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Includes bibliographical references and index
Infertility, as with many aspects of medicine, is at the mercy of rapid technological advance. Many of these developments initially seem attractive to both clinicians and patients, but need to be rigorously assessed if their real value is to be understood and clinical practice is to develop. In this book issues of importance to the management of infertile patients are discussed. The gaps in our knowledge which prevent a better understanding of the condition are identified, and recent developments, both clinical and scientific, are subjected to peer review and discussion. An important feature of the book is an acceptance that training in infertility practice is a real problem. This is perceived not only by the practising clinicians, both doctors and nurses, but particularly by the clinical scientists, including embryologists, who now provide such an essential part of the service. Similarly the provision of the clinical service has been examined in detail from a variety of standpoints, in an attempt to make sensible recommendations which balance real need with limited resource. The book is based on the papers presented and discussed at the 25th RCOG Study Group held in April 1992. The discussion after each paper was civilised but uncompromising and forms an important part of this publication. The rapid processing of the written and recorded material by the staff at the RCOG, and particularly Miss Sally Barber, has ensured that the book has been produced while the issues are live, the reviews contemporary and the discussion relevant.
Section I: Epidemiology and Clinical Presentation.- 1 Reproductive Trends in the UK.- 2 The Epidemiology of Infertility.- 3 The Causes of Infertility and Relative Effectiveness of Treatment.- Discussion.- Section II: Investigation and Treatment of the Male.- 4 Male Infertility Due to Testicular Dysfunction.- 5 Diagnosis of Male Infertility.- Discussion.- 6 Sperm Preservation: Fundamental Cryobiology and Practical Implications.- 7 Sperm-Egg Manipulation for the Treatment of Male Infertility.- 8 Epididymal Surgery.- Discussion.- Section III: Investigation and Treatment of the Female.- 9 Tubal Physiology and Function.- 10 Falloposcopy.- Discussion.- 11 The Role of Reproductive Surgery.- 12 Advanced Videolaparoscopy and Videolaseroscopy.- 13 Surgery and the Polycystic Ovarian Syndrome.- Discussion.- 14 Manipulation of the Ovarian Cycle.- 15 Induction of Ovulation.- Discussion.- Section IV: Assisted Reproduction and Related Techniques.- 16 Cryopreservation of Mammalian Oocytes.- 17 Extracorporeal Development of Immature Ovarian Follicles.- Discussion.- 18 Egg and Embryo Donation: Implantation Aspects.- 19 The Social Aspects of Ovum Donation.- 20 Egg and Embryo Donation: Legal Aspects.- Discussion.- 21 Embryo Micromanipulation.- 22 Preimplantation Diagnosis of Genetic Defects.- Discussion.- Section V: Training in Infertility.- 23 Training in Infertility: The Role of the Royal College of Obstetricians and Gynaecologists.- 24 Infertility Nurses and Counselling.- 25 Training and Accreditation of IVF Embryologists.- Discussion.- Section VI: Service Provision.- 26 The Patients' Viewpoint.- 27 Service Provision: A Tertiary Clinic Director's View.- 28 Public Health Aspects of Subfertility.- Discussion.- Recommendations.
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