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Tumor Therapy China

Ovulation Induction

If you are considering ovulation induction in China and would like to get know more information about ovulation induction, please complete the inquiry form or email us at info@shmtppp.com

Ovulation Induction

Introduction

Ovulatory disorders can be identified in the woman in 18 to 25 percent of couples presenting with infertility. Most of these women have oligomenorrhea, arbitrarily defined as menstruation that occurs at intervals of 35 days to six months. While ovulation may occasionally occur, spontaneous conception is unlikely.

Induction of ovulation in these women is aimed at inducing monofollicular development, subsequent ovulation and ultimately pregnancy and birth of a healthy newborn. Induction of ovulation should be differentiated from stimulation of multiple follicle development in ovulatory women, as is done with assisted conception techniques. The method of ovulation induction selected by the clinician should be based upon the underlying cause of anovulation and the efficacy, costs, risks, and potential complications associated with each method as they apply to the individual woman.

Ovulation induction with clomiphene citrate

Clomiphene citrate has been the most widely used treatment for fertility enhancement for the past 40 years. Clomiphene was a revolutionary advance in reproductive medicine and quickly became popular for induction of ovulation because of its ease of administration and minimal side effects. Ironically, it was initially synthesized as a synthetic estrogen for possible use as a contraceptive. The pharmacology, indications, and administration of clomiphene citrate will be reviewed here. Other drugs for induction of ovulation are discussed elsewhere.

Ovulation induction with aromatase inhibitors

Women with anovulatory infertility can be categorized based on their gonadotropin status as defined by the World Health Organization (WHO): WHO I refers to hypogonadotropic hypogonadism, WHO II refers to eugonadotropic, and WHO III refers to hypergonadotropic hypogonadism. Women with WHO II anovulatory infertility typically have normal follicular phase estrogen levels and withdrawal uterine bleeding after a progestin challenge. Clomiphene citrate (CC) is the most commonly used pharmacologic agent to induce ovulation in these women, but some women fail to conceive with this therapy. During the past decade both insulin sensitizers, such as metformin, and aromatase inhibitors have been used for ovulation induction in women who fail to conceive with CC. Aromatase inhibitors are a class of drugs that block estrogen biosynthesis, thereby reducing negative estrogenic feedback at the pituitary.

This topic review discusses studies on the experimental use of aromatase inhibitors for ovulation induction in women with WHO II anovulatory infertility. However, at this time, use of aromatase inhibitors for ovulation induction in premenopausal women is controversial due to the possibility of fetal toxicity and fetal malformations raised by one abstract. However, two subsequent publications have shown no evidence of fetal malformations with the aromatase inhibitor letrozole and no difference in birthweight compared to spontaneous conceptions.

The use of clomiphene, metformin, and gonadotropins is reviewed separately.

If you are considering ovulation induction in China and would like to get know more information about ovulation induction, please complete the inquiry form or email us at info@shmtppp.com