INDIVIDUALISED OVARIAN STIMULATION PROTOCOLS

50 %
50 %
Information about INDIVIDUALISED OVARIAN STIMULATION PROTOCOLS
Education

Published on February 18, 2014

Author: shwetakjha

Source: slideshare.net

Description

INDIVIDUALISED OVARIAN STIMULATION PROTOCOLS,ONE SIZE DOES NOT FIT ALL

INDIVIDUALISED OVARIAN STIMULATION PROTOCOL (I COS)

Dr Shweta Kaul jha  M.S.,FNB,FNAMS.  Board Certified( National Board of Examination,New Delhi) Journey has just begun……..

 LIVE BIRTH  COST EFFECTIVE  PATIENT FRIENDLY

 CONVENTIONAL APPROACH LONG AGONIST PROTOCOL WITH STANDARD AGE DEFINED DOSES OF GONADOTROPHINS.

 INDIVIDUALISED CONTROLLED OVARIAN PROTOCOLS  (I COS)

Personalised care,Variability in ovarian response,Customised with aim at moderate oocyte numbers (10-15) and increased CPR and not no.of eggs .

Our aim-

HOW IS IT POSSIBLE NOW?

Newer Drugs and technologies  Bye Bye Urinary gonadotrophins  Recombinant Gonadotrophins filled by mass FBM.  Embryo culture/Selection better.  Vitrification vs slow freezing

HOW TO INDIVIDUALISE AND WHAT TO INDIVIDUALISE?

PREDICTION BASED ON ORT BUT Response is not equivalent to reserve Depending on Ovarian Reserve Tests we predicted Poor/normal and hyper responders

FUTURE Prediction of Ovarian response  -Based on –Age       Hormonal markers Functional markers Genetic markers BMI Ethinicity Cause of infertility

AGE

HORMONAL BIOMARKERS

Best available marker-AMH for predicting number of oocyte but not to exclude from treatment. Less AMH does not mean less pregnancy.

FUNCTIONAL MARKER .

Functional biomarkers Antral follicle count  AFC (2-10 mm) day 2 – predicts reserve/response AFC RESPONSE <8 POOR 8-10 LOW NORMAL 11-15 NORMAL > 15 HYPER

WHAT WENT WRONG?

GENETIC BIOMARKERS

 SINGLE NUCLEOTIDE PROTEIN –In position 680 of FSH receptor is associated with altered response to stimulation.  LH receptor mutation-may require LH supplementation.

 PHARMACOGENETIC MODEL-MADE BY RECOGNISING GENETIC MARKERS.

OTHER CAUSES-BMI

ETHNICITY

CAUSE OF INFERTILITY

 PREDICTIVE MODELS

INDIVIDUALISE  STARTING DOSE  PROTOCOL  ADJUVANTS  TRIGGER

RESPONSE PREDICTION BASED TAILORING PATIENT TYPE OPTION AVAILABLE POOR RESPONDER ANDROGEN PRETREATMENT ,GROWTH HORMONE,FLARE/ANTAG ONIST/SHORT NORMAL ANTAG/ AGONIST HYPER RESPONDER METFORMIN,AGONIST TRIGGER ,FREEZE,DOPAMINE

 Multivariate predictive models.  Valid in different poulations  Simple to use in day to day practise  Predictor models based on genetic markers

Add a comment

Related presentations

Related pages

Individualised controlled ovarian stimulation (iCOS ...

DEBATE Open Access Individualised controlled ovarian stimulation (iCOS): maximising success rates for assisted reproductive technology patients Ernesto ...
Read more

Individualised controlled ovarian stimulation (iCOS ...

Individualised controlled ovarian stimulation ... potential protocols of controlled ovarian stimulation), ... a more individualised approach ...
Read more

Individualised controlled ovarian stimulation (iCOS ...

Individualised controlled ovarian stimulation (iCOS): maximising success rates for assisted reproductive technology patients
Read more

Individualised controlled ovarian stimulation (iCOS ...

Official Full-Text Publication: Individualised controlled ovarian stimulation (iCOS): Maximising success rates for assisted reproductive technology ...
Read more

Individualised controlled ovarian stimulation (iCOS ...

Individualised controlled ovarian stimulation (iCOS): ... Alternative COS protocols and the need for individualised treatment.
Read more

IVF: Short and long protocols explained | Fertility Blog ...

... ovarian stimulation ... protocol will be completely individualised to you. We take into account factors such as your AMH level and any previous history ...
Read more

INDIVIDUALISED IVF TREATMENT - gynescopesh.com

Era of ovarian stimulation with gonadotropins commenced in the early 80’s. ... Japanese Minimal Stimulation Protocol (Mini IVF) Clomid on day 3.
Read more

IVF - Stimulation protocols - IVF-Worldwide

You are here: Home Education Center IVF - Stimulation protocols. 1. Introduction. Terminology; Regulation. ... Ovarian Stimulation Using GnRH-antagonists ...
Read more

Individualization of controlled ovarian stimulation in IVF ...

Individualization of controlled ovarian stimulation in IVF using ... AMH and their incorporation into controlled ovarian stimulation (COS) protocols in ...
Read more