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Before implantation of the embryo to the endometrium can occur, the uterine must be prepared and ready for the arriving of the embryos. In a natural conception, the corpus luteum (the left-over empty follicle after ovulation of an mature egg) plays an important role in preparing the endometrium (lining of the uterus) for implantation. It secretes oestrogen and progesterone, which will maintain and develop the endometrium so that implantation can occur.

If no fertilisation occurs, the corpus luteum will stop producing hormones and degenerate. The progesterone levels will then fall. The falling progesterone levels will cause the endometrium to sahde off and be expelled through the vagina during menstruation. If fertilisation and implantation occur, the blastocyst will secrete human chorionic gonadotropin (hCG) and this hormone will keep the corpus luteum to continue to maintain the endometrium and the embryo that is growing and developing in it. So, low levels of progesterone will cause poor quality endometrium and failure of early pregnancy.

The use of gonadotropin releasing hormone (GnRH) agonist in COH prior to infertility treatment may cause hormonal disturbance and lead to progesterone deficiency after the embryo has been transferred and implantated. The aspiration of granulosa cells (hormone-producing cells that surround the eggs) during OPU will also may impair the ability of corpus luteum to produce progersterone.

Progesterone deficiency will cause poor quality endometrium and result in poor implantation and growth. So, at Metro IVF, all patients from IVF cycles are given progesterone and hCG supplements also know as luteal support. The luteal support can be given through three routes, injections, oral tablets, or vaginal pessary. Below are the lists of luteal support: