Practical Guide to Ovulation Induction Sonal Panchal, Chaitanya Nagori
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Acupuncture 130
Adenosine monophosphate 154
Adrenal androgen 107fc
Adrenal cytochrome, serine phosphorylation of 107
Adrenal function 40
Albumin, intravenous 172
Allergic reaction, local 162
Amenorrhea 19f
American College of Obstetricians and Gynecologists 41
American Society for Reproductive Medicine 106, 193
Androgen
intraovarian 204
metabolism 107fc
Anorexia nervosa 20
Anovulation 19f, 20, 106
causes of 19
Antagonist 94t, 115
advantages of 94
agonist protocol 64
cycle 160
disadvantages of 94
protocol 64
advantages of 114b
Antibiotic therapy 176
Antibodies, development of 102
Anticoagulant 176, 177
therapy 176
Antihistamine 176
Anti-Müllerian hormone 7, 13, 27, 28, 32, 34, 64, 65, 90, 106, 129, 169
assays 30
clinical uses of 30
high 169
immunoassays 30
normal values of 30t
physiology of 13, 29
serum 12
values 13t
Antral follicle count 7, 25, 31, 32, 34, 60, 64, 72, 73, 73f, 75, 76
Anxiety 100
Aromatase
action of 50f
inhibitor 50, 137
Ascites 175, 176
Ascitic fluid
aspiration of 177
autotransfusion of 178
Aspirin 125, 130
low dose 46
Assisted reproductive technique 25, 53, 58, 63, 76, 89, 90, 112, 118b, 124, 135, 140, 157, 170, 187
Autoimmune disease 21
B
Basal body temperature 16, 183
Batch-to-batch inconsistencies 162
Beta thalassemia 100
Blood comp 175
Body mass index 21, 33, 34, 52, 60, 64, 72, 75, 76, 108
higher 143
low 169
Bologna criteria consensus 34, 124
Bone morphogenetic protein 169
Breast 43
cancer 92
Bromocriptine 43, 44, 47, 203
Buserelin 89
C
Cabergoline 204
Calcium, intravenous 173
Carbimazole 208
Central nervous system 204
Cervical
dysmenorrhea 42
mucus 16
Cervix 42
Chemotherapy 21
Cholesterol, pathway of 182fc
Cirrhosis 100
Clomiphene 39, 46, 136, 185
citrate 39, 40, 4447, 51, 108, 110, 125, 128, 136, 161, 185
antiestrogenic effects of 42
challenge test 27, 31, 34
contraindications of 40
cycle 5, 10
indications of 40
resistant 51
risks of 43
failure 58
resistant 58
treatment, extended 43
Color Doppler 71, 74f, 84f
Computed tomography 203
Corpus luteal flow 84, 85t, 184f
high resistance 85
Corpus luteum 18, 18f, 83, 85, 91, 183
low resistance blood flow of 86f
Craniopharyngioma 20
Cryopreservation 61
Cyclic adenosine monophosphate 162
Cyst
rupture 177, 178
subcapsular 117
Cystic fibrosis transmembrane conductance regulator 169
D
Danazol 176
Dandy-Walker malformation 43
Decapeptyl 89
Dehydroepiandrosterone 4, 107, 129, 154
sulfate 12, 44, 111
Deoxyribonucleic acid 129, 159
recombinant 60
Dexamethasone 47
Diarrhea 175
Disease Control and Prevention, centers for 26
Diuretics 176, 177
Donor oocytes 125
Dopamine 176, 177, 202
agonist 172
Dual stimulation 127
Dual trigger 145, 192
Dysmucorrhea 42
Dyspnea 175
E
Electrolyte 175
replacement 176
Embryo 42, 162
transfer 62, 78, 150
Enclomiphene 39
Endocrinal tests 27
Endocrine dynamic tests 31
Endometrial
biopsy 17, 41, 183
columnar epithelium 81
flow, secretory 185f
injury 84
receptivity 52
thickness 91
vascularity 82
vessels 17
volume 82
Endometrioma 124
Endometrio-myometrial junction 80f
Endometriosis 51, 54, 92, 124, 183, 194
Endometritis, chronic 84
Endometrium 42, 85f, 153
B-mode
features of 79
ultrasound image 80f, 81f
Doppler features of 81
echogenic 85
optimum pretrigger parameters of 83t
secretory 86f
Epithelial growth factor 181
Estradiol 3, 8f, 28, 34, 91, 142
level 170
replacement 144
serum 10
supplementation 193
upregulates cystic fibrosis transmembrane conductance regulator 169
Estrogen 6, 17, 43, 44, 47, 103, 195
priming 125, 128
receptors 51, 181
Estrone-3-glucuronide 182
European Society of Human Reproduction and Embryology 34, 106, 124
Exogenous estrogen 42
Exophthalmos 208
F
Fertility
low 13
optimal 13
Fetal outcome 53
Fibroid 92
Fluid aspiration 177
Follicle 1
B-mode ultrasound image of 77f
calculated volume of 79f
multiple 92
number per ovary 20, 34, 75, 169
optimum pretrigger parameters of 83t
stimulates 54
Follicle-stimulating hormone 2f, 3, 3f, 9, 2628, 34, 39, 50, 57, 58, 59f, 62, 89, 100, 109, 124, 125, 129, 150, 153, 154, 157f, 158, 161, 166, 182, 206
clinical benefits of recombinant 63
level, correlation of 27t
midcycle 139
ovarian reserve test, exogenous 27, 31
receptor genotype 169
recombinant 58, 60, 61, 61t, 62, 62t, 63, 65, 72, 112
secretion 2
serum 9
stimulates 58
Follicular maturity 10
Follistatin 7
Follitropin
alpha 63
beta 63
Frozen embryo transfer 54, 195
cycles 195
indications of 195
G
Galactorrhea 15, 44
Gastrointestinal tract 204
Glucocorticoids 43, 44, 108, 111, 125, 129, 172
Gonadal protection during chemotherapy 92
Gonadotropin 2, 4, 43, 45, 47, 54, 57, 58, 63, 108, 111, 135137, 185
bioactivity of 112t
cycles 126
dosage of 95, 125
low dose 137
therapy 58, 101, 102, 141
indications of 58
principles of 58
Gonadotropin-releasing hormone 2, 3f, 31, 39, 73, 94, 101, 125, 139, 157, 183, 202
agonist 43, 45, 89, 90, 94, 108, 114, 126127, 141143, 150, 172, 189
clinical application of 91
downregulation 196
flare protocol 125
mechanism of action of 89t
microdose flare 125
minidose luteal phase 127
protocols 90
stop protocol 125
trigger 144
analog 89
stimulation test 27, 31, 34
antagonist 43, 93, 94, 108, 113, 125, 127, 128, 130
protocol 170
deficiency 100
therapy
advantages of 101b
disadvantages of 102b
Goserelin 89
Growth
factors 7
hormone 103, 125, 129
actions of 129b
additional of 103
releasing factor 130
H
Hematoma 102
Hemorrhage, severe postpartum 20
Hirsutism 92
Hormone
adrenocorticotropic 12,44
antidiuretic 168
release of 101
replacement therapy 21, 101
Human chorionic gonadotropin 43, 45, 54, 59f, 64, 72, 92, 101, 140, 141, 150, 162, 166, 182, 191
indications of 141
recombinant 67, 142
supplementation 184, 185
surge 141
characteristics of 141
Human menopausal gonadotropin 17, 29, 45, 57, 58, 61, 62, 95, 102, 112, 125, 137, 162, 170
exogenous 151
highly purified 62, 153
Hydrothorax 175
Hydroxyethyl starch 172
solution, intravenous 172
Hyperandrogenemia 107
Hyperandrogenism 20, 106
biochemical 20
clinical 20
Hyperinsulinemia 20, 107
inhibits sex hormone-binding globulin 107
Hyperplasia, congenital adrenal 106
Hyperprolactinemia 21, 101, 183, 202, 209
causes of 202
effect of 204
transient 204
Hyperstimulation 11
Hyperthyroidism 208, 209
Hypoestrinism, signs of 100
Hypogonadotropic hypogonadism 6, 19, 40, 58, 100, 103, 104, 140, 158
causes of 100
Hypophysectomy 20
Hypothalamic
dysfunction 144
pituitary
dysfunction 20, 140, 183
failure 19
ovarian axis 2, 3f, 40, 52, 189
Hypothyroidism 203, 206, 209
isolated 101
subclinical 207, 209
I
In vitro fertilization 27, 54, 94, 104, 108, 125, 150, 168, 191
natural cycle 71, 125, 130, 136
In vitro maturation 54, 108, 118, 125
Indomethacin 177
Infertility 110b, 206
Infusion pump, use of 102
Inhibin 6
A 12
B 12, 28
Insemination, artificial 16
Insulin
like growth factor 7, 50, 101, 129, 181
lowering drugs 108
insulin sensitizers 109
receptor, beta-chain of 107
resistance 14
sensitizer 29, 43
Intracytoplasmic sperm injection 72, 110
Intramuscular progesterone 187
Intrauterine insemination 40, 54, 58, 71, 114, 140, 168, 185, 191
K
Kallmann syndrome 20, 100
Killer cells, lymphokine-activated 182
L
Laparoscopic ovarian multi-needle intervention 116, 117
L-arginine 125, 128
Letrozole 50, 52, 54, 108, 109, 125, 128, 185
advantages of 51, 52
characteristics of 51
indications of 51, 51b
replace clomiphene citrate 54
Leukemia inhibitory factor 52, 181, 190
Leuprolide 89
Liver
disease 40
function tests 167
Low molecular weight 145
Luteal phase
defect 6, 40, 85, 85t, 144, 181, 184, 184f, 185f, 204
causes of 183, 183b
diagnosis of 183
less chances of 141
physiology 182
scan 71
Luteal serum progesterone levels 17
Luteal support, duration of 194
Luteinizing hormone 2, 2f4f, 5, 6, 29, 39, 50, 57, 65, 79, 85, 91, 94, 100, 106, 107, 125, 129, 136, 139, 140, 150, 154b, 157, 157f, 159163, 181, 208
action of 157f
addition of 95
ceiling 4, 65
detection kit 41
estimation 66
levels 158f
midcycle 16
physiology of 158
polymorphism 161
premature 89, 126
recombinant 141, 145, 172
releasing hormone 51
role of 157
serum 10, 27
stimulates 157
supplementation 65, 66, 126
suppression of 191b
surge 16
functions of 139
natural 139
therapeutic window of 158
window, concept of 5f
M
Mature follicle
B-mode
features of 76
ultrasound image of 76f
color and pulse Doppler ultrasound image of 8f
Meningoencephalitis 100
Menopause 21
diagnosis of 9
premature 21
Menstrual pattern 27
Metformin 46, 47, 110, 110b, 111b, 171
after conception 110
in vitro fertilization 110
Methimazole 208
Miscarriage 43
Multilayered endometrium, blurring of outer margin of 85
Multiple follicular rupture 142
Muscular ventricular septal defect 43
N
Naperelin 89
Natural cycle in vitro fertilization, concept of 135
Nausea 175
New promising tests 184
Norethisterone 114
O
Obesity 124, 183
Oligoanovulation 204
Oligo-ovulation 20
Oliguria 175
Oocytes 153, 162
higher number of 61
Oral contraceptive pill 9, 46, 91, 111, 114, 126, 130, 195
Oral progesterones 187
Ovarian artery perfusion 83
Ovarian blood flow 31, 33
Ovarian cancer 43
Ovarian cyst, large 40
Ovarian drilling 6, 43, 47, 108, 115, 116b
advantages of 116
disadvantages of 116
laparoscopic 115, 116, 170
method of 117
Ovarian failure 21
causes of 21
premature 101
Ovarian hyperstimulation syndrome 29, 43, 54, 59, 65, 91, 101, 106, 135, 140, 161, 166, 185
classification of 166
clinical pathology of 168fc
management of 174t
medical management of 176b
moderate 167, 174, 175t
pathophysiology of 167
prediction of 168
prevention of 170, 195
primary prevention of 170
secondary prevention of 170b, 171
severe 34, 174, 175t
surgical management of 177b
treatment of 174, 176
types of 166
Ovarian hyperstimulation, controlled 53, 58, 136, 146, 161
Ovarian reserve 26
assessment of 9, 25
diminished 35, 129
test 26, 34, 34t
Ovarian response 13t
cost-effectivity of 65t
predictive index 33
calculation of 34t
predictors of 64, 65t
Ovarian size 176
Ovarian steroids genesis 9f
Ovarian stimulation, controlled 14, 57, 65, 150
controlled 190
mild 130
optimizing 173
Ovarian stromal blood flow 75
Ovarian stromal flow 74f
index 33
Ovarian suppression 11, 172
Ovarian surgery 124
Ovarian torsion 177, 178
Ovarian volume 31, 32, 60
Ovary 42, 154f, 167
three-dimensional ultrasound image of 73f
Ovulation 1, 7, 52
clinicopathology of 9
diagnosis of 15
induction 3, 95, 103, 104, 106, 107, 124, 135, 150, 157, 184, 185
drugs 27t
mechanism of induction of 50
physiology of 1, 58
rate 41, 41t
summarizing diagnosis of 18
trigger 139, 141
Ovulatory dysfunction 100, 209
Ovum 42
donation 21, 130
pick-up 32
P
Pain, abdominal 175
Paracentesis, abdominal 178
Peak systolic velocity 7, 33, 60, 72, 75, 76, 83
Pelvic infection 124
Perifollicular resistance index 77
Pituitary tumors 20
Plasma expanders 176
Pleurocentesis 178
Polycystic ovarian
morphology 13
syndrome 5, 10, 28, 29, 33, 39, 51, 59, 93, 101, 106, 107, 118, 118b, 144, 158, 161, 169, 185, 202, 203, 207
Polymorphism, receptor 124
Postchemotherapy 124
Postradiotherapy 124
Predictive index 34
Pregnancy 170
ectopic 177, 178
loss, recurrent 190, 193
multiple 43, 59
rate 61, 62
clinical 65
status of 176
termination 177, 178
Pregnanediol 3-alpha glucuronide 182
Pre-human chorionic gonadotropin follicle, Doppler features of good 77
Pre-in vitro fertilization androgens 125, 129
Premenstrual syndrome 42
Preovulatory period 154fc
Progesterone 7, 47, 91, 103, 142, 150, 153fc, 187, 189, 193, 195
effect of 153
gel 188
induced blocking factor 182
level 154fc
micronized 47
receptor isoform 194
replacement 144
role of 181b, 186
serum 11, 183
supplementation 184, 186
synthetic 187
vaginal effervescent tablets 188
Prolactin 202, 203
effect of 202
inhibiting factor 21
serum 15
Prolactinoma 203
Propylthiouracil 208
Prostaglandin synthetase inhibitor 176
Prostatic cancer, metabolic 92
Protein contamination 162
Psychiatric disorders 100
Puberty, precocious 92
Pulsatile gonadotropin-releasing hormone therapy 101
Pulsatility index 83
Pulse Doppler 17, 71, 74f, 84f
Pulse repetition frequency 78
Pyridostigmine 125, 130
R
Radiotherapy 20, 21
Randomized control trials 46, 109
Reactive oxygen species 193
Renal failure 100, 175, 203
Reproductive techniques 9
Resistance index 60, 75, 76, 83, 85
Respiratory distress syndrome, acute 167
Royal College of Obstetricians and Gynaecologists guidelines 41
S
Sarcoidosis 100
Secretory endometrium, ring sign of 19f
Segmental uterine artery perfusion 81
Serine phosphorylation 107, 107fc
Sex hormone-binding globulin 12, 130
Sheehan's syndrome 20
Single nucleotide polymorphism 28, 161
Skin reaction 102
Society of Assisted Reproductive Treatment 26
Spiral artery flow 84, 85t
Steroid production, pathway of 154f
Steroidogenic acute regulatory 182
Stimulation, mild 135, 137
Strenuous exercises 100
Stress 20, 100, 183
Stromal blood flows, inclusion of 74
Stromal flow index 169
Stromal resistance index 169
Substitutional therapy 58
Surrogate luteinizing hormone surge, indications of 140
Syphilis 100
T
Tachycardia 208
Testosterone, serum 12
Three-dimensional manual multiplanar view techniques 73
Three-dimensional power Doppler 71
ultrasound image 75f
Three-dimensional ultrasound 71
acquired virtual organ computer-aided analysis 79f
calculated ovarian volume 74f
Thromboembolism 177
Thrombophlebitis 102
Thyroid
disorders 206
drugs for 209
function tests 40
hormone 203
stimulating hormone 203, 206
mechanism of action of 207fc
serum 15, 203
Total ovarian vascularization index 33
Transvaginal hydrolaparoscopic drilling 116, 117
Transvaginal sonography guided aspiration 177
Transvaginal ultrasound 32
guided follicular aspiration 117
Triptorelin 89
Tuberculosis 100
infections like 21
Turner's syndrome 21
Two-cell-two
gonadotropin theory 5f, 65, 153, 153fc
hormone theory 158
Two-dimensional manual multiplanar view techniques 73
U
Ultrasound 17, 71, 184
guided transvaginal ovarian needle drilling 116, 117
Urinary follicle-stimulating hormone 58, 61, 61t, 62t, 65
Urine output 175
Uterine artery flow waveform, high resistance 83f
V
Vaginal progesterone 188
Vaginal, absorption of 189f
Vascular endothelial growth factor 13, 52, 115, 139, 142, 167, 181, 182
Vascular permeability factor 168
Vascularity flow index 75f
Vascularization index 75f
Venous thrombosis 175, 167
Virtual organ computer-aided analysis 74f, 78
Vomiting 175
W
Weight loss 108
Z
Zuclomiphene 39
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Chapter Notes

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