Published online by Cambridge University Press: 02 March 2020
Since the early eighties there has been tremendous evolution in the clinical approach to ART and in how to practically carry execution of these treatments. From a patients’ perspective, some of the most significant innovations were: complete replacement of laparoscopic oocyte retrieval under general anesthesia by transvaginal puncture guided by sonography; total disappearance of E2 monitoring using urinary assessments in favor of serum determinations; clinical use of both agonists and antagonists to suppress endogenous LH-peaks avoiding LH-peak monitoring through three-hourly urine collections; specifically designed calibrated devices, called pens, to allow patients to inject daily gonadotrophins themselves instead of being dependent on nurses or hospital facilities willing to inject hCG at odd hours; and recognition of psychological stress leading to active intervention of mental-health professionals in helping patients to cope with both the infertility and with its treatments.
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