The science behind 25 years of ovarian stimulation for in vitro fertilization

Nick S. Macklon, Richard L. Stouffer, Linda C. Giudice, Bart C.J.M. Fauser

    Research output: Contribution to journalReview articlepeer-review

    340 Scopus citations


    To allow selection of embryos for transfer after in vitro fertilization, ovarian stimulation is usually carried out with exogenous gonadotropins. To compensate for changes induced by stimulation, GnRH analog cotreatment, oral contraceptive pretreatment, late follicular phase human chorionic gonadotropin, and luteal phase progesterone supplementation are usually added. These approaches render ovarian stimulation complex and costly. The stimulation of multiple follicular development disrupts the physiology of follicular development, with consequences for the oocyte, embryo, and endometrium. In recent years, recombinant gonadotropin preparations have become available, and novel stimulation protocols with less detrimental effects have been developed. In this article, the scientific background to current approaches to ovarian stimulation for in vitro fertilization is reviewed. After a brief discussion of the relevant aspect of ovarian physiology, the development, application, and consequences of ovarian stimulation strategies are reviewed in detail.

    Original languageEnglish (US)
    Pages (from-to)170-207
    Number of pages38
    JournalEndocrine reviews
    Issue number2
    StatePublished - Apr 2006

    ASJC Scopus subject areas

    • Endocrinology, Diabetes and Metabolism
    • Endocrinology

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