In Vitro Fertilization: A Comprehensive Guide

278 Pages·2012·4.89 MB·English

by  Khanh-Ha Nguyen M.D.

In Vitro Fertilization

Elizabeth S. Ginsburg (cid:129) Catherine Racowsky
Editors
In Vitro Fertilization
A Comprehensive Guide
Editors
Elizabeth S. Ginsburg, MD Catherine Racowsky, PhD
Division of Reproductive Endocrinology Division of Reproductive Endocrinology
and Infertility and Infertility
Department of Obstetrics and Department of Obstetrics and
Gynecology Gynecology
Brigham and Women’s Hospital Brigham and Women’s Hospital
Boston, MA Boston, MA
USA USA
ISBN 978-1-4419-9847-7 ISBN 978-1-4419-9848-4 (eBook)
DOI 10.1007/978-1-4419-9848-4
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2012952100
© Springer Science+Business Media New York 2012
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To our husbands and children for their constant support and
love and to our patients, who inspire us continually to move
our fi eld forward.
Elizabeth S. Ginsburg, MD
Catherine Racowsky, PhD

Preface
In vitro fertilization (IVF) gained recognition as a realistic treatment for
infertility with the birth of Louise Brown in 1978. Since then, the evaluation
of male and female infertility has been re fi ned and the fi eld has made tremen-
dous strides. Commercial development of human menopausal gonadotropins
greatly improved the ef fi ciency of ovarian stimulation, and puri fi cation of
FSH products and continued advancements, including the use of GnRH ana-
logs, has led to the development of a variety of ovarian stimulation regimens.
Improvements in ultrasound technology allowed ultrasound-guided oocyte
retrievals to replace the laparoscopic approach, decreasing the invasiveness of
the technology. Improvements in embryo transfer catheters and techniques
led to improved overall treatment ef fi cacy. Intracytoplasmic sperm injection
was developed and then rapidly adopted, effectively bypassing even the most
severe male factor infertility. Advances in the IVF laboratory led to increas-
ingly ef fi cient culture of embryos to day 2, 3, and fi nally day 5/6, with culture
to the blastocyst stage of development. Micromanipulation technology led to
the ability to perform embryo biopsy, with preimplantation genetic diagnostic
methods assessing the normality of an entire embryo through analysis of even
a single cell; these technologies are currently in rapid phases of development.
Throughout, adjunctive treatments, such as acupuncture, to enhance IVF out-
comes have continually been studied.
The future of IVF is exciting. Embryo cryopreservation has slowly moved
from slow freezing as established in the early 1990s to vitri fi cation, with
increasingly successful survival and pregnancy rates. This has led to the abil-
ity to successfully cryopreserve oocytes, allowing fertility preservation to
move closer to standard of care treatment for women facing loss of ovarian
function due to surgery and cancer treatment. Increasing maternal age has led
to increased utilization of donor oocytes, and combined with improvements
of cryobiology, the fi eld may be moving slowly towards the establishment of
oocyte banks. In addition, the increasing acceptance of third-party reproduc-
tion has led to increasing utilization of gestational carriers for women with
abnormal or absent uteri, or those at high risk of carrying a pregnancy.
The economics of assisted reproductive technology (ART), restrictive
ART regulation in some countries, globalization of the world economy, and
widespread availability of information through the Internet has led to increas-
ing cross-border reproduction, with individuals or couples obtaining care in
countries other than their own. While ART procedures too often result in
multiple gestations and high levels of stress in some patients, great efforts are
vii
viii Preface
being made to move more aggressively towards elective single embryo trans-
fer and to provide emotional support for patients.
It is truly incredible how rapidly the fi eld of assisted reproductive tech-
nologies has developed and grown over the last 20 years; many of the authors
of the chapters of this book have been part of this evolution. The goal of this
book is to provide a practical resource for clinical and laboratory staff of
in vitro fertilization programs, and to provide a thorough understanding of
ART for those beginning to familiarize themselves with these procedures. We
look forward with anticipation to the future.
Boston, MA, USA Elizabeth S. Ginsburg
Boston, MA, USA Catherine Racowsky
Contents
1 Pre IVF Evaluation of the Infertile Woman ............................. 1
Khanh-Ha Nguyen and Michael M. Alper
2 Pre-IVF Evaluation of the Infertile Man .................................. 17
Brooke Harnisch and Robert D. Oates
3 Ovulation Stimulation and Cycle Management in IVF ........... 31
Ying C. Cheong, Elizabeth S. Ginsburg,
and Nick S. Macklon
4 Oocyte Retrieval and Embryo Transfer .................................... 55
Sara E. Barton and Elizabeth S. Ginsburg
5 Moving Toward Single Embryo Transfer ................................. 75
Kevin S. Richter, Robert J. Stillman, and Eric A. Widra
6 Oocyte Insemination and Culture ............................................. 83
Roberta Maggiulli, Filippo Ubaldi, and Laura F. Rienzi
7 Micromanipulation: Intracytoplasmic Sperm Injection
and Assisted Hatching ................................................................ 99
Gianpiero D. Palermo, Queenie V. Neri, Devin Monahan,
and Zev Rosenwaks
8 Preimplantation Genetic Testing: Available
and Emerging Technologies ....................................................... 115
Paul R. Brezina, Rony T. Elias, Glenn Schattman,
and William G. Kearns
9 Embryo Cryopreservation .......................................................... 145
Matthew D. VerMilyea, Juergen Liebermann,
and Michael Tucker
10 Oocyte Donation .......................................................................... 161
Joshua U. Klein and Mark V. Sauer
11 Gestational Carrier ..................................................................... 177
Pravin Patel and Manish Banker
12 Adjunctive Treatments in ART .................................................. 193
Eric Surrey
13 Stress and ART ............................................................................ 201
Alice Domar and Jill Gross
ix