History and challenges surrounding ovarian stimulation in the treatment of infertility.
History and challenges surrounding ovarian stimulation in the treatment of infertility.
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DOI：
10.1016/j.fertnstert.2012.02.030
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发表时间：
2012-04
影响因子：
6.7
通讯作者：
DeCherney, Alan
中科院分区：
文献类型：
--
作者：
Beall, Stephanie A.;DeCherney, Alan
探讨超数排卵诱导排卵的历史，其对生殖医学的贡献及其对多胞胎的影响。使用Pubmed和其他在线工具检索相关文献。不孕症是一种已知的疾病，并研究了数千年。然而，直到上个世纪才开发出有效的治疗方法。随着我们对下丘脑-垂体轴的认识的进步，开发了利用促性腺激素刺激排卵的疗法。我们现在不仅能够治疗无排卵性不孕症，而且还能诱导超数排卵进行体外受精。这些成功带来了后果，包括多胎妊娠增加。一些国家认识到多胎生育的高昂费用，并实施了关于不孕不育行业的法规。在过去的十年里，三重和更高阶的倍数的比率已经下降。这主要是由于移植的胚胎数量减少。尽管如此，双胞胎比率一直居高不下。超数排卵已成为诱导排卵和体外受精的常规药物治疗方法。随着这项技术的发展，不孕症的有效治疗方法以及新的伦理和医学挑战已经出现。自从促性腺激素治疗出现以来，我们已经开发了技术来改善监测和减少过度刺激和高阶多胎妊娠。在未来，我们预计将设计新的工具来优化一个胚胎的单胎活产。
To examine the history of superovulation for ovulation induction, its contributions to reproductive medicine and its impact on multiple births. A search of the relevant literature using Pubmed and other online tools. Infertility has been a condition known and studied for thousands of years. However, it was not until this past century that effective treatments were developed. With the advancement of our knowledge of the hypothalamic-pituitary axis, therapies utilizing gonadotropins were developed to stimulate ovulation. Not only were we now able to treat anovulatory infertility, but also induce superovulation for in vitro fertilization. With these successes came consequences, including increased multiple pregnancies. Several countries recognized the high costs associated with multiple births and implemented regulations on the infertility industry. The rate of triplet and higher-order multiples has declined over the past decade. This is largely attributed to a decreased number of embryos transferred. Nonetheless, the twin rate has remained consistently high. Superovulation has become a routine medical therapy used for ovulation induction and in vitro fertilization. With the development of this technology have come effective therapies for infertility and new ethical and medical challenges. Since the advent of gonadotropin therapy we have already developed technologies to improve monitoring and decrease hyperstimulation and high order multiple pregnancies. In the future, we anticipate new tools devised to optimize one embryo for one singleton live birth.
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