Towards complication-free assisted reproduction technology

Best Pract Res Clin Endocrinol Metab. 2019 Feb;33(1):9-19. doi: 10.1016/j.beem.2018.10.006. Epub 2018 Nov 3.


Assisted reproductive technology (ART) has vastly improved over the last 40 years, from a frequently unsuccessful and complicated procedure requiring hospital admission and routine laparoscopy to a fairly simple outpatient technique with relatively high success rates. However, it is important to stress that ART is not without risk and medical complications may still occur. The incidence of most of these ART-related complications is associated with how women undergo ovarian stimulation. For this reason, physicians should be aware that a carefully thought-out ovarian stimulation protocol and cycle monitoring are of paramount importance to maximise the success of the treatment while avoiding potentially life-threating complications to occur in this frequently otherwise healthy patient population. This review discusses the rationale and evolution of ovarian stimulation strategies over the years and the current developments towards finding a balance between the retrieval of a sufficient number of oocytes and ART-related complication prevention.

Keywords: assisted reproductive technology; freeze-all strategy; ovarian hyperstimulation syndrome; ovarian stimulation; ovarian torsion; thromboembolism.

Publication types

  • Review

MeSH terms

  • Embryo Disposition
  • Female
  • Humans
  • Incidence
  • Ovarian Diseases / epidemiology
  • Ovarian Diseases / etiology
  • Ovarian Hyperstimulation Syndrome / epidemiology
  • Ovarian Hyperstimulation Syndrome / etiology
  • Ovulation Induction / adverse effects
  • Ovulation Induction / methods
  • Ovulation Induction / statistics & numerical data
  • Ovulation Induction / trends
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Reproductive Techniques, Assisted / adverse effects*
  • Reproductive Techniques, Assisted / trends*
  • Thromboembolism / epidemiology
  • Thromboembolism / etiology
  • Torsion Abnormality / epidemiology
  • Torsion Abnormality / etiology