The births of more than 100 apparently normal infants at term following pregnancies initiated by in vitro fertilization and embryo transfer testifies to the successful clinical application of insights obtained from studies in reproductive biology over the last 20 years. In women, these studies have included: 1) characterization of the changes in blood hormone profiles throughout ovulatory menstrual cycles; 2) documentation of the hormonal composition of antral fluid in developing and degenerating preovulatory follicles; 3) correlation of these observations with the state of oocyte maturation and the fertilizability of the oocyte; 4) application of pharmacologic agents for perturbing the normal hormone profiles to regulate the number of preovulatory follicles developing and the time of ovulation; and 5) development of non-invasi ve methods for monitoring follicular development. Optimizing methods for maturing and fertilizing eggs, for moni toring normal development in vi tro, and for transferring and achieving implantation of embryos are continuing concerns of physicians and scientists responsible for extant programs. In addition, all serious students of reproductive biology should critically examine every facet of the processes which must concatenate to assure birth of normal infants following pregnancies achieved by these methods. However, the literature which contains the informational substrate is dispersed widely in a plethora of journals not always readily accessible. Bringing the essentials together facilitates both rapid retrieval of data and access to relevant literature.
Man is entering a new era as a result of advances in human reproduction. Techniques have been developed to assist in the creation of man-artificial insemination and, now, in vitro fertilization (IVF). Soon, other new methods, based upon current advances of the IVF procedure, will develop to improve the quality of human reproduction. The book describes the conceptual framework and details of technique concerned with in vitro fertilization and embryo transfer (ET). Edwards and Steptoe first described the technique of IVF and ET and the subsequent births of two normal babies. Since then, the success rate of the system has been improved by the use of fertility drugs to provide more oocytes and preincubation to mature the oocyte before fertilization. As a result of the continued research from Melbourne and Cambridge, more than 100 babies have been born. A free interchange of information between the Cambridge and Melbourne groups has led to a predictable success rate of 15%-20% per laparoscopy, and infertility centres all over the world are now copying the techniques. It is an appropriate time to inform doctors and scientists to help them understand the various procedures involved in IVF and ET. While many advances will occur in the future, the establishment of high success rates in several of the critical steps in the procedure-oocyte pick-up rate (90%), fertilization (>90%) and early embryo development (70%-90% )-signifies that some of the new techniques are stabilized sufficiently to warrant transmission of information by text, rather than scientific journal.
The Routledge Companion to Bioethics is a comprehensive reference guide to a wide range of contemporary concerns in bioethics. The volume orients the reader in a changing landscape shaped by globalization, health disparities, and rapidly advancing technologies. Bioethics has begun a turn toward a systematic concern with social justice, population health, and public policy. While also covering more traditional topics, this volume fully captures this recent shift and foreshadows the resulting developments in bioethics. It highlights emerging issues such as climate change, transgender, and medical tourism, and re-examines enduring topics, such as autonomy, end-of-life care, and resource allocation.
Examines 2 different and often opposing worlds of in vitro fertilization: the public's political, legal and ethical concerns surrounding the technique, and the personal, pragmatic world of the individual patients who come to the centers seeding a cure for infertility. This book provides a objective analysis which answers many perplexing questions.