Mild stimulation for in vitro fertilization

Nargund, Geeta; Datta, Adrija; Fauser, Bart C.J.M.

doi:10.1016/j.fertnstert.2017.08.022

Cited by 67 publications

(58 citation statements)

References 63 publications

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“…The perceived needs and interests of our patients change too. Examples of treatment approaches that were introduced to meet perceived patient demand that changed by the time an acceptable evidence base had been generated include egg sharing (Ahuja et al, 1999), now increasingly replaced by egg banking, and mild stimulation approaches (Nargund et al, 2017), the espoused safety advantages of which are now widely considered to be met by GnRH agonist triggering, freeze-all cycles and single embryo transfer. Other criticisms of RCTs that have been well rehearsed elsewhere include the risk that imposing narrow inclusion criteria will limit the applicability of the findings to a broader patient population, whereas permitting broader inclusion criteria means individual variation in response to the studied intervention may be so great as to mask any effect.…”

Section: Why Is the Evidence Still Missing?mentioning

confidence: 99%

Building an evidence base for IVF ‘add-ons’

Macklon

Ahuja

Fauser

2019

Reproductive BioMedicine Online

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Section: Why Is the Evidence Still Missing?mentioning

confidence: 99%

Building an evidence base for IVF ‘add-ons’

Macklon

Ahuja

Fauser

2019

Reproductive BioMedicine Online

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“…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.…”

Section: In Vitro Fertilizationmentioning

confidence: 99%

Management of Acupuncture as Adjuvant Therapy for In Vitro Fertilization

Djaali

Abdurrohim

Helianthi

2019

Medical Acupuncture

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One treatment option for couples with infertility that enables the highest success rate is in vitro fertilization (IVF). With this technique, various causes of infertility can be overcome, whether they are caused by anatomical abnormalities in women or abnormalities of sexual dysfunction in men. Acupuncture, a nonpharmacologic therapy with minimal side-effects, according to various studies is be beneficial for increasing the success of IVF. There are several mechanisms of acupuncture related to this, such as: (1) modulating neuroendocrine factors; (2) increasing blood flow to the uterus and ovaries; (3) modulating immune factors; and (4) reducing stress, anxiety, and depression. Because acupuncture does not have bad side-effects, it is an adjuvant therapy that can be performed at each stage of the IVF procedure to increase the chances of successful IVF.

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“…Conventional vs mild stimulation With the mild ovarian stimulation (MOS) approach, clinicians focus on optimizing patient care rather than obtaining the highest yield of oocytes, by minimizing treatment burden and risk of complications. MOS is associated with a greater safety profile in terms of the incidence of OHSS and of venous thromboembolism (Nargund et al 2017). It is also found to be better tolerated by patients (Verberg et al 2008) and less expensive (Nargund et al 2017).…”

Section: Stimulation Strategymentioning

confidence: 99%

“…MOS is associated with a greater safety profile in terms of the incidence of OHSS and of venous thromboembolism (Nargund et al 2017). It is also found to be better tolerated by patients (Verberg et al 2008) and less expensive (Nargund et al 2017). Given that two meta-analyses of RCTs in normal responders demonstrated a lower number of retrieved oocytes in MOS (Verberg et al 2009a,b, Matsaseng et al 2013, it is not a strategy recommended for patients undergoing a PGT cycle.…”

Section: Stimulation Strategymentioning

confidence: 99%

Ovarian stimulation for preimplantation genetic testing

Rodriguez-Purata

Martínez

2019

Reproduction

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A narrative review of the management of controlled ovarian stimulation in patients undergoing preimplantation genetic testing is presented. An electronic search was performed to identify research publications that addressed ovarian stimulation and preimplantation genetic testing published until December 2017. Studies were classified in decreasing categories: randomized controlled trials, prospective controlled trials, prospective non-controlled trials, retrospective studies and experimental studies. The aim of controlled ovarian stimulation has shifted from obtaining embryos available for transfer to yielding the maximum embryos available for biopsy to increase the odds of achieving one euploid embryo available for transfer, without the distress of inducing ovarian hyperstimulation syndrome or inadequate endometrium receptivity as vitrification and deferred embryo transfer usually will be planned. The present narrative review summarizes all treatment-related variables as well as stimulation strategies after controlled ovarian stimulation that could help patients undergoing an in vitro fertilization cycle coupled with preimplantation genetic testing, including the number of oocytes needed to achieve one healthy live birth, oral contraceptive pill usage, the role of mild ovarian stimulation or random-start stimulation, the stimulation protocol and type of gonadotropin of choice, the novel progesterone protocols, agonist or dual trigger as a final oocyte maturation trigger, the accumulation of oocytes/embryos and the optimal interval before proceeding with a subsequent controlled ovarian stimulation or the optimal medication to link stimulation cycles. The discussion is being presented according to how questions are posed in clinical practice. The aim of ovarian stimulation has shifted from obtaining embryos available for transfer to yielding the maximum embryos available for biopsy to increase the odds of achieving one euploid embryo available for transfer.

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Mild stimulation for in vitro fertilization

Cited by 67 publications

References 63 publications

Building an evidence base for IVF ‘add-ons’

Building an evidence base for IVF ‘add-ons’

Management of Acupuncture as Adjuvant Therapy for In Vitro Fertilization

Ovarian stimulation for preimplantation genetic testing

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