Fully revised for this fourth edition, the Oxford Handbook of Obstetrics and Gynaecology fully reflects new developments in the field. Featuring new sections on the outcomes of the MBRRACE report, abnormally adherent and invasive placenta, pregnancies in mothers of advanced age, assisted reproduction, and ovarian cancer screening, it provides a contemporary overview of this complex and important specialty. Written and reviewed by a team of highly experienced clinicians, academics, and trainees, this Handbook is a perfect starting point for preparation for postgraduate exams. Practical advice is presented with key evidence-based guidelines, supported by visual algorithms and top clinical tips. The previous edition was Highly Commended in the Obstetrics and Gynaecology category of the BMA Book Awards. The indispensable, concise, and practical guide to all aspects of obstetric and gynaecological medical care, diagnosis, and management, this fourth edition continues to be the must-have resource for all specialist trainees, junior doctors, and students, as well as a valuable aide memoire for experienced clinicians.

Most of the following chapters were presented as plenary lectures or symposium talks at the 1986 XXXth Congress of the International Union of Physiological Sciences in Vancouver, B.C. A distinguished international group of endocrinologists and physiologists have contributed up-to-date reviews of their particular fields. The early chapters are largely concerned with the brain and neuroendocrine mechanisms controlling the secretion of gonadotropin releasing hormone (GnRH) and its action on the anterior pitui- tary gland. Later chapters focus on the gonads themselves and the systemic and intrinsic hormones influencing the functional cytology of ovarian and testicular cells. Such comprehensive subjects as sex differentiation, puberty, placentation and parturition are also discussed authoritatively. According to Pfaff and Cohen and Arai et al., gonadal steroids, especially estrogen, exert multiple effects on certain hypothalamic and preoptic neurons, including growth, protein synthesis and electrical changes, which promote plasticity and facilitate synaptogenesis. The electrophysio- logy of the hypothalamic GnRH pulse generator in the rhesus monkey is reviewed more specifically by Knobil. In ovariectomized ewes, Clarke finds both positive and negative effects of estrogen on hypothalamic release of GnRH as well as on pituitary responsiveness to the peptide. Flerk6 et al.

Many reproductive and developmental health problems are caused by exposure to chemicals that are widely dispersed in our environment. These problems include infertility, miscarriage, poor pregnancy outcomes, abnormal fetal development, early puberty, endometriosis, and diseases and cancers of reproductive organs. The compelling nature of the collective science has resulted in recognition of a new field of environmental reproductive health. Focusing on exposures to environmental contaminants, particularly during critical periods in development and their potential effects on all aspects of future reproductive life-course, this book provides the first comprehensive source of information bringing together the arguments that are spread out among various scientific disciplines in environmental health, clinical and public health fields. It provides a review of the science in key areas of the relationship between environmental contaminants and reproductive health outcomes, and recommendations on efforts toward prevention in clinical care and public policy.

Public attention on embryo research has never been greater. Modern reproductive medicine technology and the use of embryos to generate stem cells ensure that this will continue to be a topic of debate and research across many disciplines. This multidisciplinary book explores the concept of a 'healthy' embryo, its implications on the health of children and adults, and how perceptions of what constitutes child and adult health influence the concept of embryo 'health'. The concept of human embryo health is considered from preconception to pre-implantation genetic diagnosis to recent foetal surgical approaches. Burgeoning capacities in both genetic and reproductive science and their clinical implications have catalysed the necessity to explore the concept of a 'healthy' embryo. The authors are from five countries and 13 disciplines in the social sciences, humanities, biological sciences and medicine, ensuring that the book has a broad coverage and approach.

Epigenetics is a rapidly expanding field in medical and biological research which concerns heritable traits that are not attributable to changes in the DNA sequence. Epigenetic mechanisms play key roles in many biological processes, and it has become clear that their disruption can gives rise to diverse pathologies in humans. Edited by preeminent experts, Sophie Rousseaux and Saadi Khochbin, this volume in the Epigenetics and Human Health series discusses the role of epigenetics in human reproduction. The book presents epigenetic transitions that are important at defined stages of gametogenesis and during meiosis. Finally, the authors discusses how in vitro manipulation and culture in assisted reproduction can epigenetically perturb germ cells, and how this can trigger disease phenotypes in the next generation. Conceived towards advanced students, medical professionals and research scientists, this is the first comprehensive textbook on this topic that will serve as a valuable reference during the years to come."

The births of more than 100 apparently normal infants at term following pregnancies initiated by in vitro fertilization and embryo transfer testifies to the successful clinical application of insights obtained from studies in reproductive biology over the last 20 years. In women, these studies have included: 1) characterization of the changes in blood hormone profiles throughout ovulatory menstrual cycles; 2) documentation of the hormonal composition of antral fluid in developing and degenerating preovulatory follicles; 3) correlation of these observations with the state of oocyte maturation and the fertilizability of the oocyte; 4) application of pharmacologic agents for perturbing the normal hormone profiles to regulate the number of preovulatory follicles developing and the time of ovulation; and 5) development of non-invasi ve methods for monitoring follicular development. Optimizing methods for maturing and fertilizing eggs, for moni toring normal development in vi tro, and for transferring and achieving implantation of embryos are continuing concerns of physicians and scientists responsible for extant programs. In addition, all serious students of reproductive biology should critically examine every facet of the processes which must concatenate to assure birth of normal infants following pregnancies achieved by these methods. However, the literature which contains the informational substrate is dispersed widely in a plethora of journals not always readily accessible. Bringing the essentials together facilitates both rapid retrieval of data and access to relevant literature.

The early environment in which we grow up has profound, long lasting, and often irreversible consequences for us throughout our lives. Stresses due to under nutrition in early childhood can mean that in adulthood individuals are smaller, more prone to disease, and have a shorter life expectancy than those with normal diets. Disease and poor living conditions in infancy and childhood also have profound implications in adulthood. Whilst environmental effects on human growth and development are well documented, the long-term consequences due to processes taking place at the early stages of growth and development have only in past years become a focus of intense study. In this volume, first published in 1996, leading researchers in nutrition, epidemiology, human biology, anthropology and physiology bring together a uniquely accessible source of information on this fascinating topic.

Since the first successful transfer of an in vitro fertilised human egg in 1976, modern endocrinology, genetics, and assisted reproductive technologies have opened new frontiers of research with the aim to treat infertile women. In this workshop we set out to promote an interdisciplinary discussion between experts from various fields of basic, company-based and clinical research related to folliculogenesis and oocyte development. The aim of this workshop was to present, discuss and assess novel approaches in mammalian folliculogenesis and oocyte development that may have an impact on fertility/ infertility in the near or distant future. Key issues were the understanding of new modulators of folliculogenesis and regulators of cytoplasmic as well as meiotic oocyte maturation, modern technologies, the aging oocyte and pathogenetic mechanisms of infertility.

Reproductive ageing affects both individuals and wider society, and obstetricians and gynaecologists are witness to the impact of reproductive ageing and to some of the fears and misapprehensions of the general public. This book raises awareness of societal trends and their implications. The wider importance of the subject to the whole of society is emphasized by contributions from outside the world of obstetrics and gynaecology, both within and outside medicine. The 56th RCOG Study Group brought together a range of experts to examine reproductive ageing. This book presents the findings of the Study Group, with sections covering: background to ageing and demographics basic science of reproductive ageing pregnancy: the ageing mother and medical needs the outcomes: children and mothers future fertility insurance: screening, cryopreservation or egg donors? sex beyond and after fertility fertility treatment: science and reality - the NHS and the market the future: dreams and waking up."

The processes that control senescence have been the subject of more then a century of serious biological research. Two institutions closely involved in this programme, the Society for the Study of Human Biology and the British Society for Research in Ageing, held a joint symposium in 1984 to consider human ageing and longevity from an interdisciplinary point of view. The resulting book has four main sections: the evolution and genetics of ageing, biological age assessment, demographic and social aspects, and the nutritional and physiological aspects of ageing and longevity. The fundamental nature of the subject will generate interest across a wide range of biological and medical disciplines.

This Brief offers a concise, handy overview of the main concepts related to Embryology, revisited through the novel concepts that are applied daily in stem cell research and cell therapy oriented investigations.It isbased on three main areas:

-The process involved in female gamete differentiation and maturation. The main aspects related to cell biology will be covered and an overview of the epigenetic regulation of gametogenesis will be presented.

-Early stages of embryo development with a careful analysis of the regulatory mechanisms driving cleavage, polarization and genome activation.

-Stem cell and gametogenesis.

The use of the oocyte as a possible source for the derivation of stem cell lines is discussed and depicted as a powerful tool to investigate oocyte potency and asymmetric imprinting. The potential biological implications are evaluated and use of stem cells to derive oocytesis presented."

There are many haematological complications associated with obstetrics, pregnancy and gynaecology, and unfortunately, they often lead to significant morbidity or mortality for both mother and child. As the first comprehensive reference on all aspects of haematological complications of obstetrics, pregnancy and gynaecology this book will be a valuable resource to haematologists, obstetricians, gynaecologists, reproductive medicine specialists, internists, anaesthesiologists and others. The chapters are written by acknowledged experts in the field, and for each condition covered the etiology, pathophysiology, clinical and laboratory diagnosis and management are discussed where appropriate.

It is now routine to offer men the opportunity to bank sperm prior to medical treatments where there is a high risk of testicular damage. Some men also elect to bank sperm prior to vasectomy or before embarking on a high-risk activity, such as joining the armed services. This book examines the processes involved in banking sperm from sample production and storage, the subsequent treatment of the patient and the maintenance of the samples in storage, to the process of follow-up and the ultimate fate of frozen samples. Sperm Banking: Theory and Practice will be of particular interest to andrologists and embryologists involved in the running and establishment of sperm-banking services. The book will also be useful to medical and nursing professionals and counsellors involved in the diagnosis and treatment of conditions where there is a risk of infertility as a consequence of the treatment, including oncologists, hematologists and urologists.

This contemporary account of male fertility provides a much-needed bridge between those seeking to understand the subject from an evolutionary and biological perspective, and those with clinical responsibility for the investigation and treatment of male infertility. Accordingly, the first half of the book deals with evolutionary aspects of male reproduction and sperm competition, sperm production and delivery in man and other animals, spermatogenesis and epididymal function, sperm transport in the female tract, and the apparent decline in human sperm count. The second part of the book puts greater emphasis on clinical problems and opens with a discussion of ICSI, including its value and limitations. This is followed by a review of modern developments in the genetics of male infertility and proceeds to a further chapter on the role of surgical procedures in the treatment of male infertility. The contributors provide a critical review of semen analysis and a full description of the molecular techniques now being used in preimplantation diagnosis and in the study of mitochondrial inheritance. This volume, written by an international team of authors, illustrates the breadth of vision needed to tackle the problem of male infertility.

Obesity is a continuing issue around the world and in many contexts. The growing number of obese people is an increasing concern for those in the medical profession, and obesity can pose specific challenges in relation to fertility and pregnancy. Patients who are obese require specific considerations and knowledge. Bringing together experts from a variety of specialties to examine the issues and challenges of obesity, this book discusses how obesity affects fertility, reproduction, and pregnancy. Beginning with an exploration of the epidemiology of obesity, further chapters focus on specific issues related to obesity and both male and female reproduction, the complications of obesity during pregnancy and labour, and the long term effects of obesity. This is the most comprehensive resource to examine the topic of obesity and reproductive issues, making it invaluable for medical students, professionals, and researchers in public policy and medicine.
Comprehensive examination of fertility issues arising from male and female obesityClinical knowledge and expertise given to the subjectsIn-depth examination through 47 chapters of a growing, but often overlooked, issue in fertility and pregnancy

"A remarkable collection of scholarly essays, philosophical discussions, and ethical arguments concerning reproductive choices."
--"Choice"

It seems as if every week there is a new case involving reproductive technologies that raises provocative, often painful questions: What policies should be followed by centers that preserve human embryos? Are such innovations as Norplant improvements over established methods of contraception? Should R.U. 486 be available in the U.S.? Is prenatal diagnosis an ethically acceptable step to limiting the number of disabled people?

These are just some of the vital questions explored in this timely work which offers incisive analysis of the plethora of issues raised by advances in reproductive medicine. The book's major section cover abortion, contraception, cryopreservation of gametes and embryos, surrogate motherhood, and psychosocial issues of in-vitro fertilization.

In each section, introductory essays by recognized authorities such as Elizabeth Bartholet and Andrea L. Bonnicksen are followed by critical articles by professionals in such fields as women's health, medicine, biology, sociology, politics, and philosophy. In assessing a technology, the authors present well-argued analyses of problems created by that technology, including views from advocates and practitioners that raise attendant ethical and practical issues.

'Reprogen-Ethics and the Future of Gender' brings together three tightly related topics, which have so far been dealt separately in bioethics: assisted reproduction, enhancing and gender. Part one in this book targets present policies and legislature of assisted reproduction. Part two focuses on current views of the ethics of PGD and enhancing. Part three tackles the future of gender. Part four deals with artificial wombs and ectogenesis. The aim of this book is to provide a joint perspective in order to get the big picture. Contributors include Matti Hayry, Tuija Takala, Soren Holm, David Heyd, Daniel Callahan, Harriet Bradley, Ekaterina Balabanova and others. Some chapters in this book will significantly contribute to the current discussion of the topics at stake; other chapters will start a discussion on issues that have not yet been discussed. 'Reprogen-Ethics and the Future of Gender' will certainly appeal to readers who are interested in any of the intersecting topics of assisted reproduction, genetic enhancing and gender; bioethicists, sociologists, genetic counsellors, gynaecologists, legislators, and students of the relevant disciplines.

Growth, Maturation and Body Composition documents one of the most remarkable and significant studies in the field of human biology. The Fels Longitudinal Study is the longest, largest and most productive serial study of human growth, maturation and body composition. This book shows how data collected from more than 1000 participants during the past 60 years have been analysed to test a wide range of hypotheses, and describes how the findings have led to the development of improved research methods. Topics covered include the management and analysis of data, prenatal, familial and genetic studies, physical growth, development and maturation, bones and teeth, body composition, and risk factors for cardiovascular disease. With more than 1000 specialized publications of Fels data, the present book provides a unique overview of this fascinating research programme, which will be of interest to a wide range of researchers, including those in the fields of physical anthropology, nutrition science, pediatrics, gerontology, epidemiology, endocrinology, human genetics, as well as statistics.

Over the last several decades, many biologists have been intrigued with the "immunological paradox" of pregnancy, where maternal and fetal tissues peaceably coexist despite their genetic differences. With the development of new insights on the interactive components of the immune system as well as the generation of powerful new molecular and cellular tools, singular progress has been made in understanding immunological events that culminate in successful pregnancy. This volume contains the proceedings for the first US symposium on the "Immunobiology of Reproduction" held August 26 - 29, 1993 in Boston, Massachusetts. Papers address hemotopoietic cells in reproductive tissues; growth factors/cytokines in the female reproductive tract and placenta; growth factor networks in pregnancy loss and cancer; placental expression of major histocompatibility complex and associated genes; experimental models of MHC gene expression; and immunological aspects of human infertility.

The frontispiece, Leonardo da Vinci's drawing of the embryo in the womb, was chosen as a starting point for this book. It was Leonardo who in his notebooks and drawings combined artistic composition and accurate recording of the anatomy of the human body. Leonardo studied human anatomy in order to execute artistic drawings. His aim was to clarify form and function of human organs including reproductive organs. He followed up his extensive research with graphic representa tion and thereby initiated record keeping as a basis of scientific investigation. His records, accurate three-dimensional drawings, allowed others to reproduce his find ings and to test for correctness. Results could be updated and refined. Only after these steps can abnormalities be ascertained and defined as pathology. Though Leonardo was both artist and scientist, it is assumed that his anatomic drawings were used to improve his art, and thus scientific endeavor was at the service of his art. Anatomy, the offspring of science and art, is an integration of the two and became an accepted branch of the natural sciences. Although art and science continued to interact throughout the Renaissance, art was often placed in the service of science. In the course of history that followed, art and science in creasingly followed separate ways."

Forms, Souls, and Embryos allows readers coming from different backgrounds to appreciate the depth and originality with which the Neoplatonists engaged with and responded to a number of philosophical questions central to human reproduction, including: What is the causal explanation of the embryo's formation? How and to what extent are Platonic Forms involved? In what sense is a fetus 'alive,' and when does it become a human being? Where does the embryo's soul come from, and how is it connected to its body? This is the first full-length study in English of this fascinating subject, and is a must-read for anyone interested in Neoplatonism or the history of medicine and embryology.

One out of every six patients in the United States is treated in a Catholic hospital that follows the policies of the U.S. Conference of Catholic Bishops. These policies prohibit abortion, sterilization, contraception, some treatments for miscarriage and gender confirmation, and other reproductive care, undermining hard-won patients’ rights to bodily autonomy and informed decision-making. Drawing on rich interviews with patients and providers, this book reveals both how the bishops’ directives operate and how people inside Catholic hospitals navigate the resulting restrictions on medical practice. In doing so, Bishops and Bodies fleshes out a vivid picture of how The Church’s stance on sex, reproduction, and “life” itself manifests in institutions that affect us all.

This extensively updated new edition provides an indispensable account of modern in-vitro fertilization practice, building upon the popularity of previous editions. The authors initially give a comprehensive review of the biology of human gametes and embryos, before outlining basic to advanced IVF techniques. New developments in practical techniques and understanding are discussed, including in-vitro maturation, vitrification, preservation of fertility for cancer patients, stem cell technology, preimplantation genetic testing, and the role of epigenetics and imprinting. The revised introduction also incorporates a 'refresher' study review of fundamental principles of cell and molecular biology, now updated with current knowledge of meiosis in human oocytes, embryo metabolism and basic principles of genome editing. With high-quality illustrations and extensive, up-to-date reading lists, it is a must-have textbook for trainee and practising embryologists, as well as clinicians who are interested in the scientific principles that underpin successful IVF.

Reproductive tract infections and other gynaecological disorders among women represent an enormous global health burden. This significant book will help focus research on this important though neglected area. The primary aims of the book are to provide an overview of reproductive tract infections and other gynaecological disorders, to highlight the conceptual and methodological challenges associated with undertaking research on this subject, and to serve as a reference for future research in this area. The book focuses on developing country settings, and recognizes that gathering this sort of information requires a multidisciplinary and culturally sensitive approach. Findings from the research described in this book will undoubtedly assist physicians, social scientists, epidemiologists and public health practitioners in evaluating the magnitude of this problem within the community at large and in identifying potentially effective medical and behavioural interventions to address this problem.