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Review
. 2022 Apr-Jun;15(2):112-125.
doi: 10.4103/jhrs.jhrs_59_22. Epub 2022 Jun 30.

Ovarian Stimulation in Assisted Reproductive Technology Cycles for Varied Patient Profiles: An Indian Perspective

Padma Rekha Jirge  1 , Madhuri Milind Patil  2 , Rohit Gutgutia  3 , Jatin Shah  4 , Mridubhashini Govindarajan  5 , Varsha Samson Roy  6 , Nalini Kaul-Mahajan  7 , Faddy I Sharara  8
Affiliations
Review

Ovarian Stimulation in Assisted Reproductive Technology Cycles for Varied Patient Profiles: An Indian Perspective

Padma Rekha Jirge et al. J Hum Reprod Sci. 2022 Apr-Jun.

Abstract

Controlled ovarian stimulation has been an integral part of in vitro fertilisation (IVF) treatment cycles. Availability of different gonadotropins for ovarian stimulation and gonadotropin releasing hormone (GnRH) analogues for prevention of premature rise of leutinising hormone during follicular phase offer an opportunity to utilise them for a successful outcome in women with different subsets of ovarian response. Further, use of GnRH agonist as an alternative for human chorionic gonadotropin improves safety of ovarian stimulation in hyper-responders. Mild ovarian stimulation protocols have emerged as an alternative to conventional protocols in the recent years. Individualisation plays an important role in improving safety of IVF in hyper-responders while efforts continue to improve efficacy in poor responders. Some of the follicular and peri-ovulatory phase interventions may be associated with negative impact on the luteal phase and segmentalisation of the treatment with frozen embryo transfer may be an effective strategy in such a clinical scenario. This narrative review looks at the available evidence on various aspects of ovarian stimulation strategies and their consequences. In addition, it provides a concise summary of the evidence that has emerged from India on various aspects of ovarian stimulation.

Keywords: Controlled ovarian stimulation; hyper-responders; in vitro fertilization; normo-responders; poor responders.

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Conflict of interest statement

Ferring organised a meeting of all authors and facilitated discussion and provided the assistance of a medical writing team whose role was limited to aiding the search strategy and creating the flow chart for search strategy. PRJ: Is the current Editor-in-Chief of the Journal of Human Reproductive Sciences. She has not received any monetary compensation for the article. She has been a faculty for symposiums organised by Ferring in the past. She has not had any role in the peer review/editorial process/decision making about the manuscript. NM: Has not received any monetary compensation for the article. She has received honorarium as a faculty from Ferring in the past. JS: He has not received any monetary support from Ferring for the writing up of this manuscript. MMP: Has been a part of Ferring C-Create programs and was invited to speak for Abbott scientific sessions. She has not received any monetary support from Ferring for the writing up of this manuscript. RG: Has been compensated by Ferring India, Merck and Abott India in the last year for various speaker/KOL assignments. He has not received any monetary support from Ferring for the writing up of this manuscript. VSR: She has received honorarium from Ferring Pharmaceutical Pvt Ltd as an expert in Embryology towards preparing/updating & being a member of Virtual ‘C-CREATE Scientific Committee meeting, but not received any funds for this particular project. MG: Never received any monetary support or honorarium from Ferring for writing up this Manuscript. Has been part of Ferring's C-Create teaching programs and part of invited faculty in educational programs conducted by Abbott, Astra Zeneca and Shield Pharma companies. FIS: Has received compensation from Ferring (but not for this article) as part of Ferring Speaker Bureau and investigator.

Figures

Figure 1
Figure 1
Flow chart of search strategy
Figure 2
Figure 2
Criteria for initiation of controlled ovarian stimulation
See this image and copyright information in PMC

References

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