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Archive » 2010 » 2 » | Archive » Medical field » Fields » Gynecology and Obstetrics »

Ovulation Induction in Assisted Reproduction Technologies

 
Abstract:

This post is also available in: English Slovenščina (Slovenian)

More than 50 years have passed from the developmental phase of ovulation induction. During this period, new medications have been introduced and new protocols and dosages have been established, but a regimen that would suit all women has not yet been found. The success of ovulation induction in assisted reproduction technologies (ART) does not depend only on the medications used, but is also influenced by contributing key factors, such as the woman’s age and the characteristics of her menstrual cycle, as well as her body mass index, ovarian reser­ve and concomitant diseases. The first successful pregnancy followed natural cycle ART wit­hout medications. Because of a relatively low success rate, natural cycle was replaced in 1970’s with protocols that included clomiphene citrate or gonadotropins. The introduction of gona­doliberin agonists represented the greatest advantage in this field. The use of human meno­pausal gonadotropins and the recombinants, namely recombinant FSH, recombinant LH and recombinant HCG in combination with GnRH agonists, has resulted in significantly higher preg­nancy rates (cumulative up to 65%), but also in higher multiple pregnancy rates and ovarian hyperstimulation rates. This is why the use of cheaper, less complicated and more patient friend­ly principles has been renewed, including natural cycle, as well as methods for minimal and mild ovarian stimulation (use of clomiphene citrate, letrozole and small doses of human meno- pasual gonadotropin HMG or rFSH) that enable ovulation induction and pregnancy in about 30% of treated women. After half a century of developing sophisticated protocols of ovarian stimulation, modern European recommendations now favour the use of less aggressive and cheaper, as well as more effective and patient friendly methods of ovulation induction in ART.

Authors:
Gačić Marija, Vlaisavljević Veljko, Meden Vrtovec Helena

Keywords:
ovulation induction

Cite as:
Med Razgl. 2010; 49: 145–56.

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