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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:
Ovulatory disorders result in infrequent ovulation (Oligoovulation) or absent ovulation (anovulation) which causes infertility. The World Health Organisation (WHO) has classified anovulation into three main classes, which are hypogonadotropic hypogonadal anovulation (Class 1), normogonadotropic normoestrogenic anovulation (Class 2), and hypergonadotropic hypoestrogenic anovulation (Class 3).
Aromatase inhibitors are a common fertility treatment to treat women with PCOS. A meta-analysis analyzing live birth rates for women with PCOS treated with clomiphene compared to letrozole found that letrozole resulted in higher live birth rates. [11] However, ovulation induction remains an off-label indication, which affects use.
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 .
For those who after weight loss still are anovulatory or for anovulatory lean women, ovulation induction to reverse the anovulation is the principal treatment used to help infertility in PCOS. Letrozole and Clomiphene citrate are the first-line treatment in subfertile anovulatory patients with PCOS. [ 12 ]
Gonadotropin preparations are drugs that mimic the physiological effects of gonadotropins, used therapeutically mainly as fertility medication for ovarian hyperstimulation and ovulation induction. [1] For example, the so-called menotropins consist of LH and FSH extracted from human urine from menopausal women. [2] There are also recombinant ...
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
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