implantation.
But two FET protocols can achieve the same goal while creating very different physiological environments.
In an ovulation-preserving FET, the corpus luteum remains present – producing not only progesterone and estradiol, but also relaxin and other vasoactive and angiogenic signals involved in early maternal cardiovascular adaptation.
In a programmed FET, we can replace estrogen and progesterone pharmacologically – but we do not necessarily replace the corpus luteum.
Why does this matter?
Recent randomized evidence suggests that while healthy live-birth rates may be similar, maternal and obstetric outcomes may not be identical.
This raises a broader question:
Should IVF success be defined only by implantation and live birth – or should we also consider the physiology and safety of the pregnancy we help create?
In the attached article, I review the emerging evidence and discuss why FET preparation may need to move from an implantation-centred to a pregnancy-centred approach.”
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