Milder is better? advantages and disadvantages of "mild" ovarian stimulation for human in vitro fertilization

Reproductive Biology and Endocrinology

Review

Luisa Delle Piane¹  Francesca Salvagno¹  Simona Casano¹  Alberto Revelli¹ 

[1] Department of Obstetrical and Gynecological Sciences, Reproductive Medicine and IVF Unit, University of Torino, via Ventimiglia 3, 10126, Torino, Italy;

关键词: Ovarian Stimulation;    GnRH Agonist;    Clomiphene Citrate;    Poor Responder;    GnRH Antagonist;   

DOI  :  10.1186/1477-7827-9-25

 received in 2010-12-07, accepted in 2011-02-16,  发布年份 2011

来源: Springer

【 摘 要 】

In the last decades, several steps have been made aiming at rendering human IVF more successful on one side, more tolerable on the other side. The "mild" ovarian stimulation approach, in which a lower-than-average dose of exogenous gonadotropins is given and gonadotropin treatment is started from day 2 to 7 of the cycle, represents a significant step toward a more patient's friendly IVF. However, a clear view of its virtues and defects is still lacking, because only a few prospective randomized trials comparing "mild" vs. conventional stimulation exist, and they do not consider some important aspects, such as, e.g., thawing cycles. This review gives a complete panorama of the "mild" stimulation philosophy, showing its advantages vs. conventional ovarian stimulation, but also discussing its disadvantages. Both patients with a normal ovarian responsiveness to exogenous gonadotropins and women with a poor ovarian reserve are considered. Overall, we conclude that the level of evidence supporting the use of "mild" stimulation protocols is still rather poor, and further, properly powered prospective studies about "mild" treatment regimens are required.

【 授权许可】

CC BY   
© Revelli et al; licensee BioMed Central Ltd. 2011