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21 results

Page 1 of 2

  • Chapter 1 - Oral Agents for Ovarian Stimulation
  • from Section 1 - Mild Forms of Ovarian Stimulation
  • Edited by Mohamed Aboulghar, Botros Rizk, University of South Alabama
  • Book: Ovarian Stimulation
  • Published online: 14 April 2022
  • Print publication: 05 May 2022, pp 1-14
  • View extract

    Summary

    Ovarian stimulation aims at the development of one or more of the ovarian follicles to reach the stage of maturity culminating in the release of one or more mature oocytes ready for fertilization. Ovarian follicular development is under the control of local factors inside the ovaries (most of it is poorly understood), as well as hormones produced from extraovarian sources, mainly pituitary gonadotropins. Other hormones may play a role in ovarian follicular development; the extent and details of such a role are not fully understood.

  • Introduction
  • Edited by Roy Homburg, Adam H. Balen, Robert F. Casper
  • Book: 50 Big Debates in Reproductive Medicine
  • Published online: 25 November 2021
  • Print publication: 16 December 2021, pp 1-1
  • View extract

    Summary

    Human reproduction is the most basic of human functions and is the foundation of our very existence. When considering the bodily mechanisms involved, from the delicacy of the interacting endocrine network to the wonder of the cyclical changes in the ovary and uterus and the mechanism of sperm production, it is a constant source of amazement that the integration needed to produce another human being does not go wrong more often.

50 Big Debates in Reproductive Medicine
  • 50 Big Debates in Reproductive Medicine
  • Edited by Roy Homburg, Adam H. Balen, Robert F. Casper
  • Published online: 25 November 2021
  • Print publication: 16 December 2021
  • View description
    One of modern healthcare's most controversial areas, reproductive medicine is an emerging discipline that fosters hugely divergent opinions on topics such as laboratory techniques, clinical management and ethical considerations. Highlighting over 50 contentious topics in reproductive medicine, this book presents expertly argued opinions are presented for and against, often with diametrically opposing views about management. Debates such as these are being increasingly used as learning tools, helping participants develop their critical thinking skills and showing that context is vital when making decisions. Issues discussed include limits on IVF provision, ethical queries about sex selection, embryology, and ovarian stimulation. Authors are authorities in their field, combining years of experience with fresh and innovative ideas to structure their arguments. Readers will gain an insight into topical controversies, critically evaluating the different sides to enhance their own clinical practice.
  • Chapter 1 - Oral agents for ovarian stimulation
  • from Section 1: - Mild forms of ovarian stimulation
  • Edited by Mohamed Aboulghar, Botros Rizk, University of South Alabama
  • Book: Ovarian Stimulation
  • Published online: 05 August 2011
  • Print publication: 23 December 2010, pp 1-13
  • View extract

    Summary

    This chapter reviews pharmacological agents with a focus on the clinical aspects of their use. There are two groups of pharmacological agents for ovarian stimulation: the first group includes injectable gonadotropins and the second group includes oral agents that are estrogen modulators. Enclomiphene is the more potent antiestrogenic isomer and the one primarily responsible for the ovulation-stimulation actions of clomiphene citrate (CC). It is important to stress the two main prerequisites for the success of CC ovarian stimulation: presence of reasonable estrogen levels in the body and an intact hypothalamic/pituitary axis capable of producing endogenous gonadotropins. Aromatase activity is present in many normal tissues, such as the ovaries, the brain, muscle, liver, breast tissue, as well as in pathological tissues such as malignant breast tumors. The short half-life of letrozole and absence of estrogen receptor antagonism result in a very favorable profile for infertility treatment compared with CC.
  • 24 - Aromatase Inhibitors for Assisted Reproduction
  • from PART II - INFERTILITY EVALUATION AND TREATMENT
  • Edited by Botros R. M. B. Rizk, University of South Alabama, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis, University of Crete
  • Book: Infertility and Assisted Reproduction
  • Published online: 04 August 2010
  • Print publication: 15 September 2008, pp 220-227
  • View abstract

    Summary

    This chapter discusses the potential role of the new group of medications called aromatase inhibitors in assisted reproduction. When an aromatase inhibitor is applied during controlled ovarian hyperstimulation (COO), estrogen production per growing ovarian follicle has been found to be significantly lower than when aromatase inhibitors are not used. The use of aromatase inhibitors for in vitro maturation is an exciting application that can involve a brief aromatase inhibitor-induced rise in endogenous gonadotropin secretion leading to multiple ovarian follicles, followed by retrieval of immature oocytes. Both lowering supraphysiological levels of estrogen during COH and improving response to COH by enhancing endogenous gonadotropin production and increasing the ovarian follicular sensitivity to gonadotropin stimulation could be of benefit in particular groups of patients, for example, poor responders, endometriosis-associated infertility, polycystic ovarian syndrome (PCOS), and survivors of estrogen-dependant malignancies, for example, breast cancer.

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