WHEN TO PROCEED TO ART: WHAT PROCEDURE FOR WHICH COUPLE AT WHOSE PROGRAM?
LEARNING OBJECTIVES
INTRODUCTION
THE DOLLAR COST OF ART
WHOíS PAYING?
WHEN TO PROCEED TO ART Absolute Indications
WHEN TO PROCEED TO ART Relative Indications
WHEN TO PROCEED TO ART Relative Indications (contin.)
INFERTILITY FACTORS WHICH CANNOT BE TREATED BY ART
HYDROSALPINX AND ART
MYOMAS AND ART
WHAT ART PROCEDURE?
IVF vs. GIFT vs. ZIFT
ICSI vs. SPERM DONOR
ASSISTED HATCHING vs. NO ASSISTED HATCHING
IMMUNOTHERAPY vs. NO IMMUNOTHERAPY
BLASTOCYST CULTURE / TRANSFER vs. EMBRYO TRANSFER
NUMBER OF EMBRYOS TO TRANSFER
1996 SART PREGNANCY RATES PER NUMBER OF EMBRYOS TRANSFERRED
IMPACT OF HIGH-ORDER MULTIPLE BIRTHS
AVOIDANCE OF MULTIPLE BIRTHS
PROPORTION OF MULTIPLE BIRTHS CORRELATED WITH LIVE BIRTH RATE
NUMBER OF MULTIPLE BIRTHS CORRELATED WITH LIVE BIRTH RATE
COSTS OF PERINATAL CARE PER BABY AND PER PREGNANCY
COSTS OF PERINATAL CARE
CRYOPRESERVATION vs. NO CRYOPRESERVATION
INDUCED REDUCTION vs. HIGH-ORDER MULTIPLE PREGNANCY
DONOR OOCYTES vs. PATIENT OOCYTES
HOST UTERUS vs. PATIENT UTERUS
ASRM / SART GUIDELINES
WHAT ART PROGRAM?
HIGH QUALITY LABORATORY
HIGH QUALITY CLINICAL CARE
COMPREHENSIVE SERVICES
PATIENT CHOICE
EXCELLENT DOCUMENTATION
RESEARCH
PROFESSIONAL MANAGEMENT
COST-EFFECTIVE CARE
PSYCHOLOGICAL SUPPORT
ETHICAL CARE
WHICH COUPLE SHOULD
WHICH COUPLE SHOULD UNDERGO ART?
COST-BENEFIT ANALYSIS
FACTORS FAVORING ART
SUMMARY
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