Suzanne Kavic

Oocyte and embryo donation 2006: reviewing two decades of innovation and controversy

For over 21 years, oocyte and embryo donation have been used to treat infertility caused by a variety of conditions affecting the ovary. Many disorders, including premature ovarian failure, advanced reproductive age, unexplained recurrent implantation failure and inherited conditions, are amenable to gamete donation, with high pregnancy rates and good obstetrical outcomes observed in recipients. Protocols for the medical screening of recipients and donors, as well as infectious disease and genetic testing, have become relatively uniform and well accepted. Established guidelines allow synchronization of the menstrual cycles of both women to ensure that embryos are transferred to a receptive endometrium. The high demand for donor services has led to escalating costs and long waiting lists. American programmes bid against each other to secure the participation of young women often motivated as much by financial reward as altruism. In the United States, where the majority of oocyte donation is practised, more than 100,000 treatment cycles have occurred. However, to date no meaningful longitudinal studies detailing the long term effects of treatment on donors, recipients, children born, or families created have been published. Throughout its history, oocyte and embryo donation has proven to be both efficacious and clinically innovative, yet remains highly controversial.

Short Communication: Oocyte Donation Treats Infertility in Survivors of Malignancies: Ten-Year Experience

Women who are survivors of malignancy may achieve pregnancy through oocyte donation. The largest obstacle to successful reproduction in cancer patients relates to iatrogenic damage to the primary reproductive organs associated with their primary oncology treatment. Reactive damage from surgery, radiation, or chemotherapy may render these organs nonfunctional and irreparable. In cases where the ovary is primarily affected, oocyte donation provides a logical alternative for childbearing.

Intraoperative applications of saline infusion ultrasonography

The use of abdominal or transvaginal sonography combined with the introduction of saline into the upper genital tract, called sonohysterography (SHG), has become a routine gynecologic procedure for diagnostic evaluation of uterine cavity pathology. Its use has been applied in the evaluation of women with infertility, recurrent miscarriage, and abnormal uterine bleeding, as well as the assessment of tubal anatomy (1). Newer applications continue to be described including therapeutic intervention with ultrasound-guided fallopian tube cannulation for proximal tubal obstruction (2) and intrauterine biopsy and resection using concomitant transvaginal SHG (3). Intraoperative ultrasonography has been described for procedures such as dilation and evacuation for cervical stenosis and assuring complete removal of products of conception, removal of impacted foreign bodies, operative hysteroscopy, and placement of intrauterine tandem apparatus for intracavitary radiation to avoid uterine perforation (4-6). We now report the use of SHG as an adjunct to operative hysteroscopy and laparotomy and discuss its role for intrauterine, endoscopic procedures.

Oocyte donation treats infertility in survivors of malignancies

Women who are survivors of malignancy may achieve pregnancy through oocyte donation. The largest obstacle to successful reproduction in cancer patients relates to iatrogenic damage to the primary reproductive organs associated with their primary oncology treatment. Reactive damage from surgery, radiation, or chemotherapy may render these organs nonfunctional and irreparable. In cases where the ovary is primarily affected, oocyte donation provides a logical alternative for childbearing.