Manual of Ovulation Induction & Ovarian Stimulation Protocols

Fundamentals of Stimulation

• Regulation of the menstrual cycle and the effect of controlled ovarian hyperstimulation on cycle characteristics
• Regulation of Gonadotropin Secretion
• The role of gonadotropins in follicular development and their use in ovulation induction protocols for assisted reproduction
• Predictors of ovarian response to controlled ovarian stimulation:: are they useful?
• Clinical significance of antral follicle count and anti-Müllerian hormone in predicting the stimulation outcome
• Human Ovulation and Transvaginal Sonography
• The significance of monitoring folliculogenesis
• Identification of patients at high risk for excessive response to ovarian stimulation
• The impact of repeated ovulation stimulations on the ovarian reserve
• Luteinizing hormone activity in ovarian stimulation for IVF:: is it Ovulation Induction and Ovulation indispensible?
• Luteal phase support in controlled ovarian hyperstimulation protocols:: why and how?

Ovarian Stimulation Regimens

• Ovarian Stimulation Protocols
• Clomiphene Citrate for Ovarian Stimulation
• Combination Protocols Using Clomiphene Plus Gonadotropins
• Route of Administration of Gonadotropins and Ovarian Response
• Clinical Application of Recombinant Follicle Stimulating hormone
• Induction Protocols of the 2000s Using r-hLH and r-Hcg
• Step-up Protocols
• Step-down protocols for ovulation induction
• The Role of Gonadotropin-Releasing Hormone Agonists in Ovulation Induction
• Gonadotropin-releasing hormone antagonist protocols:: fixed versus flexible
• GnRH agonists vs. GnRH antagonists for ovarian stimulation:: pros and cons
• Fine-tuning the Role of GnRH Antagonists in ART Programs
• Evaluation of luteal phase in GnRH agonist/antagonist IVF protocols
• Recombinant human follicle-stimulating hormone vs. highly purified human menopausal gonadotrophin for controlled ovarian stimulation in GnRH agonist down-regulated cycles
• Can endogenous LH support treatment with rFSH only in a GnRH antagonist protocol in normogonadotropic patients?
• The efficacy of recombinant LH supplementation for controlled ovarian stimulation in r-FSH and GnRH-agonist protocols
• Substitution of recombinant FSH (rFSH) by low-dose hCG in the late follicular phase in a GnRH antagonist protocol:: Is it clinically effective?
• The benefit of luteal estradiol pre-treatment in GnRH antagonist protocols vs. long GnRH agonist protocols
• Impact of long GnRH agonist and GnRH antagonist stimulation protocols on endometrial receptivity
• The efficacy of clomiphene citrate in preventing a premature LH surge during controlled ovarian stimulation with human menopausal gonadotrophins (hMG)
• Pretreatment with combined oral contraceptives prior to stimulation:: does it help?

Aromatase inhibitors for Ovarian Stimulation

• Aromatase inhibitors for ovulation induction:: indications and clinical outcomes
• Clomiphene citrate vs. aromatase inhibitors:: mechanism of action
• Clinical efficacy and safety of letrozole vs. clomiphene citrate for ovulation induction in women with polycystic ovary syndrome
• Ovulation Induction in PCOS
• Management strategies for ovulation induction CC-resistant PCOS women
• Induction of Monofolliculogenesis in Patients with Polycystic Ovary Syndrome
• Low-dose step-down regimen for ovulation induction in PCOS
• Chronic ultra-low-dose step-up protocol for patients with polycystic ovary syndrome
• GnRH agonist vs. antagonist protocols for controlled ovarian stimulation in women with PCOS
• Influence of BMI on the IVF outcome in PCOS patients undergoing stimulation with GnRH agonists or antagonists
• Adjunctive Glucocorticoids in Ovulation Induction for Polycystic Ovarian Syndrome
• Metformin Treatment of Clomiphene-Resistant Polycystic Ovary Syndrome
• Mechanism of action of metformin for ovulation induction in PCOS patients
• Clomiphene citrate, Metformin, or both for the treatment of anovulatory women with polycystic ovary syndrome:: evidence-based recommendations
• Metformin and clomiphene citrate (CC) vs. highly purified FSH for ovulation induction in CC-resistant women with PCOS
• The current place of Metformin in infertile patients with PCOS:: an evidence-based approach
• Laparoscopic ovarian drilling for surgical induction of ovulation in polycystic ovary syndrome

Ovulation triggering

• Role of GnRH Agonists as an Ovulation Trigger
• Recombinant LH, recombinant hCG and GnRH agonist to trigger ovulation:: a critical evaluation
• LH and FSH surges for final oocyte maturation:: Is a dual surge beneficial?

Complications of COH

• Complications of ovulation induction
• Ovarian hyperstimulation syndrome:: prevention strategies
• The role of in vitro maturation in high responders and patients at risk of OHSS undergoing assisted reproductive technology

Poor Responders

• Cancelled Cycles in Poor Response-What Next? Ovulation Induction and Ovulation
• Management options for poor responders to controlled ovarian stimulation
• The efficacy of microdose GnRH agonist flare (MF) vs. GnRH antagonist/Letrozole protocols in poor responders undergoing in vitro fertilization
• Optimum maximal gonadotropin dosage used in microdose flare-up cycles
• Role of androgens in the treatment of patients with low ovarian response
• Addition of growth hormone to stimulation protocols for poor responders:: is it beneficial?
• Criteria for cycle cancellation in poor responders to ovarian stimulation
• Contribution of in vitro maturation to ovarian stimulation cycles in poor responder patients

Mild Stimulation Protocols and Natural Cycle IVF

• Embarking on natural cycle IVF:: When and how?
• The value of modified natural cycle IVF in normal ovarian responders
• Advances in Stimulation Science
• Long-acting Recombinant FSH (FSH-CTP, Corifollitropin Alfa)
• Can corifollitropin alfa replace recombinant FSH (rFSH) for ovarian stimulation using a gonadotrophin-releasing hormone antagonist protocol prior to IVF/ICSI?
• Applicability and reproducibility of Sonography-based Automated Volume Count (SonoAVC) for monitoring folliculogenesis
• The ideal stimulation protocol:: Is there one?