Yavuz Emre ŞÜKÜR, Korhan KAHRAMAN, Cem Somer ATABEKOĞLU

Ovülasyon İndüksiyonunda Ek Ajanlar

Ovaryen stimülasyon programlarında ve laboratuar tekniklerinde sağlanan tüm gelişmelere rağmen, yardımlı üreme tekniklerinin başarısı günümüzde hala sınırlıdır. Günümüzde standart olarak kabul edilen temel stimü- lan ajanlar klomifen sitrat ve gonadotropinlerdir. Bu iki ajanın kullanıldığı stimülasyon protokollerinde bazı hastalarda yeterli folikül gelişimi sağlanamamakta veya yeterli sayıda ve/veya kalitede oosit elde edilememek- tedir. Bu nedenle, yardımlı üreme tekniklerinde alternatif bazı tedavi stratejilerinin geliştirilmesine gerek du- yulmuştur. Bu tedaviler günümüzde yaygın olarak anovulatuar infertil ve kötü over yanıtı gösteren hastalarda kullanılmaktadır. Bu hastalarda hem elde edilen oositin sayısını ve kalitesini arttırmak için hem de tedavi ma- liyetini düşürmek için bazı ek ajanlar kullanılmaktadır. Bu bağlamda, bu ajanlardan en iyi bilinenleri metfor- min, aromataz inhibitörleri, dehidroepiandrosteron, androjenler, büyüme hormonu, kortikosteroidler ve antioksidanlardır.

Additional Agents in Ovulation Induction

Despite all advancement in ovarian stimulation programmes and laboratory techniques, the success of assis- ted reproductive techniques remains limited. Today, the primary stimulating agents adopted as standard are clomiphene citrate and gonadotrophins. In some patients treated with stimulation protocols using those two agents, adequate follicular development cannot be maintained or adequate amount and/or quality of oocy- tes cannot be achieved. Hence, development of some alternative treatment strategies in assisted reproduc- tive technologies has been needed. Nowadays, those treatment methods are used in anovulatory infertile patients and poor responders. Some additional agents are used in those patients in order to increase the amount and quality of achieved oocytes while decreasing treatment costs. In this sense, the best known ad- ditional agents are metformin, aromatase inhibitors, dehydrepiandrosterone, androgens, growth hormone, corticosteroids, and antioxidants.

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