Surgery, Assisted Reproductive Technologies and Infertility describes the intersection of assisted reproductive technologies (ART) and surgery in the diagnosis and treatment of a variety of clinical disorders in reproduction. Unlike many texts currently available, this book provides a road map for management well beyond the how-to for a given problem. It brings you a cogent explanation about the when and why of management. The author balances decision trees and management paradigms with equal weight to surgery and ART as complementary procedures to enhance reproductive potential. He carefully explains options incorporating diagnostic studies into the paradigm that include conventional radiography (eg, hysterosalpingography), two- and three-dimensional ultrasound imaging and MRI analysis. The text includes clear discussion of the rationale for selecting one technique over another and the supporting role for surgery as a prelude to ART or as an appropriate first line management.
The text is centered on dividing evaluations in infertility into the tandem topics of structure and function. All chapters include data from studies directed at the assessment of structure using two- or three-dimensional ultrasound and the assessment of function using the technology of the emerging field of functional genomics. The introductory chapters cover embryology and anatomy of the female reproductive tract, evidence-based medicine in reproductive medicine and diagnostic studies that include imaging studies and the emerging field of microarray analysis and the insight gained from this technology. Each clinical chapter describes specific anatomic abnormalities and an approach emphasizing contemporary diagnostics and therapeutics. Every chapter begins with a historical perspective followed by discussions of state-of-the-art diagnostic studies, etiology, surgical management and guidelines for arriving at an outcomes driven decision regarding the intersection of surgery and ART. The discussion is supported by over 300 images and drawings illustrating each abnormality and surgical procedure.
All recommendations are data and outcomes based. This approach minimizes anecdotal data, intuition or clinical hearsay. The text emphasizes an evidence-based approach and presents outcomes to support suggested plans of management. The most clinically and cost effective technology is matched to the clinical setting. Bottom line recommendations are written in a clear and concise bullet presentation at the conclusion of each chapter to help you meet the challenge of clinical infertility practice.
Table of Contents
Development of the Reproductive Tract
Evidence-Based Medicine and Clinical Algorithms for Management
Diagnostic Procedures Prior to Surgery and Assisted Reproductive Technology
Structural Abnormalities of the Uterus: Unicornuate Uterus and Rudimentary Uterine Horn
Septate, Arcuate, Bicornuate, and Bidelphic Uteri
Uterine Abnormalities Resulting from DES Exposure
Leiomyomata, Fertility, and Assisted Reproductive Technology
Congenital Absence of the Uterine Cervix
Cervical Stenosis and Techniques of Embryo Transfer
Distal Tubal Obstruction: Surgery and Assisted Reproductive Technology
Proximal Tubal Obstruction
Isthmic and Mid-Tubal Obstruction
Endometriosis and Ovarian Endometriomas
Polycystic Ovary Syndrome
Pelvic Adhesive Disease
"…Trainees and practitioners in reproductive medicine and surgery will find this book useful as a reference work and as a guide to the technique."
-The Obstetrician and Gynecologist