BookOrhan Bukulmez, editor.
Summary: This book brings together the most current research and the latest clinical approaches to the management of diminished ovarian reserve (DOR), one of the largest segments of the IVF patient population, both in the advanced reproductive age group as well as poor responders. Opening with a review of the definition and scope of the problem, as well as the current understanding of the natural history of DOR, subsequent chapters in part I outline dietary, hormonal, traditional supplements and conventional methods used to stimulate ovaries and improve ART outcomes. The main segment of chapters, comprising part II, present minimal and mild stimulation protocols and alternatives, frozen embryo transfer preparation, trigger agents and post-trigger testing, embryo culture and endometrial considerations, and a review of clinical outcomes. Part III discusses the utilization of contemporary technologies in the treatment of DOR, including fresh vs. frozen embryo transfer, cryopreservation and comprehensive chromosomal analysis. Future prospects are presented in part IV, such as the artificial oocyte and ovary development, early-age oocyte freezing, ovarian cortical tissue freezing and activation of the ovarian cortex. Utilizing the latest evidence and authored by an international array of thought leaders, Diminished Ovarian Reserve and Assisted Reproductive Technologies is an excellent resource for reproductive medicine and REI specialists, IVF lab professionals, and students and residents in these areas.
Contents:
Intro; Foreword I; Foreword II; Preface; Contents; Contributors; Part I: The Paradigm of Diminished Ovarian Reserve, Conventional & Adjuvant Treatment Approaches for Assisted Reproductive Technologies;
Chapter 1: Introduction: The Scope of the Problem with Diminished Ovarian Reserve; 1.1 Definitions: Fertility, Fecundability, and Fecundity; 1.2 Female Age; 1.3 Paradigm of Diminished Ovarian Reserve as a Clinical Reflection of Poor Ovarian Response in Assisted Reproductive Technology; 1.3.1 Poor Ovarian Response per European Society of Human Reproduction and Embryology 1.3.2 Poor Ovarian Response Criteria per Prognostic Factors; 1.4 Conclusion; References;
Chapter 2: Ovarian and Hypothalamic Aging; 2.1 Female Reproductive Aging; 2.2 Female Reproductive Aging and the Ovary; 2.2.1 Markers of Ovarian Aging; 2.2.2 Mechanisms of Ovarian Aging; 2.2.2.1 Genetic and Epigenetic Factors; 2.2.2.2 Role of Mitochondria and Mitochondrial Dysfunction; 2.2.2.3 Oxidative Stress; 2.2.2.4 Stem Cells; 2.2.2.5 Telomeres; 2.2.2.6 Metabolic Factors; 2.2.2.7 Environmental Influence; 2.2.2.8 Other Mechanisms That Affect Ovarian Aging 2.2.3 Animal Models for Accelerated Folliculogenesis in Ovarian Aging 2.3 Female Reproductive Aging and the Hypothalamic-Pituitary Axis; 2.3.1 Neuroendocrine Changes; 2.3.1.1 Rodents; 2.3.1.2 Primates and Humans; 2.3.2 Anatomic and Histologic Changes in the Hypothalamic/Pituitary Axis; 2.4 Conclusion; References;
Chapter 3: Natural History of Diminished Ovarian Reserve; 3.1 Oocyte Endowment Models: Fixed Versus Stem Cell Model; 3.2 Decline in Ovarian Reserve Over Time; 3.2.1 Estimating the Age of Natural Menopause with Histological Assessment of the Ovary 3.2.2 Estimating the Age of Menopause with Anti-Mullerian Hormone; 3.2.3 Past and Current Models for Ovarian Aging; 3.2.4 Stages of Reproductive Aging Workshop (STRAW) and the Ovarian Aging Model; 3.2.5 The Latest Ovarian Aging Model for NGF Loss; 3.2.6 Experience from Ovarian Autotransplantation; 3.3 Decline in Oocyte Quality; 3.4 Fertility Decline as Reflection of General Aging; 3.5 Conclusion; References;
Chapter 4: Definitions and Relevance: Diminished Ovarian Reserve, Poor Ovarian Response, Advanced Reproductive Age, and Premature Ovarian Insufficiency; 4.1 Introduction 4.2 Different Definition of Diminished Ovarian Reserve; 4.3 Advanced Reproductive Age, Poor Ovarian Response, and Gonadotropin Dose; 4.4 Premature Ovarian Insufficiency; 4.5 Majority of the Poor Ovarian Response Is Due to Diminished Ovarian Reserve Albeit Ovarian Reserve Assessment in General Population May Not Predict Fertility; 4.6 Closing Remarks and Conclusion; References;
Chapter 5: Food Supplements and Hormonal Products to Improve Assisted Reproductive Technology Outcomes in Patients with Diminished Ovarian Reserve; 5.1 Introduction; 5.2 Hormonal Supplementation in Women with POR ; 5.2.1 Growth Hormone