Individualizing ovarian stimulation protocols in ART

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The ideal ovarian stimulation regimen for IVF should have a low cancelation rate, minimize drug costs, have low risks and side effects, require limited monitoring for practical convenience, and maximize singleton pregnancy rates. Individualization starts from an assessment before the start of IVF cycle of the ovarian reserve by antral follicle count (AFC), antimullerian hormone (AMH), FSH, and age of the patient. AFC and AMH are the most sensitive markers of ovarian reserve identified to date and should be used to plan individualized treatment. Once the patient is categorized as a hypo-/hyper- or normoresponder the dose of gonadotropin is decided. The selection of dose is of paramount importance for optimal outcome of controlled ovarian stimulation (COS). In case of poor responders and hyper-responders, GnRH antagonist regimes are preferred. This helps in explaining the prognosis and in appropriate counseling and also ensures a safe controlled ovarian stimulation with optimal results which prevent unnecessary psychological and financial burden on the couple. Cycle monitoring is important to decide any alteration in dose or when to add GnRH antagonist. In women at high risk for ovarian stimulation, it is important to start with low doses and intensive monitoring. In case there are indications of hyperstimulation, the regime may be altered by decreasing dose or coasting. Many factors are interdependent, and hence, a careful selection of the type of ovarian stimulation will be the key factor in deciding the success of the same.

Original languageEnglish
Title of host publicationPrinciples and Practice of Controlled Ovarian Stimulation in ART
PublisherSpringer India
Pages138-145
Number of pages8
ISBN (Electronic)9788132216865
ISBN (Print)9788132216858
DOIs
Publication statusPublished - 22-09-2015

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Ovulation Induction
Anti-Mullerian Hormone
Gonadotropin-Releasing Hormone
Drug Costs
Pregnancy Rate
Gonadotropins
Counseling
Psychology
Ovarian Reserve
Antral

All Science Journal Classification (ASJC) codes

  • Health Professions(all)
  • Medicine(all)

Cite this

Kumar, P. (2015). Individualizing ovarian stimulation protocols in ART. In Principles and Practice of Controlled Ovarian Stimulation in ART (pp. 138-145). Springer India. https://doi.org/10.1007/978-81-322-1686-5_13
Kumar, Pratap. / Individualizing ovarian stimulation protocols in ART. Principles and Practice of Controlled Ovarian Stimulation in ART. Springer India, 2015. pp. 138-145
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Kumar, P 2015, Individualizing ovarian stimulation protocols in ART. in Principles and Practice of Controlled Ovarian Stimulation in ART. Springer India, pp. 138-145. https://doi.org/10.1007/978-81-322-1686-5_13

Individualizing ovarian stimulation protocols in ART. / Kumar, Pratap.

Principles and Practice of Controlled Ovarian Stimulation in ART. Springer India, 2015. p. 138-145.

Research output: Chapter in Book/Report/Conference proceedingChapter

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Kumar P. Individualizing ovarian stimulation protocols in ART. In Principles and Practice of Controlled Ovarian Stimulation in ART. Springer India. 2015. p. 138-145 https://doi.org/10.1007/978-81-322-1686-5_13