Book contents
- Frontmatter
- Contents
- Preface
- Foreword
- Acknowledgements
- Introduction
- 1 The male reproductive system
- 2 The female reproductive system
- 3 Fertilization, implantation and early development
- 4 Male factor problems
- 5 Female factor problems
- 6 Evaluation of the infertile couple
- 7 Medical and surgical treatment of infertility
- 8 Conventional in-vitro fertilization treatment
- 9 Intracytoplasmic sperm injection
- 10 Surgical sperm retrieval
- 11 Intratubal replacement of gametes and embryos (GIFT, ZIFT)
- 12 Intrauterine insemination
- 13 Cryopreservation of gametes, ovarian tissue, testicular tissue and embryos; frozen embryo replacement
- 14 Assisted hatching
- 15 Preimplantation diagnosis of genetic disease
- Appendix: Acronyms in assisted reproduction technology
- Index
7 - Medical and surgical treatment of infertility
Published online by Cambridge University Press: 11 September 2009
- Frontmatter
- Contents
- Preface
- Foreword
- Acknowledgements
- Introduction
- 1 The male reproductive system
- 2 The female reproductive system
- 3 Fertilization, implantation and early development
- 4 Male factor problems
- 5 Female factor problems
- 6 Evaluation of the infertile couple
- 7 Medical and surgical treatment of infertility
- 8 Conventional in-vitro fertilization treatment
- 9 Intracytoplasmic sperm injection
- 10 Surgical sperm retrieval
- 11 Intratubal replacement of gametes and embryos (GIFT, ZIFT)
- 12 Intrauterine insemination
- 13 Cryopreservation of gametes, ovarian tissue, testicular tissue and embryos; frozen embryo replacement
- 14 Assisted hatching
- 15 Preimplantation diagnosis of genetic disease
- Appendix: Acronyms in assisted reproduction technology
- Index
Summary
Introduction
An understanding of presently available treatment options greatly simplifies the management of infertile couples. It is then easier to identify couples who will benefit from a particular type of treatment and those who will not. The basic infertility investigations have already been described and will identify most of the patients with any of the major causes of infertility. It is prudent to complete these investigations before offering treatment to any of the partners. There is always a temptation to postpone certain investigations, like laparoscopy and dye test and even hysterosalpingography, pending the outcome of some treatments such as induction of ovulation with clomiphene citrate for indicated or empirical reasons. Many would defend this practice on the basis of cost savings, and convenience for the patient but how would they defend a situation in which a woman has ovulation induction for several months only to discover that both her tubes are blocked? Furthermore, the current uncertainty regarding the relationship of ovulation induction and the later development of ovarian and female genital tract cancers should discourage unindicated use of ovulation induction agents.
Infertile couples have traditionally been inundated with remedies, most of which are of unproven benefit to their condition. The end result of the application of useless treatment modalities is that it prolongs the infertile state and as the woman gets older it becomes more difficult for usually efficacious techniques to succeed if and when they are eventually used.
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- Publisher: Cambridge University PressPrint publication year: 2001