Dose individualization of ovarian stimulants: A comparative study of different ovulation enhancing modalities and their effect on reproductive hormones

Abstract

Background:- Many years ago, clinicians treating couples for infertility by using ovarian stimulants drugs, which produce their action on reproductive hormones, a variety of medications can temporarily correct ovulatory problems and increase a woman's ability to become pregnant.Objectives:- To identify the effect of different type of ovarian stimulents modalities on serum level of reproductive hormone which will eventually affect the out come of the cycle ( follicular maturation and ovulation).Methods:- Forty-five patients were enrolled in this study all of them suffer from primary infertility, the patients were randomized into three groups. The first group consist of fifteen patient they use clomiphene only as ovulation stimulant drug (starting from cycle day two and for five days), the second group also fifteen patient they use human menopausal gonadotropins injection (HMG) as ovulation induction drug(starting from cycle day two), and the third group also fifteen patient use both drugs for ovulation induction(first they took clomiphene from cycle day two and for five days followed by HMG injection from cycle day seven).Results:- Showed a significant increase in the serum concentration of follicular stimulating hormone and Luteinizing hormone in the third group more than the first and second groups. The rates of the follicular maturation were significantly higher in the second group more than the first and third groups. The serum concentrations of the progesterone and estrogen hormones were significantly higher in the first group more than the second and third groups.Conclusion:-Careful selection of treatment modality, dosing combined with appropriate levels of monitoring may result in excellent maturation rate.