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20 results

  • Chapter 30 - Ovarian Reserve as a Guide for Ovarian Stimulation

  • from Section 6 - Procedures before, during, and after Ovarian Stimulation
  • Edited by Mohamed Aboulghar, Botros Rizk, University of South Alabama
  • Book:
    Ovarian Stimulation
    Published online:
    14 April 2022
    Print publication:
    05 May 2022, pp 311-318

  • Summary

    Ovarian reserve refers to the number and quality of oocytes present in the ovaries of a woman at a given time and is thought to reflect her ability to respond adequately to ovarian stimulation [1;2]. The term was developed in the context of assisted reproduction to differentiate between poor, normal, and hyper-responders to controlled ovarian stimulation (COS). Although the term is also applicable to anovulatory women treated for infertility with ovarian stimulation, it is mainly used to describe women receiving COS as a part of an in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) stimulation protocol.

  • Chapter 14 - The evidence-based practice of assisted reproduction

  • Edited by David K. Gardner, University of Melbourne, Botros R. M. B. Rizk, University of South Alabama, Tommaso Falcone
  • Book:
    Human Assisted Reproductive Technology
    Published online:
    16 May 2011
    Print publication:
    31 March 2011, pp 152-166

  • Summary

    Increased understanding of the intricacies of the follicular development and selection processes has been critical to the development of many of the new developments in ovarian stimulation in clinical practice. This chapter reviews these clinically related physiological aspects of ovarian stimulation, and discusses the resulting new concepts of ovarian stimulation. Recent studies have indicated that anti-Mullerian hormone (AMH) may be a more reliable and robust predictor of ovarian response during ovarian stimulation. The long ovarian stimulation protocol combining GnRH agonist with exogenous gonadotropin administration has been the most popular treatment regime for the past 20 years. The objectives of ovarian stimulation in assisted reproductive technology (ART) are evolving. A further development which promises to further reduce the burden of ovarian stimulation is the introduction of a long-acting follicle stimulating hormone (FSH) preparation which greatly reduces the number of injections required during an in vitro fertilization (IVF) treatment cycle.

  • Chapter 36 - Ultrasonography in the prediction and management of ovarian hyperstimulation syndrome

  • from Section 4: - Early pregnancy after infertility treatment
  • Edited by Botros R. M. B. Rizk, University of South Alabama
  • Book:
    Ultrasonography in Reproductive Medicine and Infertility
    Published online:
    07 September 2011
    Print publication:
    25 March 2010, pp 299-312

  • Summary

    During the preclinical development of in-vitro fertilization (IVF) in the human, oocytes were frequently obtained at laparotomies for various indications and the time for the operative procedure was generally not scheduled close to ovulation. The ovaries could now easily be scanned without using the full-bladder technique, and transvaginal ultrasound-guided oocyte retrieval (TVOR) could generally be performed with only use of some sedative in combination with local anesthesia. In order to increase the oocyte recovery rate it was found that Teflon tubing between needle and sampling tube was optimal. Today there are various sampling sets commercially available, including needle, tubing, and sampling tubes. The different complications of TVOR are bleeding and infection. In conclusion, available data regarding possible adverse effects of ultrasonography on oocytes have been interpreted to indicate that the technique, in this respect, is as safe as laparoscopy.

Infertility and Assisted Reproduction
  • Edited by Botros R. M. B. Rizk, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis
  • Published online:
    04 August 2010
    Print publication:
    15 September 2008
  • Assisted reproductive technology (ART) is available to two-thirds of the world's population, and world-class experts, representing research from 18 different countries, have contributed to this groundbreaking textbook, detailing the techniques and philosophies behind medical procedures of infertility and assisted reproduction. This is one of the most rapidly changing and hotly debated fields in medicine. Different countries have different restrictions on the research techniques that can be applied to this field, and, therefore, experts from around the world bring varied and unique authorities to different subjects in reproductive technology. Encompassing the latest research into the physiology of reproduction, infertility evaluation and treatment, and assisted reproduction, it concludes with perspectives on the ethical dilemmas faced by clinicians and professionals. This book will be the definitive resource for those working in the areas of reproductive medicine world wide.

  • 54 - Optimizing Embryo Transfer

  • from PART III - ASSISTED REPRODUCTION
  • Edited by Botros R. M. B. Rizk, University of South Alabama, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis, University of Crete
  • Book:
    Infertility and Assisted Reproduction
    Published online:
    04 August 2010
    Print publication:
    15 September 2008, pp 506-517

  • Summary

    This chapter describes the technique of embryo transfer (ET) to evaluate the various modifications proposed in order to maximize the chances of pregnancy, and discusses the different approaches available for managing difficult ETs. Before embarking on an ET, the following factors should be considered: embryo selection, choice of the catheter, performing a trial (mock or dummy) ET, ET medium, ultrasound, flushing the cervical mucus before performing ET. Randomized trials have shown that ultrasound guidance and the use of soft catheters as opposed to firm catheters are associated with higher pregnancy rates. They have also shown that the presence of air in the catheter, its immediate removal, bed rest after ET, sexual intercourse, and the administration of aspirin after ET do not affect the results. Routine use of antibiotics, uterine relaxants, and medication to increase uterine blood flow await further evaluation.

  • Introduction

  • Edited by Botros R. M. B. Rizk, University of South Alabama, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis, University of Crete
  • Book:
    Infertility and Assisted Reproduction
    Published online:
    04 August 2010
    Print publication:
    15 September 2008, pp xxiii-xxiv

  • Summary

    The past three decades have witnessed a transformation in reproductive medicine from science fiction to one of the most advanced medical disciplines. Our textbook is a confirmation of the tremendous achievements in scientific research that changed the course of our clinical practice. Thirty years of in vitro fertilization (IVF) was celebrated this year in Alexandria, honoring Robert Edwards specifically. More than four million IVF babies have been born worldwide. The doors that were opened by Robert Edwards and Patrick Steptoe lead to many miracles. Intracytoplasmic sperm injection, in vitro maturation, oocyte vitrification, pre-implantation genetic diagnosis, and ovarian transplantation are dreams that were fulfilled. Many couples still have no hope of having their own families and demand us to keep moving forward.

    The authors of the chapters of this book have lead the world for the three decades. They contributed their finest and most advanced research. We find in every one of them a sincere desire to uphold the ethics and the respect in our society. The friendship and cordiality between them has been amazing. They represented the six continents truly, and many of them have worked in more than one continent. It is not surprising that they worked together in such an elegant and a unique way. The different chapters are individualized in style, but the spirit of the book has united them. From reproductive physiology to surgery and assisted reproduction, the authors move with great elegance. The ethical and moral issues have been thoughtfully considered.

  • 47 - The Prediction and Management of Poor Responders in ART

  • from PART III - ASSISTED REPRODUCTION
  • Edited by Botros R. M. B. Rizk, University of South Alabama, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis, University of Crete
  • Book:
    Infertility and Assisted Reproduction
    Published online:
    04 August 2010
    Print publication:
    15 September 2008, pp 428-442

  • Summary

    The evaluation and treatment of low responders in assisted reproductive technology (ART) remains a challenge. Poor responders have a higher incidence of cycle cancellation, lower fertilization, and lower pregnancy and implantation rates. Static tests for the prediction of poor responders include day 3 measurement of the concentration of serum follicle- stimulating hormone (FSH), serum inhibin B, serum estradiol (E2), and serum anti-Mullerian hormone (AMH) as well as the determination of the antral follicle count (AFC), the ovarian volume (OVVOL), and the ovarian blood flow. Dynamic tests assess the response of the ovary to a defined dose of an ovarian stimulation agent. They include the clomiphene citrate (CC) challenge test, the FSH stimulation test, as well as the gonadotrophin agonist stimulation test. Various adjuvant therapies have been suggested for improving the results of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in poor responders.