Planned parenthood - and its associated reproductive and sexual healthcare issues - has massive socioeconomic and demographic consequences worldwide. Modern contraception played a major role in the emancipation of women and has huge potential for a sustainable future world population. Yet it is a medical topic which always raises controversy, with serious ethical, religious and cultural overtones. This is an authoritative guide for all those working in reproductive healthcare. Highly practical, evidence-based, with enough detail to inform effective clinical practice, the book is structured on a lifestage approach, mirroring everyday experience of practitioners. All forms of contraceptives are covered in detail, with guidance on prescribing, the advantages and disadvantages of various techniques, and possible complications. The wider field of reproductive healthcare including subfertility and sexual assault are also covered. An ideal guide to contraception for trainees in obstetrics and gynaecology, primary care physicians and nurse-practitioners.

Anovulation - one of the most common causes of infertility - is here given a thorough review, with classification of the different subtypes, how they are diagnosed, how they are treated, and the possible complications and outcomes involved. This is a comprehensive evidence-based summary from an international expert team, with guidelines for daily practice clearly stated and summarized for your convenience.

Fertility Awareness is key to understanding sexual and reproductive health at all life stages. It can be used to either plan or avoid pregnancy. Fertility Awareness Methods (FAMs) are highly effective when motivated couples are taught by trained practitioners. These methods are in demand for ecological, medical, cultural, religious and moral reasons. The ability to control fertility naturally is a lifestyle choice. The Complete Guide to Fertility Awareness provides the science and methodology suitable for health professionals and a general audience. It covers reproductive physiology and the fertility indicators: temperature, cervical secretions and cycle length calculations. It explores ways to optimise conception and to manage conception delays. Case studies and self-assessment exercises are included throughout. The book addresses the scientific credibility of new technologies including fertility apps, home test kits, monitors and devices. The Complete Guide to Fertility Awareness offers: evidence-based information for general practitioners, practice nurses, school nurses, midwives, sexual health doctors and nurses a unique perspective on subfertility for gynaecologists and fertility nurses an authoritative source of reference for medical, nursing and midwifery students a straightforward and practical reference for new and experienced FAM users the core text for the FertilityUK Advanced Skills Course in Fertility Awareness

This monograph has been written in the hope that it will prove of value to medical students and clinicians, to Honours undergradu ates in appropriate branches of the natural sciences, and to repro ductive biologists in general. It would be pleasing if the text also caught the attention of veterinary undergraduates, since there is much information bearing on reproduction in domestic animals. First and foremost, however, the intended audience is a medical one, for scientific studies of human reproduction have been cata lyzed by the intense interest in procedures of fertilization in vitro. Some would judge that this very activity has narrowed our view of physiological events occurring within the Fallopian tubes. The pre sent work may therefore serve as a useful counterbalance to the overwhelming series of publications on procedures of in vitro fer tilization, and offer opportunities to those in the clinical field for extending their knowledge of the scientific background to much of the current work.

There is ample opportunity and scope for gynaecology in prim ary care in general practice. Many conditions and problems can be managed successfully in this context without referral to hos pital and specialist care. The first aim of this book is to deal with common problems that are referred for consultant opinion and specialist management to the average District General Hospital by analysing problems of presentation and diagnosis on a symptom-orientated basis. Selection for primary care management as opposed to hospital referral is then considered, following which the wide range of available treatment is evaluated with particular emphasis on the maximum use of up-to-date but proven regimes. The full use of the expertise of the practitioner is highlighted throughout. The second aim is to encourage the practice of primary care gynaecology and to help those doctors who have a special in terest in the subject, while hopefully stimulating others to de velop a similar one. With this in mind, the approach to the problems is realistic and often dogmatic while opportunities for individual management and for practical procedures are kept to the forefront.

Historically, sperm have been seen as simply a mechanism of transferring a haploid set of chromosomes to the oocyte. However, data from assisted reproduction therapies (ART) have demonstrated that in many couples the sperm appears to be responsible for abnormal embryogenesis. Recent advances in genetic and epigenetic techniques have identified key mechanisms by which the sperm, and the DNA carried by the sperm, can affect early embryonic development. Paternal Influences on Human Reproductive Success examines the genetic and epigenetic influences on embryogenesis, as well as practical clinical factors related to the male contribution to reproductive success. It also provides 'cutting edge' data and analysis of recent evaluations of the role of advanced paternal age, environmental influences and lifestyle factors on male reproductive fitness, making this an invaluable text for physicians treating patients for infertility, recurrent pregnancy loss, and developmental anomalies, as well as basic scientists studying embryogenesis and spermatogenesis.

Much progress has been made in recent years and new techniques have been developed in the field of plastic surgery of the breast. Breast Surgery presents plastic surgeons with a comprehensive summary of current practice and the techniques available.
Clearly written in language accessible to both specialists and non-specialists, Breast Surgery presents a variety and range of techniques with which excellent results in both plastic and reconstructive breast surgery can be achieved. Over 600 drawings and photographs, both in black and white and in colour, accompany the text, providing the plastic surgeon with clearly-illustrated guidelines to follow.
Dr. Nathalie Bricout is a leading figure in the field of plastic surgery of the breast in France.

This book is about a new surgical procedure, surgical hysteroscopy, for out-patients. It is both a diagnostic approach and a surgical procedure. As a simple and non-aggresive technique, it is a "patient-friendly" procedure with a little surgical trauma as it avoids hysterectomy or laparotomy procedures thus preserving the genital tract. It is the leading procedure in the treatment of uterine bleeding. It has also proved to be an essential investigation technique of in the assessment of infertility. This book is the result of surgical practice and teaching experience in the field of hysteroscopic procedures.

In his 35 years of teaching medical students and trainees Professor Gabor Kovacs, International Medical Director of Monash IVF, has devised a system of lectures which cover the entire core curriculum in Obstetrics and Gynaecology. The principle behind these lectures is to help the student understand various aspects of the specialty, rather than simply learning the key topics, and encourages ongoing problem solving as well as a more logical approach. Each of the lectures have been based around highly informative diagrams and tables, and each syndrome follows a set template making each topic very understandable and easy to assimilate. This will be an invaluable text for medical students, nursing and midwifery students, trainees in obstetrics and gynaecology as well as sexual and reproductive health, general and nurse practitioners.

This book aims to provide an up-to-date review of the literature in each of the major areas relating to the management of older gynecological cancer patients, and makes recommendations for best practice and future research. The authors come from a broad geographic spread including the UK, mainland Europe and North America to ensure a worldwide relevance.

As research in neuroscience increasingly points to the unparalleled influence of the first 1000 days of life from conception to two years of age in determining the baby's life trajectory, the need for high-quality early parenting education delivered by knowledgeable and dedicated professionals becomes ever more apparent. This book describes the global aims of early parenting education. It identifies the key areas that research suggests are important: building a relationship with the unborn and newborn baby; preparing for labour and birth; supporting parents' mental health; protecting the couple relationship across the transition to parenthood; and education for special groups such as same-sex couples, women with fear of birth, prisoners, military wives and parents from black and minority ethnic backgrounds. All practitioners providing early parenting programmes - midwives, health visitors, family link workers, children's centre staff and voluntary sector teachers - will gain new ideas for their practice in this book. Students taking midwifery and early childhood courses will find much to support their studies. Ultimately, the book provides inspiration for all those who are committed to the role of parenting education in reducing social inequalities.

This book covers in detail contemporary hypotheses and studies related to the immunology of implantation and provides a practical approach for the application of basic reproductive immunology research to pregnancy complications such as preeclampsia, pre-term labor and IUGR. Provides complete and up to date review of current knowledge of the role of the immune system during pregnancy and the interactions between the placenta and the maternal immune system.

To aid in unraveling the complexities of the causation of congenital malformations, various influences on their frequency are considered in this book. And of course the known and possible environmental bases of their occurrence are fully described. An introductory record of the history of perinatal mortality in the last three centuries gives foundation for the discussion of death in contemporary decades.

A synopsis of the use of lasers in gynecology is presented in this book; it is supported by more than 10 years of experience and backed up by studies inthe fields of experimental surgery, technical medicine and clinical gynecology. The authors show how laser-assisted preparation hasbroadened the spectrum of operative possibilities in gynecology. Major points of attention are experimental surgery and basic research, details of application with respect to specific indications, and future potential. Furthermore, the clear definition of the possibilities and limitations of laser technology puts an end to the highly stylized view of a patent wonder divorced from general operative standards. Thereis no doubt that users of laser technology stand on the threshold of a promising development and yet, despite the present elegant applications, thefirst steps to maturity are only now being taken.

Women with chronic medical problems are at higher risk for complications during pregnancy and, therefore, they are especially in need of appropriate preconception and contraception care. Furthermore, many women with chronic medical problems do not obtain adequate preconception and contraception care. Despite published guidelines by the Centers for Disease Control and Prevention, there is a substantial gap in medical practice regarding the use of contraception in women with co-existing medical problems. Contraception for the Medically Challenging Patient fills the gap that currently exists in the knowledge of correct contraceptive prescribing practice and shows that inappropriate contraindications can easily become a barrier to effective contraception use among women. Chapters highlight obsolete views about appropriate candidates for contraception and address the complex contraceptive needs of today's medically challenging patients with HIV/AIDS, uterine fibroids, or cardiac, neurologic or thyroid disease. The book gives attention to recommendations on the use of contraception in women with medical problems such as diabetes, obesity, epilepsy, and lupus, among others, and provides comprehensive information regarding the effects that certain drugs may have on contraceptive hormone levels. While national guidelines do exist for contraceptive eligibility, this book discusses in more detail the evidence behind the guideline recommendations and the nuances that clinicians confront in daily practice.

The study of prenatal development provides many clues for understanding the physiology as well as the pathogeny of malformations and many diseases. I became interested in the analysis of human development as a young medical student more than 30 years ago, and I have stayed in this field all my life. In my studies, I always tried to compare the events of different disciplines such as genetics, anatomy, bio chemistry and physiology. I learned that the development of a structure is, under normal circumstances, strictly determined and that the development of structures always precedes their proper function. There are no changes in function without changes in structure. The life of every cell is genetically preprogrammed and the program may be modified by complicated interactions with environment. Recent progress in our knowledge is basicly related to technology. However, using all the tools of today's technology, we are still unable to understand the basic normal development. After almost thirty years of work, I am trying to present a subjective review of the development of the human endocrine glands. I am presenting an image emerging from my experience. I personally studied several hundred human embryos using mostly anatomical, histochemical and some biochemical techniques. I found much additional information in the literature."

Sixteen British specialists pool their extensive knowledge of spontaneous abortion in one source. Their discussion is directly applicable to clinical situations and helps identify areas of debate and alternative methods.

Many women have to spend one third of their lives in a postmenopausal state and they should have a good quality of life during this period. Althoug HRT is well accepted as the logical treatment of climacteric problems, the prevalence rate is very low in some countries. The reasons for not accepting HRT are manifold and complex. The objective of this book is to describe the essential advances in basic and clinical research that forms the basis of current HRT and to give an overview of the efficacy and safety of HRT.

Professor Egon Diczfalusy, a pioneer in gynaecological endocrinology and in particular female contraception, celebrated his 80th birthday with a scientific symposium. The participants were scientists from all over the world who had been scholars and close collaborators at different points in time. The interdisciplinary meeting consisted of lectures on the epidemiological impacts of ageing, its challenge for the pharmaceutical industry, philosophical aspects of the future of mankind, and the history and future of contraception. Three round table discussions addressed the hormonal control of reproduction and ageing, new approaches and future perspectives of contraception for women and men, and hormone replacement in the elderly.

The events of September 11,2001 in the United States will always be r~membered with horror and sadness but also admiration for those who risked, and often lost, their lives attempting to save others. When the Fifth International Germ Cell Tumour Conference began, the US air space was closed and our American friends were unable to join us. We were faced with a programme that now had many gaps. What happened next was an illustration of the sense of community that prevails at the Germ Cell Tumour Conferences. Some of those who could not be there in person, such as Richard Foster and Craig Nichols, sent their slides by email, and we were indebted to those, such as Michael Jewett, Ben Mead and Malcolm Mason, who stepped into the breach to present them. Others gave impromptu, and often thought provoking, talks. The discussion periods were lively and it will come as no surprise to those who regularly attend the meeting that Tim Oliver won the prize for "Most Questions Asked", managing even to ask questions following his own presentations. The quality of the talks was outstanding. There was closer integration of the adult and paediatric sessions than in previous meetings. As a result, the differences and similarities between adult male, female and paediatric germ cell tumours became more apparent. This cross-fertilization of ideas from different groups will no doubt lead to further advances. As a result of all these efforts, the conference was a great success.

This book is a collection of preclinical and clinical reports on the appli cation of gene therapy to human disease. The focus of these studies is on cancer and cardiovascular disease. There are two fundamental technologies for delivering therapeutic genes to diseased ceHs: either viral vectors, as discussed by Dr. Bal main, or non-viral vector systems, as discussed by Dr. Felgner. The strengths and limitations of each of these delivery systems are charac terized. The use of a therapeutic gene to treat a disease has taken two general approaches. The first is to introduce anormal (i. e., wild type) gene into the patient that will restore normal gene function. Dr. Weiss man has characterized the tumor suppressor gene (pS3), and has shown that it can restore normal ceH function in cancer cells. The second ap proach is to treat the disease with antisense molecules. Abnormal gene expression can be down-regulated and selectively inhibited by anti sense molecules, which can reverse the pathologie process in cancer cells. Dr. Gewirtz has demonstrated this with anti sense genes on leuke mia, while Dr. Scanlon has applied this principle using ribozymes in human carcinomas. During this symposium, Dr. Engler described clinical studies of gene therapy using growth factors to stimulate new blood vessels in patients with cardiovascular disease. Several gene therapy strategies were used for cancer: overcoming drug resistance by Dr. Bertino, a pro-drug strategy with ganciclovir by Dr."

The introduction of colposcopy and exfoliative cytology as a means of examining the cervix uteri has opened up the possibility of studying the preceding and early stages of invasive carcinoma of the cervix and has also brought to light a number of conditions which are possibly only indirectly related, if related at all, to cervical neo with histological evaluation it is possible to plasia. Using these methods combined gain some insight into the natural history of cervical carcinoma. The importance of this is not confined to the cervix for, in this respect, the cervical lesions may prove a paradigm for those of the bladder, stomach and elsewhere. At present the broad outline of the natural history of these cervical lesions is emerging but the temporal and spatial relationships of the various phases is unclear, largely because of the number of possibilities envisaged which involves more vari ables than can be controlled in anyone investigation. In this monograph we have endeavoured to indicate the limitations of the various approaches and to stress the need for controlling the accuracy of assessment whether it be histological, cytological or colposcopic."