Background In Europe, it is estimated that almost 10% of couples currently experience a problem of sterility. There are various techniques for assisted reproduction ovarian stimulation used to induce ovulation in women with signs of hormonal dysfunction: led intercourse, intrauterine insemination (IUI), in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI).
Purpose To analyse the effectiveness of ovarian stimulation in the treatment of human infertility.
Material and methods We conducted a systematic review of the published literature on the effectiveness of ovarian stimulation in human infertility in reference sources such as PubMed, MEDLINE, Embase, Cochrane Library, etc. We selected those current publications with quality designs and proven results.
Results 86 publications met the criteria for the literature search. Of these it was deduced that ovarian stimulation is currently based on monotherapies or combination therapies with: ovulation inducers, gonadotropins and/or antagonist/agonist of gonadotropin releasing hormone. Efficacy rates of any assisted reproduction technique depends on several factors, the most important being maternal age for egg quality. However, if we analyse effectiveness by technique, it was observed that IUI was more effective with ovarian stimulation with gonadotropins against hypothalamic antioestrogens (OR 1.8) or natural cycle (OR 2.1).1 So, if we compare the success rate of both techniques treated with gonadotropins, pregnancy rates in Europe of 12% were observed for IUI compared with 31% for IVF/ICSI with own eggs and considering the average for all age groups.2 These data improve with the number of attempts up to 4 per patient.
Conclusion If we study the success rates of hormone therapy by age group for each techniques, we see a proportional decrease in ovarian reserve associated with maternal age, being more marked in less effective techniques, such as IUI. It would therefore be necessary to adapt these therapies to this clinical setting and not keep medical protocols that carry a high risk of irreversible sterility.
References and/or Acknowledgements
References and/or AcknowledgementsNo conflict of interest.
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