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Major advances have recently been made in our understanding of
Ovarian Hyperstimulation Syndrome (OHSS): improving classification,
recognizing primary and secondary risk-factors, manipulating and
monitoring ovarian stimulation, handling risky situations, and
elucidating the underlying pathophysiologic mechanisms of the
syndrome. As such, all health care professionals working in
reproductive medicine should be acquainted with the theoretical and
practical aspects of how to deal with this syndrome, both from a
prophylactic point of view and once it has developed. Focusing on
the clinically relevant aspects of the syndrome, this text is built
on acquired knowledge but minimizes speculative considerations in
order to leave room for some 'intelligent ignorance' and
contention. Well illustrated with appropriate diagrams showing
biologic mechanisms, procedural algorithms, sonographs and
radiological images, at the end of each clinical chapters there is
also a list of frequently asked questions, with appropriate
answers, to help expand and elaborate difficult practice problems.
With its definitions, classifications and treatment algorithms,
Ovarian Hyperstimulation Syndrome will be highly useful to general
gynecologists, both in practice and training. Moreover, as there is
a consistent view of OHSS in different parts of the world, the book
will also have global appeal to all reproductive physicians and
support personnel working in IVF/ICSI units. .
Worldwide, approximately 500,000 in vitro fertilization cycles are
performed every year. Although the best possible result is a
healthy child, the technology carries a number of varying risks and
complications leading to a trade-off between the efficacy of these
treatments and their quality and safety. Drawing on contributions
from international experts with academic and clinical backgrounds,
Assisted Reproductive Technologies: Quality and Safety presents an
analysis of the medical risks and complications involved in
reproductive medicine. Putting the intricacies of reproductive
health in the spotlight, the book describes side-effects, risks,
and complications related to ART treatments. It discusses ovarian
hyperstimulation syndrome, demonstrates the impact of judicious
elective single embryo transfer, and focuses heavily on multiple
pregnancy as the major risk factor of ART. The editors highlight
the relatively less likely, but important risks of oncogenic
complications, bleeding at the time of ovum retrieval, and the even
smaller but still existing risk for maternal mortality. They
include discussions of non-medical factors that can have a major
impact on people's lives such as psychological, sexual, financial,
moral, ethical, and philosophical dilemmas. In today's litigious
climate, modern management of any clinic is all about minimizing
risks and complications. Thoroughly addressing quality and safety
issues in ART, this book provides succinct, up-to-date information
on quality care in reproductive medicine.
This conference, dedicated to the etiology and treatment of
motility disor ders in spermatozoa and male sterility, attracted
some of the finest investiga tors in the field. Standards were
immensely high throughout, and discussions were meaningful and
detailed. Analyses on disorders in sperm motility de mand a
broad-based approach, involving cytologists, geneticists,
andrologists, and embryologists, because the topic has many
clinical and scientific over tones. Human spermatozoa are at the
mercy of so many factors as they form and mature in the testis and
epididymis. Their survival and fundamental char acteristics are
essential for fertilization, and the male genome imposes its
influence on the embryo as it becomes active in male pronuclei very
soon after sperm entry into the oocyte. All of these fundamental
aspects of sperm biology demanded a broad breadth of topics in the
symposium. The opening session quickly got down to fundamentals
with contributions from J.-L. Gatti, J.G. Alvarez, C. Gagnon, and
H. Breitbart. They discussed the mechanism and regulation of
motility, the metabolic strategy of human spermatozoa, the effects
of exogenous fac tors such as antibodies, infections, and toxins,
and finally the role of intracel lular calcium on sperm motility.
To these topics, the postcoffee session on the first morning
described the genetics of motility disorders and the etiology and
management of necrozoospermia. The excellent presentation provided
the background detail of the symposium and opened the way for the
discus sion of various clinical aspects of the topic.
This volume is the proceedings of the International Symposium on
Male Sterility for Motility Disorders, held in Paris, January
30-31, 1998. The internationally recognized faculty present the
latest research on etiologic factors and treatment of male
sterility for motility disorders, including the etiology of
immobile sperm; therapeutic possibilities for immotile sperm; ICSI
option; testicular sperm, physiological and pathological aspects
and retrieval; and conceptus quality in ICSI and ethical problems
with ART.
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