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16 results

  • Chapter 5 - Implantation

  • Edited by Roy G. Farquharson, Liverpool Women’s Hospital, Mary D. Stephenson, University of Illinois, Chicago, Mariëtte Goddijn, Amsterdam University Medical Centers
  • Book:
    Early Pregnancy
    Published online:
    16 April 2025
    Print publication:
    08 May 2025, pp 32-42

  • Summary

    The apparent inefficiency of human Implantation remains perplexing and is the cause of much distress when it occurs in the context of fertility treatments. Many of the prevailing paradigms that have shaped our understanding of implantation have been extrapolated from imperfect animal models, but in recent years in-vitro models have revealed novel insights into the role of the endometrium as an active, rather than passive participant in implantation. Evidence has emerged of the existence of a biosensor function ascribed to the decidualised endometrial stroma which allows for a maternal strategy of rejecting poorly viable embryos. In this chapter, this new understanding of the regulation of implantation and of the aetiology of recurrent miscarriage is addressed and implications for clinical management are considered.

Case Studies in Assisted Reproduction
  • Common and Uncommon Presentations
  • Edited by Nick S. Macklon, Human M. Fatemi, Robert J. Norman, Pasquale Patrizio
  • Published online:
    05 February 2015
    Print publication:
    22 January 2015
  • Clinical case studies have long been recognized as a useful adjunct to problem-based learning and continuing professional development. They emphasize the need for clinical reasoning, integrative thinking, problem-solving, communication, teamwork and self-directed learning - all desirable generic skills for health care professionals. This volume contains a selection of cases on assisted reproduction that will inform and challenge reproductive medicine practitioners at all stages in their careers. Both common and uncommon cases are included. The aim is to reinforce diagnostic skill through careful analysis of individual presenting patterns, and to guide treatment decisions. Each case consists of a clinical history, examination findings and special investigations, before a diagnosis is made. Clinical issues raised by each case are discussed and major teaching points emphasized. Selective references are provided. The book provides a useful complementary adjunct to existing textbooks of reproductive medicine, and an excellent resource for teaching and continuing professional development.

  • Chapter 20 - Recurrent implantation failure

  • Edited by Roy G. Farquharson, University of Liverpool, Mary D. Stephenson, University of Chicago
  • Book:
    Early Pregnancy
    Published online:
    05 October 2010
    Print publication:
    09 September 2010, pp 213-226

  • Summary

    This chapter focuses on the primary antiphospholipid syndrome, that is, in the absence of systemic lupus erythematodes. Women with thrombophilia have an increased baseline risk of venous thromboembolism. In antiphospholipid syndrome, lupus anticoagulant is more strongly related to venous thrombosis and pregnancy complications than antibodies against phospholipids. The chapter reviews the evidence regarding potential clinical implications of acquired and inherited thrombophilia for both venous thromboembolism and for pregnancy failure. Treatment guidelines vary with regard to the administration of heparin for antiphospholipid syndrome and recurrent miscarriage. For women with antiphospholipid syndrome, the evidence regarding the efficacy of aspirin with or without the addition of low-molecular-weight heparin is not solid, whereas two small trials have shown a clear benefit of unfractionated heparin. For women with inherited thrombophilia, low-molecular-weight heparin to prevent pregnancy loss is definitely experimental as solid evidence is not yet available.