History and challenges surrounding ovarian stimulation in the treatment of infertility

Abstract

OBJECTIVE To examine the history of superovulation for ovulation induction, its contributions to reproductive medicine and its impact on multiple births. DESIGN A search of the relevant literature using Pubmed and other online tools. RESULT(S) Infertility has been a condition known and studied for thousands of years. However, it was not until this past century that effective treatments were developed. With the advancement of our knowledge of the hypothalamic-pituitary axis, therapies utilizing gonadotropins were developed to stimulate ovulation. Not only were we now able to treat anovulatory infertility, but also induce superovulation for in vitro fertilization. With these successes came consequences, including increased multiple pregnancies. Several countries recognized the high costs associated with multiple births and implemented regulations on the infertility industry. The rate of triplet and higher-order multiples has declined over the past decade. This is largely attributed to a decreased number of embryos transferred. Nonetheless, the twin rate has remained consistently high. CONCLUSION(S) Superovulation has become a routine medical therapy used for ovulation induction and in vitro fertilization. With the development of this technology have come effective therapies for infertility and new ethical and medical challenges. Since the advent of gonadotropin therapy we have already developed technologies to improve monitoring and decrease hyperstimulation and high order multiple pregnancies. In the future, we anticipate new tools devised to optimize one embryo for one singleton live birth.

Music therapy in stress: proposal of extension to Assisted Reproduction

“…Other factors are several abortions (Andrade et al, 2010), family history of endometriosis (Giudice, 2010), anorexia, uppurative appendicitis, tubal disease, luteal phase defect, (Lopes & Donadio, 1997), cervical factor (Ribeiro et al, 2000), polycystic ovary syndrome, immunological factors (Badalotti et al, 1997) and major hormonal disorders. There are also factores related to male infertility (Chachamovich, 2009 (Beall & DeCherney, 2012). In Brazil, the National Health Care Politics for Human Assisted Reproduction establishes the support of the National Health System (SUS) for the treatment of infertility.…”

Comparison of Clomiphene Citrate and Low Dose Recombinant FSH for Induction of Ovulation in Infertile Women with Polycystic Ovary Syndrome

“…Despite the high risk of side effects and high costs, gonadotropin administration is accepted widely in PCOS patients. 5,13 In low dose step-up method for the induction of follicular maturation, the concept of threshold dose, which constitutes the main principle of lowdose step-up method, is important. Accordingly each follicle reacts only to FSH doses over a certain threshold dose.…”

Protective function of Bu Shen Huo Xue formula on the immunity of B6AF1 mice with experimental autoimmune premature ovarian failure

“…The most common presentation is secondary amenorrhea and the main consequence is infertility. Infertility may be the consequence of follicle depletion or a poor response to gonadotropin, which reduces the effectiveness of ovulation induction programs (1). Women with POF not only have premature aging symptoms but are also subject to a significantly increased risk of osteoporosis and cardiovascular disease (2).…”