Caroline Overton

Good Clinical Practice in Assisted Reproduction: Clinical assessment of the woman for assisted conception

In the last four decades significant progress has been made in the diagnosis and treatmentof infertile couples. It is currently estimated that about90%ofwomenwill achieve pregnancy in the first year of trying to conceive and 95% within the second year, following which the chances of natural conception are lower. The remaining 5–10%canbe defined as infertile and requiring investigation and treatment (WHO, 1992; ESHRE Capri Workshop, 1996). This timeframe can be shorter in women with risk factors such as previous history of pelvic inflammatory disease (PID), pelvic surgery, ectopic pregnancy, family history of premature ovarian failure and in women aged 35 years and over due to the natural age-related decline in fertility (van Noord-Zaadstra et al., 1991). Increasing numbers of women are delaying childbearing to an age when they are more likely to encounter problems with conceiving, and public awareness of the scientific progress made in the field of assisted conception has led to an increased number of people seeking treatment. The first consultation between an infertile couple and the clinician specializing in infertility is a crucial starting point for collecting the medical history, clinical examination and the evaluation of the appropriateness of a range of investigations to establish the cause of infertility, following which a strategy for treatment can be planned. When infertile couples present at tertiary assisted conception centres often they will have been referred by a general practitioner or gynaecologist and may already have completed basic infertility assessment. In this event it is often possible to discuss treatment strategies during the first consultation. First consultation: Medical history. Clinical examination. Investigations: – cause of infertility; – strategy of treatment.

Clinical assessment of the woman for assisted conception

In the last four decades significant progress has been made in the diagnosis and treatmentof infertile couples. It is currently estimated that about90%ofwomenwill achieve pregnancy in the first year of trying to conceive and 95% within the second year, following which the chances of natural conception are lower. The remaining 5–10%canbe defined as infertile and requiring investigation and treatment (WHO, 1992; ESHRE Capri Workshop, 1996). This timeframe can be shorter in women with risk factors such as previous history of pelvic inflammatory disease (PID), pelvic surgery, ectopic pregnancy, family history of premature ovarian failure and in women aged 35 years and over due to the natural age-related decline in fertility (van Noord-Zaadstra et al., 1991). Increasing numbers of women are delaying childbearing to an age when they are more likely to encounter problems with conceiving, and public awareness of the scientific progress made in the field of assisted conception has led to an increased number of people seeking treatment. The first consultation between an infertile couple and the clinician specializing in infertility is a crucial starting point for collecting the medical history, clinical examination and the evaluation of the appropriateness of a range of investigations to establish the cause of infertility, following which a strategy for treatment can be planned. When infertile couples present at tertiary assisted conception centres often they will have been referred by a general practitioner or gynaecologist and may already have completed basic infertility assessment. In this event it is often possible to discuss treatment strategies during the first consultation. First consultation: Medical history. Clinical examination. Investigations: – cause of infertility; – strategy of treatment.

Good Clinical Practice in Assisted Reproduction: Frontmatter

1. Clinical assessment of the woman for assisted conception Domenico Massimo Ranieri 2. Clinical assessment and management of the infertile man Suks Minhas and David Ralph 3. Laboratory assessment of the infertile man John Aitken 4. Donor insemination Matthew Tomlinson and Christopher Barratt 5. Treatment options prior to IVF Roger Hart and Melanie Davies 6. Strategies for superovulation for IVF Adam Balen 7. Techniques for IVF Tim J. Child, Imran Pirwany and Seang Lin Tan 8. Ovarian hyperstimulation syndrome Botros Rizk and Mary George Nawar 9. Early pregnancy complications after ART Eric Jauniaux and Natalie Greenwold 10. Oocyte donation Paul Serhal 11. Surrogacy Peter Brinsden 12. Clinical aspects of preimplantation genetic diagnosis Joyce Harper and Joy Delhanty 13. Controversial issues in assisted reproduction Caroline Overton and Colin Davis 14. Alternatives to IVF Ehab Kelada and Ian Craft 15. Counselling Jennifer Clifford 16. Good nursing practice in assisted conception Kathy Boon, Lee Oliphant and Elizabeth Fleming 17. Setting up an IVF unit Alpesh Doshi, Massimo Ranieri and Caroline Overton 18. Information technology Rene van den Berg 19. ART in older women Paul Serhal 20. Ethical aspects of controversies in ART Francoise Shenfield.

Good clinical practice in assisted reproduction

1. Clinical assessment of the woman for assisted conception Domenico Massimo Ranieri 2. Clinical assessment and management of the infertile man Suks Minhas and David Ralph 3. Laboratory assessment of the infertile man John Aitken 4. Donor insemination Matthew Tomlinson and Christopher Barratt 5. Treatment options prior to IVF Roger Hart and Melanie Davies 6. Strategies for superovulation for IVF Adam Balen 7. Techniques for IVF Tim J. Child, Imran Pirwany and Seang Lin Tan 8. Ovarian hyperstimulation syndrome Botros Rizk and Mary George Nawar 9. Early pregnancy complications after ART Eric Jauniaux and Natalie Greenwold 10. Oocyte donation Paul Serhal 11. Surrogacy Peter Brinsden 12. Clinical aspects of preimplantation genetic diagnosis Joyce Harper and Joy Delhanty 13. Controversial issues in assisted reproduction Caroline Overton and Colin Davis 14. Alternatives to IVF Ehab Kelada and Ian Craft 15. Counselling Jennifer Clifford 16. Good nursing practice in assisted conception Kathy Boon, Lee Oliphant and Elizabeth Fleming 17. Setting up an IVF unit Alpesh Doshi, Massimo Ranieri and Caroline Overton 18. Information technology Rene van den Berg 19. ART in older women Paul Serhal 20. Ethical aspects of controversies in ART Francoise Shenfield.

Good Clinical Practice in Assisted Reproduction: Good Clinical Practice in Assisted Reproduction

1. Clinical assessment of the woman for assisted conception Domenico Massimo Ranieri 2. Clinical assessment and management of the infertile man Suks Minhas and David Ralph 3. Laboratory assessment of the infertile man John Aitken 4. Donor insemination Matthew Tomlinson and Christopher Barratt 5. Treatment options prior to IVF Roger Hart and Melanie Davies 6. Strategies for superovulation for IVF Adam Balen 7. Techniques for IVF Tim J. Child, Imran Pirwany and Seang Lin Tan 8. Ovarian hyperstimulation syndrome Botros Rizk and Mary George Nawar 9. Early pregnancy complications after ART Eric Jauniaux and Natalie Greenwold 10. Oocyte donation Paul Serhal 11. Surrogacy Peter Brinsden 12. Clinical aspects of preimplantation genetic diagnosis Joyce Harper and Joy Delhanty 13. Controversial issues in assisted reproduction Caroline Overton and Colin Davis 14. Alternatives to IVF Ehab Kelada and Ian Craft 15. Counselling Jennifer Clifford 16. Good nursing practice in assisted conception Kathy Boon, Lee Oliphant and Elizabeth Fleming 17. Setting up an IVF unit Alpesh Doshi, Massimo Ranieri and Caroline Overton 18. Information technology Rene van den Berg 19. ART in older women Paul Serhal 20. Ethical aspects of controversies in ART Francoise Shenfield.

Good Clinical Practice in Assisted Reproduction: Contents

1. Clinical assessment of the woman for assisted conception Domenico Massimo Ranieri 2. Clinical assessment and management of the infertile man Suks Minhas and David Ralph 3. Laboratory assessment of the infertile man John Aitken 4. Donor insemination Matthew Tomlinson and Christopher Barratt 5. Treatment options prior to IVF Roger Hart and Melanie Davies 6. Strategies for superovulation for IVF Adam Balen 7. Techniques for IVF Tim J. Child, Imran Pirwany and Seang Lin Tan 8. Ovarian hyperstimulation syndrome Botros Rizk and Mary George Nawar 9. Early pregnancy complications after ART Eric Jauniaux and Natalie Greenwold 10. Oocyte donation Paul Serhal 11. Surrogacy Peter Brinsden 12. Clinical aspects of preimplantation genetic diagnosis Joyce Harper and Joy Delhanty 13. Controversial issues in assisted reproduction Caroline Overton and Colin Davis 14. Alternatives to IVF Ehab Kelada and Ian Craft 15. Counselling Jennifer Clifford 16. Good nursing practice in assisted conception Kathy Boon, Lee Oliphant and Elizabeth Fleming 17. Setting up an IVF unit Alpesh Doshi, Massimo Ranieri and Caroline Overton 18. Information technology Rene van den Berg 19. ART in older women Paul Serhal 20. Ethical aspects of controversies in ART Francoise Shenfield.

Good Clinical Practice in Assisted Reproduction: Index

1. Clinical assessment of the woman for assisted conception Domenico Massimo Ranieri 2. Clinical assessment and management of the infertile man Suks Minhas and David Ralph 3. Laboratory assessment of the infertile man John Aitken 4. Donor insemination Matthew Tomlinson and Christopher Barratt 5. Treatment options prior to IVF Roger Hart and Melanie Davies 6. Strategies for superovulation for IVF Adam Balen 7. Techniques for IVF Tim J. Child, Imran Pirwany and Seang Lin Tan 8. Ovarian hyperstimulation syndrome Botros Rizk and Mary George Nawar 9. Early pregnancy complications after ART Eric Jauniaux and Natalie Greenwold 10. Oocyte donation Paul Serhal 11. Surrogacy Peter Brinsden 12. Clinical aspects of preimplantation genetic diagnosis Joyce Harper and Joy Delhanty 13. Controversial issues in assisted reproduction Caroline Overton and Colin Davis 14. Alternatives to IVF Ehab Kelada and Ian Craft 15. Counselling Jennifer Clifford 16. Good nursing practice in assisted conception Kathy Boon, Lee Oliphant and Elizabeth Fleming 17. Setting up an IVF unit Alpesh Doshi, Massimo Ranieri and Caroline Overton 18. Information technology Rene van den Berg 19. ART in older women Paul Serhal 20. Ethical aspects of controversies in ART Francoise Shenfield.