Subfertility treatments

Published on July 31, 2019   59 min
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I am Zeev Blumenfeld, Associate Professor for reproductive endocrinology, and OBGYN at the Technion Faculty of Medicine in Haifa, Israel. I've been invited to talk in the series of female reproductive system of subfertility treatment. The issues I'll be talking about are disorders of ovulation,
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diagnosis and treatment protocols, mainly addressing clomiphene citrate and gonadotropins. Development of gonadotropins hormone preparation, from urine extraction, to recombinant synthesis. Corpus luteum insufficiency, also called luteal phase defect. Tubal damage, obesity, perturbation of the hormonal profile, possibly direct effect on the oocyte. Premature ovarian failure, also called premature ovarian insufficiency, and genetic background of infertility. Next slide, we'll start with ovulation induction by clomiphene citrate and gonadotropins.
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Clomiphene citrate has several commercial branch,
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Clomid, Serophene, Ikaclomin in Israel. It is a non-steroidal estradial agonists-antagonists molecule, a selective estrogen receptor modulator similar to tamoxifen or raloxifene. Clomiphene citrate is a racemic mixture of two stereo-chemical isomers, zuclomifene and enclomifene, as we can see on the upper right-side of this slide. In the next slide, we see the structural similarity of clomiphene citrate to estradial,