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Controlled ovarian hyperstimulation is a technique used in assisted reproduction involving the use of fertility medications to induce ovulation by multiple ovarian follicles. [1] These multiple follicles can be taken out by oocyte retrieval (egg collection) for use in in vitro fertilisation (IVF), or be given time to ovulate, resulting in ...
Clomifene citrate (Clomid is a common brand name) is the medication which is most commonly used to treat anovulation. It is a selective estrogen-receptor modulator, affecting the hypothalamic–pituitary–gonadal axis to respond as if there was an estrogen deficit in the body, in effect increasing the production of follicle-stimulating hormone.
It is suggested that there should be a size of ovarian follicles of at least 15 mm, and serum estradiol level of 0.49 nmol/L before commencing final maturation induction. There are better prospects at a follicle size of 18 mm and serum estradiol level of 0.91 nmol/L. [ 6 ]
Approximately 1–2% of ovulations release more than one oocyte. This tendency increases with maternal age. Fertilization of two different oocytes by two different spermatozoa results in fraternal twins. [10] The precise moment of ovulation was captured on film for the first time in 2008, coincidentally, during a routine hysterectomy procedure.
Depending on the situation, a physician may closely monitor a women's fluid intake and output on an outpatient basis, looking for increased discrepancy in fluid balance (over 1 liter discrepancy is cause for concern). Resolution of the syndrome is measured by decreasing size of the follicular cysts on 2 consecutive ultrasounds. [11]
The follicle is now 0.2 mm in diameter Early tertiary: The early tertiary follicle is arbitrarily divided into five classes. Class 1 follicles are 0.2 mm in diameter, class 2 about 0.4 mm, class 3 about 0.9 mm, class 4 about 2 mm, and class 5 about 5 mm. Late tertiary: Fully formed antrum, no further cytodifferentiation, no novel progress
[2] [48] Clomifene is a prodrug most importantly of 4-hydroxyclomifene and 4-hydroxy-N-desethylclomiphene, which are the most active of its metabolites. [36] [37] In one study, the peak levels after a single 50 mg dose of clomifene were 20.37 nmol/L for clomifene, 0.95 nmol/L for 4-hydroxyclomifene, and 1.15 nmol/L for 4-hydroxy-N ...
Follicles are composed of different types and number of cells according to the stage of their maturation, and their size is indicative of the stage of oocyte development. [ 11 ] : 833 When an oocyte completes its maturation in the ovary, a surge of luteinizing hormone is secreted by the pituitary gland , which stimulates the release of the ...