Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- PART III ASSISTED REPRODUCTION
- 38 Medical Strategies to Improve ART Outcome: Current Evidence
- 39 Surgical Preparation of the Patient for In Vitro Fertilization
- 40 IVF in the Medically Complicated Patient
- 41 Polycystic Ovary Syndrome and IVF
- 42 Endometriosis and Assisted Reproductive Technology
- 43 Evidence-Based Medicine Comparing hMG/FSH and Agonist/Antagonist and rec/Urinary hCG/LH/GnRH to Trigger Ovulation
- 44 Luteal Phase Support in Assisted Reproduction
- 45 Thrombophilia and Implanation Failure
- 46 Intrauterine Insemination
- 47 The Prediction and Management of Poor Responders in ART
- 48 Oocyte Donation
- 49 In Vitro Maturation of Human Oocytes
- 50 Oocyte and Embryo Freezing
- 51 Cryopreservation of Male Gametes
- 52 The Management of Azoospermia
- 53 Spermatid Injection: Current Status
- 54 Optimizing Embryo Transfer
- 55 Single Embryo Transfer
- 56 Blastocyst Transfer
- 57 Clinical Significance of Embryo Multinucleation
- 58 Quality and Risk Management in the IVF Laboratory
- 59 The Nurse and REI
- 60 Understanding Factors That Influence the Assessment of Outcomes in Assisted Reproductive Technologies
- 61 The Revolution of Assisted Reproductive Technologies: How Traditional Chinese Medicine Impacted Reproductive Outcomes in the Treatment of Infertile Couples
- 62 Complications of Assisted Reproductive Technology
- 63 Ectopic and Heterotopic Pregnancies Following in Vitro Fertilization
- 64 The Impact of Oxidative Stress on Female Reproduction and ART: An Evidence-Based Review
- 65 PGD for Chromosomal Anomalies
- 66 Preimplantation Genetic Diagnosis for Single-Gene Disorders
- 67 Epigenetics and ART
- 68 Congenital Anomalies and Assisted Reproductive Technology
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
65 - PGD for Chromosomal Anomalies
from PART III - ASSISTED REPRODUCTION
Published online by Cambridge University Press: 04 August 2010
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- PART III ASSISTED REPRODUCTION
- 38 Medical Strategies to Improve ART Outcome: Current Evidence
- 39 Surgical Preparation of the Patient for In Vitro Fertilization
- 40 IVF in the Medically Complicated Patient
- 41 Polycystic Ovary Syndrome and IVF
- 42 Endometriosis and Assisted Reproductive Technology
- 43 Evidence-Based Medicine Comparing hMG/FSH and Agonist/Antagonist and rec/Urinary hCG/LH/GnRH to Trigger Ovulation
- 44 Luteal Phase Support in Assisted Reproduction
- 45 Thrombophilia and Implanation Failure
- 46 Intrauterine Insemination
- 47 The Prediction and Management of Poor Responders in ART
- 48 Oocyte Donation
- 49 In Vitro Maturation of Human Oocytes
- 50 Oocyte and Embryo Freezing
- 51 Cryopreservation of Male Gametes
- 52 The Management of Azoospermia
- 53 Spermatid Injection: Current Status
- 54 Optimizing Embryo Transfer
- 55 Single Embryo Transfer
- 56 Blastocyst Transfer
- 57 Clinical Significance of Embryo Multinucleation
- 58 Quality and Risk Management in the IVF Laboratory
- 59 The Nurse and REI
- 60 Understanding Factors That Influence the Assessment of Outcomes in Assisted Reproductive Technologies
- 61 The Revolution of Assisted Reproductive Technologies: How Traditional Chinese Medicine Impacted Reproductive Outcomes in the Treatment of Infertile Couples
- 62 Complications of Assisted Reproductive Technology
- 63 Ectopic and Heterotopic Pregnancies Following in Vitro Fertilization
- 64 The Impact of Oxidative Stress on Female Reproduction and ART: An Evidence-Based Review
- 65 PGD for Chromosomal Anomalies
- 66 Preimplantation Genetic Diagnosis for Single-Gene Disorders
- 67 Epigenetics and ART
- 68 Congenital Anomalies and Assisted Reproductive Technology
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
Summary
INTRODUCTION
Human reproduction is a very complex process where failure is a frequent phenomenon. In contrast to many other mammals, whose rates of conception per reproductive cycle can reach 80 percent or more, human fertility seem to be relatively poor (1). In normal couples of proven fertility, the average chance of conceiving in each ovulatory cycle is only 20–25 percent and the peak rate is never higher than 33–35 percent (young women in the first three months of trying). The process can “occasionally” fail at different level: gamete's competence, egg uptake, oocyte and sperm passage along the tubes, fertilization, early embryo cleavage and its transport to the uterus, uterine receptivity, and blastocyst implantation. Human fecundity is also influenced by spontaneous abortion: approximately 15 percent of all established pregnancies end in abortion, with a lower risk (8–11 percent) in women younger than thirty years.
No data are available regarding the in vivo frequency of each step failure before implantation.
On the contrary, in the in vitro system, the first steps are controlled (and or bypassed) and embryos are known to reach the uterine cavity. Nevertheless, four to five early embryos or two to three blastocysts are needed for each baby born. In addition, although the efficiency of ART has significantly improved during the years in terms of total live birth rate, comparison with historical data suggest that the efficiency of oocyte utilization did not show similar improvement (2).
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- Information
- Infertility and Assisted Reproduction , pp. 643 - 656Publisher: Cambridge University PressPrint publication year: 2008