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10266the Art and Science of Assisted Reproductive Techniques 1st Edition Gautam N. Allahbadia Full Digital Chapters

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29 views155 pages

10266the Art and Science of Assisted Reproductive Techniques 1st Edition Gautam N. Allahbadia Full Digital Chapters

The document presents the 1st edition of 'The Art and Science of Assisted Reproductive Techniques' by Gautam N. Allahbadia, available for instant access in various digital formats. It features contributions from leading experts in reproductive medicine and covers a wide range of topics including reproductive endocrinology, ovarian stimulation, and third-party reproduction. The book aims to serve as a comprehensive resource for practitioners and researchers in the field of assisted reproductive technology.

Uploaded by

mitalipen2326
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The Art and Science of Assisted
Reproductive Techniques (ART)
The Art and Science of Assisted
Reproductive Techniques (ART)
Editors

Gautam N Allahbadia MD DNB


Scientific Director, Rotunda-Center for Human Reproduction
Mumbai, India
Consultant, Rotunda-Virk Center for Human Reproduction
Jalandhar, India
Consultant, Rotunda-Hygeia Center for Human Reproduction
Srinagar, India
Consultant, Rotunda-Southend Center for Human Reproduction
New Delhi, India
Consultant, Bombay Hospital and Medical Research Centre
Mumbai, India

Rita Basuray Das PhD


Medical Liaison Executive
Department of Reproductive Health
North America Serono
USA

Assistant Editor

Rubina Merchant PhD


Embryologist, Rotunda-Center for Human Reproduction
Mumbai, India

Foreword by

Bruno Lunenfeld MD FRCOG FACOG (hon) POGS (hon)


Faculty of Life Sciences
Bar -Ilan University Ramat Gan 52900 Israel

LONDON AND NEW YORK

A PARTHENON BOOK
© 2003 GN Allahbadia and RB Das
First published in India in 2003 by

Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India. EMCA House, 23/23B Ansari
Road, Daryaganj, New Delhi 110 002, India Phones: 23272143, 23272703, 23282021, 23245672
m\, Fax: +91–011–23276490 e-mail: [email protected], Visit our website:
http://www.jaypeebrothers.com/
This edition published in the Taylor & Francis e-Library, 2005.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of
thousands of eBooks please go to http://www.ebookstore.tandf.co.uk/.”
First published in the United Kingdom by Taylor & Francis in 2004. Exclusively distributed
worldwide (excluding the Indian Subcontinent) by Martin Dunitz, a member of the Taylor &
Francis Group. Tel.: +44 (0) 20 7583 9855 Fax.: +44 (0) 20 7842 2298 E-mail:
[email protected] Website: http://www.dunitz.co.uk/
This edition published in the Taylor & Francis e-Library, 2005.
All right reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or
othrwise, without the prior permission of the publisher or in accordance with the provisions of the
Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited
copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP.
Although every effort has been made to ensure that all owners of copyright material have been
acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or
editions any omissions brought to our attention.
Although every effort has been made to ensure that drug doses and information are presented
accurately in this publication, the ultimate responsibility rests with the prescribing physician.
Neither the publishers nor the authors can be held responsible for errors or for any consequences
arising from the use of information contained herein. For detailed presceibing information or
instructions on the use of any product or procedure dicussed herein, please consult the prescribing
information or instructional material issued by the manufacturer.
A CIP record for this book is available from the British Library.

ISBN 0-203-64051-9 Master e-book ISBN

ISBN 0-203-67727-7 (Adobe e-Reader Format)


ISBN 1 84184 449 7 (Print Edition)
Distributed in North and South America by
Taylor & Francis 2000 NW Corporate Blvd Boca Raton, FL 33431, USA
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332424 E-mail: [email protected]

dedicated to our spouses Swati and Sumit


Foreword

Prof Bruno Lunenfeld, MD, FRCOG FACOG (hon) POGS (hon)


Faculty of Life Sciences, Bar -Ilan University Ramat Gan 52900 Israel
The “conquest of infertility” is an incredible achievement, it is a victory of human
will, endurance and technology. However as we have entered the new millennium, new
challenges are arising in relation to scientific, ethical and humanitarian aspects in
infertility management. However, in spite of our increasing knowledge and skills many
questions remain unanswered and new concerns and problems constantly arise. In the
early nineties, ICSI was still an experimental therapeutic approach yet in the meantime it
has revolutionized the treatment of male infertility worldwide. Testicular sperm
extraction for ICSI and cryopreservation techniques are important milestones in assisted
reproductive technology while in vitro maturation of germinal cells the intracytoplasmic
injection of round and elongated spermatids are still in the experimental stage. In the last
few years new compounds such as recombinant gonadotropins (FSH LH and hCG) and
GnRH antagonists came into use for ovulation induction and controlled ovarian
stimulation which improved safety, allows for individualized adjusted therapies and make
treatment more patient friendly. Pre-implantation genetic diagnosis is improvingbut most
genetic implications of assisted reproduction are still under debate. Oocyte donation is
now widely practiced, but the moral, ethical and judiciary issues of Oocyte sharing
spreading from country to country and surrogacy by embryo transfer is are still under
debate. There is also an important public demand for information and transparency
regarding pregnancy and fetal outcome after ART. The relative excessive rate of high
order multiple pregnancies with negative effects on mother and child has still to be
accepted by all as a serious complication. More efforts are needed to reduce multiple
pregnancy rate as well as the occurrence of hyperstimulation and its consequences. Those
involved in reproductive medicine must, on the one hand, make all possible efforts to
enable conception to all couples desiring it and, on the other hand, make the utmost to try
to avoid maternal and neonatal complications such as the hyperstimulation syndrome,
multiple pregnancy and premature delivery. These are formidable goals and this book
attempts with theoretical considerations, discussions and newer insights into many
aspects within the broad aspect of assisted reproduction to become an important tool for
those interest in the field of reproductive medicine
It covers the basics of reproductive endocrinology, theoretical and practical aspects of
ovarian stimulation and modern understanding and management of PCOS. The book
describes recent developments in drug research with reference to both “gonadotropins,
GnRH antagonists and newer delivery systems. Besides useful sections on Endoscopy,
Third Party Reproduction, and Implantation a chapter dedicated to stem cell culture and
replication written by prominent scientists can be found.
This is a truly comprehensive book for the Obstetrician and Gynecologist who is
yearning for knowledge in the field of ART.
This book has brought together leading medical and scientific experts who describe in
a clear and concise manner the “how, why and therefore” of ART. It has been written to
be readable and usable by research fellows, who want to get an insight into the technical
developments, by a clinical and scientific team who want to know the A to Z of setting up
an ART program, as well as “veterans” in the field who want an up-to-date review on the
newest techniques and advances.

Bruno Lunenfeld
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Preface

In his famous preface to Cromwell, Victor Hugo pointed out that one seldom inspects the
cellar of a house after visiting its salons nor examines the roots of a tree after eating its
fruit. The readers of this book will judge it by the substance of its contents and its style,
not by a pretext. If the guest has returned several times, then surely he knows that the
cellar is well stocked. Having said this, it is reasonable to ask why prefaces and
forewords are written and are they ever read? My contribution is intended to present the
objectives of this book.
Within the last two decades, the amount of information generated by theoretical and
clinical research in the field of reproductive physiology and infertility has increased so
enormously that it has become virtually unmanageable. To be professionally efficient,
however, both the research worker and the clinician must constantly keep abreast with
recent developments and discoveries.
The different chapters in the book cover a wide range of reproductive medicine and
science. They represent the cutting-edges of our discipline and are written by
acknowledged experts in the field. The editors demonstrated an exceptional capacity to
select contributors who are at the forefront of their disciplines, thereby ensuring the
freshness of each chapter.
To convey the essence of a rapidly growing field in a single book, it is necessary to be
selective in both the extent and depth of coverage. This is especially true for a book
designed for students, researchers and practitioners of medicine. This book covers the
“classical problems” of reproductive medicine, including stimulation protocols, ART
procedures, implantation, cryopreservation, endocrinological disorders, male factor,
endoscopy and ultrasonography. Chapters on third party reproduction, PGD, unsolved
problems such as treatment of poor responders, treatment of the older patients and
endometriosis, and the future of infertility therapy provide important and recent
information, as well as food for thought.
I sincerely hope that young doctors and experienced clinicians, medical students and
teachers, as well as scientists working in the field of reproductive medicine and
endocrinology, will find this book interesting and helpful. Moreover, I sincerely hope that
this overview will stimulate new work and a continuous dialogue between basic scientists
and clinicians, between gynecologists and andrologists, and between immunologists,
endoscopic surgeons and psychologists. Without doubt, teams of highly specialized
scientists and clinicians must teach reproductive medicine, and infertile couples should be
treated as a unit by specialists with a broad scientific basis and clinical experience in the
diagnosis and therapy of both male and female infertility.
I would like to express my appreciation to all the authors for their valuable
contributions. They produced a book that is not only of critical substance but is also a real
pleasure to read.
Dusseldorf, Germany

Hugo C Verhoeven MD
List of Contributors

Vida Acosta MD TS
Andrology Laboratory Services Inc
Chicago, Illinois, USA
Ashok Agarwal PhD HCLD
Center for Advanced Research in Human Reproduction
Infertility, and Sexual Function
Urological Institute and Department of Obstetrics & Gynecology
Cleveland Clinic Foundation
Cleveland, Ohio 44195, USA
Richard A Ajayi MRCOG
Consultant Gynaecologist and Director
The Assisted Conception Unit, The Bridge Clinic Limited
Victoria Island, Lagos, Nigeria
Erdal Aktan MD
Ege IVF Center, Izmir-Turkey
Gautam N Allahbadia MD DNB
Scientific Director, Rotunda-Center for Human Reproduction
Mumbai, India
Consultant, Rotunda-Virk Center for Human Reproduction
Jalandhar, India
Consultant, Rotunda-Hygeia Center for Human
Reproduction, Srinagar, India
Consultant, Rotunda-Southend Center for Human
Reproduction, New Delhi, India
Consultant, Bombay Hospital and Medical Research Centre
Mumbai, India
Swati G Allahbadia MD
Associate Professor, Department of Obstetrics and Gynecology
Lokmanya Tilak Municipal Medical College and General
Hospital, Mumbai, India
Najar Amso PhD FRCOG
Senior Lecturer and Consultant Gynaecologist
University Hospital of Wales
Heath Park, Cardiff, Wales
Claus Yding Andersen MSc DMSc
Laboratory of Reproductive Biology, Rigshospitalet,
University of Copenhagen,
Copenhagen, Denmark
Carlo De Angelis MD
Professor, Chief-Center for Minimally Invasive Therapy
Department of Gynecological Sciences and Perinatology
University of Rome, “La Sapienza”
Policlinico Umberto I, Rome, Italy
Monica Antinori MD
Resident Fellow, Center for Minimally Invasive Therapy
Department of Gynecological Sciences and Perinatology
University of Rome, “La Sapienza”
Policlinico Umberto I
00161 Rome, Italy
Gerardo Ardiles MD
Department of Reproductive Medicine
Copiapo, Arica Regional Hospital, Chile
Foad Azem MD
Racine IVF Unit
Department of Obstetrics and Gynecology
Tel-Aviv Sourasky Medical Center
Affiliated to Sackler School of Medicine
University of Tel-Aviv, Israel
Ramesh B MD DGO FCPS DICOC DFP, Diploma in Gynecological Endoscopy
Consultant Gynaecologist and Endoscopic Surgeon
Bangalore, India
Antonio Barbaro
ASIC Associazione per lo studio dell’infertilita di coppia
Roma Viale Aventino 61, Italy
Sudip Basu MD DNB MRCOG MRCPI
Research Fellow and Senior Registrar
Cardiff Assisted Reproduction Unit
University Hospital of Wales, Heath Park
Cardiff, Wales
Micha Baum MD
IVF Unit
Department of Obstetrics and Gynecology
Sheba Medical Center, Tel-Hashomer, Israel 52621
and Sackler School of Medicine
Tel-Aviv University, Ramat-Aviv,
Tel-Aviv, Israel
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