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Practical Guide to Ovulation Induction
European Journal of Obstetrics & Gynecology and Reproductive Biology 107 (2003) 223–224
Book reviews Practical Guide to Ovulation Induction S.M. Sathanadan, H.S. Jacobs (Eds.), Imperial College Pr/ World Scientific Publishing (UK) Limited, London, £52.00, xiv/271 pp., ISBN 1-86094-253-9 Infertility affects one in six couples in the UK for many of whom anovulation will be a contributory factor and since the birth of Louise Brown in 1978, the use of assisted reproduction with the need for ovulation induction prior to oocyte retrieval has flourished worldwide. Unfortunately, higher order multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) remain frequent complications. This practical guide aims to help non-specialists introduce their patients to the steps, limitations, and complications of ovulation induction and assisted reproduction. The contributors include eminent gynaecologists and known experts in the field of assisted reproduction, fertility nursing, and endocrinology. The content is detailed and well referenced. A clear and consistent theme is the importance of achieving the right balance between successful ovulation and superovulation, and reducing the morbidity associated multiple pregnancy and ovarian hyperstimulation syndrome. Overall, there is a slight bias in favour of the scientific and research issues underpinning the endocrine basis and management of ovulation induction, as compared with the practical day-to-day issues involved in managing ovulation induction. However, the sections on the complications, prevention and management of OHSS and multiple pregnancy are very practical and useful. There are 14 chapters written in large easy-to-read text. The first three chapters cover general solutions and problems of ovulation induction, its endocrine basis, and baseline screening prior to treatment. Chapters 4–7 focus on the general principles of gonadotrophin therapy and ovulation induction, and on specific clinical conditions including hypogonadotrophic hypogonadism, hyperprolactinaemia, and polycystic ovary syndrome. Chapters 8–14 discuss strategies for controlled superovulation in assisted conception, side-effects and complications, monitoring, the role of a nurse, obstetric outcome, and the role of audit and computers. Most chapters are succinct and easy to read with the exception of the second chapter on the endocrine basis of spontaneous ovulation which at 40 pages was long compared to the others. However, even here the use of frequent
subtitles, and the interspersed charts and graphs made it easy to read. I particularly enjoyed reading Chapter 7 on ovulation induction in women with polycystic ovary syndrome written by S. Sathanadan and Howard Jacobs. The importance of general strategies such as weight reduction, were first highlighted before specific comments on the role of clomiphene, tamoxifen, and gonadotrophins. The section on the various regimens (classical step-up, low dose step-up, step-down and sequential step-up, step-down) for gonadotrophin therapy in anovulatory PCOS was easy to follow and understand. The use of ‘‘keypoints’’ after each section was particularly useful. Chapter 8 on strategies for controlled superovulation in normal ovulatory patients, came across as an industry sponsored thesis on the benefits of recombinant FSH. There was a detailed literature review and meta-analysis of trials showing higher clinical pregnancy rates with the use of rFSH but less data on its complications. Chapter 12 on the role of nurses detailed the responsibilities of fertility nurses and is specifically relevant as many units move towards a nurse led service. Overall, this guide is a very useful resource for health workers and scientists in assisted reproduction. William Atiomo Academic Department of Obstetrics and Gynaecology School of Human Development, B Floor East Block Queens Medical Centre Nottingham NG7 2UH, UK Tel.: þ44-115-924-9924x43500; fax: þ44-115-970-9776 Received 23 August 2002 PII: S 0 3 0 1 - 2 1 1 5 ( 0 2 ) 0 0 4 0 9 - 8
Obstetrics and Gynaecology: Clinical and Basic Science Aspects Murdoch G. Elder (Ed.), World Scientific, Singapore, 2002, 382 pp., £26.00, paperback, ISBN 1-86094-279-2, £49.00, hardback, ISBN 1-86094-276-8 The medical undergraduate, when faced with having to buy a basic textbook to learn the essentials of obstetrics and gynaecology, is faced with a bewildering choice of books on the medical school bookshop shelves. Each book, often very much based on the combined contributors from one centre, is claimed to offer educational advantages against its compe-
0301-2115/02/$ – see front matter # 2002 Elsevier Science Ireland Ltd. All rights reserved.
Book reviews Practical Guide to Ovulation Induction S.M. Sathanadan, H.S. Jacobs (Eds.), Imperial College Pr/ World Scientific Publishing (UK) Limited, London, £52.00, xiv/271 pp., ISBN 1-86094-253-9 Infertility affects one in six couples in the UK for many of whom anovulation will be a contributory factor and since the birth of Louise Brown in 1978, the use of assisted reproduction with the need for ovulation induction prior to oocyte retrieval has flourished worldwide. Unfortunately, higher order multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) remain frequent complications. This practical guide aims to help non-specialists introduce their patients to the steps, limitations, and complications of ovulation induction and assisted reproduction. The contributors include eminent gynaecologists and known experts in the field of assisted reproduction, fertility nursing, and endocrinology. The content is detailed and well referenced. A clear and consistent theme is the importance of achieving the right balance between successful ovulation and superovulation, and reducing the morbidity associated multiple pregnancy and ovarian hyperstimulation syndrome. Overall, there is a slight bias in favour of the scientific and research issues underpinning the endocrine basis and management of ovulation induction, as compared with the practical day-to-day issues involved in managing ovulation induction. However, the sections on the complications, prevention and management of OHSS and multiple pregnancy are very practical and useful. There are 14 chapters written in large easy-to-read text. The first three chapters cover general solutions and problems of ovulation induction, its endocrine basis, and baseline screening prior to treatment. Chapters 4–7 focus on the general principles of gonadotrophin therapy and ovulation induction, and on specific clinical conditions including hypogonadotrophic hypogonadism, hyperprolactinaemia, and polycystic ovary syndrome. Chapters 8–14 discuss strategies for controlled superovulation in assisted conception, side-effects and complications, monitoring, the role of a nurse, obstetric outcome, and the role of audit and computers. Most chapters are succinct and easy to read with the exception of the second chapter on the endocrine basis of spontaneous ovulation which at 40 pages was long compared to the others. However, even here the use of frequent
subtitles, and the interspersed charts and graphs made it easy to read. I particularly enjoyed reading Chapter 7 on ovulation induction in women with polycystic ovary syndrome written by S. Sathanadan and Howard Jacobs. The importance of general strategies such as weight reduction, were first highlighted before specific comments on the role of clomiphene, tamoxifen, and gonadotrophins. The section on the various regimens (classical step-up, low dose step-up, step-down and sequential step-up, step-down) for gonadotrophin therapy in anovulatory PCOS was easy to follow and understand. The use of ‘‘keypoints’’ after each section was particularly useful. Chapter 8 on strategies for controlled superovulation in normal ovulatory patients, came across as an industry sponsored thesis on the benefits of recombinant FSH. There was a detailed literature review and meta-analysis of trials showing higher clinical pregnancy rates with the use of rFSH but less data on its complications. Chapter 12 on the role of nurses detailed the responsibilities of fertility nurses and is specifically relevant as many units move towards a nurse led service. Overall, this guide is a very useful resource for health workers and scientists in assisted reproduction. William Atiomo Academic Department of Obstetrics and Gynaecology School of Human Development, B Floor East Block Queens Medical Centre Nottingham NG7 2UH, UK Tel.: þ44-115-924-9924x43500; fax: þ44-115-970-9776 Received 23 August 2002 PII: S 0 3 0 1 - 2 1 1 5 ( 0 2 ) 0 0 4 0 9 - 8
Obstetrics and Gynaecology: Clinical and Basic Science Aspects Murdoch G. Elder (Ed.), World Scientific, Singapore, 2002, 382 pp., £26.00, paperback, ISBN 1-86094-279-2, £49.00, hardback, ISBN 1-86094-276-8 The medical undergraduate, when faced with having to buy a basic textbook to learn the essentials of obstetrics and gynaecology, is faced with a bewildering choice of books on the medical school bookshop shelves. Each book, often very much based on the combined contributors from one centre, is claimed to offer educational advantages against its compe-
0301-2115/02/$ – see front matter # 2002 Elsevier Science Ireland Ltd. All rights reserved.