Đang chuẩn bị liên kết để tải về tài liệu:
Ebook Biennial review of infertility (Vol 3): Part 2

(BQ) Part 2 book “Biennial review of infertility” has contents: Reproductive tourism, vitrification of human oocytes and embryos - an overview, popularity of ICSI, clinical research design, should we eliminate fresh embryo transfer from ART, and other contents. | Patient-Tailored Approaches to Ovarian Stimulation in ART 10 Theodora C. van Tilborg, Frank J.M. Broekmans, Helen L. Torrance, and Bart C. Fauser 10.1 Introduction to Assisted Reproductive Technology The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) have defined infertility as a disease of the reproductive system by failure to achieve a clinical pregnancy after at least 12 months of regular unprotected sexual intercourse [1]. Of couples trying to conceive, 85–90 % conceives spontaneously within 12 months with most pregnancies occurring within the first 6 months [2]. Approximately 10–17 % of all couples need specialised fertility care once in their lives [2, 3]. Interventions to improve chances of a live birth for subfertile couples consist of fertility enhancing drug therapy, tubal, ovarian and uterine surgery or procedures such as intrauterine insemination (IUI) or in vitro fertilisation (IVF), where the latter is considered to be the treatment of last resort. IVF treatment consists of controlled ovarian stimulation to create multifollicular growth (COS), ovum pickup, in vitro fertilisation, embryo selection and embryo transfer. Medication used for ovarian stimulation for IVF T.C. van Tilborg, M.D. • F.J.M. Broekmans, M.D. • H.L. Torrance, M.S. • B.C. Fauser, M.D., Ph.D. (*) Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands e-mail: b.c.fauser@umcutrecht.nl has evolved from clomiphene citrate (CC), human menopausal gonadotropins (hMG), purified urinary follicle stimulating hormone (uFSH) to human recombinant FSH (rFSH). Recently, the efficacy and safety of a long-acting rFSH agonist has also been established [4, 5]. Today, gonadotropins are the principal agents for COS with starting doses varying between 100 and 600 IU/ day [6]. Midcycle dose adjustments depending on the ovarian response are often .