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Middle East Fertility Society Journal, Vol. 13, No. 1, 2008, pp. 68-68 BOOK REVIEW How to get pregnant? Sherman Silber. Little, Brown and Company, New York, Boston, London 2007. Mohamed Aboulghar, M.D. Professor in Obstetrics and Gynecology, Faculty of Medicine, Cairo University Code Number: mf08016 In the preface entitled “The Infertility Epidemic” the author discussed the importance of understanding the biological clock of the woman and then he discussed several misleading topics relating to the diagnosis of the cause of infertility. He stressed the importance of age and that fertility declines with the progress of age. The author also discusses two common factors; male factor infertility and the presence of varicocele and its importance, and endometriosis as a disease related to infertility. The he rapidly covers the subject of IVF and ICSI and explained the fact that it is very important to have a top IVF lab and that ICSI and IVF will not overcome every cause of infertility and there is no guarantee of the results. Again, he also explained the fact that even azoospermic me can father children using testicular sperms. The topic of egg donation for women with premature ovarian failure or very poor quality oocytes or aging women was also discussed. Then the author talked about simple advice for women to become pregnant without resorting to medical treatment. He discussed in a full chapter the physiology and anatomy of the female genital tract, ovulation and its diagnosis and how the menstrual cycle is controlled and how eggs are produced and which hormone control it and the number of chromosomes present in each egg. The author discusses the frequency and timing of sexual relation in relation to pregnancy rate. He also discussed infectious diseases and their effect on infertility. He devoted one whole chapter for decreased fertility of the woman by age and the low reserve of eggs in certain number of women and the possibility of freezing oocytes for future use and the technical difficulties in that. He then discussed different methods for accessing ovarian reserve and he particularly talked about the antral follicle count using ultrasound. There was another chapter devoted to simple lines of treatment which could simply be a good advice about the time of ovulation and simple treatment for ovulation induction like clomiphene citrate or bromocriptine if there is hyperprolactinemia. In this chapter he also discussed different lines of treatment of endometriosis. Tests of ovulation were discussed in details, as well as testing the patency of the tube by hysterosalpingography. There is another chapter on emotions and infertility and the effect of anxiety on the outcome of pregnancy. Another chapter was devoted to the male and how sperms are produced and ejaculated, and the count of sperms. From this the authors moves us to intrauterine insemination which is combined with ovarian stimulation. How sperms are prepared and washed, different methods of stimulation and timing of IUI. Then he moves to IVF with details on the technique starting from preparation of the patient, ovarian stimulation, embryo culture technique and then intracytoplasmic sperm injection. Also the technique of embryo transfer was discussed together with prolonged culture resulting in blastocyst transfer and the possible value of assisted hatching. The author in another chapter discussed the outcome of pregnancy and if the baby is normal and chances of congenital malformation and chromosomal abnormalities in babies born after IVF and ICSI and he showed that there is a slight increase in both anomalies and chromosomal aberrations. He also discussed preimplantation genetic diagnosis, its technique, value and limitation. Then there is another chapter devoted to miscarriage and he particularly discussed the chromosomal errors causing miscarriage. The last chapter is devoted to controversies over IVF, cloning and stem cell. This is a very interesting book which is suitable for the general reader, however, medical specialist would also enjoy reading it. ©Copyright 2008 - Middle East Fertility Society |
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