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2010, Número 1

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Rev Mex Med Repro 2010; 2.3 (1)


Estimulación ovárica controlada. Tiempo de reevaluar

Pérez PE, Gutiérrez GA, Pérez LE, Rojas RF

Idioma: Español
Referencias bibliográficas: 71
Paginas: 1-9
Archivo PDF: 86.53 Kb.


FRAGMENTO

La estimulación ovárica es determinante en la obtención de resultados en reproducción asistida. Las opciones varían desde el ciclo natural y de mínima estimulación hasta la estimulación convencional con gonadotropinas diversas y análogos de GnRH. La tendencia es regresar a esquemas más viables para evitar complicaciones, que sean a la vez cómodos y accesibles; esto no significa que haya que sacrificar la efectividad, sino que hay que hacer una buena selección de casos y diseñar esquemas terapéuticos a la medida de las pacientes. En este artículo se evalúan indicaciones, ventajas y desventajas de cada modalidad; se analizan controversias tanto en el uso de agonistas o antagonistas de GnRH, como de gonadotrofinas recombinantes o urinarias, y se señalan las nuevas preparaciones disponibles. Un punto fundamental es el uso de coadyuvantes en la estimulación, que bien seleccionados enriquecen el armamentario terapéutico y favorecen una mejor respuesta; entre ellos destacan los anticonceptivos orales, los estrógenos, los sensibilizadores a la acción de la insulina, los andrógenos, las sustancias androgénicas, los corticoides, el ácido acetilsalicílico, los inhibidores de fosfodiesterasa, los agonistas dopaminérgicos y la gonadotropina coriónica.


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