How is the superovulation induction carried out?

There are different schemes of superovulation induction. Up until recently the procedure has been conducted with the help of human menopausal gonadotropin medications (hMG) in combination with clomiphene citrate. The administration of substances started from the 2nd - 3rd day of menstrual period.

Over the last years the combination with hMG has been used more often. 
As a rule, a-GnRH are administered on the 20th-21st day of the previous menstrual period, and administration of hMG starts from the 2nd day of the period. Such a scheme of stimulationis called “long protocol”. There exists a “short protocol” scheme as well, which implies the administration of a-GnRH from the 2nd day of menstrual period simultaneously with hMG.

It is customary to follow different variants of the schemes described above, to use combinations with other medications. The choice of superovulation induction scheme depends on many factors and is made by a doctor.

In our clinic we mainly apply the scheme of stimulation with GnRH antagonists. According to CSMU statistics this protocol increased cycle effectiveness by 8-10 %. Apart from that, to the advantages of this (“optimal”) stimulation protocol the following facts can be regarded: absence of necessity to prescribe LH (the medications do not block a woman’s own LH release in the cycle); application of average and low doses of FSH, which cuts down patients’ expenses on medications; minimization of average and severe ovarian hyperstimulation occurrence.

Follicles development is controlled by means of ultrasound. When the follicles reach a certain diameter, the chorionic gonadotropin (CG) is administered. It ensures the final maturation of oocytes.