Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- PART III ASSISTED REPRODUCTION
- 38 Medical Strategies to Improve ART Outcome: Current Evidence
- 39 Surgical Preparation of the Patient for In Vitro Fertilization
- 40 IVF in the Medically Complicated Patient
- 41 Polycystic Ovary Syndrome and IVF
- 42 Endometriosis and Assisted Reproductive Technology
- 43 Evidence-Based Medicine Comparing hMG/FSH and Agonist/Antagonist and rec/Urinary hCG/LH/GnRH to Trigger Ovulation
- 44 Luteal Phase Support in Assisted Reproduction
- 45 Thrombophilia and Implanation Failure
- 46 Intrauterine Insemination
- 47 The Prediction and Management of Poor Responders in ART
- 48 Oocyte Donation
- 49 In Vitro Maturation of Human Oocytes
- 50 Oocyte and Embryo Freezing
- 51 Cryopreservation of Male Gametes
- 52 The Management of Azoospermia
- 53 Spermatid Injection: Current Status
- 54 Optimizing Embryo Transfer
- 55 Single Embryo Transfer
- 56 Blastocyst Transfer
- 57 Clinical Significance of Embryo Multinucleation
- 58 Quality and Risk Management in the IVF Laboratory
- 59 The Nurse and REI
- 60 Understanding Factors That Influence the Assessment of Outcomes in Assisted Reproductive Technologies
- 61 The Revolution of Assisted Reproductive Technologies: How Traditional Chinese Medicine Impacted Reproductive Outcomes in the Treatment of Infertile Couples
- 62 Complications of Assisted Reproductive Technology
- 63 Ectopic and Heterotopic Pregnancies Following in Vitro Fertilization
- 64 The Impact of Oxidative Stress on Female Reproduction and ART: An Evidence-Based Review
- 65 PGD for Chromosomal Anomalies
- 66 Preimplantation Genetic Diagnosis for Single-Gene Disorders
- 67 Epigenetics and ART
- 68 Congenital Anomalies and Assisted Reproductive Technology
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
60 - Understanding Factors That Influence the Assessment of Outcomes in Assisted Reproductive Technologies
from PART III - ASSISTED REPRODUCTION
Published online by Cambridge University Press: 04 August 2010
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introduction
- PART I PHYSIOLOGY OF REPRODUCTION
- PART II INFERTILITY EVALUATION AND TREATMENT
- PART III ASSISTED REPRODUCTION
- 38 Medical Strategies to Improve ART Outcome: Current Evidence
- 39 Surgical Preparation of the Patient for In Vitro Fertilization
- 40 IVF in the Medically Complicated Patient
- 41 Polycystic Ovary Syndrome and IVF
- 42 Endometriosis and Assisted Reproductive Technology
- 43 Evidence-Based Medicine Comparing hMG/FSH and Agonist/Antagonist and rec/Urinary hCG/LH/GnRH to Trigger Ovulation
- 44 Luteal Phase Support in Assisted Reproduction
- 45 Thrombophilia and Implanation Failure
- 46 Intrauterine Insemination
- 47 The Prediction and Management of Poor Responders in ART
- 48 Oocyte Donation
- 49 In Vitro Maturation of Human Oocytes
- 50 Oocyte and Embryo Freezing
- 51 Cryopreservation of Male Gametes
- 52 The Management of Azoospermia
- 53 Spermatid Injection: Current Status
- 54 Optimizing Embryo Transfer
- 55 Single Embryo Transfer
- 56 Blastocyst Transfer
- 57 Clinical Significance of Embryo Multinucleation
- 58 Quality and Risk Management in the IVF Laboratory
- 59 The Nurse and REI
- 60 Understanding Factors That Influence the Assessment of Outcomes in Assisted Reproductive Technologies
- 61 The Revolution of Assisted Reproductive Technologies: How Traditional Chinese Medicine Impacted Reproductive Outcomes in the Treatment of Infertile Couples
- 62 Complications of Assisted Reproductive Technology
- 63 Ectopic and Heterotopic Pregnancies Following in Vitro Fertilization
- 64 The Impact of Oxidative Stress on Female Reproduction and ART: An Evidence-Based Review
- 65 PGD for Chromosomal Anomalies
- 66 Preimplantation Genetic Diagnosis for Single-Gene Disorders
- 67 Epigenetics and ART
- 68 Congenital Anomalies and Assisted Reproductive Technology
- PART IV ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION
- Index
- Plate section
- References
Summary
INTRODUCTION
Therapeutic intervention to alleviate infertility has steadily evolved since the initial success of in vitro fertilization in the late 1970s. The path to a desired outcome for many remains long, daunting, and uncertain. From the outset of assisted reproductive technologies (ART) applications, clinicians and patients held mutual desire for meaningful expression of its outcomes. The approaches to identifying such data have been diverse, controversial, at times contentious, and, as yet, continuously changing. Professional societies and government regulatory agencies have focused on deciphering parameters and collection of statistics that were substantive to clinicians and yet did not fail or mislead when viewed by the patient consumer. This effort has been in place in the United States and many other countries for a fair length of time. Recent legislation demanding compliance with and contribution to a national database has made reporting mandatory for ART clinics and laboratories within the United States. Debate exists as to whether adherence to a unified system has yielded recognizable improvements in the scientific or public understanding of ART outcomes. The following critical review may lead to the recognition that current methods of ART outcomes reporting and analysis offer no more certainty to clinicians than to the public for whose benefit the government-mandated reporting was imposed.
Despite disclaimers against the utility of direct comparison between practice-reported success rates, inherent and unavoidable human behavior, for both clinician and consumer, has created a very public and competitive environment. Has this improved patient care or impaired it?
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- Information
- Infertility and Assisted Reproduction , pp. 570 - 575Publisher: Cambridge University PressPrint publication year: 2008