Journal of Human Reproductive Science
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Year : 2022  |  Volume : 15  |  Issue : 2  |  Page : 112-125
Ovarian stimulation in assisted reproductive technology cycles for varied patient profiles: An Indian perspective

1 Shreyas Hospital and Sushrut Assisted Conception Clinic, Kohlhapur, India
2 Dr. Patil's Fertility & Endoscopy Clinic, Bangalore, India
3 Nova IVF Fertility East, Kolkata, India
4 Mumbai Fertility Clinic & IVF Centre, Mumbai, India
5 Women's Centre Hospital, Coimbatore, India
6 Advanced Fertility Centre, Bangalore, India
7 Mother & Child Hospital, New Delhi, India
8 Virginia Center for Reproductive Medicine, Reston; Department of O&G, George Washington University, Washington, DC, USA

Correspondence Address:
Nalini Kaul-Mahajan
Mother and Child Hospital, D-64 Defence Colony, New Delhi - 110 024
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jhrs.jhrs_59_22

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Controlled ovarian stimulation has been an integral part of in vitro fertilisation (IVF) treatment cycles. Availability of different gonadotropins for ovarian stimulation and gonadotropin releasing hormone (GnRH) analogues for prevention of premature rise of leutinising hormone during follicular phase offer an opportunity to utilise them for a successful outcome in women with different subsets of ovarian response. Further, use of GnRH agonist as an alternative for human chorionic gonadotropin improves safety of ovarian stimulation in hyper-responders. Mild ovarian stimulation protocols have emerged as an alternative to conventional protocols in the recent years. Individualisation plays an important role in improving safety of IVF in hyper-responders while efforts continue to improve efficacy in poor responders. Some of the follicular and peri-ovulatory phase interventions may be associated with negative impact on the luteal phase and segmentalisation of the treatment with frozen embryo transfer may be an effective strategy in such a clinical scenario. This narrative review looks at the available evidence on various aspects of ovarian stimulation strategies and their consequences. In addition, it provides a concise summary of the evidence that has emerged from India on various aspects of ovarian stimulation.

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