title: Conventional ovarian stimulation no longer exists: welcome to the age of individualized ovarian stimulation.
abstract: The prediction of extremes of ovarian response to stimulation and the irreversibility of reduced ovarian reserve remain important clinical and basic science research issues of IVF treatment. Recommending commencement of ovarian stimulation using any of the available exogenous compounds without knowledge of individual ovarian potentials is simplistic and dangerous because of the possible adverse consequences for the woman. The identification of groups of patients likely to benefit from one protocol than another is central to the workup process of IVF. Determining the agents for ovarian stimulation as well as the combination of them, the daily dose and duration according to some background information should be seen as the way to enhance safety and cost-effectiveness. This discussion paper aims to introduce the concept of individualized ovarian stimulation in routine clinical practice and to generate interest for tailored stimulation protocols.
authors.affiliation: Department of Reproductive Medicine, St Mary's Hospital, CMFT University Hospitals, Manchester, UK. lnardo@gyne-health.co.uk
authors.forename: Luciano G
authors.initials: LG
authors.lastname: Nardo
authors.forename: Richard
authors.initials: R
authors.lastname: Fleming
authors.forename: Colin M
authors.initials: CM
authors.lastname: Howles
authors.forename: Ernesto
authors.initials: E
authors.lastname: Bosch
authors.forename: Samir
authors.initials: S
authors.lastname: Hamamah
authors.forename: Filippo M
authors.initials: FM
authors.lastname: Ubaldi
authors.forename: Jean-Noel
authors.initials: JN
authors.lastname: Hugues
authors.forename: Adam H
authors.initials: AH
authors.lastname: Balen
authors.forename: Scott M
authors.initials: SM
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000367:Age Factors; D000728:Androgens / Q000378:metabolism; D054304:Anti-Mullerian Hormone / Q000378:metabolism; D003362:Cost-Benefit Analysis; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007986:Luteinizing Hormone / Q000378:metabolism; D010053:Ovary / Q000473:pathology / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D018456:Reproductive Medicine / Q000379:methods* / Q000639:trends
chemical_list: D000728:Androgens; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone