Presenting an overview of the current understanding of the pathophysiology of PCOS and a paradigm for the clinical evaluation and management of the disorder, Polycystic Ovary Syndrome is written in an easy to digest, concise format that, with bulleted key points introducing each chapter, is suitable for the trainee and the busy clinician. The breadth and depth of coverage of today's queries and controversies will be of particular interest to the specialist and researcher. An international group of leading experts addresses the varied etiologies of PCOS, comprehensively covering the contemporary treatment approaches and long-term implications of PCOS, a common yet poorly understood disorder. Chapters on treatment will be of particular relevance to the clinician and the trainee as they cover conventional therapies, lifestyle, and diet, as well as address emerging strategies such as the use of statins and surgery in PCOS management. Spanning the breadth of clinical presentations and morbidities related to the diagnosis of PCOS, Polycystic Ovary Syndrome is an exceptional resource for primary care providers, gynecologists, reproductive endocrinologists, and others involved in the care of these patients, and provides the essential tools to aid clinicians in initiating a timely diagnostic workup and appropriate interventions to address both the immediate and long-term sequelae related to PCOS.

Developmental theorists have struggled with defining the relations among biology, psychology, and sociocultural context, often reducing psychological functions of a person to either biological functioning or the role of sociocultural context - nature or nurture - and considering each area of human development separately. New Perspectives on Human Development addresses fundamental questions of development with a unified approach. It encompasses theory and research on cognitive, social and moral, and language and communicative development, in various stages of life, and explores interdisciplinary perspectives. New Perspectives on Human Development revisits old questions and applies original empirical findings, offering new directions for future research in the field.

Too tiny to see with the naked eye, the human embryo was just a hypothesis until the microscope made observation of embryonic development possible. This changed forever our view of the minuscule cluster of cells that looms large in questions about the meaning of life. Embryos under the Microscope examines how our scientific understanding of the embryo has evolved from the earliest speculations of natural philosophers to today's biological engineering, with its many prospects for life-enhancing therapies. Jane Maienschein shows that research on embryos has always revealed possibilities that appear promising to some but deeply frightening to others, and she makes a persuasive case that public understanding must be informed by up-to-date scientific findings. Direct observation of embryos greatly expanded knowledge but also led to disagreements over what investigators were seeing. Biologists confirmed that embryos are living organisms undergoing rapid change and are not in any sense functioning persons. They do not feel pain or have any capacity to think until very late stages of fetal development. New information about DNA led to discoveries about embryonic regulation of genetic inheritance, as well as evolutionary relationships among species. Scientists have learned how to manipulate embryos in the lab, taking them apart, reconstructing them, and even synthesizing--practically from scratch--cells, body parts, and maybe someday entire embryos. Showing how we have learned what we now know about the biology of embryos, Maienschein changes our view of what it means to be alive.

Management of the modern reproductive endocrinology and infertility clinic has become very complex. In addition to the medical and scientific aspects, it is crucial that the modern director be aware of of incongruent fields such as marketing, accounting, management, and regulatory issues. Reproductive Endocrinology and Infertility: Integrating Modern Clinical and Laboratory Practice was developed to assist the practicing reproductive endocrinologist and/or laboratory director by providing an overview of relevant scientific, medical, and management issues in a single volume. Experts in all pertinent areas present concise, practical, evidence-based summaries of relevant topics, producing a key resource for physicians and scientists engaged in this exciting field of medicine. As novel technologies continue to amplify, Reproductive Endocrinology and Infertility: Integrating Modern Clinical and Laboratory Practice offers insight into development, and imparts extra confidence to practitioners in handling the many demands presented by their work.

Intended for readers with a background in fertility medicine as well as those less familiar with IVF, this comprehensive work presents an update on preimplantation genetic testing to enable single embryo transfer (SET). An international cast of contributors explains the treatment sequence-from ovulation induction to luteal support-aiming to transfer only one euploid embryo. Applications of molecular techniques for gamete and embryo assessment are fully detailed, with a focus on the strengths and limitations of each. In addition, expert commentary is shared across a range of regulatory challenges associated with embryo screening and cryopreservation. As access to advanced reproductive technology increases against a sharper background of healthcare reform, clinicians, economists, bioethicists and legislators alike will find this new volume relevant and highly accessible.

Over the past 10 years, studies have shown that the rates of fertility vary in different ethnic groups. Ethnic differences also play a significant role in the outcome of assisted reproductive technology (ART) cycles. In the United States, minority groups--African Americans, Hispanics (mainly Mexicans and Central Americans), East Asians (Chinese, Japanese, Koreans, Philippinos) and South Asians (Indians, Pakistanis, and Bengalis)--have significantly lower chances of live births compared to Caucasian women. Birth outcome data collected by the Society for Assisted Reproductive Technology shows a worsening trend in conception rates between the years 1999-2000 and 2004-2006, raising more concern that the disparity in fertility rates between minority groups and white women is widening over time. This comprehensive book serves to answer the questions that arise when managing infertility in a multi-ethnic population. An expert assembly of key leaders in the field of reproductive medicine imparts insight and clinical experience in order to identify and analyze the possible causes of racial disparities in fertility outcome. Some of the reviewed causes include higher Body Mass Index (BMI), tubal diseases, metabolic syndrome, and fibroids in African Americans; tubal disease and higher early pregnancy loss in Hispanics; higher incidence of diminished ovarian reserve and lower BMI in East Asians; and higher incidence of polycystic ovarian disease (PCOS) in South Asians. The book also provides a review of data on access to care and ART services in developing countries. A thoughtful combination of evidence-based medicine and advanced treatment options, this book is sure to distinguish itself as the definitive reference on ethnic differences in assisted reproduction.

Non-Invasive Sperm Selection for In Vitro Fertilization summarizes and discusses the relevant literature on the various advanced sperm selection methods used in modern Assisted Reproductive Technologies (ART). Chapters review some of the major unresolved issues in the field, the feasibility and success of the various sperm selection methods, their safety and the effects they have on sperm quality and ART outcomes. The book makes recommendations on clinical applications and future research, while helping to elucidate the benefits and promise of non-invasive sperm selection techniques. A distinguished team of scientists, embryologists, and urologists, with expertise in male infertility and ART, contributes to this original and valuable reference guide meant for academics, researchers, and professionals in the field of reproductive medicine who need an update on the current status of the study and practice of non-invasive sperm selection techniques.

This contributed volume regenerates the significance of and respect for natural phenomenon in the background of the risks and complications seen in ART such as ovarian hyperstimulation and multiple pregnancies. Balancing the clinical practice between the beneficial natural physiology and the prolific use of stimulation drugs for ART may help eliminate risks that may prove clinically, financially and psychologically expensive. It underscores the fact that 'greater' is not always synonymous with 'better' with regard to the oocyte yield. While highlighting the risks involved with the use of high-dose gonadotropins, the book presents a stratification of patients who might benefit from the 'soft' minimal and natural cycle IVF stimulation protocols that may be used. Additionally, clinicians can understand the significance of cryopreservation technology, now a useful adjunct to minimal stimulation protocols, with its manifold future advantages. Written by an international team of experts, this handbook emphasizes how minimal stimulation and natural cycle IVF can lead to a milder, safer and more effective approach to ART.

The oocyte is the largest and most mysterious cell in the body of mammalian organisms. Through its growth and maturation, it reaches extreme levels of specialization, while maintaining at the same time a condition of totipotency. Its unique ability, in co-operation with the spermatozoon, to give rise to a fully developed organism formed from hundreds of different tissues and myriads of individual cells has inspired intellectuals of all ages. Oogenesis finds impetus and purpose in casting scientific perspective towards this unique cell for the benefit of scientists and assisted reproductive technology (ART) specialists. The authors of the chapters are distinguished authorities in their respective areas of competence. From the opening of the book the reader is lead on a fantastic voyage from the formation of the primordial oocyte to the development of the early embryo, passing through crucial processes of oogenesis, such as co-ordination of oocyte and follicle growth, gene expression and organelle reorganization during growth and maturation, epigenetic mechanisms, regulation of meiosis, totipotency, cell polarity, oogenesis in vitro and maternal regulation of early development.

This book provides andrologists and other practitioners with reliable, up-to-date information on all aspects of male infertility and is designed to assist in the clinical management of patients. Clear guidance is offered on classification of infertility, sperm analysis interpretation and diagnosis. The full range of types and causes of male infertility are then discussed in depth. Particular attention is devoted to poorly understood conditions such as unexplained couple infertility and idiopathic male infertility, but the roles of diverse disorders, health and lifestyle factors and environmental pollution are also fully explored. Research considered stimulating for the reader is highlighted, reflecting the fascinating and controversial nature of the field. International treatment guidelines are presented and the role of diet and dietary supplements is discussed in view of their increasing importance. Clinicians will find that the book's straightforward approach ensures that it can be easily and rapidly consulted.

The decade that has passed since publication of the second edition of this textbook has not only witnessed a tremendous increase in knowledge within the ? eld of and- logy, but also seen the ? eld itself achieve a newfound status within the medical p- fession. Knowledge and status have been of mutual bene? t to the ? eld and the growing critical mass of diagnostic and therapeutic possibilities have caused andrology to be recognized as a medical subspecialty in some countries such as Germany, Poland, and Estonia. The European Academy of Andrology (EAA) served as a pacemaker for this development and continues to strive for establishment of andrology as a clinical ? eld. Well-designed curricula and qualifying examinations have contributed to the of? cial recognition of andrology as a speciality. This recognition of the ? eld helps patients with andrological problems to ? nd the specialist they seek. This textbook summarizes the current state of knowledge in the ? eld of andrology. It is a source of knowledge to all those who are or want to become andrologists. In addition, as andrology is clearly an interdisciplinary ? eld, this book may serve as a compendium and source of reference for all those physicians and biologists active in neighboring areas, who want to obtain an overview of andrology and who require information on special problems. The extensive references are timely and up to date.

This concise and practical book is the first of its kind to examine the use of assisted reproductive technologies (ART) in relation to blood-borne infectious diseases: human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV). The book opens with a discussion of the impact of these viruses on male and female fertility, followed by specific chapters of each of them, including ART with HIV and HCV serodiscordant couples (where either the male or female is positive) and the detection and impact of HBV and HCV in human gametes and embryos. An important character on laboratory safety when performing ART with blood-borne viruses follows, and the book concludes with a discussion of ART in austere and resource-poor settings, where these infections are often dominant due to lack of treatment and access to vaccines. Written and edited by an international array of experts in reproductive medicine, Assisted Reproductive Technologies and Infectious Diseases explores questions, techniques, and related issues with the aim of effectively helping clinicians working with serodiscordant couples wishing to have children.

This atlas provides sequential pictures for most existing reconstructive urology procedures. Though the use of technology is described, the book has been constructed in such a way that urologists from all countries will be able to pickup the technical tips to perform the laparoscopic procedures using simplified devices.

The age-friendly community movement is a global phenomenon, currently growing with the support of the WHO and multiple international and national organizations in the field of aging. Drawing on an extensive collection of international case studies, this volume provides an introduction to the movement. The contributors - both researchers and practitioners - touch on a number of current tensions and issues in the movement and offer a wide-ranging set of recommendations for advancing age-friendly community development. The book concludes with a call for a radical transformation of a medical and lifestyle model of aging into a relational model of health and social/individual wellbeing.

Reproductive medicine is a growing field with new technology emerging faster than we can assess consumer's perceptions of -the number of cancer survivors are growing and there is a great need to attend to their quality of life-this book addresses the needs of males and females, identifies effective communication strategies and proactive measures for health care professionals and researchers to use as well as identifying gaps in the literature where more research is needed.

A critical analysis of white, working class North Americans' motivations and experiences when traveling to Central Europe for donor egg IVF Each year, more and more Americans travel out of the country seeking low cost medical treatments abroad, including fertility treatments such as in vitro fertilization (IVF). As the lower middle classes of the United States have been priced out of an expensive privatized "baby business," the Czech Republic has emerged as a central hub of fertility tourism, offering a plentitude of blonde-haired, blue-eyed egg donors at a fraction of the price. Fertility Holidays presents a critical analysis of white, working class North Americans' motivations and experiences when traveling to Central Europe for donor egg IVF. Within this diaspora, patients become consumers, urged on by the representation of a white Europe and an empathetic health care system, which seems nonexistent at home. As the volume traces these American fertility journeys halfway around the world, it uncovers layers of contradiction embedded in global reproductive medicine. Speier reveals the extent to which reproductive travel heightens the hope ingrained in reproductive technologies, especially when the procedures are framed as "holidays." The pitch of combining a vacation with their treatment promises couples a stress-free IVF cycle; yet, in truth, they may become tangled in fraught situations as they endure an emotionally wrought cycle of IVF in a strange place. Offering an intimate, first-hand account of North Americans' journeys to the Czech Republic for IVF, Fertility Holidays exposes reproductive travel as a form of consumption which is motivated by complex layers of desire for white babies, a European vacation, better health care, and technological success.

"Selected by" Choice" magazine as an Outstanding Academic Title for 1996""[Marsh and Ronner make for] a highly successful combination in which faultless clinical detail and a broad social and cultural approach are seamlessly woven to produce a very impressive and beautifully written historical work of the first importance." -- Irvine Louden, "Journal of the Social History of Medicine"

In "The Empty Cradle," Margaret Marsh and Wanda Ronner delve into the origins of the many misconceptions surrounding infertility as they explore how medical and cultural beliefs emerged throughout its controversial history. Drawing on a wide variety of sources -- including intimate diaries and letters, patient records, memoirs, medical literature, and popular magazines -- "The Empty Cradle" investigates the social, cultural, scientific, and medical dimensions of infertility over the past three hundred years.

Marsh and Ronner explore reactions -- among both physicians and husbands -- to the emerging scientific evidence that infertility was a condition for which men and women bear equal responsibility. The book concludes that infertility is still a subject affected by myth and misunderstanding. A lively and compelling history of a complex medical and cultural phenomenon, "The Empty Cradle" brings a valuable perspective to current debates about how we should think about and address the experience of infertility in our own time.

"Marsh and Ronner have sought to go beyond the published medical literature to disclose the voices of those most affected by the physiological and cultural condition of infertility... they have restored to the historical record the anguish and the hopes of women whoexperienced infertility." -- Rima D. Apple, "American Historical Review"

"The book's lucid explanations of medical terms and procedures will allow me to recommend it to my infertility patients. I plan to do so, trusting that it will give them a new perspective on their predicament. Knowing that it provided me a new perspective on both infertility and the practice of gynecology, I will also assign it an honored place in my medical library." -- Janet E. Shepherd, M.D., "Journal of the American Medical Association"

" "The Empty Cradle" demonstrates the profound impact of politics as well as culture on the development of medical practice. It is an excellent model for future scholarship on the complex relationship between science and society." -- Elaine Tyler May, "Journal of the History of Medicine and Allied Sciences"

"Original, important, moving, witty and exquisitely-written. WHAT a feat." - BERNARDINE EVARISTO "Incredible... beautiful and funny and humane." - EMILIE PINE "Pristine poetry and prose." KATHERINE MAY, AUTHOR OF WINTERING "Babies who are this small, he says, have a good chance of survival. Small is not good for babies. It is not whimsical or cute or the cause of admiration. It is the first time it occurs to us that they might not survive. Babies die from smallness." Claire Lynch knew that having children with her wife would be complicated but she could never have anticipated the extent to which her life would be redrawn by the process. This dazzling debut begins with the smallest of life's substances, the microscopic cells subdividing in a petri dish in a fertility treatment centre. She moves through her story in incremental yet ever growing steps, from the fingernail-sized pregnancy test result screen which bears two affirmative lines to the premature arrival of her children who have to wear scale-model oxygen masks in their life-saving incubators. Devastatingly poignant and profoundly observant - and funny against the odds - Claire considers whether it is our smallness that makes our lives so big.

Infertility is defned as the inability to conceive after having unprotected intercourse for a year. Infertility is increasing worldwide and has various causes both in the male and the female partner. Immune reactions to sperm can contribute up to 2-30% of infertility. The sperm has both autoantigenic as well as isoantigenic potential, and is thus capable of p- ducing antisperm antibodies (ASAs) and sperm-reactive T cells in both infertile men and women. Also, over 75% vasectomized men produce autoantibodies to sperm that can cause a problem in regaining fertility even after successful re-anastomosis in vasovasostomy. Early claims regarding the incidence and involvement of ASAs in involuntary human infertility were probably overemphasized because of unreliable techniques and naivety concerning the complexity of the immune response and antigenic nature of the sperm cell. These factors, the lack of well-designed and controlled experimental studies, and the dearth of effective therapeutic modalities resulted in the confusion of the occurrence and importance of ASAs in human infertility. Consequently, evaluation of infertile couples for ASAs and their possible role in infertility was not considered a signifcant proposition. The development of more accurate assays and the discovery of mucosal immunity capable of responses independent of systemic immunity have caused inclusion of sperm cells and genital tract secretions in the analysis of ASAs.

In the last decades, major advances have been made in assisted reproductive technologies (ART) and the public demand for these procedures has increased globally. All ART clinics, from those just starting out to the well established, must employ the latest equipment and implement the best practices, while ensuring that their resources are effectively engaged to optimize patient outcomes. This is a tenet of the fiduciary role of physicians and it is increasingly recognized as a quantifiable goal regulated by formal certifications and accreditations. Quality management protocols such as those proposed by the International Organization for Standardization (ISO) are being rapidly adopted as standards of measure. Quality Management in ART Clinics: A Practical Guide provides easily adoptable ways to implement and improve formalized quality management systems. Essential to any clinic to achieve best practices and maintenance of formal regulatory certifications, this book brings together the know-how of experienced opinion leaders operating in key areas worldwide. The book offers an overview of primary regulations in the ART field, with attention to quality management demands, and links specific requirements to practical steps for implementation. Filled with process and procedure examples, flow diagrams and administrative form templates, this book is the first of its kind, gathering the necessary elements for optimizing practice, management, and quality assurance.

It is widely believed that reproductive cycles are very similar between human females. However, there are in fact considerable variations both between individuals and within the reproductive life of any given individual. 'Normal' reproductive cycles cover a wide range of eventualities, and the likelihood of successful monthly egg release and ensuing pregnancy can be modified by a large number of factors. In this book, the variability of human fertility is examined by first looking at the physiological processes regulating reproduction, and the roles of metabolic adaptation and metabolic load. Inter-population variation in normal ovarian function is then discussed, covering the importance of factors such as age, disease and breastfeeding in modifying ovarian function. First published in 1996, this is an important book for all those interested in human fertility.

Oncofertility is a specialty that bridges the disciplines of reproductive endocrinology and infertility and oncology, with the goal of expanding the reproductive options of cancer patients. Given fertility risks associated with specific cancer treatments, as well as the improved long-term survival made possible by these therapies, there has been growing interest in expanding reproductive options for cancer patients. Indeed, both cancer survivors and the medical community have acknowledged the importance of patient counseling and the pursuit of fertility preservation options prior to starting cancer treatment. Oncofertility Medical Practice: Clinical Issues and Implementation is the third in a series of timely and indispensable books on fertility preservation for cancer patients-the first one focused on advances in basic science research and the second one offered ethical, legal, and social perspectives on the theme. This book elucidates the latest practices and emerging treatments in oncofertility and provides necessary information on the successes, risks, and limitations of fertility preserving technologies. Authoritative and insightful, written by an impressive multi-disciplinary cadre of specialists, this book is a valuable up-to-date resource for all those practicing in this demanding field. "This excellent text is an invaluable resource and a "must read" for clinicians and researchers interested in Oncofertility. The editors and authors need to be congratulated for their fine work." Roger A. Lobo, MD, Professor of Obstetrics and Gynecology, Columbia University and Past President of the American Society for Reproductive Medicine

Kisspeptin has been shown to be both necessary and sufficient for activation of the reproductive axis, during puberty and later in adulthood. This makes kisspeptin a fundamental component of the reproductive axis. Kisspeptin has been deemed the single most potent stimulator of GnRH neurons yet known. The importance of kisspeptin has been documented in humans as well as non-human animal models, ranging from monkeys, sheep, and rodents to numerous fish species, thus signifying a highly conserved nature of its reproductive function. Importantly, kisspeptin neurons seem to mediate many of the regulatory effects of other signals, whether they are metabolic, circadian, hormonal, or stress. This places kisspeptin neurons in a unique position to be key nodal points and conduits for conveying numerous endogenous and exogenous signals to the reproductive axis.

This concise guide to the often overlooked association between erectile dysfunction and hypertension/cardiovascular disease covers a wide range of aspects of importance to the clinician. It examines the impact of antihypertensive drug therapy on erectile function and explains how the management of erectile dysfunction in hypertensive patients depends on a variety of factors. Different treatment approaches are described, including lifestyle modification, PDE-5 inhibitors and other novel agents and behavioral therapy and helpful therapeutic algorithms are presented. A further focus of the book is the potential role of erectile dysfunction as an early diagnostic indicator of asymptomatic coronary artery disease and a prognostic marker for cardiovascular events. In addition, key background information is supplied on epidemiology and pathophysiology, and the significance of erectile dysfunction in different patient groups, such as the elderly and those with chronic kidney disease, is examined. Erectile dysfunction is a major public health problem affecting more than ten percent of the general male population and is now considered to be predominantly of vascular origin. This book will be informative and of practical value for all practitioners responsible for caring for the very many patients who experience erectile dysfunction in the setting of hypertension and cardiovascular disease.

God of Sperm tells the remarkable story of Dr. Cappy Miles Rothman, the son of notorious gangster Norman "Roughhouse" Rothman, who went on to become a trailblazer in the field of reproductive medicine. Rothman started the California Cryobank, one of the world's largest repositories of reproductive genetic material and cord-blood stem cells. Among other achievements, Rothman also pioneered the use of microsurgery in urological procedures, postmortem sperm retrieval techniques, and was one of the first practitioners of andrology, a specialty dealing with male reproductive biology and medicine. How Cappy Rothman went from Mafia scion and man-about-town during the postwar Miami Beach--Havana era of gangster chic to one of the most consequential figures in modern medicine is an epic, only-in-America tale that is also a fine reminder of the broad horizons and wild possibilities life in the U.S. can offer.