The human egg - the rarest and most rapidly aging cell in the body - is a topic of intense scientific study. Assisted reproduction clinics are constantly vying to improve success rates - choosing the best gametes is a key step in this process. This new edition of what one reviewer of the first edition described as 'possibly the definitive work on the oocyte' covers the development, biology and pathology of the oocyte, and technologies to manipulate, enhance and control fertility. These technologies are used to overcome infertility, avoid inherited diseases, and create genetically engineered embryos from stem cells and cloning. This progress would have been impossible without the myriad of scientific and technical developments covered in this book. The new edition is thoroughly updated and includes major new research on reprogramming, oocyte molecular development, cryopreservation and viability. We are in exciting times for the egg.

Obstetrics is a unique field of medical care because, in its uncomplicated or natural form, pregnancy, labour and delivery are not diseases, but normal physiological events constituting an integral part of human life. Three equally important facets form the basis of obstetrics: the needs of the pregnant woman, the wellbeing of the baby, and the ability to perform a medical intervention should either of these be threatened - before, during and after birth. Clinical obstetrics: a South African perspective is an authoritative and up-to-date textbook dealing with current obstetric practice, focusing specifically on conditions and problems prevailing in South Africa. Clinical obstetrics: a South African perspective covers a wide range of topics from physiological adaptations, diagnosis and management of normal pregnancy and delivery, to teratogenesis, red cell allo-immunisation, congenital abnormalities and pre-term labour. It also discusses the risks involved in poor progress in labour, abnormal fetal lie and presentation, viral infections and multiple pregnancies. There are separate sections for medical and surgical conditions, as well as diagnostic procedures. Clinical obstetrics: a South African perspective is aimed primarily at medical students, but will also be of great value to nurses, registrars in obstetrics and gynaecology, general practitioners and specialists in this field.

This book is intended as a reference manual that will provide the busy clinician with up-to-date information on the diagnosis and treatment of uncommon and rare gynecological cancers. While standard textbooks briefly cover these tumors, this is intended as a more comprehensive yet easy-to-use guide. After opening chapters on epidemiology, pathology, and diagnostic imaging, the full range of infrequently encountered gynecological cancers (ovarian, uterine, cervical, vaginal, and vulval) is presented and discussed with the aid of high-quality illustrations. In each case, detailed attention is paid to both differential diagnosis and current treatment options. The book has been written by an international panel of experts and is the first to gather all the uncommon and rare gynecological cancers together within one volume.

Reconstructive Colorectal and Anal Surgery presents a didactic discussion of complex colonic, rectal, anal, and perineal problems which require reoperative surgery. The book provides a very practical description of the management towards these problems including preoperative investigation, postoperative follow-up and detailed operative approach. The text is aimed at being relatively didactic with an algorithm approach to these complicated cases using operative photographs and composite explanatory line drawings which are complemented by 'how-to' guides in all cases describing the operative technical tips and pitfalls from experienced world-renowned commentators. Given the rapid change in techniques over the last 10 years newer procedures will be incorporated. This book will be essential reading for all colorectal surgeons and trainees, general surgeons and trainees, gynecologists as well as specialist nurses in the OR room.

Current molecular understanding of estrogen action has greatly profited from advances in molecular cell biology. These advances, and their implications for clinical use, were discussed by leading researchers from industry and academia during an international symposium held in Berlin, 1-3 March 2006 and are featured in this volume.

Identification of cancer risk factors and potential prevention strategies have been some of the most important medical and research contributions to the improvement of public health in the past half-century (Steele 2003). Und- standing the role of lifestyle, exposure to endogenous factors and exogenous environmental factors, and individual genetic and epigenetic variability have contributed significantly to this effort. Cancer prevention strategies have been developed based on results of epidemiologic, preclinical, and clinical studies that have generated clues for identifying risk factors that may be modulated by changes in lifestyle, such as smoking cessation or dietary modification (Greenwald 2002a). In addition, significant progress in medical interventions involving chemoprevention-a pharmacological approach to intervention that aims to prevent, arrest, or reverse either the initiation phase of carcinogenesis or the progression of premalignant cells-is beg- ning to pay dividends in reducing risks associated with cancer. Emerging technologies, identification of biomarkers of risk, and advances in genetics research also are finding applications in chemoprevention research that p- mise to speed the acquisition of knowledge on the molecular and cellular - fects of chemopreventive agents. 2 Lifestyle Approaches Population studies from the 1950s through the early 1980s provided c- pelling evidence that modifiable lifestyle choices can either increase or - crease cancer risk. For example, several landmark epidemiologic studies in the 1950s showed a clear association between smoking and lung cancer (Wynder and Graham 1950; Levin et al. 1950). In 1964, the U. S.

This volume contains an advanced level discussion on the appropriateness of hormone replacement therapy (HRT) in modern postmenopausal women on the basis of evidence provided by recent epidemiological studies. It addresses all aspects of benefits and risks associated with HRT. It focuses, however, on cancer risk and on risk of breast cancer in particular. The book advocates further epidemiological studies which incorporate pathobiological assessments.

This concise drug guide lists 500 substances, such as pharmaceutical drugs, lifestyle drugs, and environmental toxicants, which show documented untoward effects on the male sexual organs and their functions. All substances are listed in user-friendly alphabetical order with a uniform structure throughout the book. Each listing includes evidence-based information with up-to-date references and all studies mentioned are evaluated and categorized according to study and sample types. This unique compendium provides more detailed information on each drug than any other standard pharmacology title.

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.

Bladder Pain Syndrome: A Guide for Clinicians provides a comprehensive update in the pathophysiology, epidemiology, terminology, evaluation and treatment of patients with pelvic pain perceived to be related to the urinary bladder. The volume covers the tremendous evolution during the last decade in our understanding of pain syndromes and their diagnosis and treatment. It is now clear that Bladder Pain Syndrome belongs to the family of pain syndromes, and therefore treatment has moved from the treatment of the bladder to the treatment of a pain syndrome with the special problems this presents when the pain syndrome involves urinary symptoms. Interstitial Cystitis was poorly defined and the interpretation and patient selection differed enormously around the world in many ways, making exchange of information unreliable and confusing. Bladder Pain Syndrome is clearly defined and the result is a much better patient selection. This volume provides state of the art background for making a correct evaluation and diagnosis of patients with pelvic pain and voiding problems resulting in a more focused treatment to the benefit of the patients. The volume also covers the close relationship between different pain syndromes including those outside the pelvis. Bladder Pain Syndrome: A Guide for Clinicians will be of great utility to urologists, gynecologists and all health professionals dealing with patients with pelvic pain.

The world's population is growing at an unsustainable rate. From a baseline ?gure of one billion in 1800, global population is predicted to exceed nine billion by 2050 and 87. 8% of this growth will be localized in less developed countries. Such uneven population growth will yield a harvest of poverty, malnutrition, disease and en- ronmental degradation that will affect us all. Amongst the complex mixture of political, social, cultural and technological changes needed to address this issue, the development of improved methods of fertility regulation will be critical. The inadequacy of current contraceptive technologies is indicated by recent data s- gesting that the contraceptive needs of over 120 million couples go unmet every year. As a direct consequence of this de?cit 38% of pregnancies are unplanned and more than 50% end in an abortion, generating a total of 46 million abortions per annum particularly among teenagers. If safe, effective contraceptives were ava- able to every couple experiencing an unmet family planning need, 1. 5 million lives would be saved each year (UNFPA 2003). Progress in contraceptive technology should not only generate more effective methods of regulating fertility, but should also provide a range of methods to meet the changing needs of the world's population. Contraceptive practice was revo- tionized in 1960 in the US and 1961 in Europe by the introduction of the oral contraceptive pill by Gregory Pincus, MC Chang and colleagues, based on fun- mental hormone research conducted in Germany.

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

In celebration of its 20th anniversary, a thoroughly revised and expanded edition of the leading book on fertility and women's reproductive health. Since the publication of Taking Charge of your Fertility two decades ago, Toni Weschler has taught a whole new generation of women how to become pregnant, avoid pregnancy naturally and gain better control of their gynecological and sexual health by taking just a couple minutes a day using the proven Fertility Awareness Method. Now, this 20th Anniversary Edition has been thoroughly revised and fully updated with: the latest medical advances in assisted reproductive technologies (ART) more in-depth coverage of women's gynecological and sexual health new illustrations, photographs, and an expanded color insert new sample charts an expanded appendix Six new chapters including: Three Prevalent Conditions--Endometriosis, Ovarian Cysts and PCOS Natural Ways to Balance Your Hormones Preserving Your Future Fertility Miscarriages Idiopathic Infertility Causes of Unusual Bleeding Clear and comprehensive, yet warm and approachable, Taking Charge of Your Fertility is one of the most universally lauded health books on the market today. It is an essential reference for every woman of reproductive age.

Hormone Receptors in Breast Cancer provides an up-to-date resource of the role of hormone receptors in breast cancer written in depth for both the basic molecular academic researcher and translational scientist. Advances in basic science of molecular endocrinology have undoubtedly been translated into clinical practice, and clinicians caring for this disease need to be knowledgeable about these developments. The molecular basis of hormone action has been elucidated, and the relative significance of the different estrogen and progesterone receptor isoforms has been explored. This explosion of information has lead to exciting new areas of gene specific targeting of the disease, and breast cancer prevention. Paradigm shifts in treatment options and sequencing have recently occurred in breast cancer management, necessitating close cooperation and communication between translational scientists and physicians. This book is focused on providing this communication.

This book offers a progress report on efforts to meet the challenges faced by ovarian cancer patients and their doctors. It provides a current perspective on therapeutic developments as a partnership between laboratory-based and clinical-based researchers.

Polycystic ovary syndrome (PCOS) is a classic female infertility condition affecting an estimated 6-10% of all women, many of whom are unaware of the problem. A disease that affects women from adolescence to menopause, PCOS is the single most common endrocrinologic abnormality affecting women. This book is an edited collection of writings that comprehensively covers the disease, from diagnosis and epidemiology of PCOS to clinical evaluation.

The impetus for this book came from the recent appearance of single specialty books pertaining to reoperative surgery on various organs in the pelvis, as well as from the recognition that several different disciplines are involved with the challenges of reoperative pelvic surgery. Surgeons often encounter challenging dilemmas involving organ systems that have historically been attended to by surgeonsrepresentingcloselyrelatedbut distinctspecialtyareas. Withincreasing sophisticationand knowledge about management of anatomically adjacent organs by the specialties of gynecologic oncology, gynecology, urology, and colon and rectal surgery, as well as the emergence of specialty training programs in urogynecology and pelvic floor disorders, we thought it appropriate and timely to create a textbook acknowledging this increasing knowledge and interspecialty collaboration. To this end,where appropriate, we haveincluded collaborative authors fromeach of the specialties, any ofwhommaybecalledupontoaddressaparticularanatomicarea. Itseemsinevitablethatsituations willariseinwhichthecollaborativeexpertiseofseveralseparatespecialtiesmayconvergetoprovide surgeons the benefit of the combined thought processes that would prove invaluable when such difficult problems are encountered. With this in mind, the editors, from the fields of gynecologic oncology, urology, and colon and rectal surgery, identified experts in theirown fields who could bestcontribute to the management of specific problem areas. For example, since reoperations for endometriosis may involve uterus, adnexae, ovaries, or the colorectum, the chapter concerning this condition has been coauthored by specialists in colorectal surgery and gynecologic oncology. We have been fortunate to find experts who have collaborated to bring available evidence-based medicine, best demonstrated practices, and personal experience to their contributions.

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.

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.

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.

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.

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.

Effectively prepare for certification, recertification, and practice with Breast Imaging: Case Review, 2nd Edition! Case studies illustrate how to make confident, final diagnoses through accurate pattern recognition, clinical correlation, and differential diagnosis. It's an ideal way to test and deepen your knowledge of all essential topics in breast imaging. Prepare for the new Board exam format with an updated organization that provides 4-5 multiple-choice review questions for each case. Review 200 cases organized by level of difficulty, with multiple-choice questions, answers, and rationales that mimic the new format of certification and recertification exams. Stay current with the aid of updated cases covering breast MR imaging, digital breast imaging, image-guided biopsy, imaging of high-risk lesions (ADH, LCIS), high-risk patient management, invasive lobular carcinoma, complex cystic cancer, male breast cancer, mucinous carcinoma, MRI of DCIS, desmoid tumors, and much more. See examples of the latest imaging approaches, including digital mammography, MRI, and color Doppler US.

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.