Monitoring Follicular Development with Estrogens
Daily measurements of serum or urinary estrogen(s) concentrations have been used to monitor follicular development in patients undergoing ovulation induction with human menopausal gonadotropins (hMG). In these patients, biochemical (estrogen) monitoring of the follicular response to hMG is necessary to determine the optimal time to administer the ovulatory dose of human chorionic gonadotropin (hCG) or to withhold hCG in cases of ovarian overstimulation. The goals of such monitoring in anovulatory ovulation induction are: 1) to achieve pregnancy; 2) to minimize ovarian hyperstimulation syndrome; and 3) to minimize the rate of multiple gestation. Similarly, measurements of estrogens have been used in monitoring follicular development for in vitro fertilization and embryo transfer (IVF-ET) in order to: 1) predict the exact time of ovulation; 2) determine the appropriate time for hCG administration; 3) assess follicular functional well being; 4) avoid biochemical hyperstimulation; and 5) terminate the treatment cycle in the face of abnormal estrogen secretory patterns. The object of this chapter is to discuss estrogen monitoring, and to review the experience with it in the context of IVF-ET.
KeywordsEmbryo Transfer Luteal Phase Follicular Development Luteinizing Hormone Surge Preovulatory Follicle
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