In vitro fertilization:

In: The Subfertility Handbook · 2010 · pp. 123–134 · doi:10.1017/cbo9780511919244.012 · W653974800
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Pelvic ultrasound is crucial for diagnosing infertility in women by assessing ovarian function, identifying ovulatory disorders like PCOS and POF, and detecting uterine and tubal pathologies.

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This chapter from The Subfertility Handbook reviews in vitro fertilization and other assisted reproductive techniques, discussing indications for IVF (including tubal infertility, endometriosis, ovarian dysfunction, surrogacy, and male factor) and describing the typical IVF cycle from ovarian stimulation and monitoring through trigger, oocyte retrieval, insemination/ICSI, embryo culture, embryo transfer, and luteal support. It notes that IVF indications have expanded with newer technologies such as ICSI, surgical sperm retrieval, embryo biopsy, and cryopreservation, and that IVF has become a cumulative step in the diagnosis and treatment of unexplained infertility. A major limitation is that the text is a clinician’s guide chapter rather than an empirical study, so it does not provide specific trial outcomes or evidence synthesis. Relevance to endometriosis: the chapter explicitly lists endometriosis among the indications for IVF, though its main focus is an overview of IVF indications and the standard IVF treatment workflow in subfertility.

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Abstract

The use of pelvic ultrasound to investigate the subfertile female needs a close collaboration between the gynecologist and the radiologist. Ultrasonography is now a must in the investigation of ovulation disorders, along with clinical findings and hormonal assays. It allows estimation of the ovarian function, mainly estrogen secretion, through measurement of the endometrial thickness: endometrial atrophy or severe hypotrophy (thickness more than 5 mm) indicates hypoestrogenism. It also contributes greatly to the diagnosis of ovulation disorders, in particular polycystic ovary syndrome (PCOS) and primary ovarian failure (POF), along with the clinical/biological data. The ultrasound is sensitive in detecting those lesions that are responsible for infertility through interference with egg migration and implantation and/or with sperm progression, such as fibroids, polyps, synechiae, or malformations. The 3D ultrasound can help in the diagnosis of uterine malformations. The majority of tubal obstructions are secondary to sexually transmitted infections, particularly gonorrhea and chlamydia.
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The Subfertility Handbook Buy print or eBook [Opens in a new window] A Clinician's Guide - The Subfertility Handbook - The Subfertility Handbook - Copyright page - Contents - Foreword - Contributors - Chapter 1 Subfertility – a logical approach - Chapter 2 Pre-pregnancy counseling and treatment - Chapter 3 The first interview with a new couple - Chapter 4 Investigation of the female patient - Chapter 5 Assessment of the male partner - Chapter 6 Ultrasound in the investigation of the subfertile female - Chapter 7 Treatment options for male infertility - Chapter 8 The management of anovulation (including PCOS) - Chapter 9 The role of artificial insemination with partner semen in an ART program - Chapter 10 Early pregnancy loss - Chapter 11 In vitro fertilization: - Chapter 12 In vitro maturation - Chapter 13 The use of donor insemination - Chapter 14 Using donor oocytes - Chapter 15 Embryo donation: - Chapter 16 Endometriosis and its treatment - Chapter 17 The role of surgery in female subfertility - Chapter 18 Laboratory techniques in IVF - Chapter 19 Infertility counseling - Index indications, stimulation and clinical techniques Published online by Cambridge University Press: 06 December 2010 Edited by Book contents - The Subfertility Handbook - The Subfertility Handbook - Copyright page - Contents - Foreword - Contributors - Chapter 1 Subfertility – a logical approach - Chapter 2 Pre-pregnancy counseling and treatment - Chapter 3 The first interview with a new couple - Chapter 4 Investigation of the female patient - Chapter 5 Assessment of the male partner - Chapter 6 Ultrasound in the investigation of the subfertile female - Chapter 7 Treatment options for male infertility - Chapter 8 The management of anovulation (including PCOS) - Chapter 9 The role of artificial insemination with partner semen in an ART program - Chapter 10 Early pregnancy loss - Chapter 11 In vitro fertilization: - Chapter 12 In vitro maturation - Chapter 13 The use of donor insemination - Chapter 14 Using donor oocytes - Chapter 15 Embryo donation: - Chapter 16 Endometriosis and its treatment - Chapter 17 The role of surgery in female subfertility - Chapter 18 Laboratory techniques in IVF - Chapter 19 Infertility counseling - Index In vitro fertilization (IVF) and other assisted reproductive techniques are now fully accepted modalities of treatment for subfertility in our modern world. The indications for IVF have increased with the development of newer techniques such as ICSI, surgical sperm retrieval, embryo biopsy, and cryopreservation techniques, and IVF has become the cumulative step for the diagnosis and treatment for unexplained infertility. Certain indications for subfertility discussed in this chapter include tubal infertility, endometriosis, ovarian dysfunction, surrogacy, and male factor. The typical IVF cycle involves the following stages: stimulation for multiple follicular development, monitoring follicular growth and development, trigger of follicular maturation, oocyte recovery and identification, insemination/ICSI, embryo culture, embryo replacement, luteal phase support and confirmation of pregnancy. Traditionally, pregnancy rate per cycle has been used to compare results but gradually cumulative pregnancy outcome over the course of treatment may become more pertinent to the couple. - Type - Chapter - Information - The Subfertility HandbookA Clinician's Guide, pp. 123 - 134Publisher: Cambridge University PressPrint publication year: 2010 Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - In vitro fertilization: - - Book: The Subfertility Handbook - Online publication: 06 December 2010 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - In vitro fertilization: - - Book: The Subfertility Handbook - Online publication: 06 December 2010 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - In vitro fertilization: - - Book: The Subfertility Handbook - Online publication: 06 December 2010

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