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Ovulation induction is the stimulation of ovulation by medication. It is usually used in the sense of stimulation of the development of ovarian follicles [ 1 ] [ 2 ] [ 3 ] to reverse anovulation or oligoovulation .
When used in conjunction with in vitro fertilization (IVF), controlled ovarian hyperstimulation confers a need to avoid spontaneous ovulation, since oocyte retrieval of the mature egg from the fallopian tube or uterus is much harder than from the ovarian follicle. The main regimens to achieve ovulation suppression are:
Other medications in this class include tamoxifen and raloxifene, although both are not as effective as clomiphene and are thus less widely used for fertility purposes. [7] They are used in ovulation induction by inhibiting the negative feedback of estrogen at the hypothalamus. As the negative feedback of estrogen is inhibited, the hypothalamus ...
The main medications used for induction of final maturation are human chorionic gonadotropin (hCG) and GnRH agonist. In fresh (rather than frozen ) autologous cycles of in vitro fertilization , final oocyte maturation triggering with GnRH agonist instead of hCG decreases the risk of ovarian hyperstimulation syndrome but decreases live birth rate .
Clomifene has been used almost exclusively for ovulation induction in premenopausal women, and has been studied very limitedly in postmenopausal women. [ 64 ] Clomifene was studied for treatment and prevention of breast cancer , but issues with toxicity led to abandonment of this indication, as did the discovery of tamoxifen . [ 65 ]
Sources: See template. Tamoxifen is a long-acting SERM, with a nuclear retention of the ER–tamoxifen (or metabolite) complex of greater than 48 hours. [ 71 ] [ 72 ] It has relatively little affinity for the ERs itself and instead acts as a prodrug of active metabolites such as endoxifen (4-hydroxy- N -desmethyltamoxifen) and afimoxifene (4 ...
Ovulation induction, reversing anovulation or oligoovulation; Final maturation induction of oocytes; Controlled ovarian hyperstimulation, stimulating the development of multiple follicles of the ovaries in one single cycle; Physiologic hormonal stimulation of folliculogenesis
It is in fact possible to restore ovulation using appropriate medication, and ovulation is successfully restored in approximately 90% of cases. The first step is the diagnosis of anovulation. The identification of anovulation is not easy; contrary to what is commonly believed, women undergoing anovulation still have (more or less) regular periods.