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How to improve your ART success rates: an evidence-based review of adjuncts to IVF. Edited by: Gab Kovacs. Cambridge University Press 2011, Cambridge UK. Paperback 262 Pages.

How to improve your ART success rates: an evidence-based
review of adjuncts to IVF. Edited by: Gab Kovacs. Cambridge
University Press 2011, Cambridge UK. Paperback 262 Pages.
This is one of the most up-to-date comprehensive books
reviewing all adjuncts to IVF. Although IVF success rates have
improved gradually over the years, clinicians are striving to
achieve the very best possible success rates for all patients.
Apart from the standard improvements that have been intro-
duced uniformly into the IVF procedures, there are many
other supplementary treatments that have been advocated as
possible ways to improve the selection and/or treatment of
IVF patients. The book aims to review these latest ancillary
treatments, and provide the appropriate evidence, to allow
the reader to have a reliable reference from which to decide
what should be used in the treatment of their patients. The edi-
tor managed to recruit over 70 contributors, all are important
authorities in the field, resulting in a really fantastic team of
It is worth noting that the chapters in this book are
relatively short, evidence-based and to the point, and refer-
ences included are all recent. Figures, illustrations and tables,
are present in almost all chapters, which make it very appeal-
ing and informative to the reader.
The book is divided into eight sections. The first section
entitled ‘‘Patient selection and preparation’’ covers pre-treat-
ment hormone assessment, the role of ultrasound, laparos-
copy, and hysteroscopy in patient selection and preparation.
The section also deals with management of fibroids and pol-
yps, overweight, PCOS endometriosis and hydrosalpinges.
Furthermore, the section covers immunological screening
and natural killer cell analysis, each in a separate chapter.
There is also a chapter on the role of vitamins and natural sup-
plements in improving pregnancy rates.
The second section is a small one titled ‘‘The role of AIH
before IVF’’ and it covers thoroughly the effectiveness of intra-
uterine insemination and also who should be treated and what
are the expectations.
The third section is on stimulation. It discusses and com-
pares different superstimulation protocols, including the
advantages and disadvantages of each. The section also dis-
cusses the use of oral contraceptives in scheduled controlled
ovarian hyperstimulaiton. A chapter discusses dehydroepian-
drosterone and its use for women with diminished ovarian re-
serve. The use of LH and growth hormone in ART has been
discussed in two separate chapters. The section ends with
two chapters, one on the prevention of ovarian hyperstimula-
tion syndrome and the other discusses in vitro maturation.
A small section on monitoring follows including ultrasound
and hormonal monitoring.
Section five deals with the laboratory side of ART, from
sperm selection, to culture media to embryo transfer. Meta-
bolomics, preimplantation genetic diagnosis and assisted
hatching are also discussed each in a separate chapter.
Section 6 thoroughly discusses embryo transfer, starting
with the role of ultrasound in ET, going through dummy
ET, positions during ET, ET catheters, to bed rest after ET
and intercourse around the time of ET.
Section 7 deals with ancillary treatments including heparin,
aspirin, estrogen supplements, progesterone supplementation
and corticosteroids. The section also discusses immunotherapy
for implantation failure, traditional Chinese medicine, adju-
vant therapy to improve endometrial development such as Sil-
denafil and hyperbaric oxygen therapy.
The last section is a fantastic guide on assessment of results.
It includes a chapter on how to report IVF success rates, a
chapter on RCT’s and how to design them, and finally a chap-
ter on Cochrane reviews and how to read them.
To sum up, the book contains short, evidence-based chap-
ters on a wide range of treatments and strategies that can help
improve male and female fertility, conception rates, and live
births. It is recommended to all reproductive medicine physi-
cians, ART support staff, reproductive endocrinologists, and
M. Aboulghar
Cairo University,
Obstetrics and Gynecology,
Faculty of Medicine,
Egyptian IVF center,
10 Geziret El Arab St.
Cairo, Egypt
E-mail address:
1110-5690 Ó2011 Middle East Fertility Society. Production and
hosting by Elsevier B.V. All rights reserved.
Peer review under responsibility of Middle East Fertility Society.
Production and hosting by Elsevier
Middle East Fertility Society Journal (2011) 16, 240
Middle East Fertility Society
Middle East Fertility Society Journal
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