Assisted Reproduction Techniques

1 Cover

2 Title Page

3 Copyright Page

4 Dedication Page

5 Contributors

6 Preface to the second edition

7 Preface to the first edition

8 How to use this book

9 Abbreviations

10 SECTION ONE: Counseling and preparation 1 Risk of cancer from ovarian stimulation Background Management options Answers to questions patients ask References 2 Risk of early menopause following IVF treatment Background Management options Answers to questions patients ask References 3 The HIV‐positive female Background Management options Answers to questions patients ask References 4 The HIV‐positive male Background Management options Prevention Answers to questions patients ask References 5 The hepatitis B or C carrier patient Background Management of patients Prevention References 6 The patient with cystic fibrosis Background Management options The future References 7 The patient on medication Background Management options Answers to questions patients ask References 8 The patient with thrombophilia Background Management options References 9 The patient with autoimmune disorders Background Management options References 10 The patient with malignant disease: fertility preservation Background Management options References 11 The patient with heart disease Background Management options Answers to questions patients ask References 12 The patient with diabetes Background Management options Prevention References 13 The patient with thyroid disease Background Answers to questions patients ask References 14 The patient with hyperprolactinemia Background Management options Answers to questions patients ask References 15 The patient with polycystic ovaries Background Management options Answers to questions patients ask References 16 The renal transplant patient Background Management options Answers to questions patients ask References 17 The patient with previous pelvic irradiation Background Ovarian dysfunction Investigation of ovarian function Investigation of uterine function Prevention Answers to questions patients ask References 18 Female fertility after chemotherapy Background Management options Prevention Answers to questions patients ask References 19 The patient with abnormal cervical cytology Background Management options Answers to questions patients ask References 20 The patient with previous borderline ovarian tumor Background Management options References 21 The patient with an endometrioma Background Management options References 22 The patient with cervical stenosis Background Management options Answers to questions patients ask References 23 Vaccination and ART Background Management options Answers to questions patients ask References 24 The patient with hydrosalpinx Background Management options Prevention References 25 The patient with hydrosalpinx and contraindication to laparoscopy Background Management options References 26 The patient with reduced ovarian reserve Background Management options References 27 The patient with congenital uterine anomalies Background Management options References 28 The patient with congenital cervico‐vaginal anomalies Background Management options Answers to questions patients ask References 29 The patient with uterine fibroids Background Management options Answers to questions patients ask References 30 The patient with adenomyosis Background Management options Answers to questions patients ask References 31 The patient with previous Essure ®sterilization Background Management options Answers to questions patients ask References 32 The patient with previous endometrial ablation Background Management options Answers to questions patients ask References 33 The couple with recurrent implantation failure Background Management options Answers to questions patients ask References 34 The patient with previous uterine artery embolization Background Management options Answers to questions patients ask References 35 The patient with endometrial polyp Background Management options Prevention Answers to questions patients ask References 36 The obese female patient Background Management options Answers to questions patients ask References 37 The patient with Asherman syndrome Background Management options Prevention Answers to questions patients ask References 38 The older patient Background Management options Prevention Answers to questions patients ask References 39 Requests for mild or natural cycle IVF treatment Background Management options Answers to questions patients ask References 40 The patient with psychosexual problems Background Management options Answers to questions patients ask References 41 The patient needing third‐party reproduction Background Management options Answers to questions patients ask References 42 Social oocyte freezing Background Management options Conclusion Answers to questions patients ask References 43 The male and female patients following bariatric surgery Background Management options Answers to questions patients ask References 44 Endometrial receptivity testing Background Management options Answers to questions patients ask References

11 SECTION TWO: Pituitary suppression and ovarian stimulation phase 45 Poor response during ovarian stimulation Background Management options Answers to questions patients ask References 46 Ovarian stimulation for IVF in a patient at high risk of ovarian hyperstimulation syndrome Background Management options Answers to questions patients ask References 47 Unable to achieve pituitary down‐regulation Background Management options Answers to questions patients ask References 48 The patient discovered pregnant during pituitary down‐regulation Background Management options Prevention Answers to questions patients ask References 49 Ovarian cysts following pituitary down‐regulation Background Management options Prevention Answers to questions patients ask References 50 Missed IVF medications Background Prevention Answers to questions patients ask References 51 The ART patient with a history of estrogen‐receptor positive cancer Background Management options Prevention Answers to questions patients ask References 52 The patient over‐responding to controlled ovarian stimulation during IVF Background Management options Patient counseling Answers to questions patients ask References

12 SECTION THREE: Oocyte retrieval 53 General anesthesia or sedation for oocyte retrieval? Background Management options Suggested case management Answers to questions patients ask References 54 Delayed oocyte retrieval Background Management options Prevention Suggested case management Answers to questions patients ask References 55 Empty follicle syndrome Background Management options Prevention Answers to questions patients ask References 56 Bleeding following oocyte retrieval Background Management options Prevention Answers to questions patients ask References 57 To flush or not to flush follicles at oocyte retrieval Background Management options Conclusions Answers to questions patients ask References 58 Inaccessible ovaries at oocyte retrieval Background Management options Prevention Answers to questions patients ask References 59 Endometriotic cysts at oocyte retrieval Background Management options Prevention Conclusion Answers to questions patients ask References 60 Inadvertent injury during oocyte retrieval Background Management options Prevention Answers to questions patients ask References 61 Dealing with equipment failure during oocyte retrieval Background Management options Prevention Answers to questions patients ask References

13 SECTION FOUR: Embryo transfer 62 How many embryos to transfer? Background Management options Prevention Answers to questions patients ask References 63 Poor endometrial development in ART Background Management options Answers to questions patients ask References 64 Endometrial cavity fluid identified during IVF treatment Background Management options Prevention Answers to questions patients ask References 65 Difficult embryo transfer Background Management options Prevention Answers to questions patients ask References 66 Excess cervical mucus and retained embryos at embryo transfer Background Management options Prevention Answers to questions patients ask References 67 Life after embryo transfer Background Management options Prevention Answers to questions patients ask References