Scientists investigating germ cells have, over the past 15 years, originated discoveries and innovations that give us valuable insights into the mechanisms that regulate not just stem cell function, but human development in its widest sense. With contributions from some of the leading researchers in the field, Male Germline Stem Cells: Developmental and Regenerative Potential assesses the implications of these discoveries for understanding the fundamental biology of germline stem cells as well as their potential for human stem cell-based therapies. This monograph covers many of the fundamental issues now being explored by today's generation of stem cell researchers, including the field's potential for regenerative medicine. Ranging from an assessment of the pluripotency of primordial germ cells and their possible applications in treating testicular cancer, to the recovery of once-mordant fertilization-competent sperm, this volume has it all. It is a reference point for any scientist involved in related research as well as being a timely summation of what could prove to be a hugely exciting and very fruitful area of inquiry.

This book, by two of the most distinguished figures in fertility and reproduction research, answers all the most common questions about menaupause and andropause, and hormone resupplement therapy (HRT) for menopausal women. It offers explanations of all aspects of this subject, presenting balanced and reliable information about benefits, risks, and prospects for this field. Segal invented Norplant, the first long-term implantable contraceptive, and as the leader of Reproductive Biology at the Population Council, he orchestrated and coordinated the research and trials leading to basically every new contraceptive introduced over a period of about 25 years. Mastroianni did more than anyone else to develop in vitro fertizilation as a viable treatment option, and was for many years the chairman of the largest department of obstetrics and gynecology, and the director of the most successful IVF clinic. This book is unique in including coverage of the climacteric in men.

This book offers a comprehensive roadmap for determining when and how to regulate risky reproductive technologies on behalf of future children. First, it provides three benchmarks for determining whether a reproductive practice is harmful to the children it produces. This framework synthesizes and extends past efforts to make sense of our intuitive, but paradoxical, belief that reproductive choices can be both life-giving and harmful. Next, it recommends a process for reconciling the interests of future children with the reproductive liberty of prospective parents. The author rejects a blanket preference for either parental autonomy or child welfare and proposes instead a case-by-case inquiry that takes into account the nature and magnitude of the proposed restrictions on procreative liberty, the risk of harm to future children, and the context in which the issue arises. Finally, he applies this framework to four past and future medical treatments with above average risk, including cloning and genetic engineering. Drawing lessons from these case studies, Peters criticizes the current lack of regulatory oversight and recommends both more extensive pre-market testing and closer post-market monitoring of new reproductive technologies. His moderate, pragmatic approach will be widely appreciated.

This volume, and its companion volume on the oocyte, provide an authoritative and wide-ranging account of the gametes, and their reproductive role and function in humans. Acknowledged authorities from around the world provide a detailed and timely account of the spermatozoon. The volume starts with an evolutionary perspective before focusing on the molecular and cellular biology of the sperm cell, and its structure and function. The development and maturation of sperm are described, as is their movement and transport in the male and female genital tract. Practical issues such as sperm storage and assisted contraception are fully covered. The causes of male infertility are also an important theme. The volume concludes with a thought-provoking chapter on ethical considerations. The volume will be an essential source of information for all clinicians and scientists with an interest in human reproduction.

This volume, and its companion volume on the spermatozoon, provide an authoritative and wide ranging account of the gametes and their reproductive role and function in humans. Acknowledged authorities from around the world contribute a detailed and timely account of the oocyte. The volume starts with an evolutionary perspective before focusing on the molecular and cellular biology of the oocyte and its structure and function. The development and maturation of the oocyte is fully dealt with to include the endocrine and paracrine regulation of ovarian function. Practical issues such as oocyte storage and ovarian stimulation are also fully covered. The causes of female infertility are also an important theme. The volume concludes with a thought provoking chapter on ethical considerations. The volume will be an essential source of information for all clinicians and scientists with an interest in human reproduction.

Preimplantation genetic testing (PGT) is now well established as a valuable treatment option for patients wishing to start or continue a family, for a range of indications from advanced maternal age to high risk of transmitting inherited disease. This text brings together contemporary thinking from international opinion leaders and will be an invaluable guide for practitioners in Reproductive Medicine wishing to keep pace with the latest developments and clinical data.

This important new volume in the series Cambridge Reviews in Human Reproduction provides a wide-ranging and authoritative account of the uterus and its physiological role in fertility, normal pregnancy and delivery. Acknowledged authorities from around the world provide a detailed and timely account of uterine physiology. The volume encompasses a wealth of material including cell and developmental biology, structure, function, anatomy and endocrinology, and then goes on to cover clinically important issues such as the cervix during pregnancy, measurement of uterine contractions and initiation of labour. It will prove of particular value to those involved in the management of women with pre-term labour, as well as those concerned with the development of new procedures for the prevention or amelioration of this condition.

There is renewed interest in lifestyle medicine - the focus on food, physical activity, stress management, high-quality connections, restorative sleep, and avoidance of toxic substances - in the prevention, treatment, and sometimes reversal of chronic disease, but very little information exists on its application for improving specific women's health issues across the lifespan. Consequently, there is a growing need among health professionals who care for women for a textbook that addresses evidence-based lifestyle solutions to manage the health challenges they face every day in their offices. This book begins with a review of the fundamentals of Lifestyle Medicine through the lens of a woman's lifespan. It provides information about lifestyle interventions to improve gynecologic and sexual health and to manage and sometimes reverse gynecologic diseases. It clarifies the importance of lifestyle and behaviors before and during pregnancy to address infertility, reduce adverse pregnancy outcomes, and to lower non-communicable diseases in children along with emerging epigenetic evidence. The use of Lifestyle Medicine to prevent and manage breast and gynecologic cancers, enhance health as part of cancer survivorship, and decrease the risk or reduce many of the symptoms and diseases experienced during menopause including vasomotor symptoms and osteoporosis are also discussed. Additionally, the text covers cardiovascular disease, diabetes, autoimmune disorders, dementia and mental health from the perspective of gender specific differences. This book provides practical resources on implementing the components of lifestyle medicine. Some of the topics covered include models of care for women and families, reimbursement, health coaching and behavioral change, community engagement and health equity for under-resourced settings. The electronic version of the book presents supplemental material featuring in-depth reading, as well as online and digital resources for implementing Lifestyle Medicine. The book is an evidence-based source of information on women's health issues for health professionals already practicing lifestyle medicine, as well as an entry level textbook for those new to the field of lifestyle medicine. The collective expertise of each of the editors along with content provided by leaders within the American College of Lifestyle Medicine fills a much-needed void within the specialty of Lifestyle Medicine and is for providers of women's health globally. Features: Provides a basic overview of Lifestyle Medicine (nutrient-rich diet, exercise, stress resilience, sleep, and high-quality connections) in the care of women across the lifespan. Provides lifestyle-focused treatment recommendations for specific women health issues. Includes strategies for implementing Lifestyle Medicine with vulnerable populations and in communities. Summarizes key points at the close of each chapter and includes supplemental material with in-depth reading. Features additional resources for implementing lifestyle medicine into practice. "This women's health book is evidence based and comprehensive. There is nothing like it. Women need up to date information about physical activity, nutrition, sleep, stress resilience, social connection and substance use. In addition, there is a desire to better understand the power of these pillars throughout a woman's life including pregnancy, menopause and the golden years. This book fills that need." Elizabeth Pegg Frates, MD, DipABLM, FACLM, President Elect of the American College of Lifestyle Medicine "Healthy aging begins at pre-conception. Evidence overwhelmingly shows that it's we women who-through our lifestyle behavior choices-can take far greater control of our own health destinies, as well as the health destinies of our children and generations to come. We cannot underestimate the power of what we eat, how we move, and what we think in regard to our optimal health or lack thereof. This book is a must-read for all medical professionals!" Susan Benigas, Executive Director of the American College of Lifestyle Medicine Lifestyle Medicine is the science of taking core principles and customizing how they're applied to each individual and each situation to achieve positive health behavior change. This book sets the evidence based foundation for how that process happens, and why it needs to happen, with the most important segment of health consumers - women. It is the next for all who are passionate about changing how health care is delivered." Wayne S. Dysinger, MD, MPH, Physician, Founder and Chair, Lifestyle Medical "Lifestyle factors have a powerful role in chronic disease prevention, underscoring the profound control we have over our health. Improving Women's Health Across the Lifespan applies lifestyle medicine to women's health, empowering women and their clinicians with the tools to transform their lives, and fostering a legacy of health for future generations." JoAnn E. Manson, MD, MPH, DrPH, Professor of Medicine and the Michael and Lee Bell Professor of Women's Health, Harvard Medical School Chief, Division of Preventive Medicine Brigham and Women's Hospital, Professor, Harvard Chan School of Public Health

Within 10 chapters this book addresses the whole gamut of questions that may arise in the context of pregnancy resulting from assisted reproduction. Incidence of abortion, extrauterine pregnancy or chromosomal abnormalities, pregnancy complications, problems regarding mode of delivery and the health status of children at birth are covered as well as the further development of the children and the social structure of the families. Topics such as follow-up of families in lesbian relationships and following gamete donations are also discussed.

This concise 1993 volume proposes a standardized approach to the investigation of infertility. The volume provides clear guidelines and a logical sequence of steps which will quickly lead the clinician or physician to an accurate diagnosis of the underlying cause of infertility. This standardized approach to the management of infertility will lead to more efficient, systematic and economic care for the infertile couple. The diagnostic charts, which may be photocopied, provide an unambiguous route to diagnosis of the underlying cause of infertility, whilst the text fully explains and describes the essential clinical tests. The volume summarizes the results gained from the study of more than 10,000 infertile couples, who were investigated as part of the WHO's programme to counter the widespread personal distress caused by infertility. It is hoped that the standardized approach presented here will go some way towards countering this major problem.

Many health problems are unique to, more common in, or more severe in women than men. This book examines the underpinnings of these gender differences. Sections deal with biological (hormonal, anatomic, immunologic, and pregnancy-related), social, behavioural/psychological, and lifestyle influences. Chapters are heavily referenced, packed full with data, and they provide methodological insights that will guide future women's health research.

Male infertility is a clinician-orientied book aimed at the clinician dealing with the infertile couple because rational, effective management is only possible if the couple are considered together. The aim of the work is to provide advice to the clinician and to give reference to the underlying science. This will not only enable clinicians to understand the underlying science but will also give scientists an insight to clinical work. This blend of science and clinical work is reflected in the contributors who are experts drawn from both fields.

One of modern healthcare's most controversial areas, reproductive medicine is an emerging discipline that fosters hugely divergent opinions on topics such as laboratory techniques, clinical management and ethical considerations. Highlighting over 50 contentious topics in reproductive medicine, this book presents expertly argued opinions are presented for and against, often with diametrically opposing views about management. Debates such as these are being increasingly used as learning tools, helping participants develop their critical thinking skills and showing that context is vital when making decisions. Issues discussed include limits on IVF provision, ethical queries about sex selection, embryology, and ovarian stimulation. Authors are authorities in their field, combining years of experience with fresh and innovative ideas to structure their arguments. Readers will gain an insight into topical controversies, critically evaluating the different sides to enhance their own clinical practice.

Fibrin sealant is used for numerous indications in gynecology, especially for the McIndoe Operation and Cohn biopsy, the Marshall-Marchetti-Krantz-Hirsch-Stoll-Operation, urethrocysopexy, or in vitro fertilization for embryo transfer. The use of fibrin sealant in urology has also been extended, especially in operations of the spermatic cord, reconstruction of the urethra and closing of nephrotomies.

In Manufacturing Babies and Public Consent, Jose Van Dyck sketches a map of the public debate on new reproductive technologies as it has evolved in the USA and Britain since 1978. Many people have participated in heated discussions on test-tube babies and in vitro fertilization, particularly medical researchers and feminists. The new technologies have been both embraced as the cure to infertility and condemned as the exploitation of women's bodies. Reconstructing this debate, Van Dyck juxtaposes a variety of textual material, from scientific articles to newspaper articles and works of fiction.

Despite France and Belgium sharing and interacting constantly with similar culinary tastes, music and pop culture, access to Assisted Reproductive Technologies are strikingly different. Discrimination written into French law acutely contrasts with non-discriminatory access to ART in Belgium. The contributors of this volume are social scientists from France, Belgium, England and the United States, representing different disciplines: law, political science, philosophy, sociology and anthropology. Each author has attempted, through the prism of their specialties, to demonstrate and analyse how and why this striking difference in access to ART exists.

This open access edited book brings together new research on the mechanisms by which maternal and reproductive health policies are formed and implemented in diverse locales around the world, from global policy spaces to sites of practice. The authors - both internationally respected anthropologists and new voices - demonstrate the value of ethnography and the utility of reproduction as a lens through which to generate rich insights into professionals' and lay people's intimate encounters with policy. Authors look closely at core policy debates in the history of global maternal health across six different continents, including: Women's use of misoprostol for abortion in Burkina Faso The place of traditional birth attendants in global maternal health Donor-driven maternal health programs in Tanzania Efforts to integrate qualitative evidence in WHO maternal and child health policy-making Anthropologies of Global Maternal and Reproductive Health will engage readers interested in critical conversations about global health policy today. The broad range of foci makes it a valuable resource for teaching in medical anthropology, anthropology of reproduction, and interdisciplinary global health programs. The book will also find readership amongst critical public health scholars, health policy and systems researchers, and global public health practitioners.

"A remarkable collection of scholarly essays, philosophical discussions, and ethical arguments concerning reproductive choices."
--"Choice"

It seems as if every week there is a new case involving reproductive technologies that raises provocative, often painful questions: What policies should be followed by centers that preserve human embryos? Are such innovations as Norplant improvements over established methods of contraception? Should R.U. 486 be available in the U.S.? Is prenatal diagnosis an ethically acceptable step to limiting the number of disabled people?

These are just some of the vital questions explored in this timely work which offers incisive analysis of the plethora of issues raised by advances in reproductive medicine. The book's major section cover abortion, contraception, cryopreservation of gametes and embryos, surrogate motherhood, and psychosocial issues of in-vitro fertilization.

In each section, introductory essays by recognized authorities such as Elizabeth Bartholet and Andrea L. Bonnicksen are followed by critical articles by professionals in such fields as women's health, medicine, biology, sociology, politics, and philosophy. In assessing a technology, the authors present well-argued analyses of problems created by that technology, including views from advocates and practitioners that raise attendant ethical and practical issues.

1. 1 Historical Perspective In the nineteenth century, knowledge of the events leading to ovulation, fertilization, and implantation was very limited, so much so that Seiler (1832), in his book The Uterus and the Human Egg, wrote: ." . . in the left ovary the first signs of fertilization, namely a Graaf vesicle could be seen. The right ovary shows proof of a second successful copulation: a fresh scar from the ovulated egg and the beginning of a corpus luteum. " In fact all nineteenth century authors strictly divide the female cycle into two phases: the menstrual period and the intermenstruum (ct. Hitschmann and Adler 1908). The generally accepted histology of the endometrium in those days was that of the late proliferative phase. Deviations from this were considered to be pathological (Von Ebner 1902). As Gebhard (1899) expressly put it: "As a rule, it can be said that in the mature woman the endometrial glands run straight; an irregular course of the glands is to be regarded as pathological. " The same author describes the changes occurring during the secretory phase of the cycle as "endometritis glandularis" which he believed to arise from a local nutritional disturbance. The uterine stroma was believed to be lymphoid (Toldt 1877), and the uterine glands were compared to the crypts of Lieberkiihn (Von Ebner 1902).

Endorphins and other endogenous opioids appear to be the connecting link between reproductive functions and stress adaption of the human organism. This book contains the con- tributions of an international group of biologists, bioche- mists, and endocrinologists on the opioidergic control me- chanisms in reproduction and stress physiology. Main topics covered are: endogeneous opioids and the pituitary-gonadal system; ovarian endorphinsecretion; pregnancy-associated changes of plasma endorphin; and opioid control of the hypo- thalamo-pituitary-adrenal axis. Although all chapters give an excellent review on various studies in basic opioid re- search, there are numerous clinical implications mentioned in this book.

In the USA, severe psychiatric illness after childbirth strikes one woman for every 1000 births, or about 3500 women each year. An unrecorded number of new mothers experience lesser degrees of postpartum illness, and two distinct forms of severe illness can be distinguished. One form, called postpartum psychosis, is an agitated, very changeable condition, often characterized by confusion, hallucinations, delusions and sometimes episodes of violent behaviour. The other condition, major postpartum depression, begins two or three weeks after childbirth, and is characterized by confusion, depression of mood, and often with exhaustion, headache and digestive upset. Mixtures of the two severe disorders occur frequently. This volume contains a number of essays which support the position that postpartum disorders are primarily organic and are mainly disorders of hormonal deficit. They develop as the endocrine system falls back from the hyperactivity of pregnancy toward or beyond the levels of the prior non-pregnant state. Tremendous therapeutic opportunities exist or are imminent for both the organic and the psychological components of postpartum mental illness.

During the past 20 years, endometrial carcinoma has continued to increase in frequency and it is quite possible that this carcinoma will become the major gynecologic malignancy in the future. For many years, endometrial carcinoma was considered less malignant than other gynecologic malignancies, simple hysterectomy and bil ateral salpingo-oophorectomy or surgery combined with radiation being effective in certain circumstances. It is unfortunate to note that the global 5-year survival rate for patients with advanced or recurrent endometrial carcinoma has improved only slightly. Therefore any complacency regarding this 'benign malignancy' should be reconsidered. There is a growing awareness of the nature of end ometrial carcinoma, with advances in our knowledge ranging from its etiology through its epidemiology to its clinical findings. This volume has been designed to fill a hiatus in the literature in China. To achieve this aim, we have attempted to review the world-wide advances on endometrial carcinoma and summarize systematically and comprehensively this common gynecologic malig nancy, including the clinical experiences gathered at the Cancer Institute (Hospital) of the Chinese Academy of Medical Sciences since 1958 as well as a brief description of the psychological problems in patients with gyneco logic cancers."

Doppler ultrasound is a hot topic at the present time. This is because studies of the uteroplacental and fetal circulation give fundamental information as to the physiology or pathology of placental function and the response of the fetal circulation to hypoxaemia. Dr. Arabin's clinical studies which are described in this book are an important contribution to knowledge in this field and will be of enormous interest not only to researches but also to clini cians interested in learning how this latest technology can be integrated into their clinical practice. London STUART CAMPBELL Foreword Although only three decades old, the field of perinatal medicine is marked by continuous new advances. Ultrasound diagnostic techniques comprise an important element of this new field. Dr. Arabin has taken the initiative to investigate the functional-diagnostic aspects of ultrasound. Among other things, she has further developed and refined the concept of "oxygen-con serving adaptation of fetal circulation" which originated in the Department of Obstetrics and Gynecology at the Neukolln Hospital Center in 1966. She thus has been able to show that the most reliable Doppler blood flow meas urement predictors of a high risk to the fetus are (1) a decrease in the flow volume of the descending thoracic aorta and the umbilical artery and (2) an increase in the flow volume of the common carotid arteries."

The examination for Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG) remains one of the most internationally recognised postgraduate examinations in the specialty. Over the years, the examination has evolved in keeping with changes in medical education; the Part 2 examination now consists of two papers made up of Single Best Answer (SBA) questions and Extended Matching Questions (EMQ). This invaluable resource consists of 400 SBA questions (200 in Obstetrics and 200 in Gynaecology), followed by 400 EMQs (200 in Obstetrics and 200 in Gynaecology), grouped into papers, to provide enough material to guide preparations and to give some practice experience of the examination formats. All the questions have answers with explanations and sources of evidence. In preparing for the examination, candidates should make repeated references to these sources of evidence. There is also general advice on how to prepare for the examination and discussion of the reasons why trainees fail the examination.

The Project on Reproductive Laws for the 1990s began in 1985 with the realization that reports of scientific developments and new technologies were stimulating debates and discussions among bioethicists and policymakers, and that women had little part in those discussions either as participants or as a group with interests to be considered. With the help of a planning grant from the Rutgers University Institute for Research on Women, the Women's Rights Litigation Clinic at Rutgers University Law School-Newark held a planning meeting that June attended by approximately 20 theorists and activists in the area of reproductive rights. Project purposes, methods, and general shape took form at the meeting. Two goals have characterized the Project's work since then: first, to generate discussion, debate, and, where possible, consensus among those committed to reproductive autonomy and gender equality as to how best to respond to the questions raised by re ported advances in reproductive and neonatal technology and new modes of reproduction; and second, to ensure that those shaping reproductive law and policy appreciate the ramifications of these developments for gender equality. In meeting this twofold agenda, the Project focused on six areas: time limits on abortion; prenatal screening; fetus as patient; reproductive hazards in the workplace; interference with reproductive choice; and alternative modes of reproduction. The Project identified individuals to take respon sibility for drafting model legislation and position papers in the six areas (for the drafters, see the Appendix)."