New Approaches to Assisted Reproductive Technologies

David L. Keefe; John P. Parry

doi:10.1055/s-2005-923387

Seminars in Reproductive Medicine, Table of Contents

Semin Reprod Med 2005; 23(4): 301-308
DOI: 10.1055/s-2005-923387

New Approaches to Assisted Reproductive Technologies

David L. Keefe¹ , John P. Parry²

¹Director, Division of Reproductive Medicine and Infertility, Women and Infants Hospital, Providence, Rhode Island; Medical Director, Division of Reproductive Endocrinology, Tufts-New England Medical Center, Boston, Massachusetts
²Department of Obstetrics and Gynecology, Tufts-New England Medical Center, 750 Washington Street, Boston, Massachusetts

Abstract

ABSTRACT

Egg infertility remains the greatest challenge in the treatment of the infertile couple. As women increasingly delay attempts at childbearing, egg infertility has become more prevalent. Attempts to overcome egg infertility by superovulation and in vitro fertilization have produced an epidemic of multiple gestations, itself a major public health concern. The pathophysiology of egg infertility arises from chromosomal nondisjunction. Cytogenetic analyses of polar bodies and/or blastomeres currently provide the most powerful predictors of egg infertility. Approaches that label all chromosomes (spectral karyotyping and comparative genomic hybridization), or identify predisposition to aneuploidy (spindle imaging, telomere length measurement) are on the horizon. For the foreseeable future, the treatment of egg infertility will be limited to egg donation for severe cases and transfer of the most viable embryos for milder cases. Oocyte reconstitution not only lacks evidence of clinical efficacy, but also biological credibility, given that growing evidence supports the primacy of chromosomes themselves in meiotic nondisjunction.

KEYWORDS

Reproductive technologies - fertilization in vitro - infertility - female infertility

Full Text

References

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David L KeefeM.D.

Director, Division of Reproductive Medicine and Infertility

Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905

Email: Dkeefe@wihri.org