This book presenting the latest thinking on Reproductive Endocrinology and Infertility is truly international as the authors hail from no less than four different continents (North America, Europe, Australia and Asia). The idea for this book was conceived during the XII World Congress On Fertility and Sterility where the unique confluence of our distinguished authors occurred in Singapore in October 1986. The authors were involved in the Pre And Post Congress Scientific Programmes which we organised. The overwhelming success of the Congress and the Pre And Post Congress Scientific Programmes prompted this book so that those unable to attend the meeting will still be able to benefit from the vast range of topics covered. This book will be a valuable addition to the knowledge in Reproductive Endocrinology and Infertility and will be useful reading for those wishing to pursue this subspecialty. The authors are indebted to Lee Foundation (Singapore) for help in the publication of this book. We would also like to thank Miss Jam Siew Fong and Miss Tang May Mey for their excellent secretarial assistance. Singapore, January 1988 Charles SANg F H Maurine Tsakok S LTan K H Chan ix 1 Hypothalamic and Pituitary Disorders in Reproduction ROGER J PEPPERELL 1 HYPOTHALAMIC AND PrruITARY DISORDERS Disorders of ovulation are present in 15 to 25% of couples with infertility.

Obesity epidemic is a global problem of the 21th century for women in reproductive age and also the obstetricians and pediatricians. There are influences of mother's prepragnancy and antepartal obesity, at delivery, for fetal programming and for maternal and fetal lifelong metabolism. The epidemiological results are important, but for the health care providers the skills for prevention of mother's obesity with all consequences are essential. Evaluated programms in nutrition and physical activity will be discussed.

Recent years have seen important advances in the technology and techniques available to surgeons performing gynecologic surgery as well as reconstructive of clinical pelvic procedures. These developments took place in a wide variety settings from regional teaching centers to private clinical facilities. In 1996, the leading investigators from around the world gathered to discuss the present status of pelvic surgery and adhesion prevention with a look toward the future of patient care. This volume contains the proceedings of that meeting: the Third Interna tional Congress on Pelvic Surgery and Adhesion Prevention. Each chapter in cludes the material presented at the congress as well as a timely update of the authors' latest research and clinical thinking. Presentation integrating basic and clinical science provide the basis for con sidering peritoneal repair after surgery including the interaction of growth factors and other biochemical messengers. Research has increased the understanding of mesothelial reepithelialization and has led to new surgical technologies to reduce adhesion fonnation. A state-of-the-art review of emerging surgical adjuvants for adhesion prevention is provided, including discussion of barriers, gels, and poly mers as well as "designer" drugs effective at modifying the peritoneal response to injury. Assessment of clinical outcome in a wide variety of gynecologic surgical procedures brings into focus the benefits available as a result of these new tech nologies."

Oncofertility integrates the two previously distinct fields of cancer treatment and fertility research and aims to explore and expand the reproductive future of cancer survivors. In order to achieve the goal of fertility preservation, the Oncofertility community must focus on communication and the way data is provided and received. Concomitant with the rapidly changing technology of Oncofertility, there have been radical shifts and advances in the way health educators and clinicians can produce and share information.As success rates of reproductive techniques such as egg freezing and banking continue to rise, providing increasing opportunities for young cancer patients to preserve their fertility prior to the onset of cancer treatments, communication among professionals in oncology, reproductive medicine, and psychosocial work, among others, becomes crucial, and clinical demand for Oncofertility information is expected to rise considerably.

"Oncofertility Communication" describes and addresses the myriad channels through which the multiple audiences involved in Oncofertility can be served with appropriate and accurate information about cancer-related fertility issues. The text answers frequently asked questions and provides invaluable insights to scientific and health care professionals about communication among the diverse Oncofertility audiences. It incorporates timely discussions about traditional and emerging electronic communication tools and discusses the impact of health care policy changes on the Oncofertility field. "

Prenatal testing for genetic abnormalities has transformed pregnancy and motherhood. Using sociological research, this book analyzes the social-psychological and ethical implications of invasive prenatal testing, particularly CVS and amniocentesis. Among the issues covered are changes in the genetic counseling profession and in client demographics; the challenge of nondirective genetic counseling; decisions on testing and on which test to have; the timing and risks of the procedures; abortion and grief; the ethics of sex selection; potential uses and abuses of genetic knowledge; and policy and ethical implications.

No single area of medicine promises more acrimonious and intense debate in the coming decades than the implications of new medical technologies on the maternal-fetal relationships. This is the only book to combine comprehensive coverage of the legal and social issues raised as a result of both emerging technologies for fetal intervention and increasing knowledge of fetal development. It examines such issues as the effects of maternal behavior on the fetus's health, hazards in the workplace, teenage pregnancy, and the use of therapeutic and diagnostic techniques. The volume also summarizes the legal/political context of policies regarding the mother's responsibility for the welfare of the fetus and describes the current status of these issues in public law. The work opens with a framework for examining rights and, in chapter 2, gives an in-depth description of knowledge about the impact of maternal actions on fetal development. Attention then turns to current trends in case law, as Chapter 3 traces the growing acceptance of causes of legal action for prenatal injury or death of the fetus. Chapter 4 extends this analysis to look at the changing legal context for defining standards of care for pregnant women. Chapter 5 examines three disparate but critical topics illustrating the pressures women face in the 1990s: workplace hazards, teenage pregnancy, and surrogate motherhood. The final chapter integrates the technological, legal, social, and political dimensions surrounding the maternal-fetal relationship into a context for creating an effective public policy.

'Essential reading for everyone' - Marian Keyes It's time for us to start talking about the menopause. Cracking the Menopause, from straight-talking broadcaster Mariella Frostrup and health journalist Alice Smellie, has all the information you need, delivered with characteristic wry humour. It's high time we renovated and elevated this life change. Despite the centuries of speculation and propaganda, we are not overheating or inherently cold, we are not hysterics or boiling vats of toxic poisons, we are not dried up or washed up, we are simply menopausal. In this no-holds-barred guide, Mariella shares her own journey through the menopause, along with the latest science, advice from leading experts and humorous illustrations - to provide an informative source of wisdom and enlightenment. Featuring case studies from women in every walk of life and all stages of their menopause journey, Cracking the Menopause opens up the conversation about an urgent topic that half the population will experience, but barely anyone is talking about. Designed to equip you with the knowledge to manage your symptoms from perimenopause onwards, this essential book separates the myths from the reality and offers expertise, hope and advice. 'I inhaled this book, it's fantastic. Women of all ages need to read it.' - Claudia Winkleman 'Mariella and Alice have just written one of the most important books of the year, bravo.' - Gabby Logan

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

A comprehensive, cutting-edge review of the complex interactions between maternal and fetal-placental tissues that control the establishment and maintenance of pregnancy, the proper development of the fetus, the birth process, and the behavioral aspects of bonding between mother and newborn. Expert researchers review the endocrine and physiological events that culminate in the delivery of offspring, and provide a solid base of comparative information on the menstrual cycle of primates, including humans. They also discuss the sources and functions of both steroid and protein hormones from the placenta and the details of their effects on uterine function, placental development, fetal growth and well-being, and maternal responses to pregnancy. This book will become the standard reference source not only for reproductive scientists, but also for those clinicians who want better to understand the complex factors that affect pregnancy-and their pregnant patients.

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 stimulating volume addresses vital questions about gene/environment interactions as they affect cell health from the prenatal period through later life. Beginning with a tour of epigenetic processes in the human body, the book assembles current theoretical and empirical developments across the discipline, among them transgenerational epigenetic inheritance, the effects of maternal nutrition on epigenetic change, and possible links between epigenetics and childhood obesity. Public health and policy aspects of the field are discussed in depth, with the understanding that much can be done to improve our epigenetic health as a species. And in this vein, contributors consider future possibilities, such as the reprogramming of genes to reverse cancer and other diseases. Included in the coverage: The role of environmental epigenetics in perinatal and neonatal development The epigenetic biomarker H2AX: from bench science to clinical trials What's the risk? Dental amalgam, mercury exposure, and human health risks throughout the lifespan Post-traumatic stress disorder: neurological, genetic, and epigenetic bases Children's exposure to alcohol, tobacco, and drugs: long-term outcomes Ethical implications of epigenetics Epigenetics, the Environment, and Children's Health Across Lifespans brings real-world knowledge and applications of this increasingly important field to public health practitioners, maternal and child health researchers, and environmental health experts.

Advances in technology now offer promising solutions to deal with the chronological aging of the cell, tissue or organ to synchronize its existence and its use. This book covers the developments in and benefits of the latest vitrification technology and its extensive applications in reproductive medicine. Protocols of gametes (oocyte and sperm), embryos, blastocysts and ovarian tissue cryopreservation have been reviewed by leaders in the field. In order to address the escalation in cross-border reproductive tourism entailing the transfer of reproductive cells and tissues rather than the patient, the challenges, caution and emerging possibilities of nitrogen vapor shipment of vitrified cells have been discussed. Current perspectives on oocyte banking present the reader with options and solutions to effectively utilize these gametes despite the physiological deterrents.The versatile applications and potential of vitrification of human embryonic stem cells, discussed in the concluding chapter, is an exciting reality offered by vitrification to help overcome numerous stumbling blocks in the management of various disorders.

The editor of this volume takes on the challenging task of presenting an encompassing view of childbirth in America from an anthropological perspective. The book is indeed comprehensive. . . . Collectively the chapters in Childbirth in America lay out a representative sketch of research problems of interest to sociocultural anthropologists and other social scientists working in the area of reproductive health. A distinct accomplishment is the acknowledgement in some of the chapters that not all American women want the same kind of childbirth care or have the same values and attitudes about pregnancy, birth, and parenting, and that this variation needs addressing in both childbirth policy and practice. American Journal of Physical Anthropology A comprehensive and critical examination of the experience of childbirth in America today, from pregnancy to early postpartum. This book covers many controversial issues in the context of diverse cultural, social, and economic backgrounds, which have arisen as a result of the new technologies and ideologies surrounding pregnancy and birth. Most useful as a text for courses in childbirth education, anthropology of women's health, and anthropology of medicine.

Minimally Invasive Gynecologic Surgery provides a complete, practical and timely review of the minimally invasive surgical techniques used to treat gynaecologic diseases and conditions. Recent advances in technology and instrumentation, particularly the use of robot-assisted surgery, mean that minimally invasive approaches have become increasingly established as alternatives to traditional open surgeries. This book describes the full range of minimally invasive procedures in current gynaecologic practice, with discussion of the indications and contraindications and a summary of available evidence. The book opens with a section describing instrumentation, electrosurgery, how to avoid and manage complications and single port surgery. Subsequent sections cover procedures for benign and malignant conditions and relevant robotically assisted surgeries. Highly structured chapters provide practical guidance to key steps of each procedure, alternative management options; contraindications and available evidence Stellar contributors from leading centers in the USA, Brazil, Chile, Canada, France, Italy and Belgium ensure coverage reflects global best practice

'Hill's advice is straightforward and no-nonsense' - The Guardian 'A life-transforming book... fascinating - Daily Mail 'Maisie Hill has written a bloody brilliant book (pun intended). Everything you need to know about periods and how they affect you and your life is here. It's revolutionary' - Miranda Sawyer 'Thank GOODNESS for Maisie Hill! Flipping open the lid on a vital conversation. It's about time we claimed the power of our periods!' - Gemma Cairney, broadcaster & co-founder of Boom Shakalaka Productions 'This is such an important book. Maisie's insights and cycle strategy have changed my life and my cycle. Period Power is written with such intelligence, humour and a deep understanding of women's health. If you have a period you need to read this book.' - Anna Jones, author of The Modern Cook's Year A profound and practical blueprint for aligning daily life with your menstrual cycle. Period Power is the handbook to periods and hormones that will leave you wondering why the hell nobody told you this sooner. The hormones of the menstrual cycle profoundly influence our energy, mood and behaviour, but all too often we're taught that our hormones make us unreliable, moody bitches, or that it's our lot in life to put up with 'women's problems'. Maisie Hill, a women's health practitioner, knows the power of working with the menstrual cycle and refuses to accept this theory. Instead, Maisie believes that our hormones are there to serve us and, if utilized correctly, can be used to help you get what you want out of life. Yes, we are hormonal, and that's a very good thing. This revolutionary book reveals everything you need to know about taking control of your menstrual cycle and outlines The Cycle Strategy to help us perform at our best, throughout our cycle. In Period Power you will discover how to: - maximise your natural superpowers each month while making adjustments for the darker days, and use Maisie's favourite tips to improve them - identify your personal patterns, powers and pitfalls for each phase of the menstrual cycle - plan your month to perform at your best in all aspects of your life - figure out if you have a hormonal imbalance and what to do about it. Period Power is a no-nonsense guide with all the tools you need to improve your menstrual health.

The subject matter of volume 2 of the 2-volumes-handbook focusses especially on rare sarcomas of the whole female genitalia. These entities include angiosarcoma, the different lipo- and rhabdomyosarcoma as well as newer entities like the PEComa. Furthermore, mixed mullerian tumors like the benign adenofibroma and the malignant adenosarcoma and carcinosarcoma are described in detail. The book provides a description at length of the epidemiology, etiology, pathological anatomy, prognosis, diagnosis, differential diagnosis, imaging and comprehensive therapy of each primary, relapsed, and metastasized tumor including surgery, chemo-, hormone- and radio- and targeted therapy. An own chapter is devoted to the problems of fertility and pregnancy in connection with all sarcomas, variants of leiomyoma, atypical smooth muscle tumors, disseminated peritoneal leiomyomatosis, benign metastasizing leiomyoma, intravenous leiomyomatosis and endometrial stromal tumors - endometrial stromal nodules, endometrial stromal tumor with sex cord-like elements (ESTSCLE), uterine tumor resembling ovarian sex-cord tumor (UTROSCT) -and all mixed tumors - of the female genitalia. The book aims to identify and provide diagnostic and therapeutic guidance. The listed tumor entities also constitute a particular diagnostic challenge for pathologists that contains numerous pitfalls and difficulties. This book, therefore, addresses gynecologists and pathologists in both clinical and private practice, but also surgeons and hemato-oncologists.

As office technology has exploded and decision-making become increasingly complex, physicians are faced with an endless list of treatment options for commonly presenting gynecologic disorders. This new book reviews all state-of-the-art tools of diagnosis, investigation, and management to provide an invaluable guide for the office practitioner. From endocrine disorders to breast disease, from preventive measures for osteoporosis and cardiovascular disease to management of an abnormal pap smear, from the use of ultrasonography and minimally invasive diagnostic procedures to high-level endocrine manipulation, office-based physicians are expected to be knowledgeable in all areas. This book leads the way. For gynecologists and residents, here is a solid-foundation and ready reference source, enhanced by more than 60 detailed illustrations.