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IVF Techniques for the Beginners Pankaj Talwar, Kuldeep Jain

SECTION 1: IVF SIMPLIFIED
1:Ovum Pick-up
- EGG RETRIEVAL PROCESS
- WHAT HAPPENS IN THE LAB AFTER THE EGGS ARE ASPIRATED?
2:Embryo Transfer
- SUMMARY
- INTRODUCTION
- CLINICAL DISCUSSION
  - Factors Affecting the ET Outcome
- RECENT ADVANCES
- CONCLUSION
3:Media and Quality Control in IVF Laboratory
- INTRODUCTION
- QUALITY CONTROL
- QUALITY ASSURANCE
- QUALITY IMPROVEMENT (QUALITY AUDIT)
- INTERNAL QUALITY CONTROL
- QUALITY MANAGEMENT SYSTEM
- ART LABORATORY
- CONCLUSION
4:Sperm Preparation for In Vitro Fertilization and Intracytoplasmic Sperm Injection
- METHOD
5:Sperm Retrieval Techniques (PESA, TESA, MESA, Micro-TESE, TESE)
- INTRODUCTION
- ETIOPATHOGENESIS OF AZOOSPERMIA
- DIAGNOSIS
- MANAGEMENT
- CONCLUSION
6:Surgically Retrieved Sperm Samples for ICSI
- BACKGROUND
- RETRIEVAL PROCEDURES
- PATIENTS INDICATED FOR MESA/TESE/PESA/TESA
  - Choice of Method
  - Fresh or Frozen
- SURGICAL RETRIEVAL OF SPERM
- CRYOPRESERVATION OF SURGICALLY RETRIEVED SPERM
- SPERM PREPARATION ON THE DAY OF ICSI
- SAFETY OF SURGICALLY RETRIVED SPERM
7:Intracytoplasmic Morphologically Selected Sperm Injection
- INTRODUCTION
- SELECTION OF SPERMS—NATURAL CONCEPTION AND ART
- SPERM MORPHOLOGY AND PREGNANCY OUTCOME
- VACUOLES—DNA FRAGMENTATION AND ABNORMAL CHROMATIN PACKAGING
- ABNORMAL DNA PACKAGING AND ITS IMPACT ON FERTILIZATION, EMBryONIC DEVELOPMENT AND PREGNANCY
- SELECTION OF SPERMS FOR ICSI
  - Increasing Magnification of Sperm Without Compromising Resolution
- STEPS FOR IMSI
- PREPARATION OF IMSI DISH
  - Assessment and Scoring of Spermatozoa
    - Impact of IVF-IMSI on the Outcome of the ART Procedure
- CONCLUSION
8:Vitrification
- INTRODUCTION
- PRINCIPLE OF VITRIFICATION
- VARIOUS FACTORS DETERMINE ULTIMATE SURVIVAL
  - Cooling and Warming Rates
- CRYOPROTECTANTS
- VITRIFICATION CARRIER DEVICES
- VITRIFICATION—CLOSED SYSTEMS
- ELEMENTS OF A TYPICAL VITRIFICATION PROCEDURE
- CONCLUSION
9:Ovarian Cortex Freezing
- INTRODUCTION
- INDICATIONS FOR OVARIAN CRYOPRESERVATION
  - Patients Receiving Chemo- and/or Radiotherapy for Cancer
- ASSESSMENT OF OVARIAN RESERVE
- CURRENT TECHNIQUES OF FERTILITY PRESERVATION
- OVARIAN CORTEX CRYOPRESERVATION
  - Ovarian Tissue Cryopreservation in Humans—Background
- LIMITATIONS FOR OVARIAN TISSUE CRYOPRESERVATION
- COLLECTION OF OVARIAN TISSUE
- CRYOPROTECTANT PREPARATION
- TISSUE PREPARATION (FIGS 9.5 TO 9.9)
- HISTOLOGICAL ANALYSIS
- STEPS OF OVARIAN CORTEX FREEZING (FIGS 9.11 TO 9.20) (TABLES 9.6 AND 9.7)
- PECULIARITIES OF OVARIAN TISSUE FREEZING
- METHODS OF THAWING (Table 9.8), (FIGS 9.21 TO 9.23)
- TRANSPLANT (Table 9.9)
- ETHICAL CONCERNS IN OVARIAN TISSUE CRYOPRESERVATION
10:Preimplantation Genetic Diagnosis: An Emergent Technology
- INTRODUCTION
- INDICATIONS FOR PREIMPLANTATION GENETIC DIAGNOSIS
- PREIMPLANTATION GENETIC DIAGNOSIS— HISTORICAL PERSPECTIVE
- STEPS INVOLVED IN PREIMPLANTATION GENETIC DIAGNOSIS
- EVOLUTION OF PGD FOR ANEUPLOIDIES, STRUCTURAL CHROMOSOMAL REARRANGEMENTS AND PREIMPLANTATION GENETIC SCREENING
- EVOLUTION OF PREIMPLANTATION GENETIC DIAGNOSIS FOR MONOGENIC DISORDERS
- PREIMPLANTATION GENETIC DIAGNOSIS FOR HUMAN LEUKOCYTE ANTIGEN MATCHING: SAviOUR SIBLING
- PREIMPLANTATION GENETIC DIAGNOSIS FOR CANCER PREDISPOSITION
- PREIMPLANTATION GENETIC DIAGNOSIS— CURRENT GLOBAL STATUS
- PREIMPLANTATION GENETIC DIAGNOSIS— AN INDIAN PERSPECTIVE
- CHALLENGES FACED WITH PREIMPLANTATION GENETIC DIAGNOSIS
- ETHICAL LEGAL AND SOCIAL ISSUES
- CONCLUSION
11:Assisted Hatching
- BACKGROUND
- GENERAL PRINCIPLES FOR AH
  - Indications for AH
    - Advanced Maternal Age/Elevated D3 FSH/Thick Zonae
    - Previous IVF Implantation Failures
- EXCESSIVE FRAGMENTATION
- POOR EMBRYO GROWTH RATE/MORPHOLOGY
  - Post-thaw Embryos
  - Fresh and Thawed Blastocysts
- ASSISTED HATCHING USING ACIDIC TYRODE'S SOLUTION
- DISCUSSION
12:Overview of Cryobiology in Assisted Reproductive Technology
- INTRODUCTION
- BASIC DEFINITIONS
- THERMODYNAMICS
- PHYSICS
- CONCEPT OF LATENT HEAT
  - Latent (Hidden)
- BIOLOGY OF CRYOFREEZING
- CRYOPROTECTANTS
  - Permeating Agents
    - Mechanism of Action
  - Nonpermeating Agents
    - Mechanism of Action
- PRINCIPLES OF CRYOBIOLOGY
- STEPS OF CRYOPRESERVATION
- EVENTS DURING FREEZING
- FREEZE INJURIES
- EVENTS DURING THAWING
- THAW INJURIES
- CONCLUSION
13:Simplifying IVF Program: Satellite Module
14:Fertility Preservation in Female Cancer Patients
- INTRODUCTION
- INDICATIONS OF OFFERING FERTILITY PRESERVATION
- VULNERABILITY OF THE REPRODUCTIVE SYSTEM TO CANCER TREATMENT
- MODE OF ACTION OF GONADOTOXIC AGENTS
  - Radiotherapy Induced Gonadal Damage
  - Chemotherapy Induced Gonadal Damage
- ASSESSMENT OF OVARIAN RESERVE
- FERTILITY PRESERVATION OPTIONS
- ETHICAL CONCERNS IN OVARIAN TISSUE CRYOPRESERVATION
- NOVEL OPTIONS OF FERTILITY PRESERVATION
  - Ovarian Transposition
  - Medical Options
- CONCLUSION
15:ICSI—An Introduction
- INSTRUMENTATION FOR ICSI
- MICROTOOLS
- PREPARATION OF CULTURE DISHES
  - Reminder
- SET-UP OF DISHES
- SPERM PREPARATION
- DENUDING OF OOCYTES FOR ICSI
  - Recombinant Hyaluronidase
  - Denuding
- SETTING-UP MICROSCOPE
- NARISHIGE
- RESEARCH INSTRUMENTS
- EPPENDORF
- SPERM INJECTION
  - Tips
- SPECIAL CIRCUMSTANCES OF APPLYING ICSI
- RESCUE ICSI
  - In Vitro Maturation (IVM)
- FERTILIZATION IN ICSI
- PERSONAL CARE OF ICSI PRACTITIONER
16:Guidelines and Legislation on Assisted Reproduction Technology in India
SECTION 2: ESSENTIAL PROTOCOLS IN ART
17:SPERM FREEZING
- SEMEN FREEZING
18:EMBRYO TRANSFER
- DISPOSABLES AND EQUIPMENT REQUIRED
- REAGENTS
- EMBRYO TRANSFER— PROCEDURE
19:INTRACYTOPLASMIC SPERM INJECTION PROTOCOLS
- INTRACYTOPLASMIC SPERM INJECTION MEDIA AND PIPETTES
- PREPARATION OF INTRAOYTOPLASMIC SPERM INJECTION DISHES
- DENUDATION
  - Method of Denudation during Intracytoplasmic Sperm Injection
- MANIPULATION OF SPERMATOZOA
- MANIPULATION OF OOCYTES
- MICROINJECTION OF OOCYTES WITH MATURE SPERMATOZOA
20:OOCYTE CRYOPRESERVATION
- OOCYTE CRYOPRESERVATION— S LOW COOLING
- OOCYTE CRYOPRESERVATION— VITRIFICATION
- OOCYTE WARMING PROTOCOL
  - Making the Warming Dish
  - Identification of the Straws
21:TESTICULAR BIOPSY BANKING
- TECHNIQUE FOR CRYOPRESERVATION OF TESTICULAR SPERM
22:OVUM PICK-UP
- EQUIPMENT REQUIRED
- REAGENTS REQUIRED
  - Culture Media
- PROCEDURE: OPU STEP-BY-STEP
23:FOLLICULAR TREKKING AND USE OF COLOR DOPPLER IN ART CYCLES
- EQUIPMENT REQUIRED
  - Baseline USG
    - What to Look for at the Basic Scan?
  - Treatment cycle

INDEX

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Chapter Notes