Abstract
The aim of controlled ovarian hyperstimulation (COH) for IVF is to produce multiple follicular development in order to harvest a suitable number of oocytes which can be fertilised and allow a selection of embryos which can be replaced into the uterus. Premature luteinisation is avoided by suppressing pituitary gonadotrophin production by co-treating with a GnRH agonist or antagonist, each with its own pros and cons. Individually tailoring the programme attempts to achieve the best live birth rates while taking into account the avoidance of ovarian hyperstimulation syndrome and the promotion of patient comfort, performed by utilizing several known facts such as ovarian response in any previous cycles, age, AMH or other predictors of ovarian reserve. The choice of gonadotrophin preparation for COH makes little if any difference regarding live birth rates while the antagonist is preferred over the agonist as regards patient comfort. Pre-treatment predictions of high, low and normal responders (using age, AMH and/or AFC) determines the protocol to be used and the starting dose of stimulation.
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Homburg, R. (2014). Controlled Ovarian Stimulation for IVF/ICSI. In: Ovulation Induction and Controlled Ovarian Stimulation. Springer, Cham. https://doi.org/10.1007/978-3-319-05612-8_16
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DOI: https://doi.org/10.1007/978-3-319-05612-8_16
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