FOGSI Focus Use of Adjuvants in Infertility Sunita Tandulwadkar, Madhuri Patil, Nandita Palshetkar
INDEX
Page numbers followed by f refer to figure, and t refer to table
A
Acetylcholinesterase inhibitor 6
Acetylsalicylic acid 7
Acupressure 5, 11
Acupuncture 3, 5, 11, 26, 30, 32, 34
Adhesiolysis 62, 65f
Adjuvants therapy 14
Advanced sperm selection
procedures 6
techniques 2
Adverse pregnancy outcome 64
Alpha-lipoic acid 20
controlled-release 20
Amenorrhea 65
American Society for Reproductive Medicine 59
American Thyroid Association 59
Amino acids 40
Androgens
excess, treatment of 8
pretreatment 6
Androstenedione 23
Anovulation 62
Antibiotics 40
prophylactic 65
Anti-Müllerian hormone 7, 22
Antioxidants 1, 5, 11, 40
scavenging 50, 51
therapy 50
Antithyroglobulin 56
Antithyroid
antibodies 56
peroxidase 56, 59
Antral follicle count 22
Aromatase inhibitors 5, 53
Artificial oocyte activation 2, 41, 46
Asherman's syndrome 28, 63, 65, 65f
Aspirin 2, 3, 5, 7, 10, 26, 29, 32
Assisted hatching 3, 6, 43, 44, 46
Assisted reproductive technology 1, 5, 6, 13, 23, 29, 37, 56, 62
basis of 22
cycle 32
new technologies used in 12
outcome 10
B
Blastocyst
culture 43
transfer 12, 43
trophectoderm cells, biopsy of 45
Bleeding, postoperative 63
Body mass index 8
Bologna criteria 22
Bone marrow-derived stem cells 35
Broad fundus, laparoscopic confirmation of 64f
C
Calcium
ionophores 5
ions 41
Canadian Fertility and Andrology Society Clinical Practice Guidelines 33
Carnitine 51
Catalytic antioxidants 50
Chromium polynicotinate 5, 8, 9
Clinical pregnancy rate 1, 6, 32, 39, 41
Clomiphene citrate 8, 9, 19, 27, 52, 66
Coenzyme Q10 1, 5, 9
Colony-stimulating factor 8
Comet assay 39, 40f
Conception, natural 62
Connective tissue growth factor 29
Controlled ovarian
hyperstimulation 8, 58
stimulation 6
Corticosteroids 2, 3, 32, 34
Cryopreserved oocytes, fertilization of 2
Cumulus-oocyte complexes 6
Cyclic adenosine monophosphate 10
formation 6
Cyclic guanosine monophosphate 27
Cyst, large endometriotic 67f
Cystectomy, laparoscopic 67
Cytokines 2
D
Dehydroepiandrosterone 1, 3, 6, 23
administration 6
sulfate 8
Deoxyribonucleic acid 46
denaturation of 39
Dexamethasone 5, 8
Digital polymerase chain reaction 45
Distal tubal obstruction 62, 63
Dopamine agonist 5
E
Elective single embryo transfer 37
Electroacupuncture 34
Electrosurgical complications 63
Embryo
biopsy 13
glue 3, 46
hydrogen peroxide induced damage prevention of 27
transfer 11, 18
treatment 64
Embryogenesis 59, 60
Endocrine Society 59
Endometrial receptivity
adjuvants for 32
amelioration of 27
Endometrial scratching 6, 13f, 32, 35, 68
Endometrial thickness 32
Endometrioma 66
cystectomy 62
Endometriosis 62, 66, 67
deep 66
minimal-mild 67
moderate 67
moderate-severe 67
severe 67
superficial 66
Endometrium 26, 27, 59, 60
thin 26
Energy substrates 40
Epidermal growth factor 28, 29, 33
Erectile dysfunction, treatment of 27
Estrogen pretreatment 5, 7
European Society of Human Reproduction and Embryology Classification 64
European Thyroid Association 59
F
Fatty liver disease, nonalcoholic 20
Fertility
acupressure points for 12f
acupuncture points for 11f
Fertilization 59, 60
failure 41
rates 57
Fibroblast growth factor 29
Fibroids, multiple 63
Fluid intravasation syndrome 63
Fluorescence in situ hybridization 3, 14, 45
Follicle-stimulating hormone 1, 6, 19, 23, 52, 57
recombinant 50
Follicular-fluid testosterone 23
Folliculogenesis 57
Food and Drug Administration 34
Frozen embryo transfer 26
Frozen-thawed embryo transfer 33, 40
G
Genomic hybridization 45
Germ cells 53
Glucocorticoids 5, 8
Glyceryl trinitrate 27
Gonadotropin-releasing hormone 1, 8, 18, 23, 53, 63
agonist 32, 33
Granulocyte colony stimulating factor 6, 29, 32, 34
intrauterine perfusion of 26
Granulocyte-macrophage colony-stimulating factor 40
Granulosa cells 6
Growth hormone 1, 3, 5, 6, 23, 32, 35, 50, 52
releasing
factor 6
hormones 23
H
Heparin 2, 3, 5, 10, 28, 32, 33
mechanism of action of 28f
Homeostatic model assessment 19
Human chorionic gonadotropin 5, 23, 29, 32, 33, 50, 52, 56
low-dose 26, 29
Human fertilization and embryology authority 40, 46
Human menopausal gonadotropin 8
Human oocytes activation 41
Human serum albumin 40
Hyaluronan-enriched transfer medium 40
Hyaluronic acid 39
Hyaluronic binding assay score 39
Hydrosalpinx 68
bilateral 68f
disconnection of 6
removal of 6
Hydroxyvitamin D 19
Hyperinsulinemia 8
Hyperthyroid 53
Hypnosis 5, 11
Hypomenorrhea 65
Hypothesis 45
Hypothyroid 53
Hypothyroidism, subclinical 56, 59
Hysterosalpingography, abnormal 11
Hysteroscopic myomectomy 62, 63
complications of 63
Hysteroscopic surgeries, postoperative management in 65
I
Immune therapy 2, 5
Immunoglobulin 10
A 10
G 10
Implantation 59, 60
failure, recurrent 10, 63
rate 32
In vitro fertilization 3, 5, 32
additional therapy in 1
outcome 6, 11
program 5
treatment 1, 5, 18, 23, 28, 37, 59, 62, 64, 67
Infertility 62, 65
globally, prevalence of 37
history of 64
severe male factor 38
Injury, endometrial 3
Inositol 8, 9, 18
Insulin
growth factor 1 18, 23, 28, 29, 41
resistance 8
sensitizing agents 18
International Committee for Monitoring Assisted Reproductive Technology 37
International Federation of Gynecology and Obstetrics Classification 63
International Societies, guidelines of 59t
Intracytoplasmic morphologically selected sperm injection 12, 13, 37, 38f, 46
Intracytoplasmic sperm injection 1, 2, 7, 23, 29, 32, 37, 58
Intralipid 10
Intramural fibroids 63
Intrauterine granulocyte-colony stimulating factor instillation 29
Intrauterine insemination 67
cycles 27
Ions 40
K
Ketoconazole 8
L
L-arginine 5, 7, 26, 28, 32, 33
Laser-assisted zona hatching technology 44
Letrozole 8, 53
Leukemia inhibiting factor 59
Levothyroxine 58, 59
Leydig cells 52, 53
Lipids 40
Lipoic acid 20
Live birth rate 6, 32, 37
L-methylfolate 8, 9
Low molecular weight heparin 26, 28
inhibits 2
Luteal phase
adjuvants for 32
estradiol in 24
Luteinizing hormone 6, 18, 23, 27, 57, 66
recombinant 23
therapy 52
Lycopene 52
M
Magnesium 19
Massage therapy 11
Matrix metalloproteinase 59
Meiotic spindle 42f
Melatonin 3, 5, 8, 9
Methylprednisolone 5, 8
Methylxanthine 33
Metroplasty, hysteroscopic lateral 64
Micronutrients 5, 11
Mid-tubal block 62
Miscarriage
idiopathic recurrent 2
recurrent 45
Mitochondrial deoxyribonucleic acid 41
load measurement 41
Mitochondrial function 41
Morcellator, hysteroscopic 63
Müllerian anomalies 64
Myoinositol 5
Myomas 63
Myomectomy, laparoscopic 62, 63
Myometrium 27
N
N-acetylcysteine 5, 8, 9, 19, 50
Natural killer cell 2, 10, 27, 34
Neuromuscular electric stimulation 34
Nimodipine 27
Nitric oxide donor 33
Nonpharmacological adjuvants 5, 11
O
Obesity 53
Omega-3 fatty acids 20
Oocyte 42f, 59, 60
matured in vitro, fertilization of 2
meiotic stage, assessment of 42f
Ovarian
drilling, laparoscopic 6, 62, 66
endometrioma, management of 6
follicle 57
hyperstimulation
function 58
syndrome 7, 10, 66
response 22
stimulation 14, 59
Ovulation 59, 60
Ovum pick-up 29
Oxidative stress 11
P
Pelvic floor neuromuscular electrical stimulation 30, 34
Pentoxifylline 26, 28, 32, 33, 51
Phosphodiesterase type 5 27
Physiological intracytoplasmic sperm injection 12, 13, 37, 39, 46
Pituitary downregulation 14
Placentation 59, 60
Platelet
derived growth factor 29
rich plasma 26, 29, 32, 35
Polar body 42f
Polycystic ovary
disease 66
laparoscopic drilling of 66, 66f
syndrome 6, 8, 18, 66
treatment of 5
Polyps
endometrial 65
hysteroscopic removal of 6
treatment of 66
Poor ovarian
reserve 7, 22
response 22
Poor responders
in vitro fertilization outcome in 6
treatment of 5
Poseidon classification 22, 22t
Prednisone 5, 8
Pregnancy
multiple 66
rate 27, 32
Preimplantation genetic
diagnosis 2
screening 3, 6, 13, 44, 46
cycles 2
testing 13, 44
Prolactin 53
Proximal tubal occlusion 62
Pyridostigmine 5, 6
addition of 6
R
Randomized controlled trial 1, 7, 24, 27, 32, 39, 50, 66
Reactive oxygen species 9, 32, 50
Recombinant human growth hormone, low dose of 35
Reproductive surgery 12f
Resectoscope 63
Resistance index 27, 32
Routine hysteroscopy 6, 11
laparoscopy 13f
S
Salpingitis isthmica nodosa 62
Selective estrogen receptor modulator 52
Selenium 51
Semen parameters, abnormal 2
Septal resection, methods for 64
Septate uterus 64
Septoplasty, hysteroscopic 64
Septum 6
Sertoli cells 53
Sex hormone binding globulin 53
Sildenafil 2, 5, 27, 32, 34
additional actions of 27
citrate 10, 26, 27, 34
mechanism of action of 27f
Single-nucleotide polymorphism 45
Smooth muscle relaxation 27
Somatostatin analogs 18
Sperm 59, 60
chromatin
dispersion test 40, 40f
structure assay 39, 40f
deoxyribonucleic acid fragmentation 37, 39
fertility 37
Spermatogenesis 57
Spermatozoa 39f
classification of 38, 39f
heads 38f
normal 38f
vacuolated 38f
Spindle imaging 42
Stem cell 26, 32
therapy 30, 35
Steroidogenesis, gonadotropin-induced 6
Steroids 10, 24
Subfertility, male 50
Submucous myoma 6, 63
hysteroscopic resection of 63f
Surgeries, fertility-enhancing 62, 68
T
Terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-nick-end labeling assay 39, 40f
Testis, Sertoli cells of 53
Testosterone 3, 5, 23
Thyroid
autoimmunity 56, 58, 60
effect of 60
impact of 56
on fertilization, effect of 57
on implantation, effect of 58
on ovarian reserve, effect of 57
function 58
hormone 53, 59, 59t
receptor alpha 59
receptor beta 59
peroxidase autoantibodies 60t
stimulating hormone 59, 60
Thyroxine 59
Time-lapse embryo monitoring 2, 6
Tocopherol 33
Total failed fertilization with standard insemination 2
Transcutaneous electrical acupuncture point stimulation 34
Transdermal testosterone 6
Transforming growth factor 29
Triiodothyronine 59
T-shaped
uterine cavity 64
uterus 64
Tubal
cannulation 62
factor 62
reconstruction 62
sterilization reversal 62
Tumor necrosis factor alpha 2, 28
U
Ultrasonography 66
Uterine
artery
pulsatility index 32
vasodilators 2
blood flow 26
cavity 63
factors 64
myomas 62
polyp 62, 65, 65f
radial artery 30
septum 64, 64f
volumetric flow 27
V
Varicocelectomy 53
Vascular endothelial growth factor 10, 27
Vasodilators 5, 10, 26
functions of 27
Vitamin 40
C 51
D 5, 8, 9
deficiency 19
E 26-28, 32, 33, 50
Z
Zinc 51
deficiency 51
Zona pellucida 43
×
Chapter Notes

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_fm1FOGSI Focus Use of Adjuvants in INFERTILITY
_fm2
_fm3FOGSI Focus Use of Adjuvants in INFERTILITY
Series Editor Nandita Palshetkar MD FCPS FICOG FRCOG (UK) President FOGSI 2019 Scientific Director, Bloom IVF Professor Department of Obstetrics and Gynecology Dr DY Patil Medical College, Hospital and Research Center Navi Mumbai, Maharashtra, India Editors Sunita Tandulwadkar MD (Obstetrics and Gynecology) FICS (Gyne-Endoscopy) FICOG Head, Department of Obstetrics and Gynecology, Ruby Hall Clinic, Pune, Maharashtra, India Chief, Ruby Hall IVF and Endoscopy Center, Pune Director, Solo Clinic, Center of Excellence Infertility and Endoscopy Founder and Medical Advisor, Solo Stem Cells, Stem Cells Research and Application Center, Pune Chief, IVF and Endoscopy Department, Dr DY Patil Medical College, Pune, Maharashtra Co-Founder, Solo Research Foundation—Sponsor a Birth President, IAGE (2019-2020) Chairperson, Maharashtra Chapter ISAR (2018-2020) 2nd Vice President, Indian Society of Assisted Reproduction (ISAR) (2020-21) Founder Secretary, Maharashtra Chapter ISAR Vice-President, West Zone FOGSI (2017) Chairperson, FOGSI Infertility Committee (2011-2013) Elected Board Member, International Society of Gynecological Endoscopist (ISGE) (2013-2017) Advisor and Reviewer, Journal of Human Reproductive Sciences Madhuri Patil MD DGO FCPS DFP FICOG (Mum) Clinical Director, Dr Patil's Fertility and Endoscopy Clinic, Bengaluru, Karnataka, India Editor-in-Chief, Journal of Human Reproductive Sciences Associate Editor, The Onco Fertility Journal Editorial Board Member, Endocrine Society 2020 and 2021 Founder President, Karnataka Chapter of Indian Society for Assisted Reproduction Vice-President and Founder Member, Fertility Preservation Society (India) Vice-President and Founder Member, PCOS Society (India)
Federation of Obstetric and Gynaecological Societies of India (FOGSI)
_fm4
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FOGSI Focus Use of Adjuvants in Infertility
First Edition: 2021
9789389587975
Printed at
_fm5Contributors _fm7President's Message
It gives me great pleasure to know that the FOGSI Focus Use of Adjuvants in Infertility is ready for release. The aim of this FOGSI Focus is to highlight a new emerging frontier in the area of pharmacotherapy, viz. the role of nutraceuticals, medical nutrition therapy and other medications to improve success rates in our field.
The chapters have been written by eminent experts in research and therapy areas including senior FOGSIans and faculty who are in teaching positions throughout the country. I hope this FOGSI Focus will help to improve your understanding of the role of antioxidants, micronutrients, reactive oxygen species, the scientific theories behind medical nutrition therapy and the growing evidence for adjuvant therapies.
The Presidential theme for my FOGSI year 2019 is “We for Stree—Safer, Stronger, Smarter”. During the year, we will attempt to focus on academic, social and community health initiatives aimed at improving the profile of women in India. I urge every single one of you to unite and stand with us and contribute to a series of initiatives which will refocus our contributions not only toward the health of Indian women, but also their social, financial and educational upliftment as well.
FOGSI is committed to delivering continuing medical education programs and also has a raft of initiatives to help women from poor socioeconomic areas receive appropriate care through our social and community healthcare initiatives, e.g., the FOGSI Saving Mothers Initiative. The FOGSI Manyata project also aims to bring a certain minimum standard of care to the women of India via accreditation and training of private nursing homes and healthcare personnel.
I congratulate the Editors of the book Dr Sunita Tandulwadkar and Madhuri Patil for their effort in helping to publish this FOGSI Focus and hope that it adds a new dimension in your practical approach to prescribing.
Nandita Palshetkar MD FCPS FICOG
President, FOGSI (2019)
President, IAGE (2017–18)
Chairperson, MSR (2017–18)
Vice President, AMOGS (2016–18)
Past President, MOGS (2016–17)_fm8
fm_9 
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_fm10 _fm11Preface
Sunita Tandulwadkar
Madhuri Patil
The last two decade has witnessed a striking progress in assisted reproductive technology (ART). There has also been a significant increase in the success rate of ART due to the introduction of adjuvant therapy in clinical practice, novel technologies and improved embryo culture systems. It is important that all ART clinicians keep abreast with all the newer tests, drugs, techniques and technology to implement them in their practice and provide optimal care to their patients.
This book brings fresh insights into the adjuvant therapy that can be used in clinical practice. It also provides up-to-date and practical information on the adjuvants that can be used in the laboratory management of subfertility. Every chapter lay stress on current advances in the potential strategies of various therapeutic options available to improve the management of the sub-fertile couple. Most of these adjuvants have a controversial evidence and this has been covered very well in all the chapters. This will enable each clinician depending on his/her practice conditions to adapt these newer techniques and technologies.
The preparation of this book was driven by a desire of our dear FOGSI president, Dr Nandita Palshetkar (2019) to provide a hands-on practical guide on the various add on treatments in assisted reproduction that would be accessible to those practising in this field. The contributing authors include nationally renowned clinicians and scientists actively involved in the field of reproductive medicine. We are most grateful to all who have made the publication of this “FOGSI Focus” possible.
We hope that you will enjoy reading this ready reckoner on adjuvants in ART as much as we did editing it.
Happy Reading!_fm12
_fm13Acknowledgments
We thank Nandita Palshetkar, President FOGSI (2019) for giving us the opportunity to publish the FOGSI Focus Use of Adjuvants in Infertility. We are extremely thankful to each and every author who has contributed to this edition of the FOGSI Focus. We are especially thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Ms Kritika Dua (Development Editor) and the publishing staff at M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their work in completing this book successfully.