Assisted Reproduction Techniques

Assisted reproduction techniques (ART), in particular in-vitro fertilization and intra-cytoplasmic sperm injection, are the most advanced forms of infertility treatment. They involve numerous counseling, medical, surgical and laboratory-based steps. At each step various problems and complications could be encountered that challenge even the most experienced ART practitioners. Moreover, patients with complex medical disorders may require ART, presenting further challenges. Assisted Reproduction Techniques will stimulate resourceful thinking in the ART practitioner when faced with these challenges. It outlines various management options, the reasoning behind them, and the evidence on which they are based to enable the practitioner to choose the most suitable solution for the needs of each patient. Written by 122 internationally renowned experts, Assisted Reproduction Techniques follows the patient's journey throughout the whole ART process, with chapters on: * Counseling and preparation * Ovarian stimulation * Oocyte retrieval * Embryo transfer * The luteal phase * The ART laboratory * The male patient * The ART pregnancy Each of the 100 concise chapters includes clinical cases, background, evidence-based practical management options, preventive measures and key-point summaries of the important details. Assisted Reproduction Techniques gives a wide-ranging practical guide to all those wishing to support couples who cannot conceive naturally. Assisted reproduction techniques have led to the birth of 4 million babies worldwide. Khaldoun Sharif , MBBCh, MD, FRCOG, MFFP, Istishari Fertility Center, Istishari Hospital, Amman, Jordan Arri Coomarasamy , MBChB, MD, MRCOG, Birmingham Women's Hospital, University of Birmingham, UK CONTENTS Section 1: Counseling and preparation phase 1 Risk of cancer from ovarian stimulation, 3 Nikos Kanakas, Miltiadis Pitsos and Themis Mantzavinos 2 Risk of early menopause following IVF treatment, 7 Sesh Kamal Sunkara 3 The HIV positive female, 9 Joshua U. Klein and Mark V. Sauer 4 The HIV positive male, 13 Mark V. Sauer and Joshua U. Klein 5 The hepatitis B/C carrier patient, 17 Suzanne P.M. Lutgens, I.H.M. Van Loo, E.C.M. Nelissen and G.A.J. Dunselman 6 The patient with cystic fibrosis, 21 Tarek El-Toukhy 7 The patient on medication, 25 Arri Coomarasamy 8 The patient with thrombophilia, 29 Ying C. Cheong and N.S. Macklon 9 The patient with autoimmune disorders, 34 Jos´e Bellver 10 The patient with malignant disease: fertility preservation, 38 Arri Coomarasamy 11 The patient with heart disease, 43 Natasha Thorogood and Catherine Nelson-Piercy 12 The patient with diabetes, 48 Neelam Potdar and Justin C. Konje 13 The patient with thyroid disease, 51 Shiao Chan 14 The patient with hyperprolactinemia, 56 John Ayuk 15 The patient with polycystic ovaries, 61 Adam H. Balen 16 The renal transplant patient and IVF, 65 Lynne Robinson and Clara Day 17 The patient with previous pelvic irradiation, 69 Vishvanath C. Karande 18 Fertility after chemotherapy, 73 Nivedita Reddy 19 The patient with abnormal cervical cytology, 77 Mahmood I. Shafi 20 The patient with previous borderline ovarian tumor, 80 Arri Coomarasamy and Kavita Singh 21 The patient with an endometrioma, 83 Luciano G. Nardo and Oybek Rustamov 22 The patient with cervical stenosis, 86 Khaldoun Sharif 23 Vaccination and ART, 90 Arri Coomarasamy and Dukaydah van der Berg 24 The patient with hydrosalpinx, 95 Annika Strandell 25 The patient with poor ovarian reserve, 99 Scott M. Nelson 26 The patient with congenital uterine anomalies, 105 Sarah Creighton and Lina Michala 27 The patient with congenital cervico-vaginal anomalies, 109 Sarah Creighton and Lina Michala 28 The patient with uterine fibroids, 112 Haitham Hamoda and Yakoub Khalaf 29 The patient with previous Essure® sterilization, 115 T. Justin Clark 30 The patient with previous endometrial ablation, 119 T. Justin Clark 31 The couple with recurrent implantation failure, 124 Tarek El-Toukhy 32 The patient with previous uterine artery embolization, 128 Haitham Hamoda and Yakoub Khalaf 33 Endometrial polyp detected during ART treatment, 131 Arri Coomarasamy 34 The obese patient, 135 Mostafa Metwally and Bolarinde Ola 35 Asherman syndrome, 139 Dan Yu, Enlan Xia and T.C. Li 36 The older patient, 142 William Ledger 37 Requests for mild or natural cycle IVF treatment, 146 Brad B. Swelstad and Suheil J. Muasher 38 The ART patient with psychosexual problems, 150 Sue Elkin 39 The patient needing third-party reproduction, 153 Madhurima Rajkhowa 40 Request for “social egg freezing”, 159 Valerie L. Peddie and Siladitya Bhattacharya 41 The patient with bariatric surgery, 165 Zaher O. Merhi and Harry J. Lieman Section 2: Pituitary suppression and ovarian stimulation phase 42 Poor response during ovarian stimulation, 171 Lynne Robinson and Arri Coomarasamy 43 Ovarian stimulation for IVF in a patient with previous severe ovarian hyperstimulation syndrome, 175 Khaldoun Sharif 44 Unable to achieve pituitary down-regulation, 178 K. Jayaprakasan and Nick Raine-Fenning 45 The patient discovered pregnant during pituitary down-regulation, 184 Mohammed Khairy Mahmoud and Arri Coomarasamy 46 Ovarian cysts following pituitary down-regulation, 188 Alison Taylor 47 Poor endometrial development, 192 Lynne Robinson and Arri Coomarasamy 48 Missed IVF medications, 201 Lynne Robinson and Arri Coomarasamy 49 The patient with a history of estrogen-receptor positive cancer, 205 Murat So¨nmezer and Kutluk Oktay 50 The patient over-responding to controlled ovarian stimulation during IVF, 208 Khaldoun Sharif Section 3: Oocyte retrieval 51 General anesthesia or sedation for oocyte retrieval?, 215 Andrew F. Malins 52 Delayed oocyte retrieval, 219 Khaldoun Sharif 53 Empty follicle syndrome, 223 George Ndukwe 54 Bleeding following oocyte retrieval, 227 Annika K. Ludwig and Barbara Sonntag 55 To flush or not to flush follicles at oocyte retrieval?, 232 Micah J. Hill and Eric D. Levens 56 Inaccessible ovaries at oocyte retrieval, 236 Hazem Al-Rumaih 57 Endometriotic cysts at oocyte retrieval, 239 Graciela Kohls and Juan A. Garc´ıa-Velasco Section 4: Embryo transfer 58 Couple splitting while embryos are in storage, 245 Masoud Afnan 59 Endometrial cavity fluid identified during IVF treatment, 249 Arri Coomarasamy 60 Difficult embryo transfer, 252 Khaldoun Sharif 61 Excessive cervical mucus and retained embryo at embryo transfer, 257 Hassan N. Sallam, Ahmed F. Galal and Fady S. Moeity 62 Life after embryo transfer, 261 Kelton Tremellen Section 5: The luteal phase 63 Vaginal bleeding in the luteal phase after IVF, 267 Carol Coughlan and Bolarinde Ola 64 Pelvic infection after IVF, 271 Muhammad Faisal Aslam 65 The patient presenting with ovarian hyperstimulation syndrome, 274 Khaldoun Sharif 66 Adnexal torsion after IVF, 279 Saioa Torrealday and Beth W. Rackow 67 Exposure to infection in the luteal phase of IVF, 283 Litha Pepas and Arri Coomarasamy Section 6: The ART laboratory 68 Total failure of fertilization after conventional IVF - rescue ICSI, 291 A. Albert Yuzpe 69 Couples not wishing to create surplus embryos in IVF, 296 Hossam Mohamed 70 Aneuploidy screening for advanced maternal age or repeated IVF failure, 300 Haitham Hamoda and Yacoub Khalaf 71 Choosing an embryo for transfer, 304 Denny Sakkas 72 Globozoospermia, 308 Steven Mansell, Anne Rice, Catherine Beaton and Christopher L.R. Barratt 73 Total failure of fertilization after ICSI, 313 Kaoru Yanagida 74 Refreezing of embryos, 317 Jerome H. Check 75 Infection in embryo culture medium, 320 Peter M.M. Kastrop 76 ICSI or IVF in nonmale-factor infertility?, 324 Mohamed Aboulghar 77 The ART program during a natural or human-made disaster, 328 Richard P. Dickey and Carla White 78 Using the wrong sperm or embryos in IVF, 331 Khaldoun Sharif and Mutaz Al-Ahmad Section 7: The male patient 79 Unexpected inability to produce a semen sample on the day of oocyte retrieval, 337 Khaldoun Sharif 80 The azoospermic patient, 340 Khaldoun Sharif 81 ART in men with Klinefelter syndrome, 344 Ronnie G. Fine and Darius A. Paduch 82 ART in men with 100% immotile sperm, 349 Carolina Ortega-Hrepich, Dominique Raick and Herman Tournaye 83 Request for posthumous fatherhood with perimortem surgical sperm retrieval, 353 Zamip P. Patel, Heather E. Ross and Lawrence S. Ross 84 Retrograde ejaculation and anejaculation, 360 Asif Muneer and Anthony Hirsh 85 Sperm retrieval in cancerous testes, 364 Saad Aldousari and Armand Zini 86 Leukocytospermia and ART, 367 Giuseppe Ricci 87 The infertile male patient with a genetic cause, 371 Katherine L. O’Flynn O’Brien and Ashok Agarwal 88 Y chromosome microdeletions and ART, 376 Sherman J. Silber Section 8: The ART pregnancy 89 Unexpected number or gender of babies after IVF, 383 Khaldoun Sharif 90 Suspected ectopic pregnancy after IVF, 387 Vishvanath C. Karande 91 Cervical ectopic pregnancy after IVF, 391 Usha Verma 92 Heterotopic pregnancy after IVF, 396 Abdel-Maguid Ramzy 93 Multi-fetal pregnancy reduction after ART, 400 R. Katie Morris and Mark D. Kilby 94 Multiple pregnancy after IVF: to cerclage or not to cerclage? 405 Harold Gee 95 Hyperreactio luteinalis after IVF, 409 Mohammad Ebrahim Parsanezhad, Leila Forooghinia and Maryam Parsa-Nezhad 96 Lactation by a commissioning mother in surrogacy, 412 Frank P. Biervliet and Stephen L. Atkin Section 9: General issues 97 Dealing with the emotional distress following failed IVF, 417 Linda Hammer Burns 98 IVF when the prognosis is very poor or futile, 421 Khaldoun Sharif 99 Unexpected drop in the ART clinic pregnancy rate, 425 Bulent Urman and Kayhan Yakin 100 Natural fertility after IVF, 430 Frank Nawroth and Annika K. Ludwig Index, 433