The current trends to postpone motherhood and the increase in demand for assistance in reproductive medicine highlight the need for seeking guidelines for the establishment of individualized treatment protocols. Currently available ovarian reserve tests do not provide sufficient evidence to be solely considered ideal, but they may occupy important place in initial counseling, predicting unsatisfactory results that could be improved by individualized induction schemes and reducing excessive psychological and financial burdens, and adverse effects. In this paper, we revise the role of hormonal basal and dynamic tests, as well as ultrasonographic markers, as ovarian reserve markers, in order to provide embasement for propaedeutic strategies and their interpretation in order to have reproductive success.
Os autores do presente estudo declaram que não têm nenhum conflito de interesse sobre o conteúdo discutido no texto, incluindo relações de trabalho, assessoria, honorários e direitos dos autores.
RESUmOA identificação da vesícula germinativa (VG) em oócitos obtidos após estimulação para fertilização in vitro (FIV) sugere interrupção da maturação na fase de prófase I da meiose, identificável pela observação de nucléolo compacto típico. O cancelamento de ciclos de FIV por persistência da VG constitui frustração para o casal infértil e para a equipe que o assiste, além de caracterizar-se como desafio imprevisível em serviços de medicina reprodutiva, com poucos casos descritos na literatura. Relatamos um caso de reincidência de imaturidade em amostra total de oócitos após estimulação controlada para FIV, seguida de falha total de maturação in vitro (MIV), em paciente jovem portadora de endometriose.
The current trends to postpone motherhood and the increase in demand for assistance in reproductive medicine highlight the need for seeking guidelines for the establishment of individualized treatment protocols. Although the ability to assess the functional ovarian reserve remains limited, the tests that are currently available provide guidance for assistance to infertile couples and ease the emotional burden of a process whose results are still lagging behind. In this paper, we will revisit literature and highlight current tests available for assessing functional ovarian reserve, intending to embase propaedeutic strategies and their interpretation in order to have reproductive success.
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