By Tiao-Virirak Kattygnarath MD

An Evidence-Based Framework for Managing the Most Perplexing Scenarios in Assisted Reproductive Technology (ART).

Challenging Cases and Troubleshooting in Fertility is a specialized, practical guide designed for clinicians who navigate the complexities of reproductive medicine. While comprehensive textbooks establish foundational knowledge, this text addresses the critical need for advanced diagnostic and management strategies when standard protocols prove insufficient. It serves as an essential resource for clinicians seeking to deepen their understanding of difficult cases and enhance their ability to troubleshoot unexpected clinical challenges.

Authored by distinguished reproductive endocrinologist Tiao-Virirak Kattygnarath, MD, this book systematically deconstructs the most common and complex problems encountered in ART. Each chapter provides a thorough review of the underlying pathophysiology, followed by a detailed analysis of differential diagnoses and evidence-based management solutions. The focus is on real-world applicability, moving beyond theoretical knowledge to provide the step-by-step reasoning required for effective clinical decision-making.

Key Areas of Focus Include:

Ovarian Stimulation and Cycle Management: In-depth protocols for managing Unexpected Poor Ovarian Response, Premature LH Surge, and the clinical implications of Elevated Baseline FSH. Includes a comprehensive review of the prediction, prevention, and management of Ovarian Hyperstimulation Syndrome (OHSS).

Procedural and Technical Challenges: Evidence-based techniques for overcoming Difficult Oocyte Retrievals and Difficult Embryo Transfers. Provides guidance on managing procedural complications such as Empty Follicle Syndrome and a low Oocyte-to-Follicle Ratio.

The Uterine Environment: A systematic approach to the diagnosis and treatment of a Thin Endometrium and other pathologies of the Compromised Uterine Cavity that are discovered during treatment cycles.

Embryology and Laboratory Management: A review of the etiologies of Poor Fertilization or Complete Fertilization Failure and Embryonic Arrest in Culture. Offers a framework for the prevention, detection, and crisis management of Laboratory Errors.

Genetic and Ethical Complexities: Provides current clinical guidance on the interpretation and management of Embryo Mosaicism, the disposition of Cryopreserved Embryos Following Relationship Dissolution, and the ethical considerations of Posthumous Assisted Reproduction.

Intended Audience: This text is an invaluable resource for:

Reproductive Endocrinology and Infertility (REI) Specialists

OB/GYN Residents and REI Fellows

Clinical Embryologists and Andrologists

Fertility Nurses and Allied Health Professionals

This work serves as an essential reference for any practitioner dedicated to optimizing outcomes in the most challenging scenarios encountered in assisted reproductive technology.