Insights into Infertility Management K Jayakrishnan
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1Insights into Infertility Management2
3Insights into Infertility Management
K JayakrishnanDGO MD DNB Cheif Consultant in Reproductive Medicine KJK Hospital, Fertility Research and Gynaecology Centre Nalanchira, Trivandrum, Kerala, India ForewordM Subhadra Nair
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© 2012, Jaypee Brothers Medical Publishers
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This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure a accuracy of information, the publisher and the editor specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editor. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Publisher: Jitendar P Vij
Publishing Director: Tarun Duneja
Cover Design: Seema Dogra
Insights into Infertility Management
First Edition: 2012
9789350255186
Printed at:
5Dedicated to
Dr Thomas Chandy who inspired me to take this specialty
Dr M Subhadra Nair who motivated me to choose this subspecialty
Dr K Radhakumari who moulded me into a Reproductive Medicine Specialist
Radha K Pillai, my mother whose determination, strength and passion gave me the courage to pursue my dreams
and
Lekha, Niranjana and Ashwin for making this journey worthwhile.
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7CONTRIBUTORS 9FORWORD
Newer concepts, innovations and technology have practically revolutionized the decision-making and management of various gynecological problems relating to infertility. With the explosion of information flooding the field, it became easier for an average clinician to keep pace with the advances and changes that are needed from time to time; since modern health care demands clinicians a practice of evidence-based medicine.
The consumers are also better informed and demand the latest information on the diagnosis of their problem. Moreover, rapid progress in Assisted Reproduction Technology has identified treatable causes of infertility; thus, more people have been able to achieve a successful pregnancy. Pregnancy wastage is also reduced by preimplantation genetic diagnosis that enables the birth of a genetically normal baby.
For a busy clinician, the access to clinically relevant information should be useful and readily accessible. This is exactly where the book Insights into Infertility Management by Dr Jayakrishnan steps in. Dr Jayakrishnan, along with experts in India and abroad, tell us on various problems of infertility, which they have made a mark of their own.
Starting from the role of semen analysis in the investigation for infertility, it goes on to anovulation and induction of ovulation, to polycystic ovarian disease, to hyperprolactinemia in infertility, and to unexplained infertility. It goes on to setting up of an ART clinic, intrauterine insemination, methods of enhancing the IUI success rates. It explores the laboratory set-up for IVF and ICSI and embryo culture, discusses the current scenario of IVF and ICSI, selection of human oocytes, and finally, it ends up by telling us when to stop infertility treatment with a few facts about the ART bill and its implications, which all of us have to be aware of.
I congratulate Dr Jayakrishnan and all the contributors who have generously contributed to the book Insights into Infertility Management which will be of immense benefit to all gynecologists and postgraduate students of gynecology.
I thank Dr Jayakrishnan for the privilege he has given me by asking me to be the one to write the foreword for his marvellous work. I wish the book all success.
Dr M Subhadra Nair
Senior Consultant, Obstetrician and Gynecologist
Cosmopolitan Hospital, Thiruvananthapuram
Formerly Director and Professor
Obstetrics and Gynecology Medical College
Thiruvananthapuram, Kerala, India
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11PREFACE
Reproductive medicine is an evolving specialty with new advances made everyday. When I set out to write this book, my aim was to give a comprehensive coverage of all aspects of infertility that was relevant in day-to-day practice. Most books I felt were either too concise or too elaborative; so, it was necessary to strike a balance between the two. Thus was born the idea of writing what I felt, was most relevant.
It is important that even as we practice, we follow evidence-based medicine, and I for one have been a firm believer in it. Most chapters in this book are based on the latest evidence and concepts. Each chapter has been written in a way that is lucid and at the same time tells all that we need to know while dealing with our patients. For every practitioner who wishes to practice reproductive medicine, this book serves as a primer. For the established practitioner, it acts as a refresher and a quick reference. For the postgraduate with interest in infertility, it simplifies things and answers all queries.
If after going through this book, concepts become clearer or interest is generated in Repro-ductive Medicine, I shall deem my work well done.
K Jayakrishnan
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13ACKNOWLEDGMENTS
This book is a culmination of my desire to demystify reproductive medicine, making it simple and understandable for both the generalists and the specialists.
I would not have been able to achieve this dream, if not all my colleagues have contributed to various segments of this book. I am deeply indebted to them for their useful inputs and kind contributions.
I thank Dr M Subhadra Nair, my teacher, for having been kind enough to write the foreword to this book. Having been the one who initiated me into this specialty, this foreword holds a special place in my heart.
My gratitude to Mr PV Nair, Manager and Mr Sanal Kumar, Laboratory-in-Charge, KJK Hospital, Nalanchira, Thiruvananthapuram, Kerala, India for being patient and overseeing the smooth functioning of the hospital; so that I could devote my time towards this book.
What time I got to edit the book belonged to my family, Lekha, Niranjana and Ashwin. The three of you have been very supportive of my endeavor, not once complaining about my absence. I know I could not have done this without you.
To the most important people, I express my gratitude, especially, Mr Tarun Duneja (Director-Publishing) and Mr KK Raman (Production Manager) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for the willingness shown in taking up this task at such short notice. Their promptness and enthusiasm is infectious.