Foreword |
|
xiii | |
|
Preface |
|
xv | |
About the Author |
|
xviii | |
|
1 Epidemiology of Infertility, 21st-Century Considerations and the Covid-19 Pandemic |
|
|
1 | (11) |
|
|
1 | (1) |
|
|
2 | (2) |
|
1.3 At What Age Should Couples Start Trying for a Family? |
|
|
4 | (1) |
|
|
4 | (1) |
|
1.5 Measuring Infertility and Response to Treatment |
|
|
5 | (1) |
|
1.6 Definition of Infertility |
|
|
6 | (1) |
|
1.7 Is Infertility Becoming More Common? |
|
|
6 | (2) |
|
1.8 Is Infertility on the Rise? |
|
|
8 | (1) |
|
1.9 Principles of Infertility Treatment |
|
|
9 | (1) |
|
1.10 Covid-19 and Fertility |
|
|
9 | (3) |
|
2 Prevention of Infertility |
|
|
12 | (9) |
|
|
12 | (1) |
|
2.2 Impact of Age on Male and Female Fertility |
|
|
12 | (2) |
|
2.3 Can Women Protect Fertility against Ageing? |
|
|
14 | (1) |
|
|
14 | (1) |
|
2.5 Environmental Pollutants |
|
|
15 | (1) |
|
2.6 Are Sperm Counts Falling? |
|
|
16 | (1) |
|
2.7 Hypospadias, Cryptorchidism and Testicular Cancer |
|
|
17 | (1) |
|
|
18 | (3) |
|
3 Planning a Pregnancy and Preconception Care |
|
|
21 | (25) |
|
|
21 | (1) |
|
3.2 A Preconception Healthcare Programme |
|
|
21 | (1) |
|
|
22 | (1) |
|
3.4 Dietary Advice for Women Wishing to Conceive |
|
|
23 | (1) |
|
|
24 | (1) |
|
|
25 | (1) |
|
3.7 Supplements for Male Fertility |
|
|
25 | (1) |
|
3.8 Special Diets for Sex Selection |
|
|
26 | (1) |
|
|
26 | (1) |
|
|
27 | (1) |
|
3.11 Smoking, Alcohol and Recreational Drugs |
|
|
27 | (2) |
|
3.12 Anabolic Androgenic Steroids |
|
|
29 | (1) |
|
|
29 | (1) |
|
3.14 Medical Conditions and Drugs |
|
|
30 | (1) |
|
|
30 | (3) |
|
|
33 | (1) |
|
3.17 Psychiatric Disorders |
|
|
33 | (1) |
|
3.18 Neurological Disorders |
|
|
34 | (1) |
|
3.19 Gastrointestinal Disease |
|
|
35 | (1) |
|
|
36 | (1) |
|
3.21 Cardiovascular Disease |
|
|
36 | (1) |
|
|
37 | (1) |
|
3.23 Antibiotics and Anti-Infective Agents |
|
|
37 | (2) |
|
3.24 Haematological Problems |
|
|
39 | (1) |
|
3.25 Connective Tissue Disorders |
|
|
40 | (1) |
|
|
41 | (5) |
|
4 Obesity and Reproduction |
|
|
46 | (10) |
|
|
46 | (1) |
|
4.2 Defining Obesity and the Extent of the Problem |
|
|
46 | (2) |
|
4.3 Influence of Obesity on Natural Fertility |
|
|
48 | (1) |
|
4.4 Obesity and Polycystic Ovary Syndrome |
|
|
49 | (1) |
|
4.5 Effect of Obesity on Treatment of Anovulatory Infertility |
|
|
49 | (1) |
|
4.6 Effect of Obesity on IVF and Related Treatments |
|
|
50 | (1) |
|
4.7 Effect of Obesity on Pregnancy |
|
|
51 | (1) |
|
4.8 Provision of Support in Achieving Weight Loss |
|
|
51 | (1) |
|
4.9 Guidelines for Accessing Treatment |
|
|
52 | (4) |
|
5 Investigating Infertility |
|
|
56 | (60) |
|
|
56 | (1) |
|
5.2 General Investigations |
|
|
56 | (1) |
|
5.3 Investigating the Female Partner |
|
|
57 | (4) |
|
5.4 Diagnosis of Anovulatory Infertility |
|
|
61 | (3) |
|
|
64 | (2) |
|
|
66 | (1) |
|
5.7 Follicle-Stimulating Hormone |
|
|
66 | (1) |
|
5.8 Ovarian Reserve Tests |
|
|
66 | (2) |
|
|
68 | (1) |
|
|
69 | (1) |
|
|
70 | (1) |
|
|
71 | (1) |
|
|
71 | (1) |
|
|
71 | (1) |
|
5.15 Other Investigations |
|
|
72 | (1) |
|
|
72 | (1) |
|
|
73 | (1) |
|
5.18 Differentiating between PCOM and PCOS |
|
|
74 | (5) |
|
|
79 | (3) |
|
5.20 Endometrial Assessment |
|
|
82 | (1) |
|
5.21 Doppler Ultrasound in Assisted Conception |
|
|
83 | (1) |
|
5.22 Assessment of Tubal Patency and the Uterine Cavity |
|
|
83 | (6) |
|
5.23 Ultrasound Contrast Hysterosalpingography or Hysterosalpingo Contrast Sonography |
|
|
89 | (4) |
|
5.24 Selective Salpingography and Falloposcopy |
|
|
93 | (1) |
|
5.25 Laparoscopy and Hysteroscopy |
|
|
94 | (4) |
|
5.26 Transvaginal Hydroculdoscopy/Hydrolaparoscopy/Salpingoscopy |
|
|
98 | (1) |
|
5.27 Choosing between HSG and Laparoscopy |
|
|
98 | (1) |
|
5.28 MRI/Computed Tomography Scans |
|
|
98 | (1) |
|
5.29 Investigating the Male Partner |
|
|
98 | (3) |
|
|
101 | (3) |
|
5.31 Reduced Sperm Concentration (Oligozoospermia) |
|
|
104 | (1) |
|
5.32 Impaired Sperm Morphology (Teratozoospermia) |
|
|
104 | (1) |
|
5.33 Reduced Sperm Motility (Asthenozoospermia) |
|
|
104 | (2) |
|
5.34 Sperm Dysfunction and DNA Fragmentation |
|
|
106 | (1) |
|
|
106 | (1) |
|
5.36 Cervical Mucus Penetration and the Post-Coital Test |
|
|
107 | (1) |
|
5.37 Antisperm Antibodies |
|
|
107 | (1) |
|
5.38 Serum Endocrinology in the Male |
|
|
107 | (1) |
|
5.39 Chromosomal Analysis |
|
|
108 | (1) |
|
5.40 Imaging in Male Infertility |
|
|
108 | (1) |
|
5.41 Testicular Exploration and Biopsy |
|
|
109 | (7) |
|
6 Anovulatory Infertility and Ovulation Induction |
|
|
116 | (54) |
|
|
116 | (1) |
|
6.2 Primary and Secondary Amenorrhoea |
|
|
117 | (3) |
|
6.3 Pituitary and Hypothalamic Causes of Anovulation |
|
|
120 | (1) |
|
6.4 Hypogonadotrophic Hypogonadism |
|
|
120 | (5) |
|
6.5 Weight-Related Amenorrhoea |
|
|
125 | (3) |
|
6.6 Systemic Disorders Leading to Anovulation |
|
|
128 | (1) |
|
6.7 Exercise-Related Amenorrhoea |
|
|
129 | (1) |
|
|
130 | (5) |
|
6.9 Polycystic Ovary Syndrome |
|
|
135 | (27) |
|
|
162 | (8) |
|
7 Polycystic Ovary Syndrome |
|
|
170 | (33) |
|
|
170 | (1) |
|
|
171 | (1) |
|
7.3 Pathophysiology of PCOS |
|
|
172 | (1) |
|
|
173 | (3) |
|
7.5 Hypothalamic-Pituitary-Ovarian Axis |
|
|
176 | (3) |
|
|
179 | (1) |
|
7.7 Definitions and Heterogeneity of PCOS |
|
|
180 | (3) |
|
7.8 Prevalence of PCOS and Ethnic Variations |
|
|
183 | (2) |
|
|
185 | (1) |
|
7.10 Management of Non-Fertility Aspects of PCOS |
|
|
186 | (1) |
|
7.11 Psychological Support and Quality of Life |
|
|
186 | (1) |
|
|
186 | (2) |
|
7.13 Menstrual Irregularity |
|
|
188 | (1) |
|
7.14 Hyperandrogenism and Hirsutism |
|
|
188 | (2) |
|
7.15 Reproductive Health in PCOS |
|
|
190 | (1) |
|
7.16 Health Consequences of PCOS |
|
|
191 | (3) |
|
|
194 | (1) |
|
|
195 | (8) |
|
8 Premature Ovarian Insufficiency and Oocyte Donation |
|
|
203 | (12) |
|
|
203 | (1) |
|
8.2 Control of Ovarian Ageing |
|
|
203 | (2) |
|
8.3 Incipient POI ("Resistant Ovary Syndrome") |
|
|
205 | (1) |
|
|
205 | (1) |
|
|
206 | (3) |
|
|
209 | (1) |
|
|
210 | (1) |
|
8.8 Experimental Approaches to Combatting POI |
|
|
211 | (4) |
|
|
215 | (16) |
|
|
215 | (1) |
|
|
215 | (3) |
|
9.3 Non-Invasive Testing for Biomarkers of Endometriosis |
|
|
218 | (1) |
|
9.4 Classification of Endometriosis |
|
|
218 | (1) |
|
|
218 | (1) |
|
|
219 | (3) |
|
9.7 Management of Endometriosis |
|
|
222 | (1) |
|
9.8 Medical Therapy for Fertility |
|
|
223 | (1) |
|
|
224 | (2) |
|
9.10 Endometriosis and IVF |
|
|
226 | (1) |
|
|
227 | (1) |
|
9.12 Proposed Strategy for Management of Endometriosis |
|
|
227 | (4) |
|
10 Tubal Infertility, Fibroids and Uterine Factors |
|
|
231 | (23) |
|
|
231 | (12) |
|
10.2 Uterine Problems: Congenital Anomalies, Septa, Fibroids, Polyps, Adhesions and Uterine Anomalies |
|
|
243 | (11) |
|
11 Male Factor Infertility |
|
|
254 | (24) |
|
|
254 | (1) |
|
11.2 General Lifestyle Factors |
|
|
255 | (1) |
|
|
255 | (1) |
|
11.4 Chemotherapy and Radiotherapy |
|
|
256 | (1) |
|
11.5 Occupational Factors |
|
|
256 | (1) |
|
|
256 | (1) |
|
11.7 Cannabis and Other Recreational Drugs |
|
|
256 | (1) |
|
11.8 Hypospadias, Cryptorchidism and Testicular Cancer |
|
|
256 | (1) |
|
11.9 Orchitis and Prophylactic Mumps, Measles, Rubella Vaccination |
|
|
257 | (1) |
|
11.10 Sexually Transmitted Infections |
|
|
258 | (1) |
|
|
258 | (1) |
|
|
258 | (1) |
|
11.13 Oligoasthenozoospermia |
|
|
259 | (1) |
|
11.14 Frequency of Intercourse |
|
|
260 | (1) |
|
|
260 | (1) |
|
11.16 Oxidative Stress and ROS |
|
|
260 | (1) |
|
|
261 | (1) |
|
11.18 Antisperm Antibodies |
|
|
262 | (2) |
|
11.19 Obstructive Azoospermia |
|
|
264 | (1) |
|
11.20 Congenital Bilateral Absence of the Vasa Deferentia |
|
|
264 | (1) |
|
|
265 | (1) |
|
11.22 Kartagener's Syndrome |
|
|
265 | (1) |
|
11.23 Surgical Trauma and Vasectomy |
|
|
265 | (1) |
|
11.24 Microsurgical Reconstruction of the Vasa |
|
|
265 | (2) |
|
11.25 Idiopathic Male Factor Infertility |
|
|
267 | (2) |
|
|
269 | (1) |
|
11.27 Coital Dysfunction and Psychosexual Problems |
|
|
269 | (1) |
|
11.28 Hypergonadotrophic Testicular Failure |
|
|
270 | (1) |
|
|
271 | (1) |
|
11.30 Androgen Insensitivity Syndrome |
|
|
271 | (1) |
|
|
271 | (7) |
|
12 Unexplained Infertility |
|
|
278 | (7) |
|
|
278 | (1) |
|
12.2 Assessing the Cause of Infertility |
|
|
278 | (2) |
|
12.3 Management of Unexplained Infertility |
|
|
280 | (1) |
|
|
280 | (1) |
|
|
280 | (1) |
|
|
281 | (1) |
|
12.7 Gamete Intrafallopian Transfer |
|
|
282 | (1) |
|
|
282 | (1) |
|
12.9 Strategy for Management of Unexplained Infertility |
|
|
283 | (2) |
|
13 In Vitro Fertilisation |
|
|
285 | (44) |
|
|
285 | (1) |
|
|
285 | (1) |
|
13.3 Viral Screening before Assisted Conception Therapies |
|
|
286 | (1) |
|
|
286 | (1) |
|
|
287 | (4) |
|
13.6 Dosing of Stimulation for IVF |
|
|
291 | (1) |
|
13.7 Monitoring the IVF Cycle and Ovarian Response to Stimulation |
|
|
292 | (2) |
|
13.8 Ovarian Reserve and Prediction of Response to Stimulation |
|
|
294 | (1) |
|
|
294 | (1) |
|
13.10 Response of the Polycystic Ovary to Stimulation for IVF |
|
|
295 | (6) |
|
|
301 | (1) |
|
13.12 Embryo Culture and Embryo Transfer |
|
|
301 | (5) |
|
13.13 Number of Embryos for Transfer |
|
|
306 | (3) |
|
13.14 ICSI for Severe Male Factor Infertility |
|
|
309 | (3) |
|
13.15 The Embryo Transfer Procedure |
|
|
312 | (1) |
|
13.16 Endometrial Assessment |
|
|
312 | (1) |
|
13.17 The Endometrial Scratch |
|
|
313 | (1) |
|
13.18 Luteal-Phase Support after IVF |
|
|
313 | (1) |
|
13.19 The Frozen Embryo Replacement Cycle |
|
|
314 | (1) |
|
13.20 Pregnancy Rates after IVF |
|
|
315 | (1) |
|
|
316 | (1) |
|
|
317 | (1) |
|
13.23 The Human Fertilisation and Embryology Authority and Regulation in the United Kingdom |
|
|
318 | (11) |
|
14 Fertility Preservation |
|
|
329 | (6) |
|
14.1 Cryopreservation of Gametes and Embryos |
|
|
329 | (3) |
|
14.2 In Vitro Growth of Follicles |
|
|
332 | (1) |
|
14.3 Protection of the Ovaries against Chemotherapy |
|
|
332 | (1) |
|
14.4 Testicu lar Tissue Freezi ng |
|
|
332 | (1) |
|
14.5 Transgender Fertility Preservation |
|
|
333 | (2) |
|
15 Pre-Implantation Genetic Testing and Emerging Technologies |
|
|
335 | (13) |
|
15.1 Pre-Implantation Genetic Testing |
|
|
335 | (2) |
|
15.2 Modes of Inheritance |
|
|
337 | (1) |
|
|
337 | (3) |
|
|
340 | (3) |
|
|
343 | (1) |
|
15.6 Emerging Technologies |
|
|
344 | (4) |
|
16 Complications of Ovarian Stimulation |
|
|
348 | (16) |
|
|
348 | (1) |
|
16.2 Drug-Specific Side Effects |
|
|
348 | (2) |
|
16.3 The Ovarian Hyperstimulation Syndrome |
|
|
350 | (8) |
|
|
358 | (1) |
|
16.5 The Risk of Cancers in Subfertile Populations and after Fertility Treatment |
|
|
359 | (5) |
|
17 Counselling and Modern Families |
|
|
364 | (8) |
|
|
364 | (1) |
|
17.2 Infertility and Subfertility |
|
|
364 | (1) |
|
17.3 Psychosexual Problems |
|
|
365 | (1) |
|
17.4 How to Deal with Work |
|
|
366 | (1) |
|
17.5 Special Needs of the Male Partner |
|
|
366 | (1) |
|
17.6 Adjustment to Parenthood |
|
|
367 | (1) |
|
17.7 How to Tell Children of Donated Gametes |
|
|
367 | (1) |
|
|
367 | (1) |
|
|
368 | (1) |
|
17.10 Transgender Pregnancies |
|
|
368 | (1) |
|
17.11 Emotional Support for Clinic Staff |
|
|
369 | (1) |
|
17.12 The Infertility Counsellor |
|
|
369 | (1) |
|
17.13 Welfare of the Child |
|
|
370 | (2) |
|
18 Ethical and Religious Issues |
|
|
372 | (10) |
|
|
372 | (1) |
|
18.2 Does Everyone Have a Right to Treatment? |
|
|
373 | (1) |
|
18.3 Biological Considerations |
|
|
373 | (1) |
|
18.4 Moral Status of the Embryo |
|
|
374 | (1) |
|
|
374 | (1) |
|
18.6 Experiments on Human Embryos, Cloning and Stem Cell Research |
|
|
375 | (1) |
|
|
376 | (1) |
|
|
377 | (1) |
|
|
378 | (1) |
|
18.10 Should Older Women Be Offered IVF? |
|
|
378 | (1) |
|
18.11 Rel igious Perspectives |
|
|
379 | (1) |
|
|
380 | (2) |
|
19 Health Outcomes of Children Born after Assisted Conception |
|
|
382 | (6) |
|
|
382 | (1) |
|
|
382 | (1) |
|
|
382 | (2) |
|
|
384 | (1) |
|
19.5 Imprinting Disorders |
|
|
385 | (1) |
|
19.6 Cryopreserved Gametes or Embryos |
|
|
385 | (3) |
|
20 Miscarriage and Ectopic Pregnancy |
|
|
388 | (12) |
|
|
388 | (1) |
|
20.2 Incidence of Miscarriage |
|
|
388 | (1) |
|
|
388 | (1) |
|
20.4 Health Conditions, Lifestyle Factors and Risks of Miscarriage |
|
|
389 | (1) |
|
20.5 Diagnosis of Pregnancy |
|
|
390 | (1) |
|
20.6 Prevention of Miscarriage |
|
|
391 | (1) |
|
20.7 Management of Miscarriage |
|
|
391 | (1) |
|
|
391 | (1) |
|
20.9 Diagnosis of Ectopic Pregnancy |
|
|
392 | (1) |
|
20.10 Management of Ectopic Pregnancy |
|
|
392 | (5) |
|
20.11 Counselling and Support |
|
|
397 | (3) |
|
21 Recurrent Miscarriage and Recurrent Implantation Failure |
|
|
400 | (10) |
|
|
400 | (1) |
|
21.2 Classification of Recurrent Miscarriage |
|
|
400 | (1) |
|
|
401 | (1) |
|
21.4 Environmental Factors |
|
|
401 | (1) |
|
|
402 | (1) |
|
21.6 Anatomical Abnormalities |
|
|
402 | (1) |
|
21.7 Infection and the Microbiome |
|
|
403 | (1) |
|
21.8 Endocrine Abnormalities |
|
|
403 | (1) |
|
21.9 Luteal-Phase Defects and Progesterone Therapy |
|
|
403 | (1) |
|
|
404 | (1) |
|
21.11 Immunological Causes of Recurrent Miscarriage |
|
|
405 | (1) |
|
21.12 Summary of the Investigation and Management of Couples with Recurrent Miscarriage |
|
|
406 | (1) |
|
21.13 Recurrent Implantation Failure |
|
|
406 | (4) |
|
22 Alternative Therapies and "Add-Ons" |
|
|
410 | (3) |
|
23 When to Stop Treatment and Other Options |
|
|
413 | (4) |
|
|
413 | (1) |
|
|
414 | (1) |
|
23.3 Adopting a Child from Overseas |
|
|
415 | (1) |
|
|
415 | (1) |
|
|
416 | (1) |
Appendix: Daily Vitamin and Mineral Requirements (See Chapter 3) |
|
417 | (3) |
Books for Further Reading |
|
420 | (2) |
Index |
|
422 | |