Series Editors Juan A García-Velasco MD PhD
Director IVI Madrid Madrid, Spain IVI Director Nova IVI Fertility, India and GCCAbu Dhabi, UAE
Professor of Obstetrics and Gynecology Rey Juan Carlos University Madrid, Spain
Manish Banker MD
Executive Director Nova IVI Fertility and Pulse Women
's Hospital Ahmedabad, Gujarat, India
Past President Indian Society for Assisted Reproduction (ISAR)
Editor
Rohit Gutgutia MBBS DGO
Clinical Director Nova IVI Fertility Kolkata, West Bengal, India
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Infertility Management Series: Investigating Infertility
First Edition: 2017
9789385999017
Printed at:
fm5Contributors
- Puneet Rana Arora MBBS MS MRCOF MSc (Reproduction and Development)
- Senior Consultant and Reproductive Medicine Specialist
- Infertility/Oncofertility
- Nova IVI Fertility
- New Delhi, India
- Manish Banker MD
- Executive Director
- Nova IVI Fertility and
- Pulse Women's Hospital
- Ahmedabad, Gujarat, India
- Past President
- Indian Society of Assisted Reproduction (ISAR)
- Laxmi C MD MRCOG DFSRH
- Clinical Director and Consultant in Reproductive Medicine
- Nova IVI Fertility
- Hyderabad, Andhra Pradesh, India
- Juan A García-Velasco MD PhD
- Director
- IVI Madrid, Madrid, Spain
- IVI Director
- Nova IVI Fertility India and GCC
- Abu Dhabi, UAE
- Professor of Obstetrics and Gynecology
- Rey Juan Carlos University
- Madrid, Spain
- Shalu Gupta MS (Obs and Gyne) DNB
- MNAMS FNB (Rep Med)
- Consultant, Nova IVI Fertility
- New Delhi, India
- Rohit Gutgutia MBBS DGO
- Clinical Director
- Nova IVI Fertility
- Kolkata, West Bengal, India
- Javier Herrero MSc (Clinical Embryology)
- Co-Head
- Embryology
- Nova IVI Fertility, India
- Richa Jagtap MD (Obs and Gyne) DGO
- Fellowship
- Reproductive Medicine, Singapore
- Clinical Director and Consultant Reproductive Medicine
- Nova IVI Fertility
- Mumbai, Maharashtra, India
- Founding Member
- Fertility Preservation Society (India)
- Rajni Khajuria PhD (Human Genetics)
- Lab Manager
- Igenomix
- New Delhi, India
- Manjushri Kothekar MS (Obs and Gyne)
- Associate Gynecologist and Fellow Department of Reproductive Medicine
- Nova IVI Fertility
- Mumbai, Maharashtra, India
- Carmen Rubio Lluesa PhD
- Lab Director
- Molecular Cytogenetics
- Igenomix, Spain
- Nalini Mahajan MD (Obs and Gyne)
- MMedSci (ART)(UK)
- FICOG
- Clinical Director
- Nova IVI Fertility, New Delhi, India
- President
- Fertility Preservation Society (India)
- Secretary
- Carlos Marin MSc
- Biologist, Igenomix
- Valencia, Spain
- Jose Miravet-Valenciano MSc
- Biologist, Igenomix
- Valencia, Spain
- Irene Rubio Palacios MSc (Clinical Embryology)
- Co-Head, Embryology
- Nova IVI Fertility, India
- Sayali Palnitkar MSc (Microbiology)MS (Clinical Embryology)
- Junior Embryologist
- Nova IVI Fertility
- Pune, Maharashtra, India
- Pere Mir Pardo PhD
- Laboratory Manager
- Igenomix Headquarters Valencia, Spain
- Azadeh Patel MS (Obs and Gyne)
- Fellow
- Reproductive Medicine and Endocrinology, IVI Madrid
- Madrid, Spain
- Assistant Consultant
- Nova IVI Fertility
- Ahmedabad, Gujarat, India
- Jayesh Patel MS (Obs and Gyne)
- Fellow, Reproductive Medicine and Endocrinology, IVI Madrid
- Madrid, Spain
- Assistant Consultant
- Nova IVI Fertility
- Ahmedabad, Gujarat, India
- Madhuri Patil MD DGO DFP FCPS
- FICOG (Mumbai)
- Clinical Director
- Dr. Patil's Fertility and Endoscopy Clinic
- Bengaluru, Karnataka, India
- Arindam Rath MD
- Consultant, Nova IVI Fertility
- Kolkata, West Bengal, India
- Maria Ruiz-Alonso MSc
- Biologist, Igenomix
- Valencia, Spain
- Kabir Sachdeva PhD (Human Genetics)
- Igenomix, New Delhi, India
- Rupin Shah MS MCh (Urology)
- Consultant Andrologist and Microsurgeon
- Department of Urology
- Lilavati Hospital & Research Centre
- Mumbai, Maharashtra, India
- Carlos Simon MD PhD
- Professor, Obstetrics and Gynecology
- University of Valencia, Valencia, Spain
- Scientific Director
- Instituto Valenciano de Infertilidad (IVI) and Igenomix
- Adjunct Clinical Professor Department of Obstetrics and Gynecology
- Stanford University School of Medicine, California, USA
- Adjunct Professor
- Department of Obstetrics and Gynecology
- Baylor College of Medicine
- Texas, USA
Although it is difficult to ascertain through medical research the exact figure of incidence of infertility or subfertility in the society, it is a fact that different studies have shown that on an average, any gynecological outpatient department comprises of 12–15% women complaining of inability to conceive. The same is true for any practicing gynecologist's clinic. And the studies suggest that the figure is on the rise.
While we are celebrating about a century of Rubin's tubal insufflations test or half-a-century of discovery of clomiphene citrate (which revolutionized the management of infertility in those days), our knowledge of reproductive physiology, endocrinology, immunology and genetics has grown to a commendable level since then. As a result, infertility has become a specialty of its own and the number of Assisted Reproductive Technology (ART) clinics are growing exclusively to cater to the needs of these infertile couples. However, there is no denial that a vast majority of these couples choose to consult a traditional gynecologist for their problems. Gynecologists (who are obstetricians also) of the present era will have to keep pace with the growing knowledge in various aspects of reproductive biology, mainly through consulting journals, attending conferences or seminars or visiting different websites regularly.
However, this handbook has come as a boon to the busy gynecologists or the physicians, who wish to practice or to know the nuances of the problem of infertility in a ready shape. The layout of chapters is beautifully arranged starting with basics of human reproduction, very practical aspects like history taking and clinical examination to rather rarely discussed issues on receptivity of endometrium and genetics. Evaluation and investigative details of ovarian function, tubal factor and mechanical issues have been discussed in a very academic, yet lucid, manner. Since the gynecologist's role is there as a first-level andrologist also, the issues in the male factor have been in earnest details. Lastly, the chapter on treatment of infertility has been dealt in a masterly manner.
Kudos to the contributors and the editors of this handbook, which needs to be collected and read by every practicing gynecologist to know the most recent ‘tricks of the trade’ as a ready reference, along with building up a sound knowledge base to treat infertility in a most scientific manner and not just keep it on the shelves of medical libraries.
Sanjib Mukhopadhyay MD (PGI)
fm9Preface
Dear Reader
Firstly, please allow me to thank you for embarking on a journey of hope and for engraving a smile on human hearts that turned parents across your career span. It is our moment of glory!
This book is dedicated to our patients who struggle, yet are tireless in their efforts at combating infertility. We salute them and hold their hands till we hope to help them find their destination. The authors have infused this book with practical knowledge, easy references to context and ultimately shaped a product that is an easy manual to infertility. They have allowed many an idea to take flight.
Scientific knowledge is continuously evolving and reproductive endocrinology is not immune to this phenomenon. This book is a reference guide of contemporary and clinical infertility-related information distilled into a handbook.
Far from the usual didactic and sermonizing textbook, this book is easily readable and covers a wide range of subjects in ART, ranging from the management of infertility to the latest scientific advancements in preimplantation genetic diagnosis and embryo chromosomal screening.
This book was born out of a desire to enable easy access to subjects, data, latest research, case studies and statistics related to infertility to infertility practitioners across all hierarchies.
This book is portable, handy and an easy daily reference for all of us attached to this field of medicine.
I believe this book is valuable for the infertility practitioners, nurses, general obstetricians/gynecologists and infertility counselors, and a must-read for students and residents considering a career in reproductive endocrinology and infertility. The value of this book will make itself known by the number of times its pages are turned during practice which, I am confident, will be infinite.
However, as a ‘student’, who still learns everyday from his patients and colleagues (it is another thing that I do have a ‘Dr’ prefix), I still maintain that this book should not be hailed as a standalone resource, but a stepping stone to the words of Lee C Bollinger: “You must be willing to embarrass yourself in order to learn…”
All the best being the Touchstone!
fm11Acknowledgments
We would like to thank Mr Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Chetna Malhotra Vohra (Associate Director - Content Strategy), Mr Umar Rashid (Development Editor), and the production team of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for their continuous work and commitment to this project.