New Twists in Ovarian Stimulation and Their Practical Implications

Ovarian stimulation (OS) has for objective to induce multiple ovulation in order to yield a multiple oocyte harvest and offer multiple embryos available for transfer thereby increasing the efficacy of ART. Originally, the primary risk associated with OS was the occurrence of frank ovarian hyperstimu...

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Autores principales: Pirtea, Paul, de Ziegler, Dominique, Poulain, Marine, Ayoubi, Jean Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737035/
https://www.ncbi.nlm.nih.gov/pubmed/31555650
http://dx.doi.org/10.3389/fmed.2019.00197
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author Pirtea, Paul
de Ziegler, Dominique
Poulain, Marine
Ayoubi, Jean Marc
author_facet Pirtea, Paul
de Ziegler, Dominique
Poulain, Marine
Ayoubi, Jean Marc
author_sort Pirtea, Paul
collection PubMed
description Ovarian stimulation (OS) has for objective to induce multiple ovulation in order to yield a multiple oocyte harvest and offer multiple embryos available for transfer thereby increasing the efficacy of ART. Originally, the primary risk associated with OS was the occurrence of frank ovarian hyperstimulation syndrome (OHSS), a possibly dreadful—sometime fatal—complication of ART. These fears limited the number of oocytes aimed for during OS in order to curb the risk of OHSS. On the contrary, the meager implantation rates of the early days of ART led to easily transfer multiple embryos in order to achieve acceptable pregnancy rates. Today the perspectives have changed. The advent of antagonist-based OS protocol and the possibility to trigger the ultimate phase of oocyte maturation with GnRH-a has allowed to reduce the risk of OHHS. Conversely, the markedly increased implantation rates of today's ART makes multiple pregnancy a worry that has come in the limelight worldwide, pushing the practice of single embryo transfer (SET).
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spelling pubmed-67370352019-09-25 New Twists in Ovarian Stimulation and Their Practical Implications Pirtea, Paul de Ziegler, Dominique Poulain, Marine Ayoubi, Jean Marc Front Med (Lausanne) Medicine Ovarian stimulation (OS) has for objective to induce multiple ovulation in order to yield a multiple oocyte harvest and offer multiple embryos available for transfer thereby increasing the efficacy of ART. Originally, the primary risk associated with OS was the occurrence of frank ovarian hyperstimulation syndrome (OHSS), a possibly dreadful—sometime fatal—complication of ART. These fears limited the number of oocytes aimed for during OS in order to curb the risk of OHSS. On the contrary, the meager implantation rates of the early days of ART led to easily transfer multiple embryos in order to achieve acceptable pregnancy rates. Today the perspectives have changed. The advent of antagonist-based OS protocol and the possibility to trigger the ultimate phase of oocyte maturation with GnRH-a has allowed to reduce the risk of OHHS. Conversely, the markedly increased implantation rates of today's ART makes multiple pregnancy a worry that has come in the limelight worldwide, pushing the practice of single embryo transfer (SET). Frontiers Media S.A. 2019-09-04 /pmc/articles/PMC6737035/ /pubmed/31555650 http://dx.doi.org/10.3389/fmed.2019.00197 Text en Copyright © 2019 Pirtea, de Ziegler, Poulain and Ayoubi. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Pirtea, Paul
de Ziegler, Dominique
Poulain, Marine
Ayoubi, Jean Marc
New Twists in Ovarian Stimulation and Their Practical Implications
title New Twists in Ovarian Stimulation and Their Practical Implications
title_full New Twists in Ovarian Stimulation and Their Practical Implications
title_fullStr New Twists in Ovarian Stimulation and Their Practical Implications
title_full_unstemmed New Twists in Ovarian Stimulation and Their Practical Implications
title_short New Twists in Ovarian Stimulation and Their Practical Implications
title_sort new twists in ovarian stimulation and their practical implications
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737035/
https://www.ncbi.nlm.nih.gov/pubmed/31555650
http://dx.doi.org/10.3389/fmed.2019.00197
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