Practical Management of Ovulation Induction Hemant Deshpande
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1PRACTICAL MANAGEMENT OF OVULATION INDUCTION2
3PRACTICAL MANAGEMENT OF OVULATION INDUCTION
Editor Hemant Deshpande MBBS MD Professor and Head Department of Obstetrics and Gynecology Dr DY Patil Medical College and Hospital Pune, Maharashtra, India Forewords PN Razdan KC Singhal
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Practical Management of Ovulation Induction
First Edition: 2016
9789352500284
Printed at:
5Dedicated to
Shri Guru Raghavendra Swamiji6
7Contributors
9Foreword
Infertility management is a rapidly advancing field, and ovulation induction lie at the very heart of infertility treatment. Over the past decade, there have been major advances in our understanding of ovarian physiology. These advances, together with the introduction of new medical technologies, have revolutionized the management of infertility. Patients may expect a pregnancy rate, i.e. not different from that of normal fertile women of the same age, as a result of treatment. Moreover, new techniques of monitoring have greatly reduced the rate of treatment-induced complications such as multiple pregnancy and hyperstimulation.
A concise and accurate practical guide to what are undoubtedly very complicated topics, Practical Management of Ovulation Induction provides the busy clinician with a reliable overview of the principles involved and the management needed in this area. It gives an integrated view of basic ovarian physiology and pathophysiology, and also provides core information upon which specialists can base clinical decisions. The most important feature is the inclusion of newer agents now available for ovulation induction. Newer clinical applications for older medications, as well as various treatment combinations are thoroughly discussed. Detailed descriptions are given of the optimal method of assessing of an anovulatory woman, the selection of the appropriate treatment and the practical details of its administration. There is also a full discussion about the complications of the treatment and the strategies to avoid. The book is intended for all practicing gynecologists involved in the management of subfertile patients, both the developing and the developed world.
Highly useful text cited in the book ensures that the reader is presented with easy-to-grasp, well-presented information that maximizes clarity and understanding. There is a frank discussion of risks, side effects, and the expense related to ovulation, inducing agents. Many of the results in the book have never before been published.
Written by the team of expert authors having vast experience, this is an important resource for the general gynecologists, fertility specialists, health workers and students. I congratulate Dr Hemant Deshpande and his team for their timely and stupendous task.
PN Razdan
Vice Chancellor
Dr DY Patil Vidyapeeth
Pune, Maharashtra, India
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11NIMS UNIVERSITY
JAIPUR, RAJASTHAN
PROF (DR) KC SINGHAL
MD, PhD (Med), DSc
FIAMS, FIAN, FIPS
VICE-CHANCELLOR
Foreword
The survival of human species depends on the integrity of its reproductive system. Further, the entire spectrum of reproductive events and processes that must function normally to produce a healthy offspring. Genes located in the chromosomes of germ cells transmit genetic information from previous generations and control cell differentiation and organogenesis. A healthy environment both within and outside the body is required for spermatogenesis and oogenesis. Gene has been identified that controls a vital process in the formulation of healthy fertile eggs.
Female infertility, the incidence of which is increasing, may result due to several factors including hormonal problems, damage to ovaries, poorly functioning fallopian tubes, endometriosis, abnormal uterus, and factors related to lifestyle, drugs, environment and others. The diagnosis of infertility may be simple but identification of causation and its treatment involves the understanding of physiology and patho-physiology of ovulation and factors affecting the process directly or indirectly.
Practical Management of Ovulation Induction edited by Professor Hemant Deshpande and chapters authored by him and other experienced medical scientists and gynecologists practicing management of ovulation induction at prestigious institutions provide the basic essential information and meticulously designed tools for infertility experts and also young graduates in Medicine, interested in developing and understanding, and learning hands-down techniques required to be employed.
The book is unique in that it provides a comprehensive database of information beginning from practical aspects of understanding ovulation and its regulatory factors to hyperovulation, premature ovarian failure and ovarian syndrome. Diagnostic aids which provide evidence-based pointer for planning appropriate guidelines for therapeutic approach have been described in a meticulous way.
Drugs which are employed to influence and regulate ovulation and are also used as supportive therapy for induction have been dealt with in successive chapters by experts with considerable experience. Though required in only selected situations, the book has a chapter on surgical management of anovulation.
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The book, a blend of clinical medicine and basic sciences, is designed as a practical guideline for managing ovulation induction, and authors have individually as well as collectively succeeded in their attempt.
It has been a privilege to have the opportunity to write a foreword of the book, especially when not being a gynecologist. I am confident that readers will find the book informative and as a practical guide for management of ovulation induction.
Professor Hemant Deshpande and his team has done a commendable job of making a complex issue so simple. I feel that the book will find a wide acceptance amongst undergraduate and postgraduate medical students as well as with infertility consultants.
Prof (Dr) KC Singhal
MD PhD (MCD) DSc FIAMS FIAN FIPS
Vice Chancellor
NIMS University
Jaipur, Rajasthan, India
13Preface
Learn from yesterday, live for today, hope for tomorrow.
The important thing is not to stop questioning
–Albert Einstein
It gives me immense pleasure to introduce the first edition of Practical Management of Ovulation Induction. Over the past decade, there have been major advances in our understanding of ovarian physiology. These advances, together with the introduction of new medical technologies, have revolutionized the management of infertility. Patients may expect a pregnancy rate that is not different from that of normal fertile women of the same age, as a result of treatment. Moreover, new techniques of monitoring have greatly reduced the rate of treatment-induced complication, such as multiple pregnancy and ovarian hyperstimulation.
We have tried to include highly useful text by expert authors from all over India in the book to ensure easy-to-grasp, well-presented information that maximizes clarity and understanding of a complex subject. There is a frank discussion of etiopathogenesis of anovulation, investigations, medical and surgical management, side effects, and the advances related to ovulation induction.
There is in-depth discussion of etiopathogenesis of anovulation, investigations, medical and surgical management, and the advances related to ovulation induction.
I hope that the book will be an important resource for the practicing gynecologists, infertility specialists and postgraduate students of gynecology.
Hemant Deshpande14
15Acknowledgments
In writing Practical Management of Ovulation Induction, I have been greatly encouraged and psychologically boosted by the unfailing loyal support of my colleagues Dr CS Madkar, Dr Nilesh Balkawade, Dr Umesh Sabale, Dr Sharankumar and Dr Priyanka A Dahiya.
I am grateful to all my friends, colleagues and mentors who have timely contributed chapters in the book.
Last but not least, I thank Dr Anjali Deshpande who has always been source of encouragement, inspiration and support and without whom it would not have been possible to complete this task.
I gratefully acknowledge Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director–Publishing), Mr KK Raman (Production Manager) and all other staff members of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their help and cooperation throughout the process of preparation of the book.