oa PREFACE [Hot topic: Current Concepts in Assisted Reproduction and Fertility Preservation (Part II) (Guest Editors: Sajal Gupta and Ashok Agarwal)]

The Special Issue on “Recent Advances in Reproductive Endocrinology and Women's Health” published by the Current Women's Health Reviews is a series of two volumes containing articles on cutting edge technology and contemporary topics of importance to reproductive endocrinologists, general gynecologists and specialists alike. The second volume has excellent articles on many recent advances and state-of-the-art technologies related to the field of assisted production and fertility preservation in women. Dr Kader et al. present recent updates on “Single Blastocyst Transfer: Contemporary Experience”. The authors state that the cryopreserved single blastocyst transfer has been developed as a practical method that can be used to optimize pregnancy outcomes following an unsuccessful initial transfer or in patients who do not meet initial transfer criteria. In their article on “The role of oxidative stress in assisted reproduction”, Drs. Gupta et al. explain that sperm and oocytes used in assisted reproductive techniques are subjected to oxidative stress because gametes lack the natural antioxidant defences that are present during in vivo reproduction in the male and female reproductive tract. In the past, studies quantified OS using inconvenient and labour-intensive biochemical methods to measure reactive oxygen species (ROS) and assess the antioxidant status within follicular fluid and culture fluid. Metabolomic profiling is a faster, more accurate method of quantifying OS during ART and may be used to identify gametes and embryos that are more likely to contribute to successful implantation and pregnancy. Various studies on the benefits of oral antioxidant supplementation in male and female patients undergoing ART procedures have yielded inconsistent and conflicting reports, and further research is required. Dr Ahmady et al. from the Macdonald IVF and Fertility program discuss pre-implantation and prenatal testing techniques that provide genetic information and detect birth defects or abnormalities in an embryo/fetus before implantation/birth. They emphasize that the limitations of FISH and PCR will lead to the use of whole-genome analysis/CGH in the setting of in vitro fertilization (IVF), replacing current PGD testing. Its preliminary application has been encouraging as more chromosomes can be analyzed with higher sensitivity and accuracy. Dr Aboulghar et al. from the The Egyptian IVF Center have contributed an excellent article on “coasting,” which is a popular method of preventing ovarian hyperstimulation syndrome (OHSS). The authors point out that while coasting does not totally avoid the risk of OHSS, it decreases its incidence in high-risk patients. They highlight the effectiveness of coasting in patients undergoing intracytoplasmic sperm injection (ICSI) and the fact that it does not jeopardize outcomes. Coasting for >3 days is associated with a moderate decrease in pregnancy rates. The authors state that coasting is a feasible option in patients undergoing IVF cycles with GnRH antagonists. Dr Gardner et al. have contributed an excellent article that discusses state-of-the-art technologies such as metabolomics and their application in the ART field. The authors have stated that metabolomics technology is perceived as an important diagnostic tool in clinical IVF that has the potential to assess embryo viability prior to transfer or cryopreservation. The authors conclude that as an embryo selection technique, metabolomics screening will form an integral part of ART laboratories. This will lead to an enhanced ability to determine the functional metabolic phenotype of an embryo as a key indicator of viability. They also highlight that the affordability of the new techniques is likely to improve as they become more readily available and tailored to clinical IVF and as they integrate with other cost effective and efficient technologies such as chip-based analysis. This special issue also contains 4 articles on fertility preservation by researchers from Cleveland Clinic, the University of Toledo and University Hospital-Case Western Reserve University. The article on the economics of female fertility preservation discusses the increasing demand of fertility preservation and obstacles that hinder the creation of a standard of care. The authors analyze the challenges to establishing higher quality care standards and provide suggestions for continued research and multidisciplinary collaboration for a larger patient population....