The Fertility Promise: The Facts Behind in vitro Fertilisation (IVF)

The Fertility Promise is a complete guide to the often emotional, expensive and confusing process of fertility treatment. The book offers clear explanations and advice to anyone undergoing fertility treatment (such as in vitro fertilization) or anyone seeking information about relevant treatment options. The information includes advice to both male and female patients, LGBT patients, IVF clinics, the IVF treatment process, the issues surrounding IVF ‘add-ons’, what it is really like to go through fertility treatment and what the future of IVF might look like. Covering every aspect of the topic, the book is an extremely important point of reference for all fertility patients as well as individuals who wish to broaden their perspective on fertility medicine and clinics. The Fertility Promise informs both general readers and empowers fertility patients who are looking for the correct treatment, enabling them to clearly understand the fertility treatment process and to ask appropriate and often revealing questions on the subject. Cover 1 Title 2 Copyright 3 End User License Agreement 4 Contents 6 Preface 11 CONSENT FOR PUBLICATION 12 CONFLICT OF INTEREST 12 ACKNOWLEDGEMENTS 12 Dedication 13 A Bit of History 14 Peter Hollands 14 A CHILD IS BORN 14 CONTROVERSY 15 OTHER OPTIONS FOR FERTILITY PATIENTS? 16 THE FIRST FERTILITY TREATMENTS 16 The First Technology 17 Fertility Treatment Today 18 Global IVF 18 Money! 19 ‘Breakthroughs’ 20 Nobel Prize 20 Still Not A Cure 21 Population Growth 21 ADOPTION 22 PIONEERING TIMES 22 BLACK MONDAY 23 INPATIENTS AND REGULATION 23 MORE RECENTLY 24 INNOVATION 25 PROFIT AND ‘ADD-ONS’ 25 STAGNATION 26 THE FUTURE 26 KEY POINTS OF CHAPTER 1 28 The Female Patient 29 Peter Hollands 29 INTRODUCTION 29 FEMALE INFERTILITY 30 Blocked Tubes 30 Endometriosis 30 Polycystic Ovary Syndrome (PCOS) 31 Thyroid 31 Premature Menopause 31 Surgical Damage and Fibroids 32 Sterilisation 32 Medications 33 Other Causes of Infertility 33 Idiopathic Infertility 33 Stress! 34 ‘BACK-TO-BACK’ TREATMENTS 35 A FINAL PRAYER 36 KEY POINTS OF CHAPTER 2 36 The Male Patient 37 Peter Hollands 37 INTRODUCTION 37 THE MALE ROLE IN FERTILITY TREATMENT 37 THE ‘MEN’S ROOM’ PORNOGRAPHY AND SEMEN ASSESSMENT 38 Hot Pants! 40 Testicular Damage 40 Vasectomy 40 Ejaculation and Psychosexual Disorders 41 Hormonal and Genetic Disorders 42 Medicines and Drugs 42 Life-style Issues 43 Stress 43 A FINAL PRAYER 44 KEY POINTS OF CHAPTER 3 44 The LGBT Patients 45 Peter Hollands 45 INTRODUCTION 45 SAME SEX FEMALE PATIENTS 45 Surrogacy for Same Sex Female Patients 46 Female Partner Providing Eggs for Treatment 46 SAME SEX MALE PATIENTS 47 Egg Donation and Surrogacy 47 Gender Re-Assignment 47 KEY POINTS OF CHAPTER 4 48 IVF Clinics 49 Peter Hollands 49 INTRODUCTION 49 MONEY! 50 PROFIT (OK, BUT NOT TOO MUCH!) 52 PUBLIC PROVISION OF IVF SERVICES (DIFFICULT TO DELIVER) 52 TREATMENT CYCLE NUMBERS (SIZE IS NOT EVERYTHING) 55 ‘FAMOUS’ (OR INDEED INFAMOUS) CLINIC STAFF 55 IVF MARKETING (CAVEAT EMPTOR!) 55 IVF CLINIC STATISTICS (IS THAT BLACK ACTUALLY WHITE OR IS IT GREY?) 56 SERVICE (GOOD, BAD OR INDIFFERENT) 58 FERTILITY CLINIC FACILITIES 59 FERTILITY CLINIC STAFF 60 FERTILITY CLINIC TECHNOLOGY 60 QUESTIONS TO ASK A FERTILITY CLINIC 61 KEY POINTS OF CHAPTER 5 62 The Basic Treatment 63 Peter Hollands 63 INTRODUCTION 63 THE FERTILITY MEDICATIONS 63 FOLLICULAR GROWTH MONITORING 65 OVARIAN HYPER-STIMULATION SYNDROME 65 THE EGG COLLECTION 65 SEMEN PRODUCTION AND INSEMINATION 66 IVF FROM A LABORATORY VIEWPOINT 67 THE EMBRYO REPLACEMENT (TRANSFER) 69 EMBRYO FREEZING AND REPLACEMENT 70 THE PREGNANCY TEST AND THE DAY 35 SCAN 71 A ‘PRECIOUS’ PREGNANCY 72 DONOR GAMETES (DONOR SPERM AND DONOR EGGS) 72 Donor Sperm 72 Donor Sperm in IVF 73 Donor Eggs in IVF 73 KEY POINTS OF CHAPTER 6 73 The ‘Add-Ons’ Scandal 86 Peter Hollands 86 INTRODUCTION 86 IVF TECHNOLOGIES AND WORK PRACTICE 87 The ‘Right’ Patient 87 ‘Wobbly’ Evidence 88 A ‘Re-Boot’ of IVF 89 TREATMENTS OF MALE INFERTILITY 90 ‘Catching Sperm’ 90 ‘Add-ons’ 92 Intracytoplasmic Sperm Injection (ICSI) and Related Technologies 92 Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) 93 Physiological Intracytoplasmic Sperm Injection (PICSI) 94 Sperm DNA Fragmentation Testing 94 Time-Lapse Video Analysis of Embryonic Development 95 Pre-Implantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD) 95 Pre-Implantation Genetic Screening (Aneuploidy Screening) 95 Pre-Implantation Genetic Diagnosis (PGD) 96 Endometrial ‘scratching’ (Endometrial Injury) 96 Assisted Hatching 96 Embryo Glue 97 Elective Freeze All Cycles 97 Reproductive Immunology 97 Acupuncture 98 CONCLUSIONS ON ‘ADD-ONS’ 98 MISLEADING 99 COUNSELLING AND CLINICAL TRIALS 100 STARTING FROM SCRATCH AND ‘BLOBS’ 101 KEY POINTS OF CHAPTER 7 101 The Regulators and Professional Societies 102 Peter Hollands 102 INTRODUCTION 102 POWER IS NOT ALWAYS A GOOD THING 102 UK REGULATION 103 THE ROLE OF A REGULATORY AUTHORITY 103 What Does the Regulatory Authority Regulate? 104 The European Society for Human Reproduction and Embryology (ESHRE) 108 KEY POINTS OF CHAPTER 8 108 The Patient ‘Journey’ 109 Peter Hollands 109 THE JOURNEY 109 First Things First 110 Time is Running Out! 111 The First Consultation 111 The Second and Nurse Consultation 112 At Last! The Treatment is Starting! 113 The Day of Egg Collection 113 Fertilisation Day and Onwards 114 Embryo Replacement (Transfer) Day 115 It’s Freezing in Here! 115 Pregnancy Test Day 115 The Day 35 ‘Heart Beat Scan’ 116 KEY POINTS OF CHAPTER 9 116 Advice to Fertility Patients 118 Peter Hollands 118 INTRODUCTION 118 MORE ADVICE ON ADVICE 119 Optimism and Electronic Advice 120 Clinic Counsellor 120 Who to Tell? 121 Family? 121 Friends? 122 Should I Tell People At Work? 122 Smoking, Alcohol, Obesity and Underweight 123 Smoking 123 Alcohol 124 Obesity 125 Back-to-Back Treatment Cycles 127 Egg Freezing: Good Idea, False Hope or Money-Making Machine? 128 Add-ons 130 Pregnancy, Birth and Parenthood 130 Pregnancy 131 Childbirth (Labour) 131 Parenthood 132 A Second Opinion? 132 CHANGING FERTILITY CLINICS? 133 INFERTILITY AND MENTAL HEALTH 134 IVF MYTHS 135 KEY POINTS OF CHAPTER 10 135 The Future of IVF 137 Peter Hollands 137 INTRODUCTION 137 FUTURE TECHNOLOGY 137 The Starting Point 138 Innovations 140 Profit! 140 Stagnation 141 A PROMISING FUTURE? 142 Telemedicine 142 INVOcell-A Possible Cheaper Version of IVF? 143 Laboratory Automation 144 Artificial Intelligence 145 Quantum Biology and Quantum Physics 145 PRP and Stem Cells 146 Embryonic Stem Cells and Hybrids 148 KEY POINTS OF CHAPTER 11 149 A Final Thought 150 Peter Hollands 150 INTRODUCTION 150 FERTILITY PATIENTS 150 PHYSICIANS 151 CLINICAL EMBRYOLOGISTS 152 FERTILITY NURSES 153 CLINICS 154 CONCLUSION 154 KEY POINTS OF CHAPTER 12 155 Suggested Further Reading 156 USEFUL WEBSITES 156 Glossary 157 Subject Index 159 Back Cover 165