Handbook of Current and Novel Protocols for the Treatment of Infertility

1st Edition - September 6, 2023
Editors: Michael H. Dahan, Human M. Fatemi, Nikolaos P. Polyzos, Juan A. Garcia-Velasco
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 8 5 6 8 7 - 4
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 0 1 0 6 - 2

The field of Assisted Reproductive Technology (ART) is rapidly evolving and stimulation protocols, fertility strategies and aspects of infertility treatments are constantly being… Read more

Handbook of Current and Novel Protocols for the Treatment of Infertility

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The field of Assisted Reproductive Technology (ART) is rapidly evolving and stimulation protocols, fertility strategies and aspects of infertility treatments are constantly being updated as advances and new discoveries are made.

Handbook of Current and Novel Protocols for the Treatment of Infertility is a valuable resource of well-organized, comprehensive scientific data with practical guides and step-by-step protocols for infertility management. Written by world-wide experts, this book discusses different practice patterns and approaches used internationally and presents innovative topics including preimplantation genetic testing, time lapse imaging and the role of artificial intelligence in ART.

This book provides up-to-date, evidence-based guidance on daily practice and is an important resource for infertility providers, including trainees or experienced clinicians, embryologist, and is geared for both specialist in reproductive medicine and gynecologists interested in increasing their knowledge in the field of reproductive endocrinology and intertility.

Cover image
Title page
Table of Contents
Copyright
Dedication
Dedication
Dedication
Dedication
List of contributors
Preface
Chapter 1. The evaluation of the female infertility patient
History assessment
Physical exam
Pelvic ultrasound
Evaluation of ovarian reserve
Ovulation assessment
Tubal patency evaluation
Other investigations
Conclusion
Chapter 2. The fertility evaluation of the male partner
Overview
Clinical history
Physical examination
Semen analysis
Hormonal evaluation
Genetic studies
Conditions with special considerations
Chapter 3. Sperm DNA fragmentation and male infertility: a comprehensive review for the clinicians
Sperm genetics
How do sperm genetics become dysfunctional?
Single- or double-strand breaks: does it really matter?
Which test to assess sperm chromatin integrity and SDF?
Etiologies and risk factors for SDF
The impact of SDF on male reproductive outcomes
How to manage patients with high SDF?
Clinical practice guidelines and recommendations on SDF testing
Limitations of sperm SDF testing in clinical practice?
Updates in the recent research on SDF (2019–21)
Clinical scenarios on SDF management
Conclusion
Chapter 4. The evaluation and management of recurrent pregnancy loss
Introduction
Incidence and prevalence
Etiology and risk factors
Evaluation of RPL
Prevention
Treatment
Future directions
Conclusion
Chapter 5. The role of surgery in infertility, an evidence-based approach
Introduction
Chapter 6. Ovarian stimulation and intrauterine insemination
Introduction
Definition and indications
Ovarian stimulation protocols
Final remarks
Chapter 7. Infertility care of the PCOS patient
Introduction
Preconception risk factors
Weight loss and obesity
Pharmacologic treatment strategies
Letrozole
Selective estrogen receptor modulators
Gonadotropins
Considerations for administration of ovulation induction agents
In vitro fertilization/Intracytoplasmic sperm injection
In vitro maturation
Inositol
Laparoscopic ovarian drilling
Acupuncture, herbal remedies, and traditional Chinese medicine
Conclusion
Chapter 8. The GnRH antagonist protocol
Introduction
GnRH antagonist protocols
Cetrorelix versus ganirelix
GnRH antagonist fixed protocol
GnRH antagonist flexible protocol
Fixed versus flexible GnRH antagonist protocol
Pretreatment with oral contraceptive pill in a GnRH antagonist cycle
Elevated progesterone at initiation of stimulation in a GnRH antagonist cycle
FSH dose in GnRH antagonist protocols
Initiation of FSH dose in GnRH antagonist protocols
Administration of antagonist in the early follicular phase
Delayed start GnRH antagonist protocol
Luteal GnRH antagonist administration
Criteria for triggering final oocyte maturation
GnRH antagonists and OHSS
The modified natural cycle
Use of GnRH antagonists in ovarian stimulation for intrauterine insemination
Luteal phase support in antagonist cycles
Alternative to GnRH antagonists LH suppression regimens
Chapter 9. The long gonadotropin releasing hormone agonist IVF protocol
Introduction
A brief history of IVF attempts
Gonadotropin-releasing hormone agonists
Conclusions
Chapter 10. Double stimulation in the same ovarian cycle (DuoStim) and luteal phase start IVF protocols
Introduction
Theories of folliculogenesis
Definition of poor prognosis patients
An unconventional ovarian stimulation protocol: luteal phase stimulation
DuoStim for poor prognosis patients: the evidence up to date
Framework of a DuoStim protocol
Clinical indications for DuoStim
DuoStim: is the second stimulation in the same ovarian cycle conducted in the luteal phase pf the cell cycle?
Conclusions
Chapter 11. The mild stimulation in vitro fertilization protocol
Mild ovarian stimulation for IVF
Chapter 12. The use of progestins to prevent the LH surge in IVF cycles
Alternative protocols for ovarian stimulation
Mechanism of pituitary suppression by progestins
Progestins
PPOS protocols: outcomes and schemes of treatment
Advantages and limits
Chapter 13. Triggering final oocyte maturation. The role of human chorionic gonadotropin, gonadotropin-releasing hormone agonist, and dual trigger
Introduction
Human chorionic gonadotropin, a surrogate to the naturally occurring LH surge
hCG versus GnRHa trigger
Triggering final follicular maturation in patients not at risk to develop severe OHSS
GnRHa and hCG in patients at risk to develop severe OHSS
Conclusions
Chapter 14. Pathogenesis and management in OHSS
Introduction
Pathogenesis
OHSS management
Mild OHSS
Moderate OHSS
Severe and critical OHSS
Critical OHSS
Resolution and prognosis
Chapter 15. Complications of in vitro fertilization (excluding ovarian hyperstimulation syndrome) and their management
Introduction
Complications of ovarian stimulation: specific aspects and management
Complications of the egg retrieval procedure
Intermediate/long-term complications of IVF
Conclusion
Chapter 16. In vitro maturation of immature cumulus–oocyte complexes collected from antral follicles
What is oocyte in vitro maturation?
Clinical outcomes of standard IVM as an artificial reproductive technology
Selection of appropriate patients suitable for IVM treatment
Standard IVM: clinical and laboratory protocols
Chapter 17. Stimulated in vitro oocyte maturation
Introduction
Oocyte physiology
Potential indications for IVM
IVM in the era of antagonist protocol with agonist trigger
IVM instead of natural cycle IVF
IVM instead of FSH/IUI
IVM and fertility preservation for cancer
IVM and resistant ovary syndrome
Protocols
Patient preparation
Fertilization
Aspiration technique and culture
Embryo transfer
Safety concerns
Conclusion
Chapter 18. Fertility preservation
Introduction
Indications
Cryopreservation techniques
Clinical approach
Conclusion
Chapter 19. Preimplantation genetic testing
The origins of PGT
Different kinds of PGT and their indications
Biopsy techniques
PGT-M: molecular analysis
Comprehensive chromosome testing techniques
Clinical evidence supporting PGT-A
Chromosomal mosaicism, intermediate copy numbers, and segmental aneuploidies
Alternative sources of DNA
Chapter 20. Nutritional supplements and other adjuvants in fertility care
Introduction
Growth hormone
Dehydroepiandrosterone
Chapter 21. Maximizing fertility outcomes in poor ovarian response patients
Introduction
Treatment
Adjuvant treatments
Challenges in determining evidence-based interventions
Conclusion
Chapter 22. Endometrial receptivity
Introduction
Relevance and concept of endometrial receptivity
Mechanisms of endometrial receptivity
Transcriptomics in bulk tissue
Transcriptomics at the single-cell level
Future directions
Conclusions
Chapter 23. Impact of the microbiome in fertility
Microbiome
Microbiome and infertility
Microbiome and gynecological diseases
Microbiome, obstetrics, and the offspring
Seminal microbiome
Treatment possibilities
Conclusion
Chapter 24. How to manage recurrent implantation failure, what do we know?
Definition and incidence
Treatment options in RIF
Prognosis
Conclusion
Chapter 25. How to set up an andrology laboratory for a fertility center?
Introduction
The design
Equipment
Quality assurance
Accreditation
Air quality
Hygienic maintenance before use
Quality control check for automated and manual sperm counting methods
Cryopreservation
Cryostorage standards and requirements
Cryopreservation of infectious samples
Sperm functioning tests
Chapter 26. How to set up an in vitro fertilization laboratory
The planning team
Regulatory requirements and professional guidelines
Cleanroom design and space requirements
Chapter 27. Introduction to the in vitro fertilization laboratory: management of sperm, oocytes, and embryos
A holistic perspective of the IVF laboratory
Equipment
Quality management
Gamete retrieval and preparation—oocytes
Gamete retrieval and preparation—sperm
Standard/conventional insemination
Intracytoplasmic sperm injection
Embryo culture
Embryo grading and selection
Embryo transfer
Summary
Chapter 28. Introduction to the IVM laboratory
Oocyte maturation process
Oocyte identification
IVM of immature oocytes, culture medium for IVM and supplements
Culture time for assessing in vitro maturation of immature oocytes
Insemination of mature oocytes produced from IVM cycles
Optimal ICSI timing
Culture of IVM embryos and embryo transfer
Cryopreservation of oocytes and embryos obtained from IVM cycles
Most challenging aspects to introduce IVM into the routine laboratory
Chapter 29. Time-lapse imaging
Introduction
Background of time-lapse systems
Implementation of artificial intelligence in assisted reproduction laboratories
Conclusions
Chapter 30. Troubleshooting the in vitro fertilization laboratory
Introduction
Process mapping and process control
Using root cause analysis
Is the origin of a problem always found?
Proactive troubleshooting
The value of quality
Take home messages
Index

Michael H. Dahan

Michael H. Dahan is American board certified in Obstetrics and Gynecology and Reproductive Endocrinology as well as in Infertility, and serves as professor in the department of Obstetrics and Gynecology at McGill University, Canada. With over 140 peer reviewed articles published, he is recognized as one of the leaders in the field of fertility. He has pioneered many of the current novel treatments in In Vitro Fertilization and is a member of the Poseidon group as expert in poor ovarian response. Dr Dahan is the Editor-in-Chief of the Journal of Clinical and Experimental Obstetrics & Gynecology (CEOG) and former professor at Stanford University in California and Washington University in St Louis.

Affiliations and expertise

Professor, Department of Obstetrics and Gynecology, McGill University, Canada

Human M. Fatemi

Human M. Fatemi has been a professor at the Brussels University and is the director of middle east operations for IVI, a company exclusively devoted to human Assisted Reproduction Technology. He has authored over 80 scientific papers in infertility and has been an invited speaker at 150 conferences worldwide. He completed medical school as Magna Cum Laude in 1999 at the Vrije Universiteit Brussel, in Belgium. In 2008, he completed his Ph.D. on the endocrinology of the luteal phase in stimulated and substituted cycles. Also in 2008, he was recognized as a subspecialist in Reproductive Medicine and Surgery by ESHRE (European society of Human Reproduction) and EBCOG (European Board and College of Obstetrics and Gynecology).

Affiliations and expertise

Medical Director, IVI Middle East, United Arab Emirates

Nikolaos P. Polyzos

Nikolaos Polyzos is the Clinical and Scientific Director of the Department of Reproductive Medicine of Dexeus University Hospital in Barcelona, Spain, and a Professor of Reproductive Endocrinology in the Department of Clinical Medicine in the University of Aarhus, Denmark. He has served as a Medical Director in the Centre for Reproductive Medicine in Brussels until 2017 and as a Professor in Brussels until 2019. Professor Polyzos is the principal investigator in several large pioneering multinational trials and a key opinion leader in the field of Reproductive Medicine for the treatment of poor ovarian responders in IVF programs, prediction of ovarian response and premature ovarian ageing, with more than 150 invited lectures in international congresses. He is a Section Editor in reproductive Biomedecine Online, member of the ESHRE guideline development group for ovarian stimulation and has served as an Editorial Consultant for the PIER (Physician’s Information and Education Resource) of the American College of Physicians (ACP).

Affiliations and expertise

Director, Department of Reproductive Medicine, Quirón Dexeus University Hospital, Spain

Juan A. Garcia-Velasco

Juan García-Velasco is Director of IVI Madrid. He is also Professor of Obstetrics and Gynaecology at Rey Juan Carlos University, Madrid, Spain, where he is Director of their Master’s Degree Programme in Human Reproduction. He graduated from University Medical School, Madrid, in 1990 and received his Obstetrics and Gynecology certification from La Paz Hospital, Madrid, in 1995. He completed his PhD in Medicine from Autonoma University, Madrid, in 1995 and from 1997 to 1998 he studied at Yale University, New Haven, CT, under a Reproductive Endocrinology and Infertility Fellowship. His main research interests have been in IVF and endometriosis. He is the Principal Investigator of projects funded by the Ministry of Education and Ministry of Health, Spain, and has received awards from the Spanish Fertility Society, Spanish Society of Obstetrics and Gynecology, and the European Society of Human Reproduction and Embryology. He has published over 200 peer‐reviewed articles as well as 22 book chapters on human reproduction, endometriosis and hypo‐ and hyper‐ovarian stimulation response and is the author/editor of several books.

Affiliations and expertise

Professor of Obstetrics and Gynecology, Rey Juan Carlos University, Madrid, Spain Director IVI RMA - Madrid, Spain

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Handbook of Current and Novel Protocols for the Treatment of Infertility

Purchase options

Innovate. Sustain. Transform.

Institutional subscription on ScienceDirect

Michael H. Dahan

Human M. Fatemi

Nikolaos P. Polyzos

Juan A. Garcia-Velasco

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