School of Medicine


MDSG topics

Evaluation of subfertility treatments relating to the female partner


                                                                                                                                               Key
                                                                                                                                               [R] = Review

                                                                                                                                               [P] = Protocol

Oligo/anovulation. Ovulation induction by means of

Medical therapies

  • Weight adjustment
  • Anti oestrogens (clomiphene/tamoxifen/cyclophenyl)
    [R] Clomiphene citrate for ovulation induction in women with oligo-amenorrhoea
  • GnRHas and gonadotrophins
    [R] Gonadotrophin-releasing hormone antagonists for assisted conception
  • Gonadotrophins (various preparations, regimes and modalities of administration)

Subfertility associated with endometriosis

Medical therapies

  • Danazol
    [R] Ovulation suppression for endometriosis
  • GnRH agonists
  • Progestins
  • Surgery (open and laparoscopic)
    [R] Laparoscopic surgery for subfertility associated with endometriosis
  • Assisted conception techniques
    [P] Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis

Unexplained subfertility

Medical therapies

  • Danazol
    [R] Danazol for unexplained infertility
  • Bromocriptine
    [R] Bromocriptine for unexplained subfertility in women
  • Clomiphene
    [R] Clomiphene citrate for unexplained subfertility in women
  • Gonadotrophins
  • Combinations of the above
    [R] Oral versus injectable ovulation induction agents for unexplained subfertility
  • Other
    [P] Low-dose aspirin for in vitro fertilisation Assisted conception techniques
    [P] Intra-uterine insemination for unexplained subfertility
    [R] Intrauterine insemination versus fallopian tube sperm perfusion for non tubal infertility
    [R] In vitro fertilisation for unexplained subfertility
    [R] Single versus double intrauterine insemination (IUI) in stimulated cycles for subfertile couples

Infertility associated with polycystic ovary syndrome

Medical therapies

  • Clomiphene
    [P] Oral agents for ovulation induction in subfertility associated with PCOS Bromocriptine
  • Steroids
  • Gonadotrophins (hMG and FSH)
    [R] Gonadotrophin therapy for ovulation induction in subfertility associated with polycystic ovary syndrome
    [R] Recombinant FSH versus urinary gonadotrophins or recombinant FSH for ovulation induction in subfertility associated with polycystic ovary syndrome
  • GnRH-agonists and gonadotrophins
    [P] Gonadotrophins and gonadotrophin-releasing hormone agonists for assisted reproductive technology in subfertility associated with polycystic ovary syndrome
    [R] Gonadotrophin therapy for ovulation induction in subfertility associated with polycystic ovary syndrome
    [R] Gonadotrophin-releasing hormone analogue as an adjunct to gonadotropin therapy for clomiphene-resistant polycystic ovarian syndrome
  • Pulsatile LHRH
    [R] Pulsatile gonadotrophin releasing hormone for ovulation induction in subfertility associated with polycystic ovary syndrome
  • Insulin sensitising agents
    [R] Insulin-sensitising drugs (metformin, troglitazone, rosiglitazone, pioglitazone, D-chiro-inositol) for polycystic ovary syndrome

Surgery

  • Wedge resection
  • Laparoscopic ovarian "drilling"
    [R] Laparoscopic "drilling" by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome

Mechanical infertility (tubal blockage, pelvic adhesions)

Medical therapies

Surgery

  • Tubal flushing
    [R] Oil-soluble versus water-soluble media for assessing tubal patency with hysterosalpingography or laparoscopy in subfertile women
    [R] Tubal flushing for subfertility
  • Techniques of tubal surgery
    [R] Techniques for pelvic surgery in subfertility
    [R] Surgical treatment for tubal disease in women due to undergo in vitro fertilisation
    [P] In vitro fertilisation versus tubal reanastmosis (sterilisation reversal) for subfertility after tubal sterilisation
  • Adjuvant peri-operative therapy to prevent adhesion (re)formation
    [R] Barrier agents for preventing adhesions after surgery for subfertility
    [R] Liquid and fluid agents for preventing adhesions after surgery for subfertility
  • Post-operative procedures to prevent adhesion (re) formation
    [R] Postoperative procedures for improving fertility following pelvic reproductive surgery

Subfertility associated with fibriods

Surgery

  • [P] Surgical treatment of fibroids for subfertility

Assisted conception techniques

Procedures (non-surgical)

  • Culture media or oocytes and/or embryos
    [R] Effect(s) of assisted hatching on assisted conception (IVF & ICSI)
    [R] Cleavage stage versus blastocyst stage embryo transfer in assisted conception
    [P] Number of embryos for transfer following in-vitro fertilisation or intra-cytoplasmic sperm injection
    [P] Techniques for intrauterine embryo transfer
    [R] Day three versus day two embryo transfer following in vitro fertilization or intracytoplasmic sperm injection
    [P] Follicular flushing during oocyte retrieval in assisted reproductive techniques
    [P] Conscious sedation for oocyte retrieval during in vitro fertilisation procedures
  • Luteal support (hCG; progesterone)
    [R] Luteal phase support in assisted reproduction cycles Technique modalities (IVF, GIFT, ZIFT)
    [R] Gonadotrophin-releasing hormone agonist protocols for pituitary desensitization in in vitro fertilization and gamete intrafallopian transfer cycles
    [R] Growth hormone for in vitro fertilization
    [P] Interventions for 'poor responders' to controlled ovarian hyperstimulation (COH) in in-vitro fertilisation (IVF)
  • Ovarian stimulation protocols (drug regimes and modalities)
    [R] Intra-venous albumin for preventing severe ovarian hyperstimulation syndrome
    [R] Follicle-stimulating hormone and human menopausal gonadotropin for ovarian stimulation in assisted reproduction cycles
    [R] Recombinant versus urinary follicle stimulating hormone for ovarian stimulation in assisted reproduction cycles
    [R] Depot versus daily administration of gonadotrophin releasing hormone agonist protocols for pituitary desensitization in assisted reproduction cycles
    [R] 'Coasting' (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome
    [R] Embryo freezing for preventing ovarian hyperstimulation syndrome
    [P] Recombinant versus urinary human chorionic gonadotrophin for ovulation induction in assisted conception
    [R] Gonadotrophin-releasing hormone antagonists for assisted conception
    [R] Human menopausal gonadotropin versus recombinant follicle stimulation hormone for ovarian stimulation in assisted reproductive cycles
    [P] Glucocorticoid supplementation during ovarian stimulation for IVF or ICSI
  • Embryo cryopreservation
  • Endometrial preparation
    [P] Cycle regimes for frozen-thawed embryo transfer

Surgery

  • Methods of oocyte retrieval
  • Methods of sperm preparation and oocyte insemination
  • Methods of embryo transfer
    [P] Techniques for intrauterine embryo transfer
  • Tubal surgery
    [R] Surgical treatment for tubal disease in women due to undergo in vitro fertilisation

Sperm-mucus interaction impairement; "cervical" infertility

Medical therapies

  • Mucus enhancing treatments
  • Artificial insemination by husband's sperm (AIH)
    [P] Intra-uterine insemination versus timed intercourse for cervical hostility in subfertile couples
  • Other

Infertility treatment for premature ovarian failure

  • [P] Ovulation induction in women with spontaneous premature ovarian failure

Ectopic pregnancy

  • [R] Interventions for tubal ectopic pregnancy

Other

  • [P] Chinese medicinal herbs for female subfertility
    [P] Weight loss for improving fertility in overweight women
Top