- October 18, 2017 at 20:59 #3931
IVF treatment initially utilized non-medicated or natural cycles. The timing of the egg retrieval took it is origin from the initiation of the endogenous luteinizing hormone (LH) surge as detected from multiple blood tests during the day. Overall, natural cycle and those cycles that used mild stimulation with clomiphene citrate were inefficient since couple of follicles developed. Among the first modifications that elevated IVF success considerably was using gonadotropins to stimulate the development of multiple ovarian follicles. The word “gonadotropins” describes medications which contain folliclestimulating hormone (FSH) and LH. It was an absolute improvement, but premature ovulation complicated roughly 30% of cycles, making timing of the egg retrieval challenging, and many of these cycles were canceled.
The next breakthrough happened in the late 1980s once the gonadotropinreleasing hormone (GnRH) agonist was introduced. Adding the GnRH agonist virtually eliminated any possibility of a premature LH surge and led to additional control of the cycle. Later in the 1990s, the GnRH antagonists were developed and provided another method of suppressing a premature LH surge. The ovarian hyperstimulation step is very important because the success rate is proportional to the number of oocytes, which are retrieved that, consequently, affects the number of embryos that are offered for embryo transfer. Through the years, there has been a change using gonadotropins acquired from urine of postmenopausal women to those preparations created by recombinant DNA technology. The newer gonadotropins tend to be more purified, allowing subcutaneous injection.
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