Ovulation induction and controlled ovarian stimulation: a practical guide
Gespeichert in:
| Beteilige Person: | |
|---|---|
| Format: | Buch |
| Sprache: | Englisch |
| Veröffentlicht: |
Cham [u.a.]
Springer
2014
|
| Ausgabe: | 2. ed. |
| Schlagwörter: | |
| Links: | http://deposit.dnb.de/cgi-bin/dokserv?id=4601466&prov=M&dok_var=1&dok_ext=htm http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=028036188&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| Umfang: | XV, 217 S. Ill. 21 cm |
| ISBN: | 3319056115 9783319056111 |
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| 245 | 1 | 0 | |a Ovulation induction and controlled ovarian stimulation |b a practical guide |c Roy Homburg |
| 250 | |a 2. ed. | ||
| 264 | 1 | |a Cham [u.a.] |b Springer |c 2014 | |
| 300 | |a XV, 217 S. |b Ill. |c 21 cm | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 653 | |a Ovulation Induction | ||
| 653 | |a Ovarian Stimulation | ||
| 653 | |a Ovulation | ||
| 653 | |a Anovulation | ||
| 653 | |a In Vitro Fertilization | ||
| 653 | |a Ovarian Hyperstimulation | ||
| 653 | |a Infertility | ||
| 653 | |a Hyperprolactinaemia | ||
| 653 | |a Laparoscopic Ovarian Drilling | ||
| 653 | |a IVF | ||
| 653 | |a Hypogonadism | ||
| 653 | |a Gonadotrophin | ||
| 653 | |a Ovarian Reserve | ||
| 653 | |a Hypogonadotrophic | ||
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Datensatz im Suchindex
| _version_ | 1819266559738118144 |
|---|---|
| adam_text | Titel: Ovulation induction and controlled ovarian stimulation
Autor: Homburg, Roy
Jahr: 2014
Contents
1 A Potted History of Ovulation Induction......... 1
References................................... 4
2 Physiology of Ovulation........................ 7
2.1 Hypothalamic-Pituitary-Ovarian Axis........ 8
2.1.1 Gonadotrophin Releasing
Hormone (GnRH).................. 9
2.1.2 FSH............................... 11
2.1.3 LH................................ 13
2.1.4 Two Cells: Two Gonadotrophins....... 14
2.1.5 Oestradiol.......................... 15
2.1.6 Progesterone....................... 17
2.2 Ovarian Morphology...................... 17
2.3 Selection of the Dominant Follicle........... 19
2.4 Ovulation................................ 20
2.5 Fine Tuning.............................. 21
2.5.1 Inhibin............................. 21
2.5.2 Activin and Follistatin................ 21
2.5.3 Growth Factors..................... 21
2.5.4 Anti-Mullerian Hormone (AMH)..... 22
2.6 Ovarian Steroidogenesis................... 22
3 Diagnosis and Causes of Anovulation............ 25
3.1 Prevalence............................... 26
3.2 Diagnosis................................ 27
3.2.1 Following the Diagnosis
of Anovulation...................... 31
3.3 Causes of Anovulation..................... 32
vi Contents
3.3.1 Hypothalamic-Pituitary Failure
(WHO Group I).................... 32
3.3.2 Hypothalamic-Pituitary Dysfunction
(WHO Group II).................... 33
3.3.3 Ovarian Failure (WHO Group III)..... 36
3.3.4 Hyperprolactinaemia
(WHO Group IV)................... 37
3.4 Diagnostic Schemes....................... 38
3.5 Conclusions.............................. 41
4 General Factors Influencing Ovarian Function
and the Prognosis for Ovulation Induction........ 43
4.1 Influence of Female Age................... 44
4.1.1 Ovarian Reserve.................... 45
4.1.2 Prognosis for Conception............. 46
4.2 Influence of Obesity and Weight Loss........ 47
References................................... 48
5 Assessment of Ovarian Reserve................. 51
5.1 Female Age.............................. 53
5.2 Day 3 FSH............................... 53
5.3 Antral Follicle Count...................... 54
5.4 Anti-Mullerian Hormone (AMH)........... 54
5.5 Other Methods........................... 56
References................................... 56
6 Management of Hypogonadotrophic-
Hypogonadism................................ 59
6.1 Pulsatile Gonadotrophin-Releasing
Hormone Therapy......................... 61
6.2 Gonadotrophin Therapy................... 63
References................................... 64
7 Understanding the Problems of Treating PCOS----- 65
7.1 Definition................................ 66
7.2 Pathophysiology.......................... 67
7.3 Management............................. 69
7.3.1 Weight Loss........................ 69
Contents vii
7.4 Anti-oestrogens........................... 69
7.5 Insulin Sensitisers......................... 70
7.6 Gonadotrophin Therapy................... 71
7.7 Laparoscopic Ovarian Drilling.............. 71
7.8 In-Vitro Fertilization (IVF)................. 71
7.8.1 Long-Term Health Implications
of PCOS........................... 72
References................................... 72
8 Anti-oestrogens............................... 73
8.1 Clomifene Citrate......................... 74
8.1.1 Mode of Action..................... 74
8.1.2 Dose.............................. 75
8.1.3 Results............................. 75
8.1.4 Monitoring......................... 76
8.1.5 Possible Adjuvants to Clomifene
Treatment.......................... 77
8.1.6 Unexplained Infertilty............... 79
8.2 Aromatase Inhibitors...................... 80
8.2.1 Mode of Action..................... 81
8.2.2 Possible Advantages of Letrozole...... 81
8.2.3 Results............................. 82
8.2.4 Use of Letrozole in Controlled
Ovarian Hyperstimulation............ 82
8.2.5 Questions Remaining................ 83
8.2.6 Safety.............................. 84
References................................... 84
9 Low-Dose Gonadotrophin Therapy
for Ovulation Induction........................ 87
9.1 Rationale................................ 89
9.2 Chronic Low-Dose Regimen................ 90
9.3 Results.................................. 91
9.4 Variations on a Theme..................... 92
9.5 Starting Dose............................. 92
9.6 Incremental Dose Rise..................... 92
9.7 Patience Is a Virtue........................ 93
9.8 Gonadotrophin Preparations............... 94
9.9 Summary................................ 94
References................................... 94
viii Contents
10 Insulin Lowering Agents....................... 97
10.1 Weight Loss............................ 100
10.2 Metformin............................. 101
10.3 Restoration of Ovulation................. 102
10.3.1 Metformin Alone................. 102
10.3.2 Metformin + Clomiphene.......... 103
10.3.3 Metformin + Low-Dose FSH....... 103
10.3.4 Metformin in IVF................ 104
10.3.5 Metformin During Pregnancy...... 104
10.4 The Treatment of PCOS in Adolescence.... 104
10.5 Other Insulin Lowering Drugs............ 105
References.................................. 105
11 Laparoscopic Ovarian Drilling................. 109
11.1 Surgical Methods....................... 110
11.2 Results................................ Ill
11.3 Patient Selection and Mechanism
of Action.............................. 112
11.4 How Does It Work?..................... 112
11.5 The Order of Treatment Options.......... 113
References.................................. 113
12 Management of Hyperprolactinaemia........... 115
12.1 Aetiology.............................. 116
12.2 Diagnosis.............................. 117
12.3 Indications for Treatment................ 118
12.4 Treatment.............................. 119
12.5 Results of Treatment.................... 120
13 Gonadotropins for Ovulation Induction........ 121
13.1 Principles.............................. 122
13.2 Preparations............................ 123
13.3 Urinary vs Recombinant: Safety........... 124
13.4 Urinary FSH vs Recombinant
FSH: Efficacy........................... 124
13.5 FSH vs hMG........................... 125
13.6 Treatment Protocols for Ovulation
Induction.............................. 126
References................................... 127
Contents ix
14 Unexplained Infertility........................ 129
14.1 Diagnostic Tests......................... 130
14.2 Definition.............................. 131
14.3 When to Intervene...................... 131
14.4 Treatment Options...................... 132
References.................................. 135
15 Controlled Ovarian Stimulation
for Intra-uterine Insemination.................. 137
15.1 Principles.............................. 138
15.2 Treatment Regimes for IUI............... 139
15.3 Conclusions............................ 141
References.................................. 141
16 Controlled Ovarian Stimulation for IVF/ICSI .... 143
16.1 Principles.............................. 144
16.2 Gonadotrophins in COH................. 145
16.2.1 The Choice of Gonadotrophin
Preparation...................... 145
16.2.2 LH Content...................... 147
16.2.3 Starting Doses................... 148
16.2.4 Patient Comfort.................. 148
16.2.5 Triggering Ovulation.............. 148
16.3 GnRH Agonists......................... 149
16.3.1 Protocols........................ 149
16.3.2 Oral Contraceptives and the Long
GnRH Protocol.................. 151
16.3.3 Doses........................... 152
16.4 GnRH Antagonists...................... 152
16.4.1 Principles........................ 152
16.4.2 Protocols........................ 153
16.4.3 Single or Multiple Doses,
Fixed Day or Flexible?............ 156
References................................... 157
17 Management of Poor Responders............... 159
17.1 Definition.............................. 160
17.2 Aetiology.............................. 161
x Contents
17.3 Predictive Markers...................... 162
17.4 Proposed Therapeutic Options............ 163
17.4.1 High Dose Gonadotrophins........ 163
17.4.2 GnRH Agonist................... 164
17.4.3 GnRH Antagonist................ 164
17.4.4 Natural Cycles................... 165
17.4.5 Adjuvant Therapies............... 166
17.5 Conclusions............................ 168
References.................................. 168
18 Management of High Responders.............. 169
18.1 Prediction of the High Responder......... 170
18.2 Preference of an Antagonist Protocol...... 171
18.3 Starting Dose for Stimulation............. 172
18.4 Agonist Trigger......................... 172
18.5 Oral Contraceptive Pre-treatment......... 174
18.6 Metformin............................. 175
18.7 Carbergoline........................... 175
18.8 In-Vitro Maturation (IVM)............... 175
References.................................. 176
19 Mild Stimulation Protocols.................... 177
19.1 Natural Cycles.......................... 179
19.2 Modified Natural Cycles................. 179
19.3 Delayed Low-Dose FSH with GnRH
Antagonist............................. 180
19.4 Clomifene Combined with
Gonadotrophins........................ 181
19.5 Aromatase Inhibitors Combined
with Gonadotrophins.................... 182
19.6 Summary.............................. 182
References.................................. 182
20 Ovarian Hyperstimulation Syndrome............ 185
20.1 Aetiology and Pathophysiology........... 187
20.2 Risk Factors............................ 188
Contents xi
20.3 Prevention (See Also Chap. 18)........... 191
20.3.1 Ovulation Induction
and COH for IUI................. 191
20.3.2 IVF............................. 192
20.4 Treatment.............................. 195
20.5 Conclusions............................ 196
References.................................. 197
21 Multiple Pregnancies......................... 199
21.1 Incidence of Multiple Pregnancies......... 200
21.2 Preventative Methods................... 202
21.2.1 In Ovulation Induction............ 202
21.2.2 In Ovarian Stimulation Preceding
Intra-uterine Insemination (IUI)
(See Also Chap. 15)............... 203
21.2.3 IVF/Embryo Transfer............. 205
21.3 Foetal Reduction........................ 206
21.4 Conclusions............................ 207
References.................................. 207
22 Future Perspectives........................... 209
22.1 Patient Comfort........................ 210
22.1.1 Drug Delivery Systems............ 211
22.1.2 Less Injections................... 211
22.2 Less Complications...................... 212
22.3 Better Results.......................... 213
22.3.1 Improved Protocols............... 213
22.3.2 Time-Lapse Imaging.............. 213
22.4 Less Optimistic Predictions............... 214
22.5 Utopia................................. 215
Suggested Further Reading on Time-Lapse
Imaging..................................... 217
|
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| dewey-hundreds | 600 - Technology (Applied sciences) |
| dewey-ones | 610 - Medicine and health |
| dewey-raw | 610 |
| dewey-search | 610 |
| dewey-sort | 3610 |
| dewey-tens | 610 - Medicine and health |
| discipline | Medizin |
| edition | 2. ed. |
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| id | DE-604.BV042603156 |
| illustrated | Illustrated |
| indexdate | 2024-12-20T17:15:35Z |
| institution | BVB |
| isbn | 3319056115 9783319056111 |
| language | English |
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| owner_facet | DE-19 DE-BY-UBM |
| physical | XV, 217 S. Ill. 21 cm |
| publishDate | 2014 |
| publishDateSearch | 2014 |
| publishDateSort | 2014 |
| publisher | Springer |
| record_format | marc |
| spellingShingle | Homburg, Roy Ovulation induction and controlled ovarian stimulation a practical guide |
| title | Ovulation induction and controlled ovarian stimulation a practical guide |
| title_auth | Ovulation induction and controlled ovarian stimulation a practical guide |
| title_exact_search | Ovulation induction and controlled ovarian stimulation a practical guide |
| title_full | Ovulation induction and controlled ovarian stimulation a practical guide Roy Homburg |
| title_fullStr | Ovulation induction and controlled ovarian stimulation a practical guide Roy Homburg |
| title_full_unstemmed | Ovulation induction and controlled ovarian stimulation a practical guide Roy Homburg |
| title_short | Ovulation induction and controlled ovarian stimulation |
| title_sort | ovulation induction and controlled ovarian stimulation a practical guide |
| title_sub | a practical guide |
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