Efficiency and safeness improvement and cost containment strategy in Assisted Reproduction Technique (ART)

Over the years, progress has been made in the field of Reproductive Medicine, passing from the first treatments made of spontaneous cycle, to the introduction of medical strategies of multiple follicular growth stimulation, which is associated to an improvement of outcomes in terms of the number of mature oocytes retrieved, pregnancy rate and live birth rate. The clinical introduction of GnRH antagonists, at the end of the years ' 90, opened new perspectives in ovarian stimulation strategy. Clinical data obtained from randomized controlled trials have shown the benefits of using these drugs in terms of lower dose of gonadotropins, shorter duration of treatment, reduced rates of OHSS, with an overall reduction of costs (Al-Inany HG et al., 2011). Also permitted the use of GnRH agonists for induction of oocyte final maturation, in order to reduce as much as possible OHSS rates. The ovarian response to stimulation with exogenous gonadotropins during IVF is a critical determinant of live birth rates and adverse outcomes (R.G. Steward et al., 2014; Sunkara et al., 2011). Healthcare providers and national guidelines recognize the need for individualization of the starting dose of gonadotropin by using predictive factors related to patient characteristics and diagnostic markers of ovarian reserve to attain an optimal oocyte yield while minimizing the risk of an excessive response and OHSS. This research work was carried out in order to identify the best strategies to improve the effectiveness and safety of IVF treatments. The ultimate goal is a reduction of costs associated with IVF by a reduction of cycle cancellation rate and hospitalization rate for ovarian hyperstimulation syndrome (OHSS).