Reproductive medicine is the most dynamic area within obstetrics and gynecology and, arguably, the most complicated. An explosion of scientific understanding and technological capabilities - particularly in contraception, infertility and menopause - has transformed the specialty into a high-profile subject that touches upon endocrinology, embryology, andrology, surgery, social science, and practical law and ethics. The Oxford American Handbook of Reproductive Medicine provides a practical overview of the reproductive system and a systematic approach to its disorders, covering diagnosis, assessment, and ongoing management with particular emphasis on common and important presentations. Concise, readable, and pocket-sized, this handbook is useful for medical students, primary care clinicians, and ob/gyn residents as a ready reference for daily practice.

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.

From the author of the New York Times bestseller The Plant Paradox comes a groundbreaking plan for living a long, healthy, happy life. From the moment we are born, our cells begin to age. But aging does not have to mean decline. World-renowned surgeon Dr. Steven Gundry has been treating mature patients for most of his career. He knows that everyone thinks they want to live forever, until they hit middle age and witness the suffering of their parents and even their peers. So how do we solve the paradox of wanting to live to a ripe old age-but enjoy the benefits of youth? This groundbreaking book holds the answer. Working with thousands of patients, Dr. Gundry has discovered that the "diseases of aging" we most fear are not simply a function of age; rather, they are a byproduct of the way we have lived over the decades. In The Longevity Paradox, he maps out a new approach to aging well-one that is based on supporting the health of the "oldest" parts of us: the microorganisms that live within our bodies. Our gut bugs-the bacteria that make up the microbiome-largely determine our health over the years. From diseases like cancer and Alzheimer's to common ailments like arthritis to our weight and the appearance of our skin, these bugs are in the driver's seat, controlling our quality of life as we age. The good news is, it's never too late to support these microbes and give them what they need to help them-and you-thrive. In The Longevity Paradox, Dr. Gundry outlines a nutrition and lifestyle plan to support gut health and live well for decades to come. A progressive take on the new science of aging, The Longevity Paradox offers an action plan to prevent and reverse disease as well as simple hacks to help anyone look and feel younger and more vital.

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."

In The Menopause Manifesto internationally renowned, New York Times bestselling author Dr Jen Gunter brings you empowerment through knowledge by countering stubborn myths and misunderstandings about menopause with hard facts, real science, fascinating historical perspective and expert advice.

The only thing predictable about menopause is its unpredictability. Factor in widespread misinformation, a lack of research, and the culture of shame around women's bodies, and it's no wonder women are unsure what to expect during the menopause transition and beyond.

Menopause is not a disease - it's a planned change, like puberty. And just like puberty, we should be educated on what's to come years in advance, rather than the current practice of leaving people on their own with bothersome symptoms and too much conflicting information. Knowing what is happening, why and what to do about it is both empowering and reassuring.

Frank and funny, Dr Jen debunks misogynistic attitudes and challenges the over-mystification of menopause to reveal everything you really need to know about:

• Perimenopause
• Hot flashes
• Sleep disruption
• Sex and libido
• Depression and mood changes
• Skin and hair issues
• Outdated therapies
• Breast health
• Weight and muscle mass
• Health maintenance screening
• And much more

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.

Life Before Birth provides a coherent framework for addressing bioethical issues in which the moral status of embryos and fetuses is relevant. It is based on the "interest view" which ascribes moral standing to beings with interests, and connects the possession of interests with the capacity for conscious awareness or sentience. The theoretical framework is applied to ethical and legal topics, including abortion, prenatal torts, wrongful life, the crime of feticide, substance abuse by pregnant women, compulsory cesareans, assisted reproduction, and stem cell research. Along the way, difficult philosophical problems, such as identity and the non-identity problem are thoroughly explored. The book will be of interest not only to philosophers, but also physicians, lawyers, policy makers, and anyone perplexed by the many difficulties surrounding the unborn.
"Bonnie Steinbock's excellent book is . . . consistent, thoroughgoing, and intelligible." --Nature
"Steinbock's book is valuable for all interested in the ethical/legal issues surrounding abortion, prenatal injury and liability, maternal-fetal conflict, and fetal/embryo research. The author provides an excellent historical overview of these issues, but she also addresses the issues from the stance of a particular theory of moral status, namely, interest theory. This gives coherence to her discussion as well as allowing testing of the viability of interest theory."
--Choice
"A focused, lucid, analytically fine-grained discussion of a wide variety of problems. . . extremely useful as a survey of the current state of the debate." --Religious Studies Review
"Merits serious consideration by physicians. Steinbock's interests-based approach treats all questions as open -- another and most welcome breath of fresh air." -New England Journal of Medicine
"An extremely valuable contribution to the literature. The author carefully identifies the many bioethical issues to which the status of embryos and fetuses is relevant....She thoroughly reviews the extensive medical, bioethical, and legal literature on all of these issues, offering well-developed critiques of many standard positions. She articulates and thoughtfully defends interesting positions on all of theses topics. Anyone with an interest in these issues will learn a great deal from her knowledgeable and judicious treatment of them." -- The Journal of Clinical Ethics

In recent years, increasing attention and resources have been brought to bear on the relationship between the environment and congenital diseases. These diseases were previously thought to be mostly due to genetic causes. Even though the importance of genes as factors in causation is accepted, environmental factors seem to be implicated just as strongly. This book explores some further concepts that have arisen from more recent perceptions of environmental effects and their possible interactions with living systems. Amongst the topics discussed are:

-effects of prenatal exposure to toxic chemicals

-intra-uterine exposure to drugs

-effects of endocrine disrupters

-environmental risk and sex ratio in newborns

-surveillance of environmental impact

-research and policy

Discussion and presentation of old and novel ideas is targeted at developing a more holistic and united perception of the interaction between congenital diseases and the environment.

An assessment of some ethical implications of increasing life spans. Taking as a starting point the idea that to increase longevity is a form of medical enhancement, it examines the value of living longer; the means for extending life spans; the consequences of greater longevity for the fair distribution of resources and healthcare in particular.

It has been over 40 years since the original report by Salmon and Daughaday demon strating that the ability of GH to stimulate sulfation of cartilage was mediated by a "sulfation factor. " In the ensuing decades, it has become apparent that this "sulfation factor activity" encompasses a complex system ofligands (IGFs), receptors, and carrier proteins that are, in tum, responsible for a wide array of cellular actions. The IGF system has been demonstrated to be critically involved in both intrauterine and postnatal growth, and to have important implications in cancer biology as well, owing to the ability of the IGFs to function in endocrine, paracrine, and autocrine modes and given the wide distri bution of IGFs in virtually every organ system. The contributions to The /GF System reflect the wide span of interest in the IGF system and its implications for normal and abnormal growth and metabolism. The chapters have been divided into four broad sections: I. Molecular biology of the IGF system; II. Bio logical actions of the IGFs; III. IGF physiology; and IV. Clinical aspects of the IGFs. We have made every effort to highlight the major contemporary themes in IGF biology, but as is inevitable in such a fast-moving field, perspectives will continue to change as new information is accumulated."

In species with internal fertilization, sperm competition occurs when the sperm of two or more males simultaneously occupy the reproductive tract of a female and compete to fertilize an egg (Parker, 1970). A large body of empirical research has demonstrated that, as predicted by sperm competition theory, males and females in many species possess anatomical, behavioral, and physiological adaptations that have evolved to deal with the adaptive challenges associated with sperm competition. Moreover, in recent years, evolutionary biologists and psychologists have begun to examine the extent to which sperm competition may have been an important selective pressure during human evolution. Some research has suggested that male humans, like males of many bird, insect, and rodent species, might be able to adjust the number of sperm they inseminate according to the risk of sperm competition. Other research has examined whether such responses might be accompanied by psychological changes that motivate human males to pursue copulations when the risk of sperm competition is high. Furthermore, there is research suggesting that aspects of human penile anatomy might function to enhance success in sperm competition. Much of this work has been controversial; some of the findings have been disputed and others have been greeted with skepticism. However, the idea that some aspects of human psychology and behavior might best be understood as adaptations to sperm competition remains intriguing and, in certain cases, very persuasive.

Congenital malformations are worldwide occurrences striking in every condition of society. These severe physical abnormalities which are present at birth and affecting every part of the body happen more often than usually realized, once in every 33 births. The most common, after heart defects, are those of the neural tube (the brain and spinal cord) which happen in as many as one in every 350 births. They have been noted as curiousities in man and beast throughout recorded history and received great attention in our time by various fields of study, for example, their faulty prenatal development by embryologists, familial patterns by geneticists, causation by environmentalists and variability by population scientists.

Attention turned much in recent years to the relation of these malformations to deficiency of a particular dietary ingredient, folic acid, a subject this book analyzes in depth. The greatest conundrum of all, which this latest matter like so much else hinges on, is the amazing fact of the tremendous, almost universal decrease in the frequency of these anomalies since early in the 20th century. The puzzle is 'What can this downward trend possibly mean?' and at bottom 'Whether it is part of a long-term cyclical pattern'. This fascinating biological phenomenon is explored in the book together with various other topics.

This book presents the findings of a study into the social shaping of reproductive genetics in Germany and Israel, two exceptionally interesting social settings, which share a traumatic history.

Based on a variety of empirical materials (including in-depth interviews with genetic counsellors and survey data on their practices and opinions, as well as analysis of legal, religious, professional and media texts), the study reveals dramatic differences between the way that the German and Israeli societies address the question of a life (un)worthy of living: while in Germany, social, cultural, religious and legal conditions restrict the selection of embryos based on prenatal diagnosis, in Israel they strongly encourage it.

A close comparative analysis of the ways that these two societies handle the delicate balance between the quality and sanctity of life illuminates the controversy around reproductive genetics in an original and provocative way. The study is also innovative in its use of contemporary social theory concerning the politics of life in comprehending the differences between two societies positioned at opposite extremes in their adoption of reproductive genetics. It thus offers an original cross-cultural discussion concerning present-day techno-medical manipulations of life itself.

'This is a unique and courageous book. Yael Hashiloni-Dolev studied the field of reproductive genetics in Israel and Germany, and found out that while in Germany social, cultural, legal and religious conditions restrict the selection of embryos based on prenatal diagnosis, it is strongly encouraged in Israel. This unexpected finding is brilliantly analyzed by the author. Thus this excellent book must be read and discussed by social scientists, human geneticists, genetic counsellors, bio ethicists and medical students.'
Benno Muller Hill, Dr. rer. nat. m. Prof. at the Institute of Genetics of the University of Cologne, Cologne, Germany"

This book reviews recent trends and developments in the study of the impact that the environment has on human reproduction. It thoroughly examines these issues, using the most modern techniques and methods available, to analyze the manner in which both male and female fertility can be affected and assessed. Coverage examines such diverse factors as toxic environmental contaminants, air pollution, and exposure to medical drugs.

The strength of this collection of essays is its careful consideration, from a variety of perspectives within the Catholic tradition, of the practice of embryo adoption. It approaches the question in an open and reasonable way by allowing proponents of diverse positions within the tradition. This method both sheds a great deal of light on the particular question and at the same time introduces the reader to the relevant general principles that guide Catholic moral thought.

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.

Andrology for the Clinician consists of two parts: In Part One, the busy clinician can easily find the problem-orientated information he or she needs on such issues as male factor fertility problems, male contraception, and male genital tract infection and tumours. Part Two contains in-depth subject-orientated information and adds important scientific background information to the recommendations received in Part One. Several leading experts have contributed to this work, which has been extensively subedited by world-renowned editors to ensure a well-structured didactic design and homogeneous content. This outstanding book is of great value for all Urologists, Andrologists, Dermatologists, Endocrinologists, Gynaecologists, Reproductive Biologists, GPs, Gerontologists, Psychologists, Psychiatrists, Paediatricians and anyone else interested in the problems of male sex and constitution.

This book presents an anatomical overview of the changing form and structure of the human body. Although biomechanical embryology can be traced back to the 19th century, up until recently the most commonly accepted framework for the study of human ontogeny (development of the individual) was molecular biology, which all too frequently relied on findings from animal experiments that remained untested for humans. German embryologist and anatomist Erich Blechschmidt's research concentrates on the evidence presented by the human embryo itself. He offers a new approach to the study of early human growth as a way to shed light on the development of body build, instincts, gestures, language, mathematics, tools, and dress.

Implantation is a complex phenomenon, still not thoroughly understood, involving the embryo and the endometrium. Successful implantation is considered to stem from an efficient combination of various embryo and/or maternal factors. Repeated failure of any of these factors or of their combination might decrease the chance of implantation and eventually lead to recurrent implantation failure. Despite technological advances, only about a quarter of In Vitro Fertilization procedures will result in live birth, leading many couples to experience multiple failures. This text from international experts explores the various factors at play and offers a helpful summary of the state of knowledge to help guide clinicians in their management of this complex and important problem. Contents: What is Recurrent Implantation Failure? * The psychosocial aspects of recurrent implantation failure * The role of life-style factors in RIF * Endocrine causes of recurrent implantation failure * Congenital uterine anomalies and recurrent implantation failure * Immunological causes of recurrent implantation failure * Acquired uterine conditions, reproductive surgery, and RIF? * Thrombophilia: diagnosis and management in women with recurrent implantation failure * Andrological causes of RIF * Diagnostic evaluation of RIF? (Modalities and algorithm) * Optimizing embryo culture for RIF? * Optimizing endometrial receptivity for patients with recurrent implantation failure: The role of progesterone on the day of triggering final oocyte maturation * Is there a role of follicular phase LH and E2 on the day of triggering final oocyte maturation for embryo implantation? * Manipulating the endometrium: Can RIF be managed by inducing endometrial inflammation or by the use of novel research therapies * The embryo in RIF: Genetic selection and strategies for improving its implantation potential * Is oocyte donation efficient in patients with RIF? * Sperm donation and RIF? * Optimizing embryo transfer technique for RIF management * Proposed management of patients with recurrent implantation failure and directions for future research * When should patients abandon treatment?

A practical guide to how we can positively adapt to a changing world, from the internationally bestselling authors of The 100-Year Life 'The London Business School professors Andrew J. Scott and Lynda Gratton have been predicting how society must adapt for years. Now they have a post-pandemic road map for us all' Sunday Times Smart new technologies. Longer, healthier lives. Human progress has risen to great heights, but at the same time it has prompted anxiety about where we're heading. Are our jobs under threat? If we live to 100, will we ever really stop working? And how will this change the way we love, manage and learn from others? One thing is clear: advances in technology have not been matched by the necessary innovation to our social structures. In our era of unprecedented change, we haven't yet discovered new ways of living. Drawing from the fields of economics and psychology, Andrew J. Scott and Lynda Gratton offer a simple framework based on three fundamental principles (Narrate, Explore and Relate) to give you the tools to navigate the challenges ahead. The New Long Life is the essential guide to a longer, smarter, happier life.

Mammalian spermatozoa have complex structures. The structure-function relationship of sperm has been studied from various viewpoints. Accumulated evidence has shown that the sperm components undergo sequential changes from the beginning of spermatogenesis to the time of fertilization/embryogenesis. Structural analyses have been performed using various new techniques of light and electron microscopy as well as immunohistochemistry and immunocytochemistry in combination with specific probes such as antibodies against sperm components. Recently developed gene-manipulation techniques have accelerated investigations on the events that govern the relationship between the structure and molecular components of sperm. In addition, animal models with gene manipulations have been shown to exhibit various morphological and functional abnormalities that lead to infertility.

In humans, male infertility is caused by a number of factors such as the external environment, nutrient changes, genotoxins, and mutagens. These factors affect not only the development of germ cells during spermatogenesis but also the functions of mature sperm, ultimately impairing fertilization or embryogenesis. Typical phenotypes of impaired fertilization or embryogenesis are visible in conditions such as azoospermia, oligozoospermia, and teratozoospermia, which have been induced in model animals with gene deficiencies. Thus, comparative analyses of the phenotypes expressed by model animals carrying gene mutations and infertile human patients should be performed in relation to the normal (natural) fertilization process to clarify the etiology of infertility due to male factors.

In this book, I discuss the events that occur in the normal sperm head and govern the structure-function relationship from the time of spermatogenesis to that of fertilization or egg activation. In this regard, I describe dynamic modifications and maturation events occurring in sperm-head components and compare the outcomes of these events with the outcomes of their failure.

Externally the vertebrate body plan presents a bilateral symmetry in relation to the midline. However, inside the body the distribution of the visceral organs follows a very particular pattern that is not symmetrical in relation to the midline.

The last 10 years have seen remarkable advances in our understanding of how the internal asymmetries typical of the vertebrate body are established and controlled. The use of different development models has permitted to uncover fascinating ways of creating asymmetry, like the activity of the nodal cilia. A host of studies has also unravelled the involvement of many genes in the left right patterning pathway.

Based on this knowledge the genetic basis of human laterality defects are beginning to be revealed. It is a major challenge now to understand how all these genes control left right development as well as the complex set of interactions established between them.

As the older population in the United States is becoming more racially and ethnically diverse, it is important to understand the characteristics, the potential, and the needs of this population. In this new and fully revised edition of Aging and Diversity, Chandra Mehrotra and Lisa Wagner address key topics in diversity and aging, discussing how the aging experience is affected by not only race and ethnicity but also gender, religious affiliation, social class, rural-urban community location, and sexual orientation and gender identity. Taking this broad view of human diversity allows the authors to convey some of the rich complexities facing our aging population - complexities that provide both challenges to meet the needs of a diverse population of elders and opportunities to learn how to live in a pluralistic society. Mehrotra and Wagner present up-to-date knowledge and scholarship about aging and diversity in a way that engages readers in active learning, placing ongoing emphasis on developing readers' knowledge and skills, fostering higher order thinking, and encouraging exploration of personal values and attitudes.

Preimplantation genetic testing (PGT) is now well established as a valuable treatment option for patients wishing to start or continue a family, for a range of indications from advanced maternal age to high risk of transmitting inherited disease. This text brings together contemporary thinking from international opinion leaders and will be an invaluable guide for practitioners in Reproductive Medicine wishing to keep pace with the latest developments and clinical data.