Despite its universality in human female aging, the menopause and its biology are not completely understood. New biologic mechanisms by which sex hormones may be detrimental or confer protection are continually being discovered. We are now starting to understand that the role of the estrogen receptor is not identical in all tissues. Important nongenomic effects for sex hormones have also been described. Hormone replacement therapy (HRT) has produced effects on health risks: some are reduced, some are increased, and the rest remain uncertain. HRT is being used by an increasing number of women to alleviate climacteric symptoms in the perimenopausal period and to prevent osteoporosis and cardiovascular disease later. Positive effects on Alzheimer's disease and dementia on the one hand, and an increase in venous thrombosis on the other, are currently being reported by several groups. Both the preventive benefits and the risk of breast cancer seem to be linked to long-term and current use. HRT requires further testing through specific clinical trials, currently underway in the United States, before confident recommendations may be made about the full range of benefits and risks.

Human reproduction is the most dynamic of processes. The events which lead to the birth of a normal healthy infant have their origin long before actual fertilization. Indeed, the whole process can be looked upon as a continuum. Human fertilization and early development, once sequestered in the protective environment of the fallopian tubes and uterus, have now been exposed in the laboratory. These events have, over time, been extensively observed and catalogued in animal models. The tools of modem morphology and molecular biology have reopened issues long since considered settled as facets of early reproduction are reexplored. This volume, consisting of the proceedings of a workshop on uterine and embryonic factors in early pregnancy, has been designed to enhance that effort. Attention is focused largely on early embryonal development with special attention to the interrelationship between the embryo and the uterus in early pregnancy. Each of the contributing scientists brings with him or her the perspective of one specific discipline or another. The common denominator is the application of emerging techniques in modem molecular biology to problems pertaining to embryonal-uterine interaction. The goal is to consider specific areas of concern in a multidisciplinary way and to reexplore the factors behind early development and implantation. Uterine complement, the function of uterine macrophages immunoregulatory loops in the peri-implantation period, colony stimulating factors and interferon-like factors are reviewed and their interrelationship explored. Uterine angiogenesis factors as well as embryonic growth factors are also considered.

Hemorrhage and thrombosis are major hazards for pregnant women and their newborn infants. This book is concerned with the developmental mechanisms, the diagnosis and treatment, as well as the prevention of these hemorrhagic and thrombotic disorders. The topics discussed in this volume, (1) perinatal hemorrhage in mothers and their offspring; (2) coagulation disorders complicating pregnancy; (3) neonatal intracranial hemorrhage; and, (4) vitamin K deficiency in the neonate, will help bridge the gap between basic scientists and clinicians and between the pediatri- cian and the obstetrician. Hopefully, all those concerned with preventing these disorders will be stimulated by the information and questions raised in the fol- lowing presentations. Acknowledgements We wish to thank Professors Takeshi Abe (Vice President, Teikyo University), Nobuyoshi Shinagawa (Hirosaki University), Hiroaki Soma (Tokyo Medical College), Tamotsu Miyazaki and Keisuke Sakurada (Hokkaido University) for their helpful advice. SHIGENORI SUZUKI WILLIAM E. HATHAWAY JOHN BONNAR ANTON H. SUTOR SHIGENORI SUZUKI. * 1936 in Sapporo, Japan. M.D., Uni- 'versity of Hokkaido, 1963. Lecturer, Hokkaido Univer- sity, 1974. Alexander Humboldt-Foundation Scholarship, Free University of Berlin. University of Munich, 1974- 1976. Foriner President, Japanese Society of Obstetrical, Gynecological, and Neonatal Hematology. President of International Symposium on Perinatal Thrombosis and Hemostasis (1989 Sapporo). Professor, College of Medi- cal Technology affiliated with Hokkaido University since 1983. WILLIAM E. HATHAWAY. * 1929 in Oklahoma, USA.

Nearly one-half of an American woman's life is spent after the cessation of reproductive function. A woman of 40 years has an additional life expectancy of nearly 40 years; a woman of 75, over 11 years. This pattern of longevity is likely to continue, so that by the year 2000, it has been estimated, 30 percent of the female population will be postmenopausal. While it is difficult to separate the results of aging from those of estrogen deprivation, it is important that we try to do so, since the results of the latter are amenable to treatment. The medical infirmities resulting from estrogen deprivation take a high toll among postmenopausal women. Nearly 200,000 hip fractures occur annually in this group, resulting in 15,000 deaths and a high morbidity rate. Sleep disorders, compromised sexuality, psychomotor alterations of the climacterium, and urinary tract disorders all contribute to a lowered quality of life. Appropriate treatment of these disturbing postmenopausal conditions requires an understanding of the underlying bio chemical, endocrinologic, psychologic, and pathophysiologic al terations of estrogen deprivation. Toward this end, the reader will find herein chapters dealing with estrogen metabolism in the postmenopausal female, end-organ response to estrogen deprivation, and bone metabolism and osteoporosis. Next, the reader will find chapters dealing with specific or gans, organ systems, or conditions related to the quality of life; for example, sexuality, urinary tract problems, sleep disorders, the breast, sports and exercise, the climacteric, and the psycho biology of the menopause."

''A valuable resource for those concerned with experimental teratology and risk assessment and those requiring general information about the causes of birth defects. The treatment of these issues is sophisticated, succinct, and logical.'' --- American Scientist, from a review of a previous volume The current volume covers intergenerational factors in pregnancy outcome, the thresholds for developmental toxicants, and four other subjects.

The book that you hold in your hands is the second in a series. The two titles in the series are the following: Genetic Influences on Human Fertility and Sexuality: Theoretical and Empirical Contributions from the Biological and Behavior Sciences Edited by Joseph Lee Rodgers, David C. Rowe, & Warren B. Miller Published by Kluwer Academic Press, 2000 The Biodemography of Human Reproduction and Fertility Edited by Joseph Lee Rodgers & Hans-Peter Kohler Published by Kluwer Academic Press, 2002 The series has published chapters by researchers who study human fertility, from a particular perspective: Biodemography. We welcome your interest and participation in this developing subfield. Or, perhaps, biodemography may be better referred to as a "superfield. " Because biodemography so naturally crosses interdisciplinary boundaries, and because its application draws together researchers from disparate disciplines, it may well be more appropriate to consider that biodemography subsumes a number of other disciplines, rather than the other way around. In this preface, we will describe our own efforts and those of many others to promote and develop the study of human fertility, using methods, models, and theories from both biological and demographic domains. In December, 1997, 25 participants from three different countries gathered in Tucson, Arizona for a small conference with the title "Genetic Influences on Fertility-Related Processes. " That conference represented a fascinating blending of research from two apparently separate domains.

The regulation of cell death in various reproductive tissues, as in other ma jor organ systems of the body, has become a focal point of research activity in many laboratories over the past few years. As such, the need for a "for mal" meeting to highlight recent work in this field, as well as to integrate knowledge from other sources (such as investigators working on cell death in cancer and immune function) in the broad context of identifying con served pathways that coordinate life-and-death decisions in diverse cell types, became apparent. Therefore, the goals of the Scientific Committee of the International Symposium on Cell Death in Reproductive Physiology, spon sored by Serono Symposia USA, were already predetermined by this need. Simply stated, we sought to bring together for the first time a select cohort of reproductive biologists and cell death researchers, many but not all cho sen based on their pioneering efforts in elucidating the fundamental aspects of apoptosis in reproductive and nonreproductive tissues, as a means to re view the current status of the field, foster new ideas, and promote scientific collaborations. In the ensuing chapters of this book, summaries of work dis cussed at the meeting are presented to emphasize both the diversity and the similarities in the occurrence and regulation of apoptosis in tissues of the male and female reproductive systems.

Introduction to Mammalian Reproduction is a welcome contribution to the fields of gametogenesis, gamete transport, fertilization, and reproduction technologies. Key topics covered include:
*formation and maturation of male gametes;
*morphology and physiology of female gametes;
*how the sperm meets the egg;
*sperm-egg fusion, egg activation, and implantation of fertilized egg;
*assisted reproduction and environmental chemicals that have an effect on formation and function of male and female gametes. This book is for both researchers and students involved in reproductive biology.

Androgen Receptors is the most comprehensive and up to date volume on the topic, including discussions of the basic mechanisms of androgen-androgen receptor actions, their roles in the androgen-related diseases, and their potential clinical applications. Key topics covered include: -The discovery and cloning of the androgen receptor; -Androgen receptor coregulators; -Androgen related genes and their consensus DNA response elements; -Basic mechanism of action including functional analyses, cellular localization and phosphorylation studies; -Cross-talk to other signal transduction systems; -The recent connections of androgens to women's diseases, such as osteoporosis and ovarian cancer. This book is of interest to students, basic scientists, and clinicians as both a study guide and reference of research in the androgen field. It could also be used as an advanced level text in endocrinology, urology, OBGYN, or oncology.

This is the definitive reference on the medical, surgical, legal, and ethical aspects of establishing and maintaining an office-based egg donation program. The editor has assembled an international list of authors with known expertise in this rapidly expanding field. The clinical procedures are clearly depicted in the book's many line drawings and photographs.

approaches to the experimental problems that still face us in understanding this most fascinating of organs. Too many people contributed to the completion of this volume to allow acknowledg ment of all the individual efforts, but we particularly thank the reviewers whose input into the editorial process was invaluable and the authors of these chapters who revised their text, sometimes more than once, to bring it to the high standards set by the Editors. The Com mittee gratefully acknowledges the support ofVysis, Inc. , in the publication of a color figure in Chapter 19, by S. Weber-Hall and Trevor Dale. Finally, we wish to express our heartfelt appreciation to Margot Ip and Bonnie Asch, who worked long and hard to bring this volume to fruition. Margaret C. Neville for the Committee on Mammary Gland Biology Preface One of the most exciting and beneficial developments in research on mammary gland biology and breast cancer has been the influx of increased funding to support this work. This influx, which has been due primarily to the tireless efforts of breast cancer activists to gamer addi tional money from various federal and state sources, has led to a rapid expansion of research efforts by attracting numerous new investigators into the field. These new investigators include students, postdoctoral fellows, and scientists from other fields.

Peritoneoscopy and culdoscopy were first introduced in the second edition of TeLinde's Operative Gynecology in 1953. TeLinde noted, "In many instances we find peritoneoscopy to be a useful procedure. Nevertheless it often left something to be desired." During the subsequent four decades, enormous progress has allowed the expansion of the application of laparoscopy and hysteroscopy throughout gynecol- ogy. Thus, it is appropriate and quite useful to have a text devoted solely to this rapidly advancing specialty. In its second edition, the text Practical Manual of Operative Laparoscopy and Hys- teroscopy is a complete and honest overview of the field providing the reader with a critical appraisal of the current literature on technique, development, and long- term follow-up. Refreshingly, the authors include not only the American experi- ence but also advances from Europe and Asia. Ricardo Azziz and Ana Alvarez Murphy have carefully organized the text into general concepts and laparoscopic and hysteroscopic operative techniques. The editors have selected authors of national and international stature to prepare chap- ters in their areas of expertise. The edited text carefully analyzes the advantages and disadvantages of each operative technique so as to allow readers insight as to the proper place for a particular endoscopic technique in their surgical practices.

"Fertility Preservation in Males: Emerging Technologies and Clinical Applications" contains a selection of the valuable chapters and protocols of Seli and Agarwal s previously published hardcover text "Fertility Preservation: Emerging Technologies and Clinical Applications." Newly available in this convenient and affordable softcover format, this practical reference guide provides an update on options for fertility preservation in men, while also discussing important related epidemiologic, ethical, medico-legal, psychological, and social aspects. Using a format that combines concise scientific background with practical methodological information and easy-to-grasp algorithms, the chapters all conform to a uniform structure, including step by step protocol of laboratory procedures, key issues in commentary and a list of references. The result is a unique resource for reproductive endocrinologists, urologists, embryologists, reproductive scientists, and oncologists."

Recent work in quantitative biology has shown theoretically why Fisher's Fundamental Theorem of Natural Selection does not preclude genetic influences on fertility, sexuality, and related processes. Genetic Influences on Human Fertility and Sexuality takes the next step, and presents a number of successful empirical searches for such genetic influence on a broad range of processes, such as puberty, marriage, sexual behavior, and twinning. Employing a broad range of methodological approaches, including molecular and behavioral genetics, this book weaves a new theoretical framework that shows how genes can help relate fertility planning to fertility outcome, and how puberty, sexuality, marriage, and reproduction can be conceptually linked through the genes that contribute to individual differences in the human process.

More often than not, progress in medicine occurs incrementally. The report of an 'important' new observation is typically greeted by a mixture of excitement and skepticism. Yet the true value of the discovery may not be known for several years until it is confirmed (or refuted) by independently conducted studies. In some cases, controversy may continue to shroud a topic due to the discordant results generated by different research groups. Since the last Gynecologic Oncology volume in the Cancer Treatment and Research series, a number of new areas have emerged that shed new light on the pathogenesis, diagnosis, and treatment of gynecologic malignancies. In this volume of the Cancer Treatment and Research series, I have attempted to integrate articles that highlight some of these newest developments with chapters that provide an overview of selected areas of controversy. This volume is not meant to be an abbreviated text of gynecologic oncology but rather a collection of selected works that can provide the reader with a better perspective on the areas of change within the field. The application of molecular biology to cervical cancer has allowed us to understand more completely the roles of human papilloma viruses and cellular oncogenes in the development of cancer of the uterine cervix.

Pelvic Inflammatory Disease is an in-depth, thorough guide for the clinician on the most common complication of sexually transmitted pathogens. Edited and written by the preeminent experts in the field, this volume presents the etiology, treatment, and diagnosis of PID, as well as chapters on risk factors, epidemiology, and prevention. In addition, the myriad clinical complications and challenges are discussed in chapters on tuboovarian abscess, PID and HIV infection, sequelae of PID, PID in adolescence, and PID in pregnancy. This is a must-have resource for obstetrician-gynecologists, primary care physicians, and all clinicians who provide health care to women of all ages.

Reproductive Immunology is a compilation of research articles presented during the VII International Congress of Reproductive Immunology which was held in New Delhi, India on 27-30 October 1998. The articles pertain to the following six major themes: Molecular and Immunological Aspects of Sperm-Egg Interaction Embryonic-Endometrial Cross-Talk Immunobiology of Pregnancy Autoantibodies and Infertility Immunocontraception Mucosal Immunology and Reproductive Tract Infections . The first section deals with our current understanding of various steps involved in fertilization. The functional significance of sperm surface mannosidase and glutathione S-transferases to bind zona pellucida is described. The role of zona pellucida glycoproteins in the binding of sperm, induction of acrosome reactions and avoidance of polyspermy is discussed. In the second section, the role of various cytokines, growth factors and immunomodulatory agents in implantation of embryos is described. In the field of reproductive immunology, one of the major issues is to explore the successful gestation of the histoincompatible fetus in the uterus of an immunologically competent mother. The Proceedings presents the issues of paternal antigens at the feto-maternal interface and shows that Th2-type of immunity is involved in normal successful conception. The role of membrane-bound and soluble HLA-G in protecting the fetus from the lytic activities of maternal uterine and peripheral blood natural killer (NK) cells is also presented. Nature's experiments suggest that antibodies against sperm-specific antigens are responsible for infertility in some women. The possibility that an immunogenetic background contributes to production of sperm-immobilizing antibodies in infertile women is discussed in the section on autoantibodies and infertility. The Proceedings presents the issue of Th1-type cytokines in inducing recurrent spontaneous abortions of unexplained etiology. The roles of β2-glycoprotein 1 (β2-GP1)-dependent anticardiolipin antibody, lupus anticoagulant, antiphospholipids, anti-thyroid antibody and anti-nuclear antibody in miscarriages are also described. The rising global human population, particularly in the developing countries, has driven the need for new and safer methods of contraception. Fertility regulation by vaccines is thus an interesting proposition. The section on contraceptive vaccines discusses the latest advances in this area and describes the current status of vaccines based on βhCG, sperm antigens, zona pellucida glycoproteins, and riboflavin carrier proteins. The issues of mucosal immunity and strategies for enhancing local genital immune responses to combat HIV infection is discussed. The role of inflammatory and related cytokines in chorioamnionitis is described. The contents of this Proceedings describes various facets of reproductive immunology which will help us to design strategies to combat genital infections and miscarriages caused by immunological etiology. Descriptions of the molecular basis of gamete recognition, implantation and survival of the allogenic fetus will help in designing strategies for overcoming infertility and also new contraceptive approaches. The Proceedings will be useful to researchers and clinicians involved in basic or applied research in the disciplines of reproductive biology, reproductive immunology, and obstetrics and gynecology.

An excellent reference for the experienced breast surgeon is now available in Plastic and Reconstructive Breast Surgery, An Atlas. It assumes that the reader has a solid foundation in plastic surgery and is familiar with various operative methods. It describes the complete range of breast surgery: augmentation and reduction mammaplasty, anomalies, the treatment of primary breast cancer and breast reconstruction. The various flaps and grafts are described with emphasis placed on the presentation of specific details and complications. This is done with a series of illustrations and an accompanying text that is very easy to read. By looking up a similar case, the surgeon will find direct help for his own decision-making. Many less common types of cases are included to provide the broadest coverage possible. Coming from a single hospital, this atlas gives up-to-date information based on years of expertise. The authors present only the methods and techniques that have proved most successful at their hospital in the past two decades. A comprehensive bibliography directs you to further reading.

From a review of an earlier volume: 'Both the experimental and the human aspects of teratology are presented in this comprehensive text by a stellar group of internationally recognized scientists and clinicians....A valuable resource for those concerned with experimental teratology and risk assessment and those requiring general information about the causes of birth defects. The treatment of these issues is sophisticated, succinct, and logical.'-American Scientist

Pituitary adenomas account for 10-15% of all intracranial tumors and they frequently impair fertility. The development of medical and surgical therapy for such tumors has turned pregnancy into a reality for women harboring pituitary adenomas. However, gestation risks for both mother and fetus are still of concern for endocrinologists, gynecologists and pediatricians. This book intends to update knowledge on this topic, mainly regarding fertility restoration as well as gestational and post gestational management of patients with pituitary tumors.

Recently, attention has been called to the role that microvascular organization plays in the functional morphology of all organs and tissues, both in normal and pathological conditions. Since its development by Murakami, the corrosion cast method for scanning electron microscopy has come to be considered one of the most efficient means in clarifying the three-dimensional features of the microcirculation of organs and tissues. Scanning Electron Microscopy of Vascular Casts: Methods and Applications was planned to supply fundamental and new information regarding microcirculation studies to general biologists, anatomists, pathologists and clinicians. The contributions to this volume, contain original findings and excellent electron micrographs obtained by using recently improved corrosion cast methods. The rich variety of papers in this book will be useful to many, and will provide both the basic and clinically oriented readers with good ideas, suggestions, and original and worthwhile information.

Chronic Pelvic Pain: Evaluation and Management presents a clinically oriented, multi-disciplinary approach to the diagnosis, treatment, and management of chronic pelvic pain in women -- one of the most common problems encountered in the practice setting. The editors present this challenging and often vexing subject in a practical, user-friendly, highly illustrated text, including chapters on: physiology of pain; pain associated with endometriosis; pain associated with fibroids; surgical management; the role of office based surgery; the role of the psychiatrist in pain management; pelvic pain of urinary origin; pelvic pain of gastrointestinal origin. Designed to be incorporated into the every day practice, this book is a must for all clinicians in obstetrics-gynecology as well as for any physician involved in the health care of women.

The field of human artificial reproductive technology (ART) is continually advancing and has witnessed significant changes since the inception of Louise Brown in 1978. Though Louise Brown herself was conceived after the trans fer of a blastocyst, there remain significant confusion and debate regarding the stage at which the human embryo conceived in the laboratory should be replaced in the mother. Developments in culture media formulations, leading to the introduction of sequential media, have brought the role of the blasto cyst in human ART back into the spotlight. It was due to this resurgence of interest in the niche of extended culture in human infertility treatment that the symposium on "ART and the Human Blastocyst" was held. of this meeting within this volume bring to the forefront The proceedings the main issues raised with the transfer of embryos at the blastocyst stage. It is evident from the chapters that follow that ART needs to be perceived as a continuum of procedures, each one dependent on the preceding one, and all equally as important as each other. That is to say, the development of a com petent embryo is ultimately dependent on the quality of the gametes from which it was derived. With regard to the oocyte, this then places the emphasis on the physician to use a stimulation protocol that both produces quality oocytes and does not impair endometrial function. Maintenance of gamete and embryo quality is the laboratory's role.

The 15th International Symposium of the Japan Human Cell Society on Cell and Molecular Biology of Endometrial Carcinoma brought together leading researchers from Japan and around the world. The papers collected here are the work of twenty-two leaders in their field and are organized in ten major categories. The first section, in vitro experimental systems, takes up the pioneering work by Kuramoto in 1968 and Nishida in 1980 in establishing, respectively, the HEC-1 and hormone-responsive endometrial carcinoma cell lines. Other topics include apoptosis, proliferation, and growth factors; cell cycle regulators; signaling pathways; angiogenesis; carcinogenesis; hormones and hormone receptors; genes and gene expression; endometrial receptivity; and chemo-resistance and -sensitivity. Presenting the latest work in the cell and molecular biology of endometrial carcinoma, this volume is a valuable resource for gynecologists, pathologists, and molecular biologists.