Ovulation Stimulation with Gonadotropins by Jean-Claude Emperaire

Author:Jean-Claude Emperaire
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

30.

Proctor A, Hurst BS, Marshburn PB, Mathews ML (2006) Effect of progesterone supplementation in early pregnancy on the pregnancy outcome after in vitro fertilization. Fertil Steril 85:1550–1552PubMedCrossRef

© Springer International Publishing Switzerland 2015

Jean-Claude EmperaireOvulation Stimulation with Gonadotropins10.1007/978-3-319-18654-2_8

8. Avoiding Complications

Jean-Claude Emperaire1

(1)Bordeaux, France

Stimulating ovulation is a formidable procedure, and as such includes risk for complications commensurate with its intensity. One must always keep in mind the balance between expected benefits and predictable hazards. All aspects should be carefully explained to the couple who are, after all, the principal role players in this plan. Essentially all of the risk can be ascribed to excessive stimulation, of which there are two basic types: predictable problems, typically uncovered during a preliminary assessment of the couple’s fertility parameters that may be considered as primary prevention, and unpredictable problems, which appear during the treatment (i.e., secondary prevention).

It is of course always possible to stop a stimulation cycle if and when conditions exceed the fixed limits. But deprogramming a cycle has a cost, at the least an emotional cost for the patient who has already committed to a number of injections, blood tests, and ultrasound examinations. Plus there is a financial cost that may vary according to the couple’s health care plan. Thus both clinician and patient tend to be reluctant to drop out of a stimulation cycle and this is how consideration of hazard tends to become a notion of reasoned risk, or a presumed risk. Whereas some complications appear to be totally unexpected, even a posteriori, most are in fact objectively foreseeable. The weight of the human factor, which is clearly the most difficult factor to manage, remains of major importance.

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