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Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives

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Controlled ovarian hyperstimulation: a review for the non-ART patient.

M Y Willis¹, A S Browne, D R Session

¹Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30308, USA.

Minerva Ginecologica

|April 22, 2011

Summary

Controlled ovarian hyperstimulation (COH) uses oral or injectable medications to treat infertility. Injectable medications offer higher pregnancy rates but increase risks; combined protocols may balance efficacy and safety.

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Area of Science:

Reproductive endocrinology and infertility treatments.

Background:

Controlled ovarian hyperstimulation (COH) is a key treatment for infertility.
It involves medications to induce ovulation or superovulation.

Purpose of the Study:

To review different medication types and protocols for COH.
To discuss strategies for enhancing medication response and managing risks.

Main Methods:

Review of oral medications (clomiphene, letrozole) and injectable medications (FSH, hMG).
Discussion of adjunctive treatments (metformin, dexamethasone) for PCOS.
Analysis of combined protocols and specific considerations for hypogonadotropic amenorrhea.

Main Results:

Injectable medications yield higher pregnancy rates than oral ones.

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Injectables carry increased risks of multiple gestation, OHSS, cost, and monitoring.

Combined protocols may reduce risks and costs without compromising pregnancy chances.

Conclusions:

Initial COH often starts with oral medications, except in hypogonadotropic amenorrhea.
Adjunctive therapies can improve outcomes in PCOS patients.
Luteal phase support with progesterone is recommended for injectable cycles.