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Textbook of Minimal Stimulation IVF: Milder, Mildest or Back to Nautre
Editors: Alejandro Chavez-Badiola and Gautam N. Allahbadia
ISBN 13:
978-93-5025-014-3
Jaypee brothers Medical Publishers (P) Ltd.
List Price: $75.00  Hard Cover  192 Pages
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Description (Back of Book):

Textbook of Minimal Stimulation IVF- Milder, Mildest or Back to Nature

Textbook of Minimal stimulation IVF edited by Drs. Alejandro Chavez-Badiola and Gautam N. Allahbadia, is an intelligently conceived, contemporary useful edition, that is a mandatory introspective re-evaluation and a pause in time to rethink and reflect on the pits along the undaunted success of ART and alternative solutions that partially, if not completely mimic natural phenomenon.  It comes as a welcome answer to the inherent prospective risks and complications, such as overian hyperstimulation and multiple pregnancies, beset in the clinical practice of ART and the financial, psychological, ethical and legal issues that it brews despite its souring success and applications.  The authoritative views and experiences of world pioneers and experts aired herein provide balanced physiologically, psychologically, financially and ethically friendly solutions to regulate and streamline the clinical practice of ART within safe limits and re-instill the confidence in dealing with the confronting challenges.  This stimulating volume would go a long way in motivating clinicians to judiciously weigh the options that ART offers and the risks it carries, and arrive at a universally acceptable and successful solution.

Table of Contents:

1. Time to Rethink

The Concerns
Multiple gestations, perinatal morbidity and mortality
The availability of ART
The developments
The results
Result analysis

2. Terminology in Ovarian Stimulation for IVF

Clinical Discussion
Natural Cycles
Stimulated cycles

3. Mild Approaches: A Whole Different Philosophy in IVF Approaches- An Overview

Clinical Discussion
Clomiphene citrate
Letrozole
Gonadotropins

Results
Pregnancy rates
Complication rates
Dropout rate
Cost-effective treatment
Drawbacks

Case Studies
Patients with poor ovarian reserve
Polycystic ovary syndrome and patients at risk of OHSS

Recent Advances
Vitrification
Genetics

4. Neuroendocrine Regulation of the Menstral Cycle and the Effect of Controlled Ovarian Hyperstimulation on Follicle and Endometrial Development

Clinical Discussion
Ovarian organogenesis
Folliculogenesis
Endometrial cycle
Controlled ovarian hyperstimulation (COH)
Effect of GnRH agonist and antagonist
LH levels during stimulation
Endometrial changes during COH

5. Natural and Modified Natural IVF in Patients with Diminished Ovarian Reserve

Clinical Discussion
Natural cycle IVF (NC-IVF)
Modified natural cycle (MNC-IVF)

6. Protocols for ild Ovarian Stimulation

Clinical Discussion
Protocols for patients with regular menstrual cycles and normal ovarian reserves
Protocols for patients with long cycles (>35 Days) and PCO patients
Protocols for patients with a compromised ovarian reserve

Case Studies
Case 1: Natural cycle IVF following failed IUI
Case 2: Programmed mild gonadotropin stimulation cycle with a GnRH agonist trigger and IVF
Case 3: Programed Letrozole stimulation cycle with a GnRH agonist trigger in a patient with PCOS-like symptoms
Case 4: Natural cycle IVF in an elderly patient with previously failed multiple gonadotropin-stimulated IUI and IVF attempts
Case 5:---------------------

7. Cycle Preparation: Use of Oral Contraceptives before Ovarian Stimulation in In Vitro Fertilization Cycles

Clinical Discussion
Oral contraceptive pretreatment and GnRH agonists
Oral contraceptive pretreatment and GnRH antagonists
Oral contraceptive pills and poor responders

8. Clomiphene Citrate for IVF

Clinical Discussion
Hormonal measurement
Hormone kinetics of the natural cycle
Logic of avoiding the LH surge
Clomiphene citrate regimen
Supplementing exogenous FSH

9. Letrozole Protocols for Ovarian Stimulation

Aromatase enzyme and aromatase inhibitors
Clinical Discussion
Letrozole use for ART: hypothetical role
Hypotheses of Letrozole mechanism of ovarian stimulation
Hypothesis for detrimental effects of supraphysiological estrogen levels on the outcome of fertility treatment
Reducing the risk of ovarian hyperstimulation syndrome (OHSS)
In vitro maturation
Patient subgroups benefitting from low estrogen levels
Available evidence for Letrozole use during ART treatment
Improving response to gonadotropins in poor responders
Safety of Letrozole for ovarian stimulation
Adverse effects of Letrozole
Pregnancy outcome following Letrozole treatment

10. Ovarian Stimulation and Embryo Quality

Clinical Discussion
Basic follicular physiology
Natural cycle IVF and minimal stimulation IVF
Optimizing embryo culture in an IVF laboratory
Insemination and intracytoplasmic sperm injection (ICSI)

11. Ovarian Stimulation and Endometrial Receptivity
Gene expression profiling
Clinical Discussion
Secretory endometrial ultrastructure
Trophoblast invasion and placentation
Effects of ovarian stimulation on endometrial receptivity
Luteinizing hormone (LH) deficiency
Follicular phase importance
Luteal phase support and supplementation
Human chorionic gonadotropin (hCG)
Progesterone
Cryotranfer versus fresh embryo transfer

12. Significance of the Retrieval of a Low Number of Oocytes following Mild Ovarian Stimulation for IVF
Clinical Discussion
Basic physiology of follicle development
Concept of mild disruption of single dominant follicle selection in IVF treatment
Implication of mild ovarian stimulation on oocyte and embryo quality
Recent Advances

13. Use of GnRH Antagonists
Clinical Discussion
Use of GnRH antagonists in ovarian stimulation for IVF
Case Studies
Antagonist protocols versus long luteal agonist protocols
Fixed versus flexible antagonist administration
LH supplementation
Luteal phase supplementation
Patients with poor response
Patients with PCOS and risk of OHSS
Minimal stimulation
Recent Advances

14. Premature Ovulation and Cycle Cancellation
Clinical Discussion
Case Studies
Human chorionic gonadotropin (hCG)
Indomethacin
GnRH antagonists
Recent Advances

15. Ovulation Triggering and Prevention of the Premature LH Surge
Ovulation Trigger
Clinical Discussion
Spontaneous LH/FSH surge
GnRHa-induced LH/FSH surge
Prevention of premature LH surge
GnRH agonist stimulation protocol
Role of the GnRH antagonist in mild stimulation protocols
Recent Advances

16. Optimizing Technique in Follicular Aspiration and Flushing
Introduction
History
Simple basics of physics for aspiration and flushing of fluids in pipes
Clinical Discussion
Innovative devices for oocyte retrieval and follicular flushing
Gauge finding study

17. Single Embryo Transfer
Clinical Discussion
Why choose single embryo transfer?
Single embryo transfer-definitions
Introducing a single embryo transfer policy in practice
Optimizing the day of transfer
Cryopreservation

18. Natural Cycle and Endometrial Preparation Protocols for Frozen Embryo Transfer
Clinical Discussion
Frozen-Thawed embryo transfer (FET)- endometrial preparation protocols
Natural Cycle (NC)
Endometrial thickness
Endometrial pattern
Doppler ultrasound
Case Studies
Natural cycle in patients with oligomenorrhea
Poorly developing endometrium
Recent Advances
Genomics
Pinopode formation assessment
Vitrification

19. Luteal Phase Support in Mildly Stimulated IVF Cycles
Clinical Discussion
Normal luteal phase
Luteal phase defect
Luteal phase and controlled ovarian hyperstimulation
Luteal phase in mildly stimulated cycles
Luteal phase support

20. Reliable Cryopreserving Techniques
Clinical Discussion
Oocyte cryopreservation
Embryo cryopreservation

21. Embryo and Oocyte Vitrification Banking through Natural or Minimal Ovarian Stimulation
Clinical Discussion
Oocyte banking for donation programs
Embryo vs oocyte banking

Case Studies
Embryo banking through minimal stimulation and natural cycle IVF in women with a low ovarian reserve
Live birth in a premature ovarian failure patient through ovarian tissue transplantation and embryo banking

22. In Vitro Maturation of Oocyte
Clinical Discussion
Oocyte maturation in vivo and in vitro
Outline of an IVM treatment cycle

23. Patient with a Previous Poor Ovarian Response
Markers of ovarian reserve
Clinical Discussion
Treatment options in patients with a previous poor ovarian response
Recent Advances

24. PCOS and Patients at Risk for OHSS
Clinical Presentation
Clinical Discussion
Polycystic ovaries and other risk factors
Etiology of OHSS
Prevention of OHSS
Treatment of OHSS

25. Results in ART: How should these be Measured?
Clinical Discussion
Patient characteristics
Treatment characteristics
ART pregnancies
National registries

26. Low Cost IVF for Developing Countries
Clinical Discussion
Ethics
Cost
Infrastructure
Protocols
Procedures leading to ART
Supplementary techniques
Patient referral systems
Training
Cost-effectiveness
Case studies
Recent Advances

27. Mini-IVF Experience at the New Hope Fertility Center
Clinical Discussion
Study subjects and protocol
Results
Case Study

28. The Kato Ladies Clinic Experience

Circumstances that led to the switch from stimulation cycle egg recovery to natural cycle egg recovery
What is wrong with stimulation cycles?
Drug-free IVF stimulation vs Clomiphene cycle IVF
What is nasal hMG spray?

Index

 

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