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Alternative approaches to ovarian stimulation for IVF

Published online by Cambridge University Press:  05 July 2001

NS Macklon
Affiliation:
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands
BCJM Fauser
Affiliation:
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands

Abstract

Ovarian stimulation protocols applied world-wide today may take several weeks per stimulated cycle, are complex, expensive and associated with a certain degree of risk. Gonadotrophin preparations are administered to stimulate multiple follicle development usually at daily doses of 150–300 IU (and sometimes higher) for one to three weeks. A premature rise in serum luteinizing hormone (LH) levels, generally believed to be detrimental for in vitro fertilization (IVF) outcome, is prevented by the co-administration of a gonadotrophin-releasing hormone (GnRH) agonist. This is usually initiated in the preceding cycle to allow for pituitary downregulation to occur before the initiation of exogenous follicle-stimulating hormone (FSH). Finally, the resumption of oocyte meiotic maturation is induced by a single bolus injection of human chorionic gonadotrophin (hCG) during the late follicular phase. In addition, the corpus luteum is supported during the luteal phase by repeated administration of hCG or supplemented by exogenous progesterone.

Type
Research Article
Copyright
© 2001 Cambridge University Press

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