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.

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

The concept of reproductive health promises to play a crucial role in improving health care provision and legal protection for women around the world. This is an authoritative and much-needed introduction to and defence of the concept of reproductive health, which though internationally endorsed, is still contested. The authors are leading authorities on reproductive medicine, women's health, human rights, medical law, and bioethics. They integrate their disciplines to provide an accessible but comprehensive picture. They analyse 15 cases from different countries and cultures, and explore options for resolution. The aim is to equip readers to fashion solutions in their own health care circumstances, compatibly with ethical, legal and human rights principles.

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.

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.

'It is very hard to produce a timely book about a subject that changes as quickly as technologically assisted reproduction, but John Harris and Soren Holm have managed to do exactly that. The fourteen essays in this small volume provide an extremely useful and highly readable overview of the key moral, legal, and social themes raised by new ways of making babies. . . . The book is unique in that it offers perspectives on all these topics from a variety of disciplines and professions as well as from a broad range of national and cultural perspectives.' Arthur Caplan, British Medical Journal

With the rigor of a dedicated scholar and the passion of a committed activist, Nancy Lublin offers a fresh perspective on the ethical dimensions of providing and using reproductive technologies, including contraception, assisted conception, and antenatal and childbirth interventions. Combining feminist philosophy and legal theory, Lublin considers these issues under a single category that she calls 'technological intervention in the womb.' She addresses the positions of technophiles (who advocate acceptance of technological intervention in the womb as a source of liberation), technophobic feminists (who reject artificial invasions as anti-natural and anti-women), and other feminists who have argued that technological intervention in the womb should be legal and available to women because freedom of choice should be gender-neutral. Lublin identifies core principles that are common to a kaleidoscope of feminist theories, and she argues that a materialist feminism provides the most effective framework for establishing public policy and creating social change in the name of gender justice.

Substantial Relations examines global reproductive medicine in India, focusing on in vitro fertilization. Since the 1970s, India has played a central but shifting role in shaping global reproductive medicine-from a provider of raw material, to a producer of knowledge and technology, to a creator of a thriving medical market that attracts patients from all over the world. Relying on archival material and oral history, Substantial Relations traces the path of this transnational historical trajectory. This book also examines the contemporary making of IVF in Delhi. Drawing on ethnographic research in homes, hospitals, and laboratories, Sandra Barnreuther provides deep insights into the intricacies of clinical life and everyday experience by depicting IVF users' quest for offspring and their fears of establishing unwanted ties, as well as the minute engagements of clinicians and laboratory staff with reproductive substances. Thinking through substances-metaphorically and materially-Sandra Barnreuther provides a novel and rich analysis of the various relations that the burgeoning IVF sector in India has relied on and generated. Substantial Relations contributes to a broader understanding of reproductive medicine as a global phenomenon constantly in the making, situating India in the midst of, rather than peripheral to, this process.

Random Families is about the unprecedented families that have grown up at the intersection of new reproductive technologies, social media, and the human desire for belonging. Children of the same donor and their families, with the help of the internet, can now locate each other and make contact. Based on over 350 interviews with children (ages 10-28), their parents and related donors from all over the U.S., Random Families chronicles the chain of choices that couples and single mothers make from what donor to use to how to participate (or not) in donor sibling networks. Children reveal their understanding of a donor, the donor's spot on the family tree and the meaning of their donor siblings. Through rich first-person accounts of network membership, the book illustrates how these extraordinary relationships-woven from bits of online information and shared genetic ties-are transformed into new possibilities for kinship. Random Families offers down-to-earth stories from real families to highlight just how truly distinctive these contemporary new forms of family are.

During the last two decades, a new form of trade in commercial surrogacy grew across Asia. Starting in India, a "disruptive" model of surrogacy offered mass availability, rapid accessibility, and created new demands for surrogacy services from people who could not afford or access surrogacy elsewhere. In International Surrogacy as Disruptive Industry in Southeast Asia, Andrea Whittaker traces the development of this industry and its movement across Southeast Asia following a sequence of governmental bans in India, Nepal, Thailand, and Cambodia. Through a case study of the industry in Thailand, the book offers a nuanced and sympathetic examination of the industry from the perspectives of the people involved in it: surrogates, intended parents, and facilitators. The industry offers intended parents the opportunity to form much desired families, but also creates vulnerabilities for all people involved. These vulnerabilities became evident in cases of trafficking, exploitation, and criminality that emerged in southeast Asia, leading to greater scrutiny on the industry as a whole. Yet the trade continues in new flexible hybrid forms, involving the circulation of reproductive gametes, embryos, surrogates, and ova donors across international borders to circumvent regulations. The book demonstrates the need for new forms of regulation to protect those involved in international surrogacy arrangements.

Sexual problems are approached from a psychological and educational perspective with stress placed on the importance of the enhancement of individual relationships in this new text for clinical psychologists, psychiatrists, psychiatric nurse therapists, social workers and other professional groups.;Of special interest is the book's academic basis as it includes a review of the literature regarding the aetiology of psychosexual dysfunction and in the treatment that is provided.;Assessment of problems is comprehensive and the need for a tailored programme of treatment is supported by clinical examples. Problems encountered by the physically or intellectually handicapped, homosexuals and older people are addressed with sensitivity.;This cognitive-behavioural approach to the subject brings together the main therapies in a unique sythesis combined with the author's individual emphases, based on her clinical experience in Great Britain and Australia.

Making a Good Life takes a timely look at the ideas and values that inform how people think about reproduction and assisted reproductive technologies. In an era of heightened scrutiny about parenting and reproduction, fears about environmental degradation, and the rise of the biotechnology industry, Katharine Dow delves into the reproductive ethics of those who do not have a personal stake in assisted reproductive technologies, but who are building lives inspired and influenced by environmentalism and concerns about the natural world's future. Moving away from experiences of infertility treatments tied to the clinic and laboratory, Dow instead explores reproduction and assisted reproductive technologies as topics of public concern and debate, and she examines how people living in a coastal village in rural Scotland make ethical decisions and judgments about these matters. In particular, Dow engages with people's ideas about nature and naturalness, and how these relate to views about parenting and building stable environments for future generations. Taking into account the ways daily responsibilities and commitments are balanced with moral values, Dow suggests there is still much to uncover about reproductive ethics. Analyzing how ideas about reproduction intersect with wider ethical struggles, Making a Good Life offers a new approach to researching, thinking, and writing about nature, ethics, and reproduction.

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.

This book is on ovulation induction and controlled ovarian stimulation which is an integral part of most infertility therapies like intrauterine insemination and in vitro fertilization. It would deal with causes of anovulation and indications for ovarian stimulation. This book deals with basics as well as current and advanced practices. It provides a step by step protocol for ovarian stimulation. It gives a clear understanding of the science of reproductive endocrinology behind these stimulation protocols and roadmaps the latest therapies, defining their current relevance to treatment. Besides the practical guidance it also covers latest research work done in this field. In this day of information overload it is an attempt to integrate relevant information in a manner which can be applied in infertility practice in evidence based manner, making it rational, logical and rewarding for the reader.

Brown Bodies, White Babies focuses on the practice of cross-racial gestational surrogacy, in which a woman - through in-vitro fertilization using the sperm and egg of intended parents or donors - carries a pregnancy for intended parents of a different race. Focusing on the racial differences between parents and surrogates, this book is interested in how reproductive technologies intersect with race, particularly when brown bodies produce white babies. While the potential of reproductive technologies is far from pre-determined, the ways in which these technologies are currently deployed often serve the interests of dominant groups, through the creation of white, middle-class, heteronormative families. Laura Harrison, providing an important understanding of the work of women of color as surrogates, connects this labor to the history of racialized reproduction in the United States. Cross-racial surrogacy is one end of a continuum in which dominant groups rely on the reproductive potential of nonwhite women, whose own reproductive desires have been historically thwarted and even demonized. Brown Bodies, White Babies provides am interdisciplinary analysis that includes legal cases of contested surrogacy, historical examples of surrogacy as a form of racialized reproductive labor, the role of genetics in the assisted reproduction industry, and the recent turn toward reproductive tourism. Joining the ongoing feminist debates surrounding reproduction, motherhood, race, and the body, Brown Bodies, White Babies ultimately critiques the new potentials for parenthood that put the very contours of kinship into question.

The average physician and even cancer care-givers are not knowledgeable about the effects of cancer treatment on sex and reproductive life. They are even less aware of the options available for treatment of such patients. Cancer and Sexual Health fills a great need for a reference work devoted to the link between cancer and human sexuality. The volume is designed to give a comprehensive and state-of-the-art review of the sexual and reproductive consequences of cancer diagnosis and treatment. It will prove an invaluable resource for those clinicians caring for cancer patients as well as acting as a reference text for the sexual medicine clinician who may not see a large number of cancer patients.

An authoritative account of the causes of infertility that fully explores the clinical assessment of patients and covers the decision-making behind treatment options. The content follows the MRCOG syllabus as well as delving deeper into subjects covered by the RCOG Advanced Training Skills Modules (ATSMs), leaving readers well prepared for their examinations. Written by nationally recognised leaders in the field, this volume concisely reviews contemporary clinical practice. Using an aetiology-based approach, chapters discuss ovulatory dysfunction, endometriosis, male infertility, uterine/tubal factors and unexplained infertility. The increasing use of third-party reproduction and surrogacy is explored, along with the psychosocial aspects of this type of treatment. Ethical dilemmas surrounding reproductive medicine and their management are covered in depth. With an emphasis on practical approaches to the delivery and organisation of clinical and laboratory services, readers learn how to ensure the support and care they offer is of the highest quality.

Millions of Americans rely on the likes of birth control, IVF, and genetic testing to make plans as intimate and farreaching as any over a lifetime. This is no less than the medicine of miracles. It fills empty cradles, frees families from terrible disease, and empowers them to fashion their lives on their own terms. But accidents happen. Pharmacists mix up pills. Lab techs misread tests. Obstetricians tell women their healthy fetuses would be stillborn. Political and economic forces conspire against regulation. And judges throw up their hands when professionals foist parenthood on people who didn't want it, or childlessness on those who did. Failed abortions, switched donors, and lost embryos may be first-world problems. But these aren't innocent lapses or harmless errors. They're wrongs in need of rights. This book lifts the curtain on reproductive negligence, gives voice to the lives it upends, and vindicates the interests that advances in medicine and technology bring to full expression. It charts the legal universe of errors that: (1) deprive pregnancy or parenthood of people who set out to pursue them; (2) impose pregnancy or parenthood on those who tried to avoid these roles; or (3) confound efforts to have a child with or without certain genetic traits. This novel architecture forces citizens and courts to rethink the reproductive controversies of our time, and equips us to meet the new challenges-from womb transplants to gene editing-that lie just over the horizon.

In US security culture, motherhood is a site of intense contestation--both a powerful form of cultural currency and a target of unprecedented assault. Linked by an atmosphere of crisis and perceived vulnerability, motherhood and nation have become intimately entwined, dangerously positioning national security as reliant on the control of women's bodies. Drawing on feminist scholarship and critical studies of security culture, Natalie Fixmer-Oraiz explores homeland maternity by calling our attention to the ways that authorities see both non-reproductive and "overly" reproductive women's bodies as threats to social norms--and thus to security. Homeland maternity culture intensifies motherhood's requirements and works to discipline those who refuse to adhere. Analyzing the opt-out revolution, public debates over emergency contraception, and other controversies, Fixmer-Oraiz compellingly demonstrates how policing maternal bodies serves the political function of securing the nation in a time of supposed danger--with profound and troubling implications for women's lives and agency.

It is crucially important to increase awareness of gender equality to provide analytical and practical tools for health program managers and others to address gender and reproductive rights. Moreover, it is vital to ensure both men's and women's participation in these efforts. This manual is intended for use in facilitating a 6-day workshop on gender and rights in reproductive and maternal health for health managers, policy-makers and others with responsibilities in reproductive health. Other stakeholders working on advocacy and policy and program change in reproductive health, such as nongovernmental organizations and international partners may also find it useful. Although designed as a stand-alone course, it could be integrated with pre- or in-service programs on health systems, rights and gender.

In order to provide evidence-based information to assist governments international agencies and nongovernmental organizations to develop policies and projects, the WHO Western Pacific Regional Office supported eight countries namely Cambodia, China, Lao People's Democratic Republic, Malaysia, Mongolia, Philippines, Republic of Korea and Viet Nam to conduct a literature and programme review on adolescent sexual and reproductive health (ASRH). The reviews summarize the experiences and lessons learnt and also point out the challenges for improving adolescent sexual and reproductive health.

Now in a completely newly revised and expanded second edition, this comprehensive text presents the current state of the art in our understanding and management of polycystic ovary syndrome (PCOS), the most common hormonal disorder of reproductive aged women. The numerous bothersome symptoms of PCOS include menstrual irregularities, hirsutism, acne, scalp hair thinning, weigh excess and infertility; additionally, as they age, women with PCOS are at a higher risk for metabolic abnormalities such as diabetes and dyslipidemias, as well as for cardiovascular disease and even certain cancers. Despite improvements in our understanding of this condition, the exact cause/s of PCOS remain elusive; genetic, hormonal, metabolic and environmental underpinnings are all suggested as relevant. All chapters have been updated, with eight new chapters added across seven thematic sections. Part one discusses the epidemiology of PCOS in both adults and adolescents. Part two covers the pathophysiology of PCOS, including genetics, the hypothalamo-pituitary-ovarian and the hypothalamo-pituitary-adrenal axes, insulin resistance, inflammation, and obesity. The next three sections present the various management strategies, medical and surgical, for harnessing the symptomatology, including PCOS-related infertility; these chapters include added case material to provide real-world examples of the treatments in action and their efficacy. Part six covers the comorbidities that women with PCOS commonly encounter, such as issues of mental health, sleep disturbances, endometrial hyperplasia, and cancer, as well as examines the economic burden of PCOS. The final section discusses emerging concepts surrounding possible mechanisms and potential therapeutic approaches to PCOS, including angiogenic dysfunction, the role of vitamin D, future potential therapies to targeted AMH signaling. The closing chapter, by familiarizing the readers with the intergenerational implications of PCOS and by raising awareness of potential "ripple effects", aims at alerting the community on a need for vigilance as regards the health of PCOS progeny. With contributions from leaders in the field, Polycystic Ovary Syndrome, Second Edition remains the gold-standard text on this common medical condition and a valuable resource for the wide range of healthcare professionals engaged in caring for the women with PCOS (including but not limited to reproductive endocrinologists, gynecologists, family physicians, dermatologists, mental health professionals), for the aspiring women's health providers of tomorrow, and for the researchers who are striving to unravel the mysteries of the complex entity that PCOS is.

This book aims to address a number of controversies concerning the use of testosterone treatment. It explains topics that clinicians regularly encounter such as whether to use free or total testosterone in the evaluation of the patient with testosterone deficiency; what factors actually impact testosterone levels, polycythemia, gynecomastia, bone density, and hyperprolactinemia in the testosterone deficient patient; critical analysis of the numerous questionnaires that are available to clinicians; and the impact of testosterone therapy on male fertility, cardiovascular disease, and prostate events including prostate cancer. Guiding the reader in both evaluation and management, the book also illuminates novel concepts in the T space such as testosterone use in the transgender population, T therapy as an endothelial modulator, bipolar testosterone therapy in the patient with advanced prostate cancer, and testosterone therapy as a performance enhancer. Controversies in Testosterone Deficiency is intended for any clinician involved in the care of patients with testosterone deficiency, exploring hot topics and correcting existent misinformation in the routine care of patients.

Cloning, genetic screening, embryo freezing, in vitro fertilization, Norplant, RU486--these are the technologies revolutionizing our reproductive landscape. Through the lens of procreative liberty--meaning both the freedom to decide whether or not to have children as well as the freedom to control one's reproductive capacity--John Robertson, a leading legal bioethicist, analyzes the ethical, legal, and social controversies surrounding each major technology and opens up a multitude of fascinating questions: Do frozen embryos have the right to be born? Should parents be allowed to select offspring traits? May a government force welfare recipients to take contraceptives? Robertson's arguments examine the broad range of consequences of each reproductive technology and offers a timely, multifaceted analysis of the competing interests at stake for patients, couples, doctors, policymakers, lawyers, and ethicists.

This book presents the latest insights into all the critical aspects of Klinefelter's Syndrome, in order to promote a more homogeneous a medical approach to this condition, leading to better and more "evidence-based" support, and improving patient satisfaction. It offers physicians and all health professionals involved in treating these patients (andrologists, pediatricians, endocrinologists, psychologists) a comprehensive overview and a useful tool for their daily clinical practice.