Principles & Practice of Assisted Reproductive Technology (3 Volumes) Kamini A Rao, Howard Carp, Robert Fischer
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1Principles and Practice of ASSISTED REPRODUCTIVE TECHNOLOGY2
3Principles and Practice of ASSISTED REPRODUCTIVE TECHNOLOGY
Volume 1 Infertility
Volume 2 IVF and Laboratory Aspects of Andrology
Volume 3 Atlas of Human Embryology
Kamini A RaoDGO DORCP DCh FRCOG (UK) MCh (UK) FICOG PGDMLE (Law) FNAMS Medical Director Milann—The Fertility Center (A Unit of BACC Healthcare Pvt Ltd) Bengaluru, Karnataka, India Co-editorsHoward Carp MBBS FRCOG Professor Department of Obstetrics and Gynecology Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel Robert FischerMD Founder and Medical Director IVF-Unit, Fertility Center Hamburg, Germany Active Member, American Society of Reproductive Medicine (ASRM), USA Founding Member, European Society of Human Reproduction (ESHRE), Belgium Assistant EditorDeepika KMBBS MS FIRM Consultant in Reproductive Medicine Milann—The Fertility Center (A Unit of BACC Healthcare Pvt Ltd) Bengaluru, Karnataka, India ForewordAlan H DeCherney
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This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the editors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Principles and Practice of Assisted Reproductive Technology—Volume 1 (Infertility)
Principles and Practice of Assisted Reproductive Technology—Volume 2 (IVF and Laboratory Aspects of Andrology)
Principles and Practice of Assisted Reproductive Technology—Volume 3 (Atlas of Human Embryology)
First Edition: 2014
9789350907368
Printed at
5Dedicated to
Our patients who despite having a compromised quality of life, continue to hope and pursue their dreams of parenthood
6
7Contributors 13Foreword
The editors have put together an excellent text on Assisted Reproductive Technology. It is comprehensive, insightful and also beautiful.
An area to focus upon is andrology which is extremely well handled in this textbook, the chart on varicocele management is a great template for all such paradigms. In addition to this, the discussion of male infertility includes a thorough chapter on the cytogenetics of male infertility and medical management.
In regards to the female, it is hard to find an area that is not covered. Interesting to this, there are chapters on Tuberculosis and Infertility and the Role of Fibroids in Infertility to site just a few. It is an extremely current contribution because of the temporal interest in lifesytle that is addressed in a thoughtful way.
Medical endocrinology includes the diseases of the thyroid and prolactin.
The usual important aspects of the treatment of the infertile patient including ovulation induction and in vitro fertilization are covered.
A fair portion of the book is devoted to ancillary topics and that are important to the practicing physician including obstetrical outcome and the outcome of children in regards to infertility treatment.
The text not only serves as an integrated theoretical text but it is also a practical manual. Volume 1 is based on Infertility, Volume 2 is IVF and Laboratory Aspects of Andrology, Volume 3 is an Atlas of Human Embryology, and, therefore, this is a complete companion for whatever anyone would need to know who is practicing infertility.
The text is quite up-to-date as an evidence by the chapter on Single Embryo Transfer and the Role of Aneuploidy in Preimplantation Embryos. There is even a chapter on Stem Cells and Reproduction.
The basic science of the book is excellent including andrology, embryology and physiology, including sperm chromatin assessment and an analysis of fertilization.
Besides the excellent text and the authoritive editors, the book itself is beautifully illustrated; the drawings and photographs are clear, colorful and well labeled.
This is an excellent textbook on Assisted Reproductive Technology, it not only reads easily but is also superb. It is a well-indexed and referenced text. The book is also well written so a person could read it for pleasure.
Alan H DeCherney MD
Chief
Reproductive Biology and Medicine Branch Director
Program in Reproductive and Adult Endocrinology
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of Health
Building 10, CRC, 1E-3140
10 Center Drive, Bethesda, Maryland, USA 20892
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15Preface
Infertility is a fast-emerging global disease. The speed, at which the incidence of infertility is rising, has been matched equally by the growth of our understanding of the disease and the pace of emerging new technologies. Thirty-five years after the birth of Louise Brown, the first child to be conceived by assisted reproductive technology (ART), the treatment options are mind-boggling. The use of medical interventions for fertility preservation has reached new heights. We are now able to cryopreserve embryos, spermatozoa and oocytes as well as ovarian tissue. The breakthrough technology of vitrification has ensured that egg banking is appropriate for women who wish to defer family building into later years when ovarian function may decline, or for women facing treatment such as cancer therapy that may diminish ovarian function or lead to menopause. With increasingly complex modalities, available for treatment, come the need for a clear, concise and practical textbook, which can serve as a ready-reckoner for healthcare providers.
The book has been divided into three volumes to adequately cover the enormity of the diverse field of reproductive medicine. The objective of the book is to present important and cutting-edge topics relevant to fertility and make it accessible to all ART specialists and gynecologists involved in treating infertile couples. All the chapters have been written by acknowledged pioneers and experts in their own respective areas with special emphasis on evidence-based medicine. Notwithstanding the limitations of our published literature, we have endeavored to provide a balanced view of existing information that is clinically relevant for the evolving areas of our specialty. The text is directed at a broad reader base and will be of immense value to clinicians, embryologists, andrologists, and ultrasonographers from all spheres, be they laboratory technicians, postgraduates, postdoctoral fellow students, private practitioners or researchers.
Volume 1: Infertility
This well-illustrated volume provides concise yet comprehensive practical information on the modern-day approach to the diagnosis and treatment of infertility. It starts from basic principles of reproductive physiology, before moving on to the evaluation and management of the infertile couple and then describes and explains the full armory of ART from ovulation induction and its complications to the outcome following ART. We have also introduced a section highlighting the dilemmas frequently encountered in the field of reproductive medicine in which contrasting points of view are presented. Some recent advances, such as cryopreservation of ovarian tissue and oocytes, have generated great excitement, because of the prospect of fertility preservation prior to cancer therapy which has been covered in-depth. Future clinical applications, such as endometrial stem cells and reproduction, are also dealt with in a separate section.
Volume 2: IVF and Laboratory Aspects of Andrology
The set-up of an in vitro fertilization (IVF) laboratory and the equipment that is used during the IVF process must provide an optimum environment for embryos while they are growing in the laboratory. The personnel should be adequately trained in reproductive research techniques as well as have the necessary technical and administrative skills to manage these laboratories. The text of this volume deals with the laboratory aspects of ART with an emphasis on practical information through which one can readily translate theory into clinical practice. It covers the whole of andrology and embryology dealing with it in four separate sections. The section on andrology deals with all aspects starting from semen examination and interpretation of reports to its cryopreservation. The techniques of intracytoplasmic sperm injection (ICSI), assisted hatching and polar body biopsy have been dealt with a special focus on practicalities. Recent newer techniques, such as intracytoplasmic morphologically selected sperm injection (IMSI), polarization microscopy and omics, have also been well covered. Laboratory management deserves utmost importance with all aspects of quality control and quality management playing a vital role in the success rates of an ART clinic. Practitioners wishing for a greater understanding of the intricacies of how a sperm meets an egg will find this volume especially useful in their clinical practice.
Volume 3: Atlas of Human Embryology
To complement the two volumes, we have designed a high-quality comprehensive Atlas of Human Embryology which offers an exciting, pictorial glimpse into oocytes and embryos at various stages of development. The text here is limited to a brief 16description of the images. Owing to sophisticated computer technology that is currently on hand, we have made great efforts to capture all the photographs on digital films and digital videotapes. This volume serves as a handbook and ready-reckoner for all embryologists who, when in doubt, can get a sneak peek of the images when working in the laboratory.
Throughout the book, the aim has been to explain issues clearly, simply and directly in such a way that it will be understood by gynecologists, infertility specialists as well as scientists and laboratory personnel. The end aim of the book is to help in optimizing results and generate ART treatment of high quality and we are confident that it works towards this end and that all our readers will appreciate the book's distinctiveness and merit.
Kamini A Rao
Howard Carp
Robert Fischer
17Acknowledgments
We wish to express our gratitude to all the contributors for their time, effort and commitment to sharing their knowledge and expertise. A book of this quality could never have been achieved without the untiring efforts of our entire team of doctors, Dr Deepika K, Dr Divyashree PS, Dr Mir Jaffar, Dr Divya Sardana, Dr Manishi Mittal, Dr Mandeep Kaur, Dr Rajesh and Dr Nameeta Mokashi Bhalerao, who painstakingly proofread the manuscripts, modified drafts and checked for scientific authenticity. Our sincere thanks to Ms Elizabeth Solomon for communicating with the contributors and single handedly coordinating this entire effort to ensure a final product of quality while maintaining a pleasant and congenial atmosphere in the workplace. We have to acknowledge the support of our publisher, M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their continuous guidance and support; and finally, our entire families whose diligence, support and patience have underpinned the successful completion of the book.