ABSTRACT
Over the years the efficiency and efficacy of both ovulation induction and controlled ovarian stimulation have improved considerably. Protocols have been modified and ovarian function manipulated to achieve the best pregnancy rates. The stresses and strains, trials and tribulations, expectations and disappointments that infertile couples must endure have not changed. Most units now employ a psychologist/social worker who is available to relieve some of the tensions involved. The adoption of ‘softer’ protocols for ovarian stimulation are being examined, most involving the novel application of a gonadotropin releasing hormone (GnRH) antagonist. Less close monitoring and fewer hospital visits are now the rule, and the advent of ovarian stimulating agents that, owing to their purity and freedom from extraneous proteins, can be self-injected subcutaneously, has gone some way to increasing patient comfort. The emphasis of the drug companies has now turned to improved delivery systems on the one hand and ways to lessen the number of injections on the other.
