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  3. Implantation and Early Development
Publisher:
Cambridge University Press
Online publication date:
June 2014
Print publication year:
2005
Online ISBN:
9781107784680
DOI:
https://doi.org/10.1017/CBO9781107784680
Subjects:
Obstetrics and Gynecology, Reproductive Medicine, Medicine
Series:
Royal College of Obstetricians and Gynaecologists Study Group
Information

Book description

Successful implantation and early development need a union of healthy genes and an optimal uterine environment. The 48th RCOG Study Group, an international multidisciplinary expert forum, considered factors involved in preparation for implantation within the uterus; how to determine a good egg and good sperm; lessons from animal models; transgenic and genomic technologies; sporadic and recurrent early pregnancy loss; single-embryo transfer; and the developmental consequences of assisted reproduction technologies. This book presents the findings of the Study Group, with sections covering:preparation for implantation - the uterine environmentthe embryolessons from animal models (transgenics) and novel technologiesclinical sequelae.

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Contents

Page 2 of 2

Contents
  • 22 - Paediatric outcome after assisted reproductive technology
    pp 268-280
  • View abstract

    Summary

    Plurality at birth is of prime importance and is the single most significant determinant of paediatric outcome after assisted reproductive technology (ART). The types of treatment used, such as in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), blastocyst transfer and others, become mere subtleties when faced with the birth of triplets. There is probably a continuum of risk between standard IVF and the more recent ICSI, with even more invasive forms of ART such as ICSI with testicular sperm aspiration (TESA) being of higher risk for the birth of children with birth defects. Doyle et al estimated that 20000 children would be required to observe a doubling or halving of the risk of childhood cancer in children conceived after ART compared with the general population. There has been some suggestion from a Swedish study that children born after IVF have an increased risk of developing neurological problems, particularly cerebral palsy.
  • 23 - Consensus views arising from the 48th Study Group: Implantation and Early Development
    pp 283-286
  • View abstract

    Summary

    The multidisciplinary systems biology approach that is needed to assess endometrial receptivity should be used to understand the reciprocal dialogue between the embryo and the decidualised endometrium. This chapter focuses on human embryo research and the development of appropriate functional models of implantation that will allow the investigation of molecules mediating blastocyst-endometrial/decidual interaction. Ectopic pregnancy could be considered as a model to study the failure or the absence of mechanisms that limit implantation. Experience with cell nuclear replacement has identified the key role of cytoplasmic and nuclear factors for normal embryonic development. The conventional measurements of sperm concentration, motility and morphology only act as surrogate markers of fertility. Pre-implantation genetic diagnosis (PGD) should be carried out by specialist centres that have a multidisciplinary genetic support infrastructure including genetic counselling, and clinical pathology accreditation (CPA) qualified cytogenetics and molecular genetics laboratories.

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