This gold standard text has kept its readers abreast of rapid advancements in reproductive medicine and surgery since 1983. Continuing this tradition, this fifth edition has been fully updated and revised to provide clear, didactic advice on best practice for a variety of clinical situations faced by practitioners across many specialties - including urologists, gynecologists, reproductive endocrinologists, medical endocrinologists and many in internal medicine and family practice who see men with suboptimal fertility and reproductive problems. Completely restructured to include pedagogical features such as easily accessible key concepts that cement understanding and real-world use. Covering everything from foundations of anatomy and embryology, through clinical evaluation, diagnostic approaches, treatment and fertility care in context within the healthcare system and society, thrilling advances and future directions are also included. This new edition is an essential reference for all who are working in this young and rapidly evolving field.

This book contributes in an important way to the psychoanalytic understanding and impact of Assisted Reproductive Technology on a majority of patients who have difficulties starting new families. Recent advances in reproductive technology and the increased use of techniques based upon it have created a need for psychoanalytic thinking and understanding of the psychological implications of Assisted reproductive procedures, in-vitro fertilization and other similar procedures.The recent and rapid advances in medical technologies confront us with a mandate in our clinical work to understand their complex impact on women, men, and children. However, attention to the intra psychic conflicts, traumatic experience of the use of such techniques has not been addressed in psychoanalytic literature. The developmental trauma and intra psychic conflicts of individuals using reproductive technologies are ubiquitous, yet it has been neglected as a topic of special interest in our clinical work.The centerpiece of these collective chapters deal with psychic trauma of infertility, the compulsion to repeat through persistent repeated use of assisted reproductive technology, anxiety about motherhood, and finally the lives of children who are born and do not know from where they came.These poignant topics deal with family complexes and the Oedipal circle, repetition compulsion, trials and failures, anxiety related to motherhood, egg and sperm donors, parental identity formation, infertility, trauma, and discussion of a contemporary film depicting the challenging and newly defined family structure.

How do rapid social and technological changes shape reproductive realms today? This book considers the complex choices, anxieties and challenges that come alongside postmodern reproduction for women and men in the West. Topics include surrogacy, fatherhood, sperm banking, egg donation, contraception, breastfeeding, and postpartum body image.

The development of the placenta was a pivotal event in evolution. Without it, we would still be laying eggs instead of giving birth to live offspring. It represents the critical link between the foetus and the mother, but its character is extraordinary - it is, in effect, a foreign tissue that invades the mother's body. Compared to many other animals, the human placenta represents a particularly aggressive body. But how is it managed and controlled? How did such an organ evolve in the first place? And why is it tolerated by the mother? Y.W. Loke, a highly respected expert in the placenta and its development, explores the nature of the placenta and what it can tell us about evolution, development, and genetics.

The phenomenon of bleeding has been shown to appear in up to 22% of all pregnancies and is associated with significant maternal and fetal morbidities, and even mortality. Although vaginal bleeding occurs mainly during the first trimester, it can appear at any stage of pregnancy and in the postpartum period. This sometimes life-threatening event requires an extensive work-up in order to recognize its cause and establish a rapid and effective therapeutic approach. This book is a comprehensive appraisal of this critical condition. It draws on evidence-based data and brings together, in a single volume, updated information on all aspects of pregnancy-related bleeding. A global group of interdisciplinary experts contributed chapters on: bleeding during early pregnancy (early pregnancy loss, ectopic pregnancy, gestational trophoblastic disease, and cancer of the reproductive tract during pregnancy); bleeding in late pregnancy (preterm delivery, placental abruption, placenta previa, vasa previa and uterine rupture); and postpartum hemorrhage.

In species with internal fertilization, sperm competition occurs when the sperm of two or more males simultaneously occupy the reproductive tract of a female and compete to fertilize an egg (Parker, 1970). A large body of empirical research has demonstrated that, as predicted by sperm competition theory, males and females in many species possess anatomical, behavioral, and physiological adaptations that have evolved to deal with the adaptive challenges associated with sperm competition. Moreover, in recent years, evolutionary biologists and psychologists have begun to examine the extent to which sperm competition may have been an important selective pressure during human evolution. Some research has suggested that male humans, like males of many bird, insect, and rodent species, might be able to adjust the number of sperm they inseminate according to the risk of sperm competition. Other research has examined whether such responses might be accompanied by psychological changes that motivate human males to pursue copulations when the risk of sperm competition is high. Furthermore, there is research suggesting that aspects of human penile anatomy might function to enhance success in sperm competition. Much of this work has been controversial; some of the findings have been disputed and others have been greeted with skepticism. However, the idea that some aspects of human psychology and behavior might best be understood as adaptations to sperm competition remains intriguing and, in certain cases, very persuasive.

This book is a point-of-care resource for effective sexual and reproductive healthcare for patients of all ages, sexual orientations, gender identities and medical backgrounds in the primary care setting. This useful guide is divided into three parts, and other than part three, which deals exclusively with transgender and gender diverse patients, all content will relate to patients of all gender identities. Part one presents sexual and reproductive health (SRH) using a lifespan approach, including chapters on pediatrics, adolescents and young adults, adults, and older adult patients. Part two presents an approach to common SRH issues that span multiple age groups, including contraception and family planning, sexually transmitted infections and cancer screenings as well as sexual and reproductive health in the setting of common medical conditions. Part three is dedicated to sexual and reproductive health for transgender and gender non-binary patients, including psychosocial, medical, surgical and legal aspects of health. This book provides primary care clinicians with a framework for providing effective sexual and reproductive healthcare to patients of all ages, sexual orientations and gender identities in a way that is inclusive, focuses on health, and addresses the needs unique to specific populations.

An assessment of some ethical implications of increasing life spans. Taking as a starting point the idea that to increase longevity is a form of medical enhancement, it examines the value of living longer; the means for extending life spans; the consequences of greater longevity for the fair distribution of resources and healthcare in particular.

In Quest for Conception, Marcia C. Inhorn portrays the poignant struggles of poor, urban Egyptian women and their attempts to overcome infertility. The author draws upon fifteen months of fieldwork in urban Egypt to present moving stories of infertile Muslim women whose tumultuous medical pilgrimages - or their "search for children," as they call their quests for conception - have yet to produce the desired pregnancies. Inhorn examines the devastating impact of infertility on the lives of these women, who are threatened with divorce by their husbands, harassed by their husbands' families, and ostracized by neighbors. Beliefs about procreation and infertility causation and cure among the Egyptian urban poor derive from a five-thousand-year history of shifting medical pluralism. Although colonially produced Western biomedicine is the dominant system in Egypt today, it represents only one of an array of therapeutic alternatives. Infertile women seek help from both "biogynecologists" (practitioners of Western biomedicine) and "ethnogynecologists" (practitioners of indigenous ethnomedicine), often using the remedies of both simultaneously. Quest for Conception examines in detail the variety of ethnomedical and biomedical treatments for infertility and concludes that treatments of both types are often ineffective and sometimes harmful. Given this untherapeutic setting, the future of infertile Egyptian women is explored in light of needed changes in reproductive health policy and the introduction of new reproductive technologies. Quest for Conception is the first comprehensive account of non-Western women's experiences of infertility and is a novel study within the literature on Middle Easternwomen.

With advances in ultrasound, birth defects are increasingly detected during pregnancy and may be amenable to surgical correction before delivery, to improve outcomes. This essential book discusses the different birth defects that can be treated during pregnancy and the important anesthetic considerations for the mother and fetus undergoing these procedures. Experts in the fields of anesthesiology, maternal fetal medicine, surgery, and pediatrics have come together to develop the content of this book. Enhanced throughout with full color images and illustrations, the book covers important topics such as spina bifida, twin-twin transfusion syndrome, sacrococcygeal teratoma, and lung masses, as well as fetal cardiac intervention, intrauterine transfusion, ex utero intrapartum treatment, and multidisciplinary approaches to fetal surgery. An invaluable guide for pediatric and obstetric anesthesiologists, anesthesiology, obstetrics, and surgical trainees, nurse anesthetists, and maternal-fetal medicine specialists.

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.

Gender, Identity and Reproduction draws on a variety of perspectives relevant to an understanding of reproduction across the life-course. Through a consideration of the representation of reproductive identities and experiences, the book highlights difference and diversity in relation to contemporary reproductive choices. The book focuses on women's and men's experiences of agency, control and negotiation within the context of cultural, medical, political, theoretical and lay ideologies of the reproductive process in contemporary Western societies.

Clinical case studies have long been recognized as a useful adjunct to problem-based learning and continuing professional development. They emphasize the need for clinical reasoning, integrative thinking, problem-solving, communication, teamwork and self-directed learning - all desirable generic skills for health care professionals. This volume contains a selection of cases on assisted reproduction that will inform and challenge reproductive medicine practitioners at all stages in their careers. Both common and uncommon cases are included. The aim is to reinforce diagnostic skill through careful analysis of individual presenting patterns, and to guide treatment decisions. Each case consists of a clinical history, examination findings and special investigations, before a diagnosis is made. Clinical issues raised by each case are discussed and major teaching points emphasized. Selective references are provided. The book provides a useful complementary adjunct to existing textbooks of reproductive medicine, and an excellent resource for teaching and continuing professional development.

The development of new reproductive technologies has raised urgent questions and debates about how and by whom these treatments should be controlled. On the one hand individuals and groups have claimed access to assisted reproduction as a right, and some have also claimed that this access should be available free of charge. As well as clinically infertile heterosexual couples, this right has been claimed by single women, gay couples, post-menopausal women, and couples who wish to delay having children for various reasons. Others have argued that a desire to have children does not make it a human right, and, moreover, that there are some people who should not be assisted to become parents, on grounds of age, sexuality, or lifestyle. Mary Warnock steers a clear path through the web of complex issues underlying these views. She begins by analyzing what it means to claim something as a 'right', and goes on to discuss the cases of different groups of people. She also examines the ethical problems faced by particular types of assisted reproduction, including artificial insemination, in-vitro fertilization, and surrogacy, and argues that in the future human cloning may well be a viable an