Course details

General
FacultyHealth Sciences
DepartmentMedicine
Education level2nd / Post-graduate
Course codePMHRΒ007Trimester1
Course titleOvarian stimulation
Independent teaching activitiesHours per weekECTS
Lectures1
Exercises3
Total45
CoursetypeGeneral knowledge, skill acquiring
Prerequisite coursesNone
Teaching and assessment languageEnglish
Course URLOvarian Stimulation

Learning outcomes

Aim

Upon the completion of this module, the post-graduate student will possess the basic principles of ovarian stimulation on a daily practice use and he /she will be capable of managing patients undergoing ovarian stimulation with standard protocols used for this purpose.

Knowledge

The participants will acquire knowledge regarding:

  • The types of gonadotrophins used for ovarian stimulation, and their differences regarding effectiveness and costs.
  • The types of GnRH analogues used for ovarian stimulation and their pros and cons.
  • The protocols used for ovulation induction
  • Prognosis of ovarian response to gonadotrophins stimulation.
  • The optimal management of poor ovarian response
  • The management of premature progesterone elevation during ovarian stimulation.
  • The optimal management of supporting luteal phase after ovarian stimulation
  • The potential complications of ovarian stimulation
Skills

The participants will be able to:

  • Apply the basic principles of ovarian stimulation on everyday clinical practice.
  • Evaluate and select the optimal ovarian stimulation scheme according to patient characteristics.

Syllabus

  1. Introduction to ovarian stimulation, gonadotrophins: evolution, types, pros and cons, cost
  2. Long acting FSH
  3. GnRH analogues : evolution, types, pros and cons, meta-analyses regarding effectiveness
  4. Ovulation induction
  5. Prognosis of ovarian response
  6. Ovarian stimulation in the poor responder
  7. Ovarian stimulation in the high responder
  8. Progesterone elevation during the follicular phase
  9. Luteal phase support after ovarian stimulation
  10. Complications of ovarian stimulation
  11. Ovarian stimulation in every day clinical practice: preliminary tests, gonadotrophin choice, GnRH analogue choice, follow-up of ovarian stimulation, criteria used for triggering final oocyte maturation, unexpected problems during ovarian stimulation.

Teaching and learning methods – evaluation

Teaching methodsFace to face
Distance learning
Use of information and
communication technologies (ICT)

  • Use of ICT in Teaching- Moodle Virtual learning environment (VLE) (asynchronous learning)

  • Use of information technology for clinical training - Moodle Virtual learning environment (VLE) (asynchronous learning, wikis, Online Discussion Fora, Educational Portfolio)
  • Use of information technology for the communication with the post-graduate students (e-mail, direct messages through Moodle)
Module structureWork Hours per SemesterActivity
Lectures 40
Exercises (Quiz) 10
Exercises (Online discussion fora) 25
Suggested reading20
Final assignment30
Overall work for the course125
Assessment Methods
  • Final assignment, in English, up to 2500 words, that will be submitted after the completion of the module

  • Knowledge evaluation during the beginning and the end of the module through short-answer questions and short assays

  • Multiple-choice questions on a weekly basis

  • Evaluation of the fora participation for each post-graduate student during the online weeks

Suggested reading

  1. Shi W, Hongwei T, Zhang W, Li N, Li M, Li W, Shi J. A Prospective Randomized Controlled Study of Laser-Assisted Hatching on the Outcome of First Fresh IVF-ET Cycle in Advanced Age Women. Reprod Sci 2016.Gleicher N, Kushnir V, Albertini D, Barad DH. Improvements in IVF in women of advanced age. J Endocrinol 2016.
  2. Bosdou JK, Venetis CA, Dafopoulos K, Zepiridis L, Chatzimeletiou K, Anifandis G, Mitsoli A, Makedos A, Messinis IE, Tarlatzis BC et al. Transdermal testosterone pretreatment in poor responders undergoing ICSI: a randomized clinical trial. Hum Reprod 2016;31: 977-985.
  3. Bosch E, Labarta E, Kolibianakis E, Rosen M, Meldrum D. Regimen of ovarian stimulation affects oocyte and therefore embryo quality. Fertil Steril 2016;105: 560-570.
  4. Zhang J. Luteal phase ovarian stimulation following oocyte retrieval: is it helpful for poor responders? Reprod Biol Endocrinol 2015;13: 76.
  5. Yu X, Ruan J, He LP, Hu W, Xu Q, Tang J, Jiang J, Han J, Peng YF. Efficacy of growth hormone supplementation with gonadotrophins in vitro fertilization for poor ovarian responders: an updated meta-analysis. Int J Clin Exp Med 2015;8: 4954-4967.
  6. Tartagni M, Cicinelli MV, Baldini D, Tartagni MV, Alrasheed H, DeSalvia MA, Loverro G, Montagnani M. Dehydroepiandrosterone decreases the age-related decline of the in vitro fertilization outcome in women younger than 40 years old. Reprod Biol Endocrinol 2015;13: 18.
  7. Szymusik I, Marianowski P, Zygula A, Wielgos M. Poor responders in IVF–is there any evidence-based treatment for them? Neuro Endocrinol Lett 2015;36: 209-213.
  8. Nagels HE, Rishworth JR, Siristatidis CS, Kroon B. Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction. Cochrane Database Syst Rev 2015;11: CD009749.
  9. Nagels HE, Rishworth JR, Siristatidis CS, Kroon B. Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction. Cochrane Database Syst Rev 2015;11: CD009749.
  10. Merviel P, Cabry-Goubet R, Lourdel E, Devaux A, Belhadri-Mansouri N, Copin H, Benkhalifa M. Comparative prospective study of 2 ovarian stimulation protocols in poor responders: effect on implantation rate and ongoing pregnancy. Reprod Health 2015;12: 52.
  11. Li J, Yuan H, Chen Y, Wu H, Wu H, Li L. A meta-analysis of dehydroepiandrosterone supplementation among women with diminished ovarian reserve undergoing in vitro fertilization or intracytoplasmic sperm injection. Int J Gynaecol Obstet 2015;131: 240-245.
  12. Lefebvre J, Antaki R, Kadoch IJ, Dean NL, Sylvestre C, Bissonnette F, Benoit J, Menard S, Lapensee L. 450 IU versus 600 IU gonadotropin for controlled ovarian stimulation in poor responders: a randomized controlled trial. Fertil Steril 2015;104: 1419-1425.
  13. Kolibianakis EM, Venetis CA, Bosdou JK, Zepiridis L, Chatzimeletiou K, Makedos A, Masouridou S, Triantafillidis S, Mitsoli A, Tarlatzis BC. Corifollitropin alfa compared with follitropin beta in poor responders undergoing ICSI: a randomized controlled trial. Hum Reprod 2015;30: 432-440.
  14. Giovanale V, Pulcinelli FM, Ralli E, Primiero FM, Caserta D. Poor responders in IVF: an update in therapy. Gynecol Endocrinol 2015;31: 253-257.

Tutor

Efstratios M. Kolibianakis