Ovulation Induction

Assisted reproductive technologies – is it gaining the upper hand over natural physiology?

“…This results in patterns of gonadotrophin levels markedly dissimilar from those seen in the course of normal ovarian physiology (lack of pulsatility, achievement of a single maximum over 24 hours approximately 12 hours after injection, and gradual accumulation over the days of follicle recruitment). Despite this, daily injection has not been shown to be inferior to more frequent or pulsatile administration 9 . Pharmacokinetics after intra muscular or subcutaneous administration of recombinant preparations is similar, even in obese women.…”

“…Some formulations contain FSH and LH, while others contain FSH only 7 . Newer more purified products permit subcutaneous, rather than intramuscular administration, and recombinant techniques allow for easier control of purity and consistency of the preparations 9 . Daily dosing is the usual practice.…”

“…Monitoring for a follicular response predicting fertile ovulation, but not excessive response is essential. This relies on a combination of biophysical and hormonal data 9 . Serial ultrasound scans, usually through the transvaginal route are used for the determination of the number and the size of the developing follicles.…”