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Chapter 14 - The evidence-based practice of assisted reproduction

Published online by Cambridge University Press:  16 May 2011

By
Hassan N. Sallam
Edited by
David K. Gardner ,
Botros R. M. B. Rizk  and
Tommaso Falcone
David K. Gardner
Affiliation:
University of Melbourne
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Tommaso Falcone
Affiliation:
Cleveland Clinic Foundation
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Summary

This chapter reviews the current status of assisted reproduction techniques in the light of the best evidence available. In order to optimize the results of assisted reproduction, various laboratory modifications have been suggested. These include performing Intracytoplasmic sperm injection (ICSI) rather than in vitro fertilization (IVF) for all oocytes, using co-culturing techniques, assisted hatching techniques, as well as selecting the embryos with the best potential for implantation based on their morphology, their metabolism, or by prolonging their culture in vitro to the blastocyst stage. Embryo transfer (ET) is arguably the most critical step in assisted reproduction and the least successful. Various attempts have been made to improve endometrial receptivity in order to increase the clinical outcome of IVF and ICSI. These include various regimens of luteal support, the use of corticosteroids, the removal of hydrosalpinges, diminishing uterine contractions as well as enhancing the endometrial blood flow.

Keywords

anti-Mullerian hormoneassisted reproductive technologyfollicle stimulating hormoneovarian stimulationin vitro fertilizationGnRH agonistfollicular development
Type
Chapter
Information
Human Assisted Reproductive Technology
Future Trends in Laboratory and Clinical Practice
 , pp. 152 - 166
Publisher: Cambridge University Press
Print publication year: 2011

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