Main description:

This is the first book in a series inspired by the WOOSP (World Congress on Ovulation Induction & Ovarian Stimulation Protocols) Conferences, which were a bi-annual event in India hosted by the IVF Lite Foundation. This volume is based on the updated lectures from WOOSP 2015, held in Seychelles in September 2015.

Ovarian stimulation protocols are currently chosen mainly on the basis of personal preferences and individual experience rather than objective evidence based medicine, and in poor responders, as well as in polycystic ovary syndrome (PCOS) patients undergoing assisted reproductive techniques (ART), they constitute a significant challenge for clinicians, even today. Several protocols have been proposed that, when properly utilized, should improve pregnancy rates while keeping potential complications to a minimum. This book defines better predictors of ovarian response to stimulation and allow stimulation protocols to be tailored to individual patients. As such, it is a must-have textbook for clinicians wanting to sharpen their skills and keep abreast of developments in the field.

Contents:

Part I: Physiology.- The Physiology of Ovulation - Current Concepts.- The Physiology of Controlled Ovarian Stimulation: Contemporary Understanding.- Physiology of Mild Stimulation : Current Concepts.- Part II: All About IUI.- Single Versus Double Inseminations in IUI - Scientific Rationale and Results.- Do We Get Acceptable PRs Using GnRHa as Trigger in IUI cycles?.- Stimulation Protocols for IUI.- Clomiphene Citrate Versus Aromatase Inhibitors in IUI Cycles.- Effect of GnRH Antagonists on Clinical Pregnancy Rates in Ovulation Induction Protocols With Gonadotropins and IUI Therapy.- Part III: Agonist Cycles.- In Vitro Fertilization Using Pituitary Down-regulation with Depot GnRHa.- The Serum Level of C-Reactive Protein in Patients Undergoing GnRH Agonist Protocols for In Vitro Fertilization Cycles.- Part IV: Antagonist Cycles.- Tackling Follicular Asynchrony in GnRH Antagonist Cycles.- Newer Antagonist Protocols.- Part V: Role of LH.- Efficiency and Efficacy of Exogenous Gonadotropins Containing LH Activity.- Luteinizing Hormone Add-back: Is it Needed in Controlled Ovarian Stimulation? If Yes, When?.- Part VI: Triggering Ovulation in ART.- GnRH Trigger to Prevent OHSS.- GNRHa Trigger: Why, When, How?.- Dual Triggering with GNRHa & hCG.- Luteal Phase Support After Gonadotropin Releasing Hormone Agonist Triggering in Fresh Embryo Transfer.- Part VII: Poor Responders.- Minimal Stimulation in Poor Responders.- Recombinant LH in Diminished Ovarian Reserve (DOR).- Does the Addition of Clomiphene Citrate or Letrozole to Gonadotropin Treatment Enhance the Oocyte Yield in Poor Responders Undergoing IVF?.- Concurrent Dual Stimulation for Poor Responders.- IVF Lite With PGT-A is the Way Forward in 2019.- Microdose Flare-up vs. Flexible-multidose GnRH Antagonist Protocols for Poor Responder Patients.- LH Pretreatment as a Novel Strategy for Poor Responders.- Part VIII: Hyper-responders.- PCOS and Antagonist Protocol.- Agonist and Antagonist Coast.- First Intention IVF Protocol for Polycystic Ovaries: Does Oral Contraceptive Pill Pretreatment Influence COH Outcome?.- Comparison of Albumin and Cabergoline in the Prevention of Ovarian Hyperstimulation Syndrome.- Outcome of Ovarian Drilling in Women with Polycystic Ovary Syndrome.- Comparison Between Unilateral and Bilateral Ovarian Drilling in Clomiphene Citrate Resistance Polycystic Ovary Syndrome Patients.- Ovulation Induction in Obese PCOS Patients.- Part IX: Luteal Phase Support.- Newer Friendly Subcutaneous Progesterone.- Should Intramuscular Progesterone Still be Used in ART?.- Part X: Ultrasound.- One Step Ultrasound Assessment of the Infertile Woman.- Comparison of Ovarian volume and Antral Follicle Count with Endocrine Tests for Prediction of Responsiveness in Ovulation Induction Protocols.- Fluid in the Endometrial Cavity - Does it Really Matter for Implantation Success?.- Part XI: Endometriosis.- Effect of Endometrioma and Its Excision on Ovarian Reserve.- Management of Endometrioma in Reproductive Aged Women: Balancing Harm and Benefit.- Ovarian Response in IVF after Laparoscopic Ovarian Cystectomy.- Comparison of Ovulation Induction Protocols after Endometrioma Resection.- Part XII: Vitrification.- Then and Now - Evolution of Vitrification Techniques in 30 years.- Oocyte Vitrification and Cancer Patients.- Practical Clinical Aspects of Oocyte Vitrification for Elective Fertility Preservation.- Embryo Vitrification Program: Technique, Device or Embryo Quality - What Matters?.- Frozen Embryo Transfer Protocol: Does Spontaneous Cycle Give Good Result?.- Outcome of Vitrified-Thawed Embryo Transfer in the GnRH Agonist Versus Antagonist Protocols.- Part XIII: PGD/PGS.- Stimulation Strategies Before PGD/PGS.- The Current Status of Preimplantation Genetic Screening.- PGD for Couples at Chromosomal Risk.- Part XIV: Controversies.- Stimulation Strategies Before Preimplantation Genetic Testing.- Evidence Based Management of unexplained Infertility.- Role of Antibiotics Prior to Embryo Transfer.- Role of GCSF in ART Cycles.- Strategies to Improve Endometrial Thickness.- Is There Still A Role for Injury to the Endometrium Before IVF.- Estrogen Priming - Resource or Gimmick?.- The Contribution of Sildenafil (Viagra) to Ovarian Stimulation With Gonadotropins.- Should ART Cycles be Primed with OCP or Progesterone.- Does Endometrial Thickness Have Any Role in Replacement Cycle Success Rate?.- Role of Oral Fertility Drugs in Unexplained Infertility.- What Not to Do in Infertility Practice.- Part XV: IVM.- IVM vs. IVF with a Gonadotropin-Releasing Hormone Antagonist for Women With Polycystic Ovarian Syndrome: Can Superiority be Defined?.- Estrogen Suppressed In Vitro Maturation: A Novel Approach to IVM.- Part XVI: Stimulation & Malignancy.- Is There An Ideal Stimulation Protocol for Cancer Patients?.- Part XVII: The IVF Lab.- Time-lapse in the IVF-lab: How Should We Assess Potential Benefit?.- Importance of Cytoplasmic Granularity of Human Oocytes in In-Vitro Fertilization Treatments.- Part XVIII: Natural Cycle & Minimal Stimulation Protocols.- Modified Natural Cycle in In-Vitro Fertilization.- Impact of Minimal Stimulation Protocols on the Developing Embryo.- Part XIX: Progress.- Tailor-made Ovarian Stimulation- The Future of IVF.- Newer Advances in Fertility Treatment.