Synchronization of Ovarian Stimulation for in Vitro Fertilization With Follicular Wave Emergence
Status:
Unknown status
Trial end date:
2014-12-01
Target enrollment:
Participant gender:
Summary
Ovarian stimulation is an important phase of in vitro fertilization (IVF) treatments. The
harvest of a larger number of viable eggs per cycle compensate eventual laboratory
difficulties and allow for the selection of embryos with higher implantation potential. In
the current protocols, based on the most prevailing theory of ovarian follicular development,
stimulation drugs are usually started on the second or third day after the beginning of
menses. The follicular phase of the menstrual cycle is believed to be the only favorable
moment for follicular development.
In the early 2000's a new model of human ovarian follicular development (follicular waves)
has been proposed based on frequent transvaginal ultrasound observations between two
ovulations. It has been shown that ovarian antral follicles develop in synchronous groups,
two to three times in a cycle. In fact the follicular wave phenomenon has been initially
described in the 80's on domestic animals, like the mare and the cow. Moreover, studies in
these animals have shown that synchronizing the start of the ovarian stimulation drugs with
the beginning of a follicular wave yields better results for assisted reproductive
treatments. Consequently in ovarian stimulation protocols for animal assisted reproduction it
is important to control the initiation of a follicular wave.
Current protocols of ovarian stimulation for IVF in women do not consider the start of a
follicular wave to begin drug administration. Therefore the purpose of this study is to
evaluate two methods to control the emergence of a follicular wave (ovulation induction and
dominant follicle aspiration) and to investigate the effects of synchronizing ovarian
stimulation for IVF with follicular wave emergence in women compared to one of the current
stimulation protocols (flexible GnRH protocol).