Human In Vitro Fertilization And Embryo Transfer

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.

The use of human in vitro fertilization in the management of infertility is the outgrowth of years of laboratory observations on in vitro sperm-egg interaction. "The editors of this work have themselves contributed significantly to basic knowledge of the mammalian fertilization process. The observations of Don Wolf on sperm penetration, the block to polyspermy and, most recently, sperm hyperactivation in the monkey and human, Gregory Kopf's elucidation of the mechanisms of sperm activation during penetration and the reciprocal dialogue between sperm and egg, and Barry Bavister's definition of culture conditions and requirements necessary for in vitro oocyte maturation, fertilization and development in model mammalian systems including nonhuman primates have contributed greatly to our understanding of the mammalian fertilization process. Wolf, Kopf and Gerrity have enjoyed substantial interaction with clinicians in Departments of Obstetrics and Gynecology and have been directly involved with successful IVF programs. Both Wolf and Kopf have served as research scientists in the Division of Reproductive Biology at the University of Pennsylvania, which, for more than 22 years, has fostered co-mingling of clinically oriented and basic science faculty. It is through such interaction, which clearly exists at many institutions including the University of Wisconsin, that the process of technology transfer is best served. Without an exquisitely coordinated laboratory, there can be no consistent success in human in vitro fertilization. Quality control is pivotal, but close collaboration between the laboratory and the clinic is also essential as information is shared and correlated.

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.

The new edition of this text admirably fills the need for a primer on the central topics involved in Human In Vitro Fertilization (IVF). Supplying a comprehensive and hands-on approach to IVF, this source presents established state-of-the-art procedures and techniques, as well as the most current research in the field. Expert contributors also discuss the history of IVF and the potential of future research. Offering essential information for reproductive endocrinologists, IVF practitioners and embryologists, this book guides readers though every step of human assisted conception, from patient pre-treatment to monitoring of outcomes.

It is a genuine honor and a privilege of distinction to provide the foreword for the proceedings that follow. This marvelous symposium reflects the unique qualities of its two principal sponsors. Whenever the Oregon Regional Primate Research Center is involved in matters of science, we see a consistent record of exceptional quality in both the work is unequaled and the people who do it. Likewise, Serono Symposia, USA in assuring a world-class speakers' forum, utterly without taint of commercial influence. The proceedings published herein are a remarkable testimony, not only to the contributors, but to Drs. Brenner, Wolf, Stouffer, and Burnett, who have shepherded its conception, presentation, and publication. Readers will notice immediately one of the universal strengths of this total composition; that is, the diversity of investigational interests among attendees. Presentations on the core topic of primate in vitro fertilization and embryo transfer were joined by specialist presentations in related areas, including human-assisted reproductive technologies, reproductive physiology of the great apes, sperm biology, implantation mechanisms, cryobiology, coculture systems for embryogenesis, micromanipulation technologies, and genetic diagnosis of heritable diseases in the pre embryo. Even though pro-fertility issues understandably dominated this forum, there was significant attention given to fertility-control research, especially the role of primates in this endeavor (more on this subject below).