By Roy Homburg
A speedily advancing box, ovulation induction and regulated ovarian stimulation lie on the very middle of infertility remedy.
A concise and exact useful consultant to what are absolutely very complex subject matters, this essentially written textual content presents the busy clinician with a competent evaluation of the foundations concerned and the administration wanted during this area.
Including an exploration of the historical past of ovulation induction and stimulation, in addition to dialogue of destiny chances and advancements, the most physique of the textual content is equipped on logical facts and evidence-based suggestions. a few hugely necessary algorithms and explanatory tables make stronger this procedure, making sure that the reader is gifted with easy-to-grasp, well-presented details that maximizes readability and understanding.
Written by means of a professional writer of virtually 40 years event, this is often an incredible source for the overall gynecologist, fertility expert, medical examiner and student.
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Additional info for Ovulation Induction and Controlled Ovarian Stimulation: A Practical Guide
Sample text
Once it was synthesized and made available for therapy, it became apparent that continuous infusion did not produce the desired release of gonadotropins but, paradoxically, down-regulated their receptors and suppressed their release. When an agonist of GnRH was developed, this had the same effect. This discovery proved to be extremely important 39 Chapter 05 4/3/05 3:02 pm Page 40 OVULATION INDUCTION AND CONTROLLED OVARIAN STIMULATION – A PRACTICAL GUIDE and revolutionized reproductive physiology and eventually treatment.
Hum Reprod 1988; 3: 285–8 12. Lord JM, Flight IH, Norman RJ. Insulin-sensitizing drugs (metformin, troglitazone, rosiglitazone, pioglitazone, D-chiro-inositol) for polycystic ovary syndrome. Cochrane Database Syst Rev 2003; (3): CD003053 13. Harborne L, Fleming R, Lyall H, et al. Descriptive review of the evidence for the use of metformin in polycystic ovary syndrome. Lancet 2003; 361:1894–901 14. Vandermolen DT, Ratts VS, Evans WS, et al. Metformin increases the ovulatory rate and pregnancy rate with clomiphene citrate in patients with polycystic ovary syndrome who are resistant to clomiphene citrate alone.
Practically, the diagnosis of PCOS can be made in almost every case without blood sampling. Although not essential for initial diagnostic or therapeutic decisions, for screening I usually take a blood sample for LH, FSH, total testosterone and fasting glucose and insulin concentrations. The ratio of fasting glucose/insulin levels gives a good indication of insulin sensitivity and, as hyperinsulinemia is present in about 80% of obese women and 30–40% of women of normal weight with PCOS and is strongly associated with anovulation, it is certainly useful to know the ratio for possible therapeutic intervention.