Current issues in ovulation induction

Gorthi, Srilatha; Balen, Adam; Tang, Thomas

doi:10.1111/j.1744-4667.2012.00117.x

Cited by 4 publications

(3 citation statements)

References 40 publications

(64 reference statements)

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“…Ovulatory dysfunction is the most common cause (25 to 50%) [ 17 , 18 ] and is mainly due to hormonal problems related to the dysfunction/malfunction of the hypothalamic-pituitary-ovarian axis. Beyond the efficacy, the conventional ovulation-induction therapies (exogenous gonadotropins or clomiphene citrate) [ 19 , 20 ] have been associated with side effects, including the ovarian hyperstimulation syndrome, myocardial infarction and ovarian cancer [ 20 , 21 , 22 , 23 ]. In line with this, people increasingly seek alternatives such as plant-derived medicines thought to be safer and playing an important role in health care systems, especially in the developing world where up to 80% of the population rely on traditional medicine for their primary healthcare.…”

Section: Introductionmentioning

confidence: 99%

Myrianthus arboreus P. Beauv (Cecropiaceae) Extracts Accelerates Sexual Maturation, and Increases Fertility Index and Gestational Rate in Female Wistar Rats

et al. 2018

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Background: Despite the wide use of leaves of Myrianthus arboreus (Cecropiaceae) in several African countries including Cameroon as food and against amenorrhea and female infertility, it has never been tested for this purpose. Methods: Using immature female Wistar rats, the impact of M. arboreus on the sexual maturation parameters (vaginal opening, ovarian relative weight and follicle maturation, gonadotropins and ovarian hormones serum levels) and fertility index has been evaluated through a 30-day oral administration of aqueous and methanol extracts of leaves at the doses of 20, 110 and 200 g/kg/day. Results: Aqueous extract increased the ovarian relative weight (p < 0.001), progesterone (p < 0.001) and gonadotropins (p < 0.001) serum levels, and induced the maturation of ovarian follicles. The methanol extract additionally induced an early vaginal opening (p < 0.001), uterine growth (p < 0.01) and increased estradiol (p < 0.001) serum levels. The fertility index generally increased following treatments, while the gestation rate remained almost unaffected except at the highest tested dose of M. arboreus extracts where lowest values were observed. Conclusion: Globally, M. arboreus induced an early puberty onset and an increased fertility rate validating at least in part its traditional use for female infertility.

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Section: Introductionmentioning

confidence: 99%

Myrianthus arboreus P. Beauv (Cecropiaceae) Extracts Accelerates Sexual Maturation, and Increases Fertility Index and Gestational Rate in Female Wistar Rats

et al. 2018

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“…Clomiphene citrate is used to stimulate ovulation by blocking estrogen receptors in the hypothalamus and negating the inhibitory effect of estradiol, resulting in increased secretion of endogenous FSH (3) .…”

Section: Introductionmentioning

confidence: 99%

Traditional Clomiphene Citrate with Phytoestrogen Versus Traditional Clomiphene Citrate Versus Stair Step Protocol in Patients with Polycystic Ovaries: A Randomized Clinical Trial

2023

The Egyptian Journal of Hospital Medicine

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Introduction: Polycystic ovary syndrome (PCOS) ranks among the most prevalent endocrine disease affecting women of reproductive age. Multiple therapeutic approaches have been suggested for the management of PCOS. Anovulation is responsible for approximately 40% of female infertility cases, and a significant portion of individuals dealing with infertility are also diagnosed with polycystic ovary syndrome. Patients and methods: This was a prospective multi-center randomized clinical trial conducted from April 2022 till March 2023 involving one hundred fifty female patients with PCOS categorized into three categories, category I (traditional protocol) involved 50 subjects who received traditional clomiphene citrate (CC) 100 mg for 5 days, and category II stair-step protocol (SS) involved 50 subjects who received clomiphene citrate 50 mg for 5 days followed by 100 mg for another 5 days and phytoestrogen given for the whole 10 days. In addition, group III clomiphene + phytoestrogen (CCP) included 50 patients who received 100 mg of clomiphene citrate for 5 days and phytoestrogen for 10 days. Results: There was significantly thinner endometrium in the CC group as compared to the other two groups; the greatest endometrial thickness was in the SS protocol group, followed by the CCP group; a higher pregnancy rate and ovulation rate were in the SS protocol group, followed by the CCP group; and the lowest pregnancy rate and ovulation rate were in the CC group. Conclusions: Clomiphene, when used as an SS regimen, improves pregnancy rates without any side effects compared to traditional regimens. Adding phytoestrogens to CC is associated with improving endometrial thickness and pregnancy rates.

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“…To facilitate the therapeutic approach, the World Health Organization (WHO) proposed a 3-group classification of infertile anovulatory women [ 6 ], based on their gonadotropin and estrogen levels [ 7 ]. WHO group II represents 80–90% of cases, including patients with polycystic ovary syndrome (PCOS) and non-PCOS patients with dysfunctional hypothalamic pituitary ovarian axis [ 8 ]. The latter, in particular, have physiologic basal levels of hormones but inconsistent release of gonadotropin-releasing hormone (GnRH) during ovarian folliculogenesis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

D-chiro-inositol Induces Ovulation in Non-Polycystic Ovary Syndrome (PCOS), Non-Insulin-Resistant Young Women, Likely by Modulating Aromatase Expression: A Report of 2 Cases

Espinola¹,

Laganà

Bilotta³

et al. 2021

Am J Case Rep

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Case series Patients: Female, 19-year-old • Female, 23-year-old Final Diagnosis: Anovulation Symptoms: Oligomenorrhea Medication: — Clinical Procedure: — Specialty: Obstetrics and Gynecology Objective: Unknown etiology Background: Anovulation consists in the lack of oocyte release during the menstrual cycle, leading to an irregular menstrual cycle. Untreated chronic anovulation is one of the major causes of female infertility and can induce hypoestrogenism. Different etiological factors can contribute to anovulation; therefore, the clinical approaches to manage this condition should take into account the specific patient characteristics. Oral ovulation-inducing agents are first-line treatments for most anovulatory patients. Drugs used include selective estrogen receptor modulators (SERMs) such as clomiphene citrate and aromatase inhibitors (AIs) such as letrozole. The latter, in particular, halts the estrogen biosynthesis by blocking the activity of steroidogenic enzyme aromatase, which catalyzes the conversion of androgens to estrogens. Similarly, d -chiro-inositol (DCI) modulates the activity of aromatase by reducing the corresponding gene expression, and DCI supplementation was successfully used to induce ovulation in anovulatory PCOS patients. Here, we report the use of DCI to induce ovulation in non-PCOS anovulatory oligomenorrheic women. Case Reports: Two young non-PCOS anovulatory oligomenorrheic women received treatment with high-dose (1200 mg) DCI for 6 weeks. Based on an initial evaluation, both patients had normal hormone levels and were non-insulin-resistant. Ovulation assessment was based on the increment of progesterone and LH levels, as well as on the endometrial thickening. Also, the treatment with DCI resulted in a reduction of testosterone levels relative to baseline values. Conclusions: After the 6-week treatment with 1200 mg DCI, ovulation was restored in both women, as confirmed by increased progesterone and LH and endometrial thickening.

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Current issues in ovulation induction

Cited by 4 publications

References 40 publications

Myrianthus arboreus P. Beauv (Cecropiaceae) Extracts Accelerates Sexual Maturation, and Increases Fertility Index and Gestational Rate in Female Wistar Rats

Myrianthus arboreus P. Beauv (Cecropiaceae) Extracts Accelerates Sexual Maturation, and Increases Fertility Index and Gestational Rate in Female Wistar Rats

Traditional Clomiphene Citrate with Phytoestrogen Versus Traditional Clomiphene Citrate Versus Stair Step Protocol in Patients with Polycystic Ovaries: A Randomized Clinical Trial

D-chiro-inositol Induces Ovulation in Non-Polycystic Ovary Syndrome (PCOS), Non-Insulin-Resistant Young Women, Likely by Modulating Aromatase Expression: A Report of 2 Cases

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