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  3. Human Assisted Reproductive Technology
  • Cited by 5
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    • Publisher:
      Cambridge University Press
      Publication date:
      May 2011
      March 2011
      ISBN:
      9780511734755
      9781107001121
      DOI:
      https://doi.org/10.1017/CBO9780511734755
      Dimensions:
      (246 x 189 mm)
      Weight & Pages:
      0.94kg, 250 Pages
      Dimensions:
      Weight & Pages:
      • Subjects:
      Obstetrics and Gynecology, Reproductive Medicine, Medicine
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    • Selected: Digital
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    Subjects:
    Obstetrics and Gynecology, Reproductive Medicine, Medicine
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    Book description

    Human Assisted Reproductive Technology: Future Trends in Laboratory and Clinical Practice offers a collection of concise, practical review articles on cutting-edge topics within reproductive medicine. Each article presents a balanced view of clinically relevant information and looks ahead to how practice will change over the next five years. The clinical section discusses advances in reproductive surgery and current use of robotic surgery for tubal reversal and removal of fibroids. It looks into the refinement of surgical procedures for fertility preservation purposes. Chapters also discuss non-invasive diagnosis of endometriosis with proteomics technology, new concepts in ovarian stimulation and in the management of polycystic ovary syndrome, and evidence-based ART. The embryology section discusses issues ranging from three-dimensional in-vitro ovarian follicle culture, and morphometric and proteomics analysis of embryos, to oocyte and embryo cyropreservation. This forward-looking volume of review articles is key reading for reproductive medicine physicians, gynecologists, reproductive endocrinologists, urologists and andrologists.

    Reviews

    '… educational, well written and comprehensive …'

    Source: Acta Obstetricia et Gynecologica Scandinavica

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    Contents

    Page 2 of 2

    Contents
    • Chapter 23 - Embryo biopsy:
      pp 260-268
    • towards trophectoderm isolation and blastocyst analysis
    • View abstract

      Summary

      This chapter describes the progress that has been made in the development of in vitro ovarian follicle culture systems, and highlights the importance of maintaining follicular architecture to facilitate follicle growth and oocyte development. The follicle is the main reproductive unit of the ovary, and is composed of a single oocyte and its surrounding somatic support cells. The interaction between follicle cells and the surrounding extracellular matrix (ECM) is essential for facilitating intercellular communication within an individual follicle. The goal in ovarian follicle culture, particularly with follicles from larger mammalian species, is to mimic the complex molecular, functional, and structural changes that occur in vivo in order to produce a fully mature, fertilizable egg in vitro. The chapter reviews the various systems that have been developed for the in vitro culture of preantral follicles. Initial work focused on achieving oocyte growth in vitro relied on adherent two-dimensional (2D) culture systems.
    • Chapter 24 - Analysis of the embryonic transcriptome
      pp 269-277
    • View abstract

      Summary

      This chapter reviews the relevant studies with human and animal cells aimed at the development of artificial gametes. During female gametogenesis (oogenesis), oogonia start the first meiotic division in the fetal period of life, but the process becomes arrested at a late prophase until puberty. Unlike oogenesis, male gametogenesis (spermatogenesis) is a continuous process in which spermatogonia enter meiosis and form primary spermatocytes. The chapter outlines the main methodological problems in artificial female and male gamete production, and suggests possible ways of their solution. As compared with mature oocytes, the use of germinal vesicle oocytes for somatic cell nucleus haploidization represents an even greater challenge because two steps of reduction are necessary. Experiments with the embryonic stem (ES) cells can help understand the mechanisms guiding the differentiation of stem cells towards the germline and thus prepare the route for the work with the adult stem (AS) cells.
    • Chapter 25 - Analysis of embryo-derived factors as markers of developmental potential and viability
      pp 278-288
    • View abstract

      Summary

      This chapter examines the process of in vitro maturation (IVM), its efficacy and safety, and explores why it is not more routinely used to treat infertility and what is required to make it a more viable clinical option. The treatment of infertility is based on in vitro fertilization (IVF) as the technology of choice. IVM is an alternative approach for generating mature oocytes that eliminates or significantly reduces the need for hormonal stimulation of the ovary. The benefit of IVM is that the procedure removes the need to administer large multiple doses of follicle stimulating hormone (FSH) normally used in conventional IVF treatment to women. Current IVM conditions compromise subsequent embryo development rates following fertilization. It is concluded that IVM, despite the reduced efficiencies of implantation potential and increased early miscarriage, should be viewed as having no risk of an adverse outcome to mother and child compared with conventional IVF.
    • Chapter 26 - Proteomics analysis of the endometrium and embryo. Can we improve IVF outcome?
      pp 289-300
    • View abstract

      Summary

      Polscope imaging provides valuable information on the structure and architecture of themeiotic spindle and the zona pellucida (ZP), which helps predict fertilization, embryo development, and pregnancy. Differential interference contrast (DIC) is most efficient when imaging through glass coverslips, an impractical requirement for clinical in vitro fertilization (IVF), so most IVF laboratories employ variations of the DIC method, such as Hoffman modulation (HM). When imaging the oocyte for IVF, it is important to maintain tight temperature control, because both reduced and elevated temperature disrupts the integrity of the meiotic spindle. Spindles can be imaged non-invasively by polarized light microscopy. A quantitative polarized light microscope, the polscope, which uses circularly rather than plane polarized light, provides orientation-independent and, therefore, quantitative measurement of retardance in living specimens. Further studies are needed to determine whether spindle abnormalities predict aneuploidy as revealed by the more invasive preimplantation genetic screening (PGS).
    • Chapter 27 - Analysis of embryo metabolism and the metabolome to identify the most viable embryo within a cohort
      pp 301-312
    • View abstract

      Summary

      The body of knowledge regarding granulosa cell physiology offers an opportunity to improve human assisted reproduction. With the current understanding of granulosa cell/oocyte physiology, it is apparent that the granulosa cell (particularly cumulus cells) pathways are regulated by the oocyte, and the functional properties of the granulosa cells are reflective of oocyte quality. Traditional methods for oocyte and embryo selection for human assisted reproductive technologies (ART) rely on subjective morphological assessments. Biochemical assessment of follicles would generate additional objective information to better understand successful fertilization and embryo development. Cumulus cell co-culture has also been proposed to optimize embryo quality with in vitro fertilization (IVF) aside from the adjunct of in vitro maturation (IVM). In most mammalian species, including humans, the cumulus which surrounds the oocyte is still present at the time of fertilization and remains until embryonic implantation.
    • Chapter 28 - Oocyte and embryo cryopreservation
      pp 313-325
    • View abstract

      Summary

      This chapter examines the current and new methods available to diagnose and select the best sperm to fertilize the egg. Preparation of sperm with media containing antioxidants has shown improvement in the overall functional parameters of the spermatozoa and reduction in the ROS level. This may improve the quality of gametes used for protecting the spermatozoa from high oxidative stress. A novel and promising technique of annexin V-conjugated microbeads (ANMB), magnetic-activated cell sorting (MACS) has been shown to remove spermatozoa with phosphatidylserine externalization (marker of apoptosis) and produce a higher-quality non-apoptotic sperm fraction. Furthermore, these negative-apoptotic marker cells display higher fertilization rates when used for animal model in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). A number of studies have now indicated that hyaluronic acid (HA)-bound sperm used in the ICSI procedure may lead to increased implantation rates.

    Page 2 of 2

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