[Induced ovarian follicular development: theoretical basis and therapeutic applications]

The fine mechanisms involved in human follicular growth in the ovary are not completely elucidated yet. The morphometric parameters are, by far, better understood than the metabolic ones. However, new data on the steroidogenic follicular human activity and their ability to respond to endogenous and exogenous gonadotropins lead to a better understanding of the results of our different therapeutic schemes. On the other hand, the selection criteria of patients have been modified, dealing now with the ovarian age much more than the real age. A precise determination of the ovarian age allows us to better drive our stimulation protocols and helps us to switch to other alternatives rather than multiplying useless and ineffective stimulations. This is of major importance in term of psychological aspects as well as in term of public health costs for the society.