Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- PART III ASSISTED REPRODUCTION
- 38 Medical Strategies to Improve ART Outcome: Current Evidence
- 39 Surgical Preparation of the Patient for In Vitro Fertilization
- 40 IVF in the Medically Complicated Patient
- 41 Polycystic Ovary Syndrome and IVF
- 42 Endometriosis and Assisted Reproductive Technology
- 43 Evidence-Based Medicine Comparing hMG/FSH and Agonist/Antagonist and rec/Urinary hCG/LH/GnRH to Trigger Ovulation
- 44 Luteal Phase Support in Assisted Reproduction
- 45 Thrombophilia and Implanation Failure
- 46 Intrauterine Insemination
- 47 The Prediction and Management of Poor Responders in ART
- 48 Oocyte Donation
- 49 In Vitro Maturation of Human Oocytes
- 50 Oocyte and Embryo Freezing
- 51 Cryopreservation of Male Gametes
- 52 The Management of Azoospermia
- 53 Spermatid Injection: Current Status
- 54 Optimizing Embryo Transfer
- 55 Single Embryo Transfer
- 56 Blastocyst Transfer
- 57 Clinical Significance of Embryo Multinucleation
- 58 Quality and Risk Management in the IVF Laboratory
- 59 The Nurse and REI
- 60 Understanding Factors That Influence the Assessment of Outcomes in Assisted Reproductive Technologies
- 61 The Revolution of Assisted Reproductive Technologies: How Traditional Chinese Medicine Impacted Reproductive Outcomes in the Treatment of Infertile Couples
- 62 Complications of Assisted Reproductive Technology
- 63 Ectopic and Heterotopic Pregnancies Following in Vitro Fertilization
- 64 The Impact of Oxidative Stress on Female Reproduction and ART: An Evidence-Based Review
- 65 PGD for Chromosomal Anomalies
- 66 Preimplantation Genetic Diagnosis for Single-Gene Disorders
- 67 Epigenetics and ART
- 68 Congenital Anomalies and Assisted Reproductive Technology
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
40 - IVF in the Medically Complicated Patient
from PART III - ASSISTED REPRODUCTION
Published online by Cambridge University Press: 04 August 2010
Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- PART III ASSISTED REPRODUCTION
- 38 Medical Strategies to Improve ART Outcome: Current Evidence
- 39 Surgical Preparation of the Patient for In Vitro Fertilization
- 40 IVF in the Medically Complicated Patient
- 41 Polycystic Ovary Syndrome and IVF
- 42 Endometriosis and Assisted Reproductive Technology
- 43 Evidence-Based Medicine Comparing hMG/FSH and Agonist/Antagonist and rec/Urinary hCG/LH/GnRH to Trigger Ovulation
- 44 Luteal Phase Support in Assisted Reproduction
- 45 Thrombophilia and Implanation Failure
- 46 Intrauterine Insemination
- 47 The Prediction and Management of Poor Responders in ART
- 48 Oocyte Donation
- 49 In Vitro Maturation of Human Oocytes
- 50 Oocyte and Embryo Freezing
- 51 Cryopreservation of Male Gametes
- 52 The Management of Azoospermia
- 53 Spermatid Injection: Current Status
- 54 Optimizing Embryo Transfer
- 55 Single Embryo Transfer
- 56 Blastocyst Transfer
- 57 Clinical Significance of Embryo Multinucleation
- 58 Quality and Risk Management in the IVF Laboratory
- 59 The Nurse and REI
- 60 Understanding Factors That Influence the Assessment of Outcomes in Assisted Reproductive Technologies
- 61 The Revolution of Assisted Reproductive Technologies: How Traditional Chinese Medicine Impacted Reproductive Outcomes in the Treatment of Infertile Couples
- 62 Complications of Assisted Reproductive Technology
- 63 Ectopic and Heterotopic Pregnancies Following in Vitro Fertilization
- 64 The Impact of Oxidative Stress on Female Reproduction and ART: An Evidence-Based Review
- 65 PGD for Chromosomal Anomalies
- 66 Preimplantation Genetic Diagnosis for Single-Gene Disorders
- 67 Epigenetics and ART
- 68 Congenital Anomalies and Assisted Reproductive Technology
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
Summary
The majority of women undergoing assisted reproduction are healthy and relatively young. However, the tendency to delay pregnancy to later on in life may mean that some of the patients may present with a concurrent condition that may have implications for in vitro fertilization (IVF), pregnancy, and its outcome. Preparing the couple for pregnancy is an important task, which the infertility specialist has to undertake.
Some of the important issues that may be challenging to the clinician are medical problems that affect a variety of systems. With the increasing survival of cancer patients, many patients are not only satisfied with their cure but are also eager to fulfill their reproductive potential. The patient with endocrine problems such as hyperprolactinemia and hypopituitarism, Cushing's syndrome, and diabetes mellitus have to be addressed prior to assisted conception couples that are discordant for human immunodeficiency virus (HIV) present their own challenge regarding infertility treatment. Couples with sexual dysfunction may also present for assisted conception. Finally, patients at risk for thrombosis could pose tremendous challenges during assisted reproduction treatment and a subsequent pregnancy as discussed in the chapter 45.
Some patients present with gynecologic problems that are either challenging or that impact the IVF outcome. Patients with endometriosis exemplify this scenario as discussed in the chapter 42. Patients with fibroids and hydrosalpynx require surgical treatment prior to IVF as discussed in the chapter 39.
Keywords
- Type
- Chapter
- Information
- Infertility and Assisted Reproduction , pp. 371 - 374Publisher: Cambridge University PressPrint publication year: 2008
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