Management of ovarian stimulation for IVF: narrative review of evidence provided for World Health Organization guidance

Counting ovarian antral follicles by ultrasound: a practical guide

“…AFC is accepted as being one of the best markers for assessing the functional ovarian reserve 3,4 , for predicting response to gonadotropin stimulation [36][37][38][39] and for assessing the chance of pregnancy following IVF 29 . AFC can predict both poor ovarian response and exaggerated response 16,38 , and is therefore useful to individualize optimal gonadotropin dosage 5,29,38,40,41 . AFC < 5-7 is associated with small number of oocytes retrieved 42,37 and reduced pregnancy rate 43 .…”

“…presence of endometrial polyps or submucous leiomyomas). Adding AMH to AFC improves only the prediction of excessive response to ovarian stimulation, and not the prediction of poor ovarian response. In cases in which there are technical difficulties in performing AFC (e.g.…”

How should we report outcomes in reproductive medicine?

“…Importantly, while the aim of reproductive medicine is to assist infertile couples in achieving a baby, the aim of a RCT is to inform infertile couples and clinicians on their best treatment choice. This was demonstrated in a recent review on ovarian stimulation, in which the use of recombinant follicle-stimulating hormone (FSH) plus recombinant luteinizing hormone (LH) was associated with an increased live-birth rate compared with using recombinant FSH alone (four RCTs, including 367 women: OR, 2.46; 95% CI, 1.42-4.25) 24 . However, for the same comparison, there were many more studies reporting on ongoing pregnancy as an endpoint (12 RCTs, including 1367 women), and this comparison showed a much lower benefit from adding LH, which was not statistically significant.…”

Management of Acupuncture as Adjuvant Therapy for In Vitro Fertilization

“…Final oocyte maturation is triggered by administration of human chorionic gonadotropin, GnRH agonists, or both. 11,12 After COS, OPU is carried out to be fertilized with sperm cells in vitro.…”