Human Reproduction Update Advance Access originally published online on November 15, 2007
Human Reproduction Update 2008 14(1):1-14; doi:10.1093/humupd/dmm034
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Predictors of ovarian response: progress towards individualized treatment in ovulation induction and ovarian stimulation
1 Department of Reproductive Medicine and Gynecology, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands 2 Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, 23538 Luebeck, Germany 3 Center of Reproductive Medicine, Free University Brussels, Brussels, Belgium
4 Correspondence address. E-mail: b.c.fauser{at}umcutrecht.nl
Ovarian stimulation is applied in the clinic to restore mono-ovulatory cycles in anovulatory women (ovulation induction) or to induce the development of multiple dominant follicles for assisted reproduction. Ovarian response is the endocrine and follicular reaction of the ovaries to stimulation. Achieving an appropriate ovarian response to anti-estrogens or exogenous gonadotrophins is central to ovulation induction and ovarian stimulation protocols. However, achieving an adequate response, without cycle cancellation or adverse events related to under- or over-stimulation, is complicated by high intra- and inter-individual variability. To predict each patient's ovarian response to medication for ovarian stimulation and to individualize the starting dose of exogenous gonadotrophin or the need for exogenous luteinizing hormone, various clinical, endocrine, ovarian ultrasonographic and genetic characteristics have been explored. Some of these features have been incorporated into prediction models. In this review, the methodology behind predictive factors and prediction models and their potential clinical applicability across ovulation induction and ovarian stimulation are explored.
Key words: predictive factors / predictive models / ovulation inductions / multifollicular stimulation
Received on July 6, 2007; revised August 13, 2007; accepted on October 10, 2007
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