ASSISTED REPRODUCTION TECHNIQUES. CHALLENGES AND MANAGEMENT OPTIONS. 2ND EDITION

Contributors xiii
Preface to the second edition xxviii
Preface to the first edition xxix
How to use this book xxx
Abbreviations xxxi
• Section 1: Counseling and preparation 1
1 Risk of cancer from ovarian stimulation 3
2 Risk of early menopause following IVF treatment 9
3 The HIV-positive female 12
4 The HIV-positive male 19
5 The hepatitis B or C carrier patient 26
6 The patient with cystic fibrosis 32
7 The patient on medication 37
8 The patient with thrombophilia 48
9 The patient with autoimmune disorders 56
10 The patient with malignant disease: fertility preservation 61
11 The patient with heart disease 69
12 The patient with diabetes 75
13 The patient with thyroid disease 81
14 The patient with hyperprolactinemia 89
15 The patient with polycystic ovaries 96
16 The renal transplant patient 103
17 The patient with previous pelvic irradiation 110
18 Female fertility after chemotherapy 116
19 The patient with abnormal cervical cytology 123
20 The patient with previous borderline ovarian tumor 127
21 The patient with an endometrioma 132
22 The patient with cervical stenosis 137
23 Vaccination and ART 142
24 The patient with hydrosalpinx 147
25 The patient with hydrosalpinx and contraindication to laparoscopy 153
26 The patient with reduced ovarian reserve 159
27 The patient with congenital uterine anomalies 166
28 The patient with congenital cervico-vaginal anomalies 171
29 The patient with uterine fibroids 176
30 The patient with adenomyosis 182
31 The patient with previous Essure® sterilization 187
32 The patient with previous endometrial ablation 192
33 The couple with recurrent implantation failure 200
34 The patient with previous uterine artery embolization 207
35 The patient with endometrial polyp 212
36 The obese female patient 217
37 The patient with Asherman syndrome 223
38 The older patient 228
39 Requests for mild or natural cycle IVF treatment 234
40 The patient with psychosexual problems 239
41 The patient needing third-party reproduction 246
42 Social oocyte freezing 252
43 The male and female patients following bariatric surgery 258
44 Endometrial receptivity testing 265
• Section 2: Pituitary suppression and ovarian stimulation phase 271
45 Poor response during ovarian stimulation 273
46 Ovarian stimulation for IVF in a patient at high risk of ovarian hyperstimulation syndrome 279
47 Unable to achieve pituitary down-regulation 284
48 The patient discovered pregnant during pituitary down-regulation 291
49 Ovarian cysts following pituitary down-regulation 296
50 Missed IVF medications 302
51 The ART patient with a history of estrogen-receptor
positive cancer 309
52 The patient over-responding to controlled ovarian stimulation during IVF 315
• Section 3: Oocyte retrieval 323
53 General anesthesia or sedation for oocyte retrieval? 325
54 Delayed oocyte retrieval 331
55 Empty follicle syndrome 337
56 Bleeding following oocyte retrieval 344
57 To flush or not to flush follicles at oocyte retrieval 351
58 Inaccessible ovaries at oocyte retrieval 358
59 Endometriotic cysts at oocyte retrieval 363
60 Inadvertent injury during oocyte retrieval 369
61 Dealing with equipment failure during oocyte retrieval 377
• Section 4: Embryo transfer 381
62 How many embryos to transfer? 383
63 Poor endometrial development in ART 390
64 Endometrial cavity fluid identified during IVF treatment 400
65 Difficult embryo transfer 404
66 Excess cervical mucus and retained embryos at embryo transfer 413
67 Life after embryo transfer 419
• Section 5: The luteal phase 427
68 Vaginal bleeding in the luteal phase after IVF 429
69 Pelvic infection after IVF 435
70 The patient presenting with ovarian hyperstimulation syndrome 440
71 Adnexal torsion after IVF 447
72 Exposure to infection in the luteal phase of IVF 453
• Section 6: The ART laboratory 465
73 Total failure of fertilization after conventional IVF – rescue ICSI 467
74 Couples not wishing to create surplus embryos in IVF 473
75 Routine preimplantation genetic testing for aneuploidy 478
76 Choosing an embryo for transfer 484
77 Globozoospermia 492
78 Total failure of fertilization after ICSI 498
79 Refreezing of embryos 503
80 Infection in embryo culture medium 509
81 ICSI or IVF for nonmale-factor infertility? 515
82 Cryostorage failure in ART 522
83 The ART program during a disaster 527
84 Using the wrong sperm or embryos in IVF 533
• Section 7: The male patient 539
85 Unexpected inability to produce a semen sample on the day of oocyte retrieval 541
86 The azoospermic patient 545
87 ART in men with Klinefelter syndrome 553
88 ART in men with 100% immotile sperm 559
89 Request for posthumous fatherhood with perimortem surgical sperm retrieval 565
90 Retrograde ejaculation and anejaculation 575
91 Sperm retrieval in cancerous testes 580
92 Leukocytospermia and ART 584
93 The infertile male patient with a genetic cause 589
94 Y chromosome microdeletions and ART 598
95 DNA fragmentation, antioxidants and ART 606
• Section 8: The ART pregnancy 613
96 Unexpected number or sex of babies after IVF 615
97 Suspected ectopic pregnancy after IVF 620
98 Cervical ectopic pregnancy after IVF 626
99 Heterotopic pregnancy after IVF 632
100 Multifetal pregnancy reduction after IVF 638
101 Multiple pregnancy after IVF: how to reduce preterm delivery 644
102 Hyperreactio luteinalis after IVF 650
103 Lactation by a commissioning mother in surrogacy 654
104 Children of ART 658
• Section 9: General and organizational issues 665
105 Managing physical symptoms during IVF 667
106 IVF when the prognosis is very poor or futile 673
107 Dealing with the emotional distress following failed IVF 678
108 Couple splitting while embryos are in storage 684
109 Unexpected drop in the IVF clinic pregnancy rate 690
110 Natural fertility after IVF 696
111 Training in ART 699
112 Keeping up to date in ART practice 706
113 Cross-border reproductive care 714
114 Satellite and transport ART treatment 720
115 Social media use in ART 725
116 Managing an ART unit as a profitable business 733
Index 739

Assisted reproduction techniques have led to the birth of 8 million babies worldwide
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 171 internationally renowned experts, Assisted Reproduction Techniques follows the patient's journey throughout the whole ART process, with chapters on:

• Counseling and preparation
• Pituitary suppression and ovarian stimulation
• Oocyte retrieval
• Embryo transfer
• The luteal phase
• The ART laboratory
• The male patient
• The ART pregnancy
• General and organizational issues

Each of the 116 concise chapters includes clinical cases, background, evidence-based practical management options, preventive measures, key-point summaries of the important details and answers to questions patients ask.
Assisted Reproduction Techniques first edition has established its place as a “must read” for ART trainees and practitioners alike, and in this second edition all chapters have been updated, with the addition of new ones addressing training issues, organizational and business skills, and social media use in ART.