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Ovarian Stimulation covers all the basic and advanced aspects of ovarian stimulation for women undergoing ovulation induction and assisted reproduction. It gives a comprehensive review of the modern approach to ovarian stimulation and its alternatives - both in IVF and in other areas of reproductive endocrinology where it is employed. The book is divided into six sections that cover mild forms, non-conventional forms, IVF, complications and their management, alternatives, and procedures. The chapters are clearly written and well illustrated, discussing a wide range of relevant topics, including the protocols of gonadotropin, oral agents for ovulation induction, aromatase inhibitors and surgical induction of ovulation, ovarian hyperstimulation syndrome, and alternatives to drug treatment. Written by leading experts on reproductive health and fertility, it will assist infertility specialists, gynecologists, reproductive endocrinologists and radiologists in determining their patients' treatment.
This chapter explores the concerns with conventional ovarian stimulation regimens, which have provoked a need to develop alternative strategies. Natural and modified natural cycles for in vitro fertilization (IVF) are briefly discussed. Elective single embryo transfer correlates well with the NHS funding policy. However, as long as couples pay for IVF treatments themselves, many of them will opt for double embryo transfer because it can result in a higher chance of success in older women. Clomiphene citrate (CC) acts antagonistically on the estradiol receptor at the hypothalamic level, inhibiting negative as well as positive feedback, and resulting in ovarian stimulation and suppression of the luteinizing hormone (LH) surge. To improve effectiveness, natural cycle IVF could be offered as a series of treatment cycles, since it is safer and less stressful compared with conventional stimulation. Mild ovarian stimulation aims at reducing the psychological burden of IVF treatment.