Final maturation induction
Induction of final maturation of
The main medications used for induction of final maturation are
Usage with ovulation
Induction of final maturation also initiates the mechanisms that eventually result in
Administration of a drug to trigger oocyte release without oocyte retrieval results in a predictable time of ovulation, with the interval from drug administration to ovulation depending on the type of drug. This avails for
In
Usage with artificial oocyte retrieval
In
In IVF, final maturation induction is preceded by controlled ovarian hyperstimulation. It is suggested that there should be a size of ovarian follicles of at least 15 mm, and serum estradiol level of 0.49 nmol/L before commencing final maturation induction. There are better prospects at a follicle size of 18 mm and serum estradiol level of 0.91 nmol/L.[6]
Medications
Medications used for final maturation and/or release of oocytes include:
- in vitro fertilization, where it makes the follicles perform their final maturation. A transvaginal oocyte retrieval is then performed at a time usually between 34 and 36 hours after hCG injection, that is, shortly before when the follicles would rupture. A retrieval at 36 hours after final maturation induction appears to result in optimal embryo quality and pregnancy outcomes.[9] HCG injection confers a risk of ovarian hyperstimulation syndrome.
- Recombinant luteinizing hormone (rLH), recombinant HCG (rHCG) and urine-derived hCG (uHCG) are equally effective in achieving final follicular maturation in IVF with regards to pregnancy rates and risk of ovarian hyperstimulation syndrome.[10] Therefore, urine-derived hCG (uHCG) is regarded as the best choice for final oocyte maturation triggering in IVF due to availability and cost.[10]
- GnRH antagonist protocol for suppression of ovulation during ovarian hyperstimulation, because using GnRH agonist for that purpose as well inactivates the axis for which it is intended to work for final maturation induction.
HCG versus GnRH agonist
Final maturation induction using GnRH agonist results in a substantial decrease in the risk of
However, using GnRH agonist has a lower
Final maturation induction using a GnRH agonist is recommended in women with cancer undergoing fertility preservation, because ovarian hyperstimulation syndrome is associated with an increased risk of arterial thrombotic events such as stroke, myocardial infarction and peripheral arterial embolism, and this risk can add to an already increased risk caused by the cancer.[11]
Using hCG versus GnRH agonist has no effect on the risk of
References
- ^ PMID 25358904.
- ^ "About.com". Archived from the original on 2012-11-18. Retrieved 2014-05-10.
- ^ IVF.com > Ovulation Induction Archived 2012-02-26 at the Wayback Machine Retrieved on Mars 7, 2010
- ^ PMID 23809505.
- ^ Clomiphene Citrate, Clomid Archived 2014-05-10 at archive.today. By Robert B. McWilliams. The Center for Reproduction and Women's Health Care, Houston, Texas. Retrieved May 2014
- ^ Follicular monitoring from Radiopaedia. By Dr Praveen Jha et al.
- PMID 24639791.)
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: CS1 maint: multiple names: authors list (link - ^ HCG Injection After Ovulation Induction With Clomiphene Citrate at Medscape. By Peter Kovacs. Posted: 04/23/2004
- PMID 18556681.)
{{cite journal}}
: CS1 maint: multiple names: authors list (link - ^ PMID 30117155.
- PMID 25013217.