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Human Reproduction, Vol. 3, No. suppl_2, pp. 11-21, 1988
© 1988 European Society of Human Reproduction and Embryology

Ovarian stimulation for in-vitro fertilization: clomiphene and HMG

F. Lehmann, N. Baban and B. Webber

Städtische Krankenanstalten Bielefeld an der Rosenhöhe 27, 4800 Bielefeld 14, FRG

Details of the problems and successes obtained after various forms of hormonal stimulation in an IVF programme are presented. The endocrine conditions normally existing in the natural menstrual cycle are discussed first, followed by analyses of the types of responses to clomiphene, clomiphene and HMG, HMG alone and LHRH agonists. Clomiphene produces fewer embryos than other treatments but gives a good control of follicle growth and ovulation. Clomiphene and HMG increases the number of available oocytes, and this raises the chance of pregnancy, but there is a greater heterogeneity in the follicular population. HMG alone is suitable for most conditions except for those with PCO syndrome and gives an average of six oocytes per treatment cycle. The problems associated with premature rises in levels of LH are ovecome by using LHRH agonists with HMG, and this results in satisfactory numbers of oocytes but requires endocrine support in the luteal phase. The need for luteal phase support after various therapies remains unclear, and a calculation of the ratios between various steroids may help to clarify the need for it.

Key words: human/ovarian stimulation/gonadotrophins/clomiphene/LHRH agonists

Submitted on June 13, 1988;
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