التفاصيل البيبلوغرافية
| العنوان: |
Ovarian stimulation in ART - Unwinding pressing issues. |
| المؤلفون: |
Zech NH; IVF Centers Prof. Zech, Bregenz, Austria - n.zech@ivf.at., Zech M, Baldauf S, Comploj G, Murtinger M, Spitzer D, Hradecký L, Ajayi R, Schuff M, Zech H |
| المصدر: |
Minerva ginecologica [Minerva Ginecol] 2015 Apr; Vol. 67 (2), pp. 127-47. Date of Electronic Publication: 2015 Feb 10. |
| نوع المنشور: |
Journal Article; Review |
| اللغة: |
English |
| بيانات الدورية: |
Publisher: Edicioni Minerva medica Country of Publication: Italy NLM ID: 0400731 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1827-1650 (Electronic) Linking ISSN: 00264784 NLM ISO Abbreviation: Minerva Ginecol Subsets: MEDLINE |
| أسماء مطبوعة: |
Original Publication: Torino, Edicioni Minerva medica. |
| مواضيع طبية MeSH: |
Fertilization in Vitro/*methods , Ovarian Hyperstimulation Syndrome/*prevention & control , Ovulation Induction/*methods, Blastocyst/metabolism ; Embryo Transfer/economics ; Embryo Transfer/methods ; Female ; Fertilization in Vitro/economics ; Gonadotropin-Releasing Hormone/administration & dosage ; Humans ; Infant, Newborn ; Maternal Age ; Ovarian Hyperstimulation Syndrome/etiology ; Ovulation Induction/economics ; Pregnancy ; Pregnancy Rate |
| مستخلص: |
Conventional controlled ovarian stimulation (cCOS) can cause significant discomfort, including ovarian hyperstimulation syndrome (OHSS). Clearly, management of OHSS and poor responder patients requires new strategies to overcome these problems and facilitate the birth of a healthy child with the fewest stimulation cycles. Several alternative methods have been developed. Non-conventional controlled ovarian stimulation (non-cCOS) is based on low-dose stimulation regimens and is often termed "light", "soft", "mini", "minimal", "mild", "low cost", or "low dose IVF". Non-controlled ovarian stimulation therapies (non-COS) include natural cycle IVF or a mixture between non-controlled and non-cCOS, termed "modified natural IVF" or "antiestrogen/aromatase inhibitor/low dose FSH-cycles", in which cycles are monitored but not controlled. These approaches promise to reduce the physical, emotional, and financial burden of IVF therapy while maintaining acceptable pregnancy rates. Such approaches might reduce the risk of OHSS. However, the overall cost per baby increases due to the higher number of stimulation cycles required, and the inconvenience of ovum pick-up still remains. The primary focus should be to obtain several good quality blastocysts after a single cCOS cycle. Thus, adequate numbers of mature oocytes are mandatory. What is more difficult and expensive for patients: several non-COS/non-cCOS cycles to obtain a baby or a single cCOS cycle with a high probability to obtain more than one child? Classic cCOS using the GnRH agonist long protocol followed by single embryo transfer (SET) at the blastocyst stage and aseptic vitrification of surplus embryos optimizes the IVF outcome. This strategy, combined with outpatient management in the case of OHSS, minimizes inconvenience and risks of OHSS. Accumulation cycles (AC) by repeated COS with subsequent freezing of blastocysts, combined with preimplantation genetic screening (PGS), is a promising new approach for low responders, especially in cases of advanced maternal age (AMA). |
| المشرفين على المادة: |
33515-09-2 (Gonadotropin-Releasing Hormone) |
| تواريخ الأحداث: |
Date Created: 20150211 Date Completed: 20161213 Latest Revision: 20161230 |
| رمز التحديث: |
20240628 |
| PMID: |
25668422 |
| قاعدة البيانات: |
MEDLINE |
