Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-18T10:26:33.099Z Has data issue: false hasContentIssue false

Chapter 6 - Hormonal Ovarian Treatment

from Section 2 - Assisted Reproductive Procedures

Published online by Cambridge University Press:  05 March 2021

By
Raoul Orvieto  and
Eliezer Girsh
Edited by
Eliezer Girsh
Eliezer Girsh
Affiliation:
Barzilai Medical Center, Ashkelon
Get access

Summary

At the beginning of the menstrual cycle, there is an increase in bioactive follicle-stimulating hormone (FSH) levels, a stimulus for the growth and differentiation of follicular granulosa cells (GCs). GC steroidogenic enzymes are also inducible by FSH and are necessary for the production of estradiol (E2) and progesterone (P4), as well as expression of luteinizing hormone (LH) receptors on theca cells (TCs). LH then stimulates theca cells to produce androgens, which are metabolized to E2 by GCs under the influence of FSH. Elevated levels of E2 then inhibit FSH secretion, providing a negative feedback effect. Growth of the leading follicle continues owing to elevated levels of FSH receptors, whereas secondary follicles with fewer FSH receptors undergo atresia. Taken together, FSH and LH work in concert, as depicted by the classic two-cell (TC and GC), two-gonadotropin (FSH and LH) theory.

Type
Chapter
Information
A Textbook of Clinical Embryology , pp. 71 - 84
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Pandya, G, Cohen, MR. The effect of cis-isomer of clomiphene citrate (cis-clomiphene) on cervical mucus and vaginal cytology. J. Reprod. Med. 1972; 8:133–138.Google Scholar
Kerin, JF, Liu, JH, Phillipou, G, Yen, SS. Evidence for a hypothalamic site of action of clomiphene citrate in women. J. Clin. Endocrinol. Metab. 1985; 61:265–268.Google Scholar
Kelly, JL, Adashi, EY. Ovulation induction. Obstet. Gynecol. Clin. North Am. 1987; 14:831–864.Google Scholar
Palomba, S. Aromatase inhibitors for ovulation induction. J. Clin. Endocrinol. Metab. 2015; 100:1742–1747.Google Scholar
Deary, AJ, Seaton, JE, Prentice, A, et al. Single versus double insemination: a retrospective audit of pregnancy rates with two treatment protocols in donor insemination. Hum. Reprod. 1997; 12:1494–1496.Google Scholar
van Rijswijk, J, Caanen, MR, Mijatovic, V, et al. Immobilization or mobilization after IUI: an RCT. Hum. Reprod. 2017; 32:2218–2224.Google Scholar
Kim, A, Young Lee, J, Il Ji, Y, et al. Do endometrial movements affect the achievement of pregnancy during intrauterine insemination? Int. J. Fertil. Steril. 2015; 8:339–408.Google Scholar
Akino, N, Isono, W, Wada-Hiraike, O. Predicting suitable timing for artificial reproductive technology treatment in aged infertile women. Reprod. Med. Biol. 2016; 15:253–259.CrossRefGoogle ScholarPubMed
Cantineau, AE, Heineman, MJ, Cohlen, BJ. Single versus double intrauterine insemination in stimulated cycles for subfertile couples: a systematic review based on a Cochrane review. Hum. Reprod. 2003; 18:941–946.CrossRefGoogle ScholarPubMed
Abou-Setta, AM, Mansour, RT, Al-Inany, HG, et al. Intrauterine insemination catheters for assisted reproduction: a systematic review and meta-analysis. Hum. Reprod. 2006; 21:1961–1967.Google Scholar
Guzick, DS, Carson, SA, Coutifaris, C, et al. Efficacy of superovulation and intrauterine insemination in the treatment of infertility. National Cooperative Reproductive Medicine Network. N. Engl. J. Med. 1999; 340:177–183.CrossRefGoogle ScholarPubMed
Collins, J. Stimulated intra-uterine insemination is not a natural choice for the treatment of unexplained subfertility. Current best evidence for the advanced treatment of unexplained subfertility. Hum. Reprod. 2003; 18:907–912.CrossRefGoogle Scholar
Cèdrin-Durnerin, I, Bständig, B, Parneix, I, et al. Effects of oral contraceptive, synthetic progestogen or natural estrogen pre-treatments on the hormonal profile and the antral follicle cohort before GnRH antagonist protocol. Hum. Reprod. 2007; 22:109–116.CrossRefGoogle ScholarPubMed
La Marca, A, Sunkara, SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum. Reprod. Update 2014; 20:124–140.Google Scholar
Moraloğlu, Ö, Tonguc, EA, Özel, M, et al. The effects of peak and mid-luteal estradiol levels on in vitro fertilization outcome. Arch. Gynecol. Obstet. 2012; 285:857–862.Google Scholar
Andersen, CY, Westergaard, LG, Sinosich, MJ, Byskov, AG. Human preovulatory follicular fluid: inhibin and free steroids related to optimal follicular maturation in ovarian stimulation regimes and possible function in ovulation. Hum. Reprod. 1992; 7:765–769.Google Scholar
Ventura-Juncá, P, Irarrázaval, I, Rolle, AJ, et al. In vitro fertilization (IVF) in mammals: epigenetic and developmental alterations. Scientific and bioethical implications for IVF in humans. Biol. Res. 2015; 48:68.CrossRefGoogle ScholarPubMed
Jiang, Z, Wang, Y, Lin, J, et al. Genetic and epigenetic risks of assisted reproduction. Best Pract. Res. Clin. Obstet. Gynaecol. 2017; 44:90–104.CrossRefGoogle ScholarPubMed
Macklon, NS, Stouffer, RL, Giudice, LC, Fauser, BC. The science behind 25 years of ovarian stimulation for in vitro fertilization. Endocr. Rev. 2006; 27:170–207.Google Scholar
Gonen, Y, Balakier, H, Powell, W, Casper, RF. Use of gonadotropin-releasing hormone agonist to trigger follicular maturation for in vitro fertilization. J. Clin. Endocrinol. Metab. 1990; 71:918–922.CrossRefGoogle ScholarPubMed
Albano, C, Smitz, J, Camus, M, et al. Comparison of different doses of gonadotropin-releasing hormone antagonist cetrorelix during controlled ovarian hyperstimulation. Fertil. Steril. 1997; 67:917–922.Google Scholar
Tarlatzis, B, Fauser, B, Kilibianakis, E, Diedrich, K, Devroey, P. GnRH antagonists in ovarian stimulation for IVF. Hum. Reprod. Update 2006;12:333–340.CrossRefGoogle ScholarPubMed
Lyttle Schumacher, MB, Mersereau, JE, Steiner, AZ. Cycle day, estrogen level, and lead follicle size: analysis of 27,790 in vitro fertilization cycles to determine optimal start criteria for gonadotropin-releasing hormone antagonist. Fertil. Steril. 2018; 109:633–637.Google Scholar
Blunt, SM, Butt, WR. Pulsatile GnRH therapy for the induction of ovulation in hypogonadotropic hypogonadism. Acta Endocrinol. Suppl. (Copenh.) 1988; 288:58–65.Google ScholarPubMed
Nargund, G, Hutchison, L, Scaramuzzi, R, Campbell, S. Low-dose HCG is useful in preventing OHSS in high-risk women without adversely affecting the outcome of IVF cycles. RBM Online 2007; 14:682–685.Google ScholarPubMed
Wang, W, Zhang, X-H, Wang, W-H, et al. The time interval between hCG priming and oocyte retrieval in ART program: a meta-analysis. J. Assist. Reprod. Genet. 2011; 28:901–910.Google Scholar
Bosch, E, Labarta, E, Kolibianakis, E, Roen, M, Meldrum, D. Regimen of ovarian stimulation affects oocyte quality and therefore embryo quality. Fertil. Steril. 2016; 105:560–570.Google Scholar
Itskovitz-Eldor, J, Kol, S, Mannaerts, B. Use of a single bolus of GnRH agonist triptorelin to trigger ovulation after GnRH antagonist ganirelix treatment in women undergoing ovarian stimulation for assisted reproduction, with special reference to the prevention of ovarian hyperstimulation syndrome: preliminary report: short communication. Hum. Reprod. 2000; 15:1965–1968.CrossRefGoogle Scholar
Kolibianakis, EM, Schultze-Mosgau, A, Schroer, A, et al. A lower ongoing pregnancy rate can be expected when GnRH agonist is used for triggering final oocyte maturation instead of HCG in patients undergoing IVF with GnRH antagonists. Hum. Reprod. 2005; 20:2887–2892.Google Scholar
Choi, JH, Gilks, CB, Auersperg, N, Leung, PC. Immunolocalization of gonadotropin-releasing hormone (GnRH)-I, GnRH-II, and type I GnRH receptor during follicular development in the human ovary. J. Clin. Endocrinol. Metab. 2006; 91:4562–4570.Google Scholar
Laprise, SL. Implications of epigenetics and genomic imprinting in assisted reproductive technologies. Mol. Reprod. Dev. 2009; 76:1006–1018.CrossRefGoogle ScholarPubMed
Rubio, C, Mercader, A, Alamá, P, et al. Prospective cohort study in high responder oocyte donors using two hormonal stimulation protocols: impact on embryo aneuploidy and development. Hum. Reprod. 2010; 25:2290–2297.Google Scholar
van der Gaast, MH, Eijkemans, MJ, van der Net, JB, et al. Optimum number of oocytes for a successful first IVF treatment cycle. RBM Online 2006; 13:476–480.Google Scholar
Steward, RG, Lan, L, Shah, AA, et al. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256,381 in vitro fertilization cycles. Fertil. Steril. 2014; 101:967–973.CrossRefGoogle ScholarPubMed
Vermey, BG, Chua, SJ, Zafarmand, MH, et al. Is there an association between oocyte number and embryo quality? A systematic review and meta-analysis. RBM Online 2019; 39:751–763.Google ScholarPubMed
Haaf, T, Lambrecht, A, Grossmann, B, et al. A high oocyte yield for intracytoplasmic sperm injection treatment is associated with an increased chromosome error rate. Fertil. Steril. 2009; 91:733–738.Google Scholar
ESHRE Capri Workshop Group. Health and fertility in World Health Organization group 2 anovulatory women. Hum. Reprod. Update 2012; 18:586–599.Google Scholar
Homburg, R, Ray, A, Bhide, P, et al. The relationship of serum anti-Mullerian hormone with polycystic ovarian morphology and polycystic ovary syndrome: a prospective cohort study. Hum. Reprod. 2013; 28:1077–1083.CrossRefGoogle ScholarPubMed
Dumesic, DA, Padmanabhan, V, Abbott, DH. Polycystic ovary syndrome and oocyte developmental competence. Obstet. Gynecol. Surv. 2008; 63:39–48.Google Scholar
Wood, JR, Dumesic, DA, Abbott, DH, Strauss, JF 3rd. Molecular abnormalities in oocytes from women with polycystic ovary syndrome revealed by microarray analysis. J. Clin. Endocrinol. Metab. 2007; 92:705–713.CrossRefGoogle ScholarPubMed
Amato, G, Conte, M, Mazziotti, G, et al. Serum and follicular fluid cytokines in polycystic ovary syndrome during stimulated cycles. Obstet. Gynecol. 2003; 101:1177–1182.Google Scholar
Gallinelli, A, Ciaccio, I, Giannella, L, et al. Correlations between concentrations of interleukin-12 and interleukin-13 and lymphocyte subsets in the follicular fluid of women with and without polycystic ovary syndrome. Fertil. Steril. 2003; 79:1365–1372.CrossRefGoogle ScholarPubMed
Wu, CH, Winkel, CA. The effect of therapy initiation day on clomiphene citrate therapy. Fertil. Steril. 1989; 52:564–568.Google Scholar
Dickey, RP, Taylor, SN, Lu, PY, et al. Effect of diagnosis, age, sperm quality, and number of preovulatory follicles on the outcome of multiple cycles of clomiphene citrate-intrauterine insemination. Fertil. Steril. 2002; 78:1088–1095.Google Scholar
Veltman-Verhulst, SM, Fauser, BC, Eijkemans, MJ. High singleton live birth rate confirmed after ovulation induction in women with anovulatory polycystic ovary syndrome: validation of a prediction model for clinical practice. Fertil. Steril. 2012; 98:761–768.Google Scholar
Mathur, R, Alexander, CJ, Yano, J, Trivax, B, Azziz, R. Use of metformin in polycystic ovary syndrome. Am. J. Obstet. Gynecol. 2008; 199:596–609.Google Scholar
Sinawat, S, Buppasiri, P, Lumbiganon, P, Pattanittum, P. Long versus short course treatment with metformin and clomiphene citrate for ovulation induction in women with PCOS. Cochrane Database Syst. Rev. 2012; 10:CD006226. doi:10.1002/14651858.CD006226.pub3.Google Scholar
Gleicher, N, Barad, DH. Dehydroepiandrosterone (DHEA) supplementation in diminished ovarian reserve (DOR). Reprod. Biol. Endocrinol. 2011; 9:67, doi:10.1186/1477-7827-9-67.Google Scholar
Narkwichean, A, Maalouf, W, Campbell, BK, Jayaprakasan, K. Efficacy of dehydroepiandrosterone to improve ovarian response in women with diminished ovarian reserve: a meta-analysis. Reprod. Biol. Endocrinol. 2013; 11:44, doi:10.1186/1477-7827-11-44.CrossRefGoogle ScholarPubMed
Yeung, T, Chai, J, Li, R, et al. A double-blind randomised trial on the effect of dehydroepiandrosterone on ovarian reserve markers, ovarian response and number of oocyte in anticipated normal ovarian responders. BJOG 2016; 123:1097–1105.Google Scholar
Gómez, R, Soares, SR, Busso, C, et al. Physiology and pathology of ovarian hyperstimulation syndrome. Sem. Reprod. Med. 2010; 28:448–457.Google Scholar
Kasum, M, Danolic, D, Oreskovic, S, et al. Thrombosis following ovarian hyperstimulation syndrome. Gynecol. Endocrinol. 2014; 30:764–768.Google Scholar
Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome. Fertil. Steril. 2016; 106:1634–1647.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×