Nearly one-half of an American woman's life is spent after the cessation of reproductive function. A woman of 40 years has an additional life expectancy of nearly 40 years; a woman of 75, over 11 years. This pattern of longevity is likely to continue, so that by the year 2000, it has been estimated, 30 percent of the female population will be postmenopausal. While it is difficult to separate the results of aging from those of estrogen deprivation, it is important that we try to do so, since the results of the latter are amenable to treatment. The medical infirmities resulting from estrogen deprivation take a high toll among postmenopausal women. Nearly 200,000 hip fractures occur annually in this group, resulting in 15,000 deaths and a high morbidity rate. Sleep disorders, compromised sexuality, psychomotor alterations of the climacterium, and urinary tract disorders all contribute to a lowered quality of life. Appropriate treatment of these disturbing postmenopausal conditions requires an understanding of the underlying bio chemical, endocrinologic, psychologic, and pathophysiologic al terations of estrogen deprivation. Toward this end, the reader will find herein chapters dealing with estrogen metabolism in the postmenopausal female, end-organ response to estrogen deprivation, and bone metabolism and osteoporosis. Next, the reader will find chapters dealing with specific or gans, organ systems, or conditions related to the quality of life; for example, sexuality, urinary tract problems, sleep disorders, the breast, sports and exercise, the climacteric, and the psycho biology of the menopause."

''A valuable resource for those concerned with experimental teratology and risk assessment and those requiring general information about the causes of birth defects. The treatment of these issues is sophisticated, succinct, and logical.'' --- American Scientist, from a review of a previous volume The current volume covers intergenerational factors in pregnancy outcome, the thresholds for developmental toxicants, and four other subjects.

The book that you hold in your hands is the second in a series. The two titles in the series are the following: Genetic Influences on Human Fertility and Sexuality: Theoretical and Empirical Contributions from the Biological and Behavior Sciences Edited by Joseph Lee Rodgers, David C. Rowe, & Warren B. Miller Published by Kluwer Academic Press, 2000 The Biodemography of Human Reproduction and Fertility Edited by Joseph Lee Rodgers & Hans-Peter Kohler Published by Kluwer Academic Press, 2002 The series has published chapters by researchers who study human fertility, from a particular perspective: Biodemography. We welcome your interest and participation in this developing subfield. Or, perhaps, biodemography may be better referred to as a "superfield. " Because biodemography so naturally crosses interdisciplinary boundaries, and because its application draws together researchers from disparate disciplines, it may well be more appropriate to consider that biodemography subsumes a number of other disciplines, rather than the other way around. In this preface, we will describe our own efforts and those of many others to promote and develop the study of human fertility, using methods, models, and theories from both biological and demographic domains. In December, 1997, 25 participants from three different countries gathered in Tucson, Arizona for a small conference with the title "Genetic Influences on Fertility-Related Processes. " That conference represented a fascinating blending of research from two apparently separate domains.

This is the definitive reference on the medical, surgical, legal, and ethical aspects of establishing and maintaining an office-based egg donation program. The editor has assembled an international list of authors with known expertise in this rapidly expanding field. The clinical procedures are clearly depicted in the book's many line drawings and photographs.

approaches to the experimental problems that still face us in understanding this most fascinating of organs. Too many people contributed to the completion of this volume to allow acknowledg ment of all the individual efforts, but we particularly thank the reviewers whose input into the editorial process was invaluable and the authors of these chapters who revised their text, sometimes more than once, to bring it to the high standards set by the Editors. The Com mittee gratefully acknowledges the support ofVysis, Inc. , in the publication of a color figure in Chapter 19, by S. Weber-Hall and Trevor Dale. Finally, we wish to express our heartfelt appreciation to Margot Ip and Bonnie Asch, who worked long and hard to bring this volume to fruition. Margaret C. Neville for the Committee on Mammary Gland Biology Preface One of the most exciting and beneficial developments in research on mammary gland biology and breast cancer has been the influx of increased funding to support this work. This influx, which has been due primarily to the tireless efforts of breast cancer activists to gamer addi tional money from various federal and state sources, has led to a rapid expansion of research efforts by attracting numerous new investigators into the field. These new investigators include students, postdoctoral fellows, and scientists from other fields.

Peritoneoscopy and culdoscopy were first introduced in the second edition of TeLinde's Operative Gynecology in 1953. TeLinde noted, "In many instances we find peritoneoscopy to be a useful procedure. Nevertheless it often left something to be desired." During the subsequent four decades, enormous progress has allowed the expansion of the application of laparoscopy and hysteroscopy throughout gynecol- ogy. Thus, it is appropriate and quite useful to have a text devoted solely to this rapidly advancing specialty. In its second edition, the text Practical Manual of Operative Laparoscopy and Hys- teroscopy is a complete and honest overview of the field providing the reader with a critical appraisal of the current literature on technique, development, and long- term follow-up. Refreshingly, the authors include not only the American experi- ence but also advances from Europe and Asia. Ricardo Azziz and Ana Alvarez Murphy have carefully organized the text into general concepts and laparoscopic and hysteroscopic operative techniques. The editors have selected authors of national and international stature to prepare chap- ters in their areas of expertise. The edited text carefully analyzes the advantages and disadvantages of each operative technique so as to allow readers insight as to the proper place for a particular endoscopic technique in their surgical practices.

"Fertility Preservation in Males: Emerging Technologies and Clinical Applications" contains a selection of the valuable chapters and protocols of Seli and Agarwal s previously published hardcover text "Fertility Preservation: Emerging Technologies and Clinical Applications." Newly available in this convenient and affordable softcover format, this practical reference guide provides an update on options for fertility preservation in men, while also discussing important related epidemiologic, ethical, medico-legal, psychological, and social aspects. Using a format that combines concise scientific background with practical methodological information and easy-to-grasp algorithms, the chapters all conform to a uniform structure, including step by step protocol of laboratory procedures, key issues in commentary and a list of references. The result is a unique resource for reproductive endocrinologists, urologists, embryologists, reproductive scientists, and oncologists."

Recent work in quantitative biology has shown theoretically why Fisher's Fundamental Theorem of Natural Selection does not preclude genetic influences on fertility, sexuality, and related processes. Genetic Influences on Human Fertility and Sexuality takes the next step, and presents a number of successful empirical searches for such genetic influence on a broad range of processes, such as puberty, marriage, sexual behavior, and twinning. Employing a broad range of methodological approaches, including molecular and behavioral genetics, this book weaves a new theoretical framework that shows how genes can help relate fertility planning to fertility outcome, and how puberty, sexuality, marriage, and reproduction can be conceptually linked through the genes that contribute to individual differences in the human process.

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.

Pelvic Inflammatory Disease is an in-depth, thorough guide for the clinician on the most common complication of sexually transmitted pathogens. Edited and written by the preeminent experts in the field, this volume presents the etiology, treatment, and diagnosis of PID, as well as chapters on risk factors, epidemiology, and prevention. In addition, the myriad clinical complications and challenges are discussed in chapters on tuboovarian abscess, PID and HIV infection, sequelae of PID, PID in adolescence, and PID in pregnancy. This is a must-have resource for obstetrician-gynecologists, primary care physicians, and all clinicians who provide health care to women of all ages.

This volume is designed to motivate and engage scientists, policymakers, and practitioners to greater scientific discourse, reduce the stigma on and validate the importance of women's sexual and reproductive health. It brings together historians, anthropologists, psychologists, sociologists, epidemiologists, public health researchers, genetic counselors, attorneys, social workers, nurses and physicians, and presents comprehensive coverage that will benefit women's health advocates, students, and practitioners.

From a review of an earlier volume: 'Both the experimental and the human aspects of teratology are presented in this comprehensive text by a stellar group of internationally recognized scientists and clinicians....A valuable resource for those concerned with experimental teratology and risk assessment and those requiring general information about the causes of birth defects. The treatment of these issues is sophisticated, succinct, and logical.'-American Scientist

Pituitary adenomas account for 10-15% of all intracranial tumors and they frequently impair fertility. The development of medical and surgical therapy for such tumors has turned pregnancy into a reality for women harboring pituitary adenomas. However, gestation risks for both mother and fetus are still of concern for endocrinologists, gynecologists and pediatricians. This book intends to update knowledge on this topic, mainly regarding fertility restoration as well as gestational and post gestational management of patients with pituitary tumors.

Recently, attention has been called to the role that microvascular organization plays in the functional morphology of all organs and tissues, both in normal and pathological conditions. Since its development by Murakami, the corrosion cast method for scanning electron microscopy has come to be considered one of the most efficient means in clarifying the three-dimensional features of the microcirculation of organs and tissues. Scanning Electron Microscopy of Vascular Casts: Methods and Applications was planned to supply fundamental and new information regarding microcirculation studies to general biologists, anatomists, pathologists and clinicians. The contributions to this volume, contain original findings and excellent electron micrographs obtained by using recently improved corrosion cast methods. The rich variety of papers in this book will be useful to many, and will provide both the basic and clinically oriented readers with good ideas, suggestions, and original and worthwhile information.

The title "Stem Cells from Cord Blood, In Utero Stem Cell Develop ment, and Transplantation-Inclusive Gene Therapy" suggests that more than one topic is combined in one workshop. Indeed, at first glance the recovery of stem cells from cord blood has to be seen as separate from the attempts to achieve effective in utero therapy by stem cell trans plantation, because the first issue deals with an innovative stem cell source as an alternative to bone marrow, which is already spreading rapidly in medical practice, whereas the second topic is still strictly ex perimental and only investigated in medical centers with the appropri ate background. It is, however, not only justified, but helpful to com bine the two topics in one workshop and consequently to cover them in the same volume of the Ernst Schering Research Foundation Work shop series, because they are intimately related and both based on the new insights into the biology of stem cells. Professor Werner Arber, the Nobel Laureate from the University of Basel, pointed out in his In- Professor Dr. W. Holzgreve VI Preface The participants of the workshop troductory Lecture that our understanding of hematopoietic stem cells as descendents of totipotent cells and our current approaches to using them in post-and prenatal therapy have been furthered significantly by genetic engineering technologies which are "artificial contributions to the process of biologic evolution.""

Cancer in pregnancy, although thankfully a relatively uncommon occurrence, presents physicians and their patients with a major dilemma. The urge to use the highest tolerable doses of chemotherapy, high doses of irradiation and surgery has to be weighed carefully against their risks to the unborn baby. This book is the very first to attempt to quantify these risks and provide physicians with a core of knowledge that will be very relevant to making sound clinical decisions in the face of sometimes conflicting interests. The volume evaluates the results of the Motherisk Program, which was set up specifically to address this problem, and reviews maternal and fetal outcomes from a sizeable database of the most common cases of cancer in pregnancy. In reviewing this program and the experience of others in this area, this volume sets out to create a clinically relevant tool for oncologists, obstetrician-gynecologists, perinatologists and neonatologists.

The 15th International Symposium of the Japan Human Cell Society on Cell and Molecular Biology of Endometrial Carcinoma brought together leading researchers from Japan and around the world. The papers collected here are the work of twenty-two leaders in their field and are organized in ten major categories. The first section, in vitro experimental systems, takes up the pioneering work by Kuramoto in 1968 and Nishida in 1980 in establishing, respectively, the HEC-1 and hormone-responsive endometrial carcinoma cell lines. Other topics include apoptosis, proliferation, and growth factors; cell cycle regulators; signaling pathways; angiogenesis; carcinogenesis; hormones and hormone receptors; genes and gene expression; endometrial receptivity; and chemo-resistance and -sensitivity. Presenting the latest work in the cell and molecular biology of endometrial carcinoma, this volume is a valuable resource for gynecologists, pathologists, and molecular biologists.

Advocating for Women with Postpartum Psychosis takes the reader into the world of one of the most misunderstood mental illnesses. Affecting 1 to 2 out of 1,000 childbearing women a year in the United States, postpartum psychosis creates hallucinations and delusions, which, if untreated, can lead to infanticide and subsequently imprisonment or death for the mother. While other parts in the world, particularly the United Kingdom have more sympathetic laws, in the United States, women with postpartum psychosis are often stigmatized as "baby killers", and face the ultimate penalty. Through this book, though, authors Feingold and Lewis humanize the mother's experience to promote understanding and compassion. Beginning with an overview of the mental health and legal facets surrounding postpartum psychosis, the authors then provide vital resources and tools for mental health practitioners and legal professionals to enact change in their practices and communities. Complete with case studies and the authors' experiences in changing the law in their own state of Illinois, this book is a necessary resource for furthering dialogue and action around maternal mental illness.

Documenting the daily efforts of African Americans to protect their community against highly oppressive conditions, this ground-breaking volume chronicles the unique experiences of black women that place them at higher risk for morbidity and mortality - especially during pregnancy. Stress and Resilience: The Social Context of Reproduction in Central Harlem examines the processes through which economic circumstances, environmental issues, and social conditions create situations that expose African American women to stress and chronic strain. Detailing the individual and community assets and strategies used to address these conditions, this volume provides a model methodology for translating research into public health and social action.Based on interactive community partnered research, Stress and Resilience: The Social Context of Reproduction in Central Harlem * Facilitates more exact hypotheses about the relationship between risk factors, protective factors and reproductive health; * Furnishes a better understanding of chronic disease patterns and suggests more effective interventions to reduce rates of infant mortality; * Incorporates the voices of the community and of women themselves through their own words and actions; * Sheds light on epidemiologic research and intervention protocols; * Examines the social context in which reproductive behaviors are practiced; * Provides a holistic framework in which to understand infant mortality; * And more. Filling a large gap in the literature on the social context of reproduction this important monograph offers indispensable information for public health researchers, program planners, anthropologists, sociologists, urban planners, medical providers, policy makers, and private funders.

At the Mie International Symposium held in Japan in April 1994, leading scientists reviewed recent advances in the understanding of the contractile mechanism in smooth muscle. The present volume collects the papers presented at the symposium, summarizing the latest advances in smooth muscle function and emphasizing important components of the contraction-relaxation cycle. Topics include a discussion of the smooth muscle cell membrane, with emphasis on its ion channels; the regulation of cytosolic Ca2+ levels and the relationship to force in smooth muscle; aspects of the two key regulatory enzymes involved with myosin phosphorylation-dephosphorylation; the molecular basis for pharmacomechanical coupling in smooth muscle; developments in the basic contractile mechanisms involving the crossbridge cycle of tonic and phasic muscle; the role of myosin light chains; and many others. The approach is broad and presents contemporary opinions in pharmacology, physiology, and biochemistry as they relate to smooth muscle function. The book will appeal not only to those working in these disciplines, but to vascular clinicians, obstetric-gynecological physicians, and gastroenterologists as well.

The pregnant host is at risk for any of the viral diseases her nonpregnant counterpart acquires. Additionally, pregnancy heightens our concerns regarding specific viral diseases be cause of their potential for enhanced adverse effects on both maternal and fetal well-being. All too often the obstetrician relinquishes responsibility for the management of the gravida infected by a viral pathogen, and those expert in infectious diseases are confounded by the influence of pregnancy on these conditions. A major goal of this textbook is to narrow the gap between the two aforementioned management dichotomies in the virally infected pregnant woman. Weare at the infancy of our understanding of viral infections in pregnancy. The current and anticipated advancements are due in large part to a burgeoning oftechnological achievements in the areas of immunodiagnostics, molecular biology, and pharmacotherapeutics. Our in utero diagnostic capabilities, both invasive and noninvasive, have also allowed us new opportunities to study the effects of various maternal infectious disease processes on the developing fetus. New insights have been recognized pertaining to the maternal-fetal interface, the placenta, in that this structure is now acknowledged to function as both a mechanical and an immunological barrier to vertical transmission of infection. These observations suggest that there will be an outpouring of new data in the next several years that clinicians will need to master to maintain an appropriate level of expertise in the care of their patients.

Numerous reports demonstrate that the reproductive system could be affected by multiple potential toxicological agents. The volume includes different aspects of the development of new approaches to in vitro testing using sperm cells and systems involved on reproduction in mammals. Comparative analysis of in vivo and in vitro methods has been included to take steps towards the further development of and applications of new systems for germline toxicology.

The advent in the 1960s of the unique and exciting new form of energy called laser brought to medicine a marvelous tool that could accomplish new treatments of previously untreatable disorders as well as improved treat ment of mundane problems. This brilliant form of light energy is many times more powerful than the energy of the sun yet can be focused microscopically to spot sizes as small as 30 microns. Lasers can be directed into seemingly inaccessible areas by mirrors or fiberoptic cables or can be directly applied into sensitive areas such as the retina without damage to intervening structures. There has been a rapid proliferation in the use of lasers in all surgical specialties. Starting with bold ideas and experiments of "thought leaders" in each specialty, the application of lasers has evolved into commonplace usage. Beginning with the era when laser presentations and publications were an oddity, now nearly all specialty areas have whole sections of meetings or journals devoted exclusively to laser usage. Laser specialty societies within a specialty have developed and residency training programs routinely instruct trainees in laser techniques. Basic science and clinical experimentation has supported laser knowledge. Laser usage has also become international. Newer wavelengths and accessories have added to the armamentarium of laser usage. Despite the rapid growth in laser interest, no single source exists to instruct the many new laser users in proper, safe, and effective use of this new modality."