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Chapter 10 - Progestin-Primed Ovarian Stimulation

from Section 2 - Ovarian Hyperstimulation for IVF

Published online by Cambridge University Press:  14 April 2022

By
Xuefeng Lu  and
Yanping Kuang
Edited by
Mohamed Aboulghar  and
Botros Rizk
Mohamed Aboulghar
Affiliation:
University of Cairo IVF Centre
Botros Rizk
Affiliation:
University of South Alabama
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Summary

The reproductive cycle requires complex interactions and feedback between gonadotropin-releasing hormone (GnRH), the gonadotropins follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and the ovarian sex steroid hormones estrogen and progesterone. To improve the success rate of in vitro fertilization-embryo transfer (IVF-ET) by optimizing oocyte retrieval, controlled ovarian stimulation (COS) has been widely performed. Exogenous gonadotropins were used to achieve supraphysiological levels during the follicular phase to override the process of dominant follicle selection and enable multiple follicular recruitment, which lead to a rapidly increasing serum estradiol level and induce a premature LH surge. GnRH agonist (GnRHa) and GnRH antagonist were used to prevent the premature LH surge and premature ovulation [1]. In 2003, based on ultrasonographic studies, Baerwald et al. demonstrated that multiple cohorts or “waves” of 2–5 mm follicles were recruited continuously during a menstrual cycle, including in the luteal phase [2;3].

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Chapter
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Ovarian Stimulation , pp. 93 - 100
Publisher: Cambridge University Press
Print publication year: 2022

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References

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