Human Reproduction, Vol. 18, No. 12, 2499-2502,
December 2003
© 2003 European Society of Human Reproduction and Embryology
Is there a future for ovulation induction in the current era of assisted reproduction?
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
1 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, Erasmus Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. e-mail: e.vansantbrink{at}erasmusmc.nl
The clinical use of medical induction of ovulation in normogonadotrophic anovulatory women (WHO II), including polycystic ovary syndrome, is increasingly questioned. However, we believe that this treatment modality still represents a highly effective means of fertility treatment in women with low pregnancy chances without intervention. A conventional treatment algorithm involving clomiphene citrate (CC) followed by FSH induction of ovulation may result in a 71% cumulative singleton live birth rate. In attempts to improve treatment outcome further and reduce complication rates, new compounds such as insulin-sensitizing agents or aromatase inhibitors are currently used increasingly. Approaches such as patient selection for different treatment modalities on the basis of initial screening characteristics and alternative protocols for FSH ovulation induction may also be proposed to render treatment algorithms more patient tailored and therefore improve overall outcomes. More research is needed in this area, rather than referring these patients to assisted reproduction prematurely. This may lead to a more individually tailored approach for ovulation induction in a given patient, resulting in a further improvement of the balance between chances for success versus complications.
Key words: anovulation/FSH/ovulation induction/prediction model/step-down
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  The Thessaloniki ESHRE/ASRM-Sponsored PCOS Consens Consensus on infertility treatment related to polycystic ovary syndrome Hum. Reprod., March 1, 2008; 23(3): 462 - 477. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B.C.J.M. Fauser, K. Diedrich, P. Devroey, and on behalf of the Evian Annual Reproduction (EVAR) Predictors of ovarian response: progress towards individualized treatment in ovulation induction and ovarian stimulation Hum. Reprod. Update, January 1, 2008; 14(1): 1 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E.M.E.W. Heijnen, M.J.C. Eijkemans, E.G. Hughes, J.S.E. Laven, N.S. Macklon, and B.C.J.M. Fauser A meta-analysis of outcomes of conventional IVF in women with polycystic ovary syndrome Hum. Reprod. Update, January 1, 2006; 12(1): 13 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. E. Messinis Ovulation induction: a mini review Hum. Reprod., October 1, 2005; 20(10): 2688 - 2697. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.R. Richmond, N. Deshpande, H. Lyall, R.W.S. Yates, and R. Fleming Follicular diameters in conception cycles with and without multiple pregnancy after stimulated ovulation induction Hum. Reprod., March 1, 2005; 20(3): 756 - 760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Balen, A. G. Mulders, B. C. Fauser, B. C. Schoot, M. A. Renier, P. Devroey, M. J. Struijs, and B. M. Mannaerts Pharmacodynamics of a Single Low Dose of Long-Acting Recombinant Follicle-Stimulating Hormone (FSH-Carboxy Terminal Peptide, Corifollitropin Alfa) in Women with World Health Organization Group II Anovulatory Infertility J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 6297 - 6304. [Abstract] [Full Text] [PDF]
|
|