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Ovulation Stimulation and Cycle Management in IVF

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In Vitro Fertilization

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Abstract

Ovarian stimulation is a key component of assisted conception treatments. Stimulating growth of multiple follicles enables the retrieval of many cumulus–oocyte complexes, which allows for inefficiencies of fertilization in vitro and embryo culture, enabling selection of embryos for transfer in order to increase the chance of implantation. Gonadotrophin preparations have developed over a number of decades from preparations of human menopausal gonadotrophin (hMG, containing both LH and FSH bioactivity), followed by purified urinary derived follicle stimulation hormone (FSH) and more recently recombinant FSH, LH, hCG, and long acting FSH preparations. In parallel, the development and clinical application of GnRH analogs has ameliorated the risk of premature ovulation which complicated early IVF practice. However, the specific treatment protocols used continue to vary considerably from center to center and, globally, from region to region. In recent years, a large number of published studies (observational and randomized controlled trials) have examined the effectiveness of various ovarian stimulation protocols, including the use of GnRH agonists and antagonists, and other aspects of treatment. In this chapter, ovarian stimulation protocols and luteal phase support in current clinical practice in the UK and USA are discussed, within the context of in vitro fertilization (IVF); and the evidence base for improving outcomes in specific patient groups (“individualized care”) is reviewed.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Princess Anne Hospital (MP815), University of Southampton, Coxford Road, Southampton, SO16 5YA, UK

    Ying C. Cheong M.D.

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Elizabeth S. Ginsburg M.D.

  3. Division of Human Development and Health, Princess Anne Hospital, University of Southampton, Coxford Road, Southampton, SO16 5YA, UK

    Nick S. Macklon M.D.

Authors
  1. Ying C. Cheong M.D.
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  2. Elizabeth S. Ginsburg M.D.
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  3. Nick S. Macklon M.D.
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Corresponding author

Correspondence to Nick S. Macklon M.D. .

Editor information

Editors and Affiliations

  1. and Infertility, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Francis St 75, Boston, 02115, Massachusetts, USA

    Elizabeth S. Ginsburg

  2. and Infertility, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinlogy, Francis St. 75, Boston, 02115, Massachusetts, USA

    Catherine Racowsky

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© 2012 Springer Science+Business Media New York

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Cheong, Y.C., Ginsburg, E.S., Macklon, N.S. (2012). Ovulation Stimulation and Cycle Management in IVF. In: Ginsburg, E., Racowsky, C. (eds) In Vitro Fertilization. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9848-4_3

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  • DOI: https://doi.org/10.1007/978-1-4419-9848-4_3

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