Concurrent Therapy with CC/ Letrozole .How many members approve this type Condiments in the curry??!!! -Adjuncts drugs which improves pregnancy rates in OI / IUI / IVF cycles:-

Name of the agent. Purpose

1.Agonist To prevent LH surge-Almost no premature LH surge, OHSS, Ov. Cyst formation, S/S of hypooestrinism,

2.Dexamethasone

0.5 mg dose daily on continuous basis. May be up to 2 mg for only for 5 days of stimulation of CC & another following 5 days. Health of oocytes is related to ratio of cortisol to cortisone present in the follicular fluid. More relevant in lean PCOS, & CC resistant women and women failing to conceive with IVF.

3) Low dose Aspirin.

4) Dopamine agonists. Bromocriptine / Cabergolin.

5) Metformin. Thyroxine, Growth factors, Vitamins.

6) Mini-dose Growth hormones.

• Dilemma should we stop “ ASA/Ecosprin.”-Yes or No Doctors need to advise women to stop taking these drugs if they want to be fertile.— Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to inhibit ovulation and reduce progesterone levels in young women, which could seriously undermine fertility, new research suggests. Members opinion on these issue pl ?

Pretreatments with only estrogens and OCP.

7) Only estrogen: - Administer 4 mg. daily of E2 Valerate from day 21(midluteal phase-with the onset of stimulation on the day of discontinuation-no gap. This will ensure synchrony of the resting follicles. Response to Gn also rise and

8) Pretreatment with OCP:-More used in Gn cycles in IVF rater than IVF cycles. Advantages are reduction of OV cyst formation due to agonist cycles (Leuprolide).There should be overlapping of Agonist and last few Tab of OCP but that overlap should not exceed 5 days.

9) Members opinion on these issue pl & members practice pattern any objection and any study on this adjunct therapy kindly express your wisdom and knowledge.

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