Related Experiment Video
Updated: Jun 28, 2026
08:46
Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives
Published on: September 16, 2021
Strategies to reduce multiple pregnancies due to ovulation stimulation
1Department of Obstetrics and Gynecology, Louisiana State University School of Medicine, The Fertility Institute of New Orleans, New Orleans, Louisiana, USA. rdickeyrei@fertilityinstitute.com
Fertility and Sterility
|November 1, 2008
Summary
High-order multiple births from ovulation induction can be reduced to 2% or less. Less aggressive stimulation strategies, like using clomiphene before gonadotropins, minimize risks without lowering pregnancy rates.
Area of Science:
- Reproductive Endocrinology
- Infertility Treatment
- Maternal-Fetal Medicine
Background:
- Ovulation induction (OI) is frequently used to treat infertility.
- High-order multiple births (HOMP) are a significant risk associated with OI.
- Reducing HOMP rates is crucial for improving patient outcomes.
Purpose of the Study:
- To identify factors contributing to HOMB in OI.
- To evaluate strategies for reducing HOMP occurrence.
- To assess the impact of these strategies on pregnancy rates.
Main Methods:
- Retrospective analysis of published studies.
- Focus on OI with intrauterine insemination (IUI) cycles.
- Inclusion of studies with fully documented patient and cycle characteristics.
Main Results:
- HOMP positively correlated with high gonadotropin doses, follicle number, and estradiol levels.
- HOMP inversely correlated with patient age and number of treatment cycles.
- Successful HOMP reduction strategies include clomiphene use, minimal gonadotropin doses, cycle cancellation for >3 follicles, and follicle aspiration.
Conclusions:
- HOMP rates can be reduced to ≤2% through less aggressive OI protocols.
- Strategies exist to minimize HOMP without compromising overall pregnancy rates.
- Careful monitoring and dose adjustment are key to safe and effective OI.
Related Concept Videos
01:22Birth Control Methods
Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although vasectomy...
01:27Ovarian Cycle
The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle length...
01:24In Vitro Fertilization
In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
01:30Hormonal Control of the Ovarian Cycle
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
01:57Meiosis II
Meiosis II is the second and final stage of meiosis. It relies on the haploid cells produced during meiosis I, each of which contain only 23 chromosomes—one from each homologous initial pair. Importantly, each chromosome in these cells is composed of two joined copies, and when these cells enter meiosis II, the goal is to separate such sister chromatids using the same microtubule-based network employed in other division processes. The result of meiosis II is two haploid cells, each containing...
02:07Oogenesis
In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...