Alberto Vaiarelli1, Roberta Venturella, Damiano Vizziello, Francesco Bulletti, Filippo M Ubaldi. 1. aGENERA Center for Reproductive Medicine, Valle Giulia Clinic, Rome bDepartment of Human Pathology, University of Messina, Messina cGENERA Center for Reproductive Medicine, Ruesch Clinic, Naples dDepartment of Obstetrics and Gynecology, 'Magna Graecia' University, Catanzaro eIRCCS, Policlinico San Donato, Università degli Studi di Milano, Milan, Italy fUniversity of Targu Mures, Targu Mures, Romania.
Abstract
PURPOSE OF REVIEW: The opportunity to use gonadotropins to stimulate the growth of antral follicles coming from different follicular waves available in different moment of the menstrual cycle allowed the implementation of innovative protocols in assisted reproductive technologies. The purpose of this review is to explore the possible advantages related to these new controlled ovarian stimulation (COS) strategies. RECENT FINDINGS: Women exhibit major and minor wave patterns of ovarian follicular development during the menstrual cycle, as it is in animal species. These observations led to the introduction of two new strategies for COS: the random start and the double ovarian stimulation within a single menstrual cycle. SUMMARY: The use of gonadotropin-releasing hormone antagonist COS protocols, started randomly at any day of the menstrual cycle, is today a standard procedure in those cases where obtaining oocytes is an urgent task, such as in case of fertility preservation for malignant diseases or other medical indications.On the other hand, in poor prognosis patients, double ovarian stimulation has been suggested with the aim of maximizing the number of oocytes retrieved within a single menstrual cycle and, in turn increasing the chance to obtain a reproductively competent embryo. Randomized control trials are necessary to confirm these preliminary findings.
PURPOSE OF REVIEW: The opportunity to use gonadotropins to stimulate the growth of antral follicles coming from different follicular waves available in different moment of the menstrual cycle allowed the implementation of innovative protocols in assisted reproductive technologies. The purpose of this review is to explore the possible advantages related to these new controlled ovarian stimulation (COS) strategies. RECENT FINDINGS:Women exhibit major and minor wave patterns of ovarian follicular development during the menstrual cycle, as it is in animal species. These observations led to the introduction of two new strategies for COS: the random start and the double ovarian stimulation within a single menstrual cycle. SUMMARY: The use of gonadotropin-releasing hormone antagonist COS protocols, started randomly at any day of the menstrual cycle, is today a standard procedure in those cases where obtaining oocytes is an urgent task, such as in case of fertility preservation for malignant diseases or other medical indications.On the other hand, in poor prognosis patients, double ovarian stimulation has been suggested with the aim of maximizing the number of oocytes retrieved within a single menstrual cycle and, in turn increasing the chance to obtain a reproductively competent embryo. Randomized control trials are necessary to confirm these preliminary findings.
Authors: Filippo Maria Ubaldi; Danilo Cimadomo; Alberto Vaiarelli; Gemma Fabozzi; Roberta Venturella; Roberta Maggiulli; Rossella Mazzilli; Susanna Ferrero; Antonio Palagiano; Laura Rienzi Journal: Front Endocrinol (Lausanne) Date: 2019-02-20 Impact factor: 5.555
Authors: Camila Cruz de Moraes; Victoria Furquim Werneck Marinho; Ana Luísa Menezes Campos; Janaína de Souza Guedes; Érica Becker de Sousa Xavier; João Pedro Junqueira Caetano; Ricardo Mello Marinho Journal: JBRA Assist Reprod Date: 2019-04-30
Authors: Alberto Vaiarelli; Danilo Cimadomo; Elisabetta Trabucco; Roberta Vallefuoco; Laura Buffo; Ludovica Dusi; Fabrizio Fiorini; Nicoletta Barnocchi; Francesco Maria Bulletti; Laura Rienzi; Filippo Maria Ubaldi Journal: Front Endocrinol (Lausanne) Date: 2018-06-14 Impact factor: 5.555