In Manufacturing Babies and Public Consent, Jose Van Dyck sketches a map of the public debate on new reproductive technologies as it has evolved in the USA and Britain since 1978. Many people have participated in heated discussions on test-tube babies and in vitro fertilization, particularly medical researchers and feminists. The new technologies have been both embraced as the cure to infertility and condemned as the exploitation of women's bodies. Reconstructing this debate, Van Dyck juxtaposes a variety of textual material, from scientific articles to newspaper articles and works of fiction.

This open access edited book brings together new research on the mechanisms by which maternal and reproductive health policies are formed and implemented in diverse locales around the world, from global policy spaces to sites of practice. The authors - both internationally respected anthropologists and new voices - demonstrate the value of ethnography and the utility of reproduction as a lens through which to generate rich insights into professionals' and lay people's intimate encounters with policy. Authors look closely at core policy debates in the history of global maternal health across six different continents, including: Women's use of misoprostol for abortion in Burkina Faso The place of traditional birth attendants in global maternal health Donor-driven maternal health programs in Tanzania Efforts to integrate qualitative evidence in WHO maternal and child health policy-making Anthropologies of Global Maternal and Reproductive Health will engage readers interested in critical conversations about global health policy today. The broad range of foci makes it a valuable resource for teaching in medical anthropology, anthropology of reproduction, and interdisciplinary global health programs. The book will also find readership amongst critical public health scholars, health policy and systems researchers, and global public health practitioners.

1. 1 The Cytokeratins as a Member of the Intermediate Filament Protein Family Intermediate filaments together with microtubules and actin microfilaments make up the filamentous cytoskeleton found in the cytoplasm of vertebrate cells. Recently, intermediate filament proteins have also been described in invertebrates, but their chemistry is not yet known (for review see Biessmann and Walter 1989). These filaments (about 10 nm in diameter) used to be categorized into five classes - cytokeratin, vimentin, desmin, glial fibrillary acidic protein (GFAP), and neurofilaments (NFs). The expression of these proteins follows differentiation-dependent rules: cytokeratins occur in epi- thelial cells, NF proteins are expressed in neurons, GFAP in astrocytes and some nonglial cells, desmin in smooth muscle cells and in striated myocytes, and vimentin in mesenchymal cells (for review see Lazarides 1980; Osborn and Weber 1983). Recent investigations including deoxyribonucleic acid (DNA) and protein sequencing and peptide mapping have redefined the intermediate filaments into five types or subfamilies (type I, acidic cytokeratins; type II, basic cytokeratins; type III, vimentin, desmin, peripherin, and GFAP; type IV, the three NF proteins; and type V, the nuclear lamins (for review see Nagle 1988). A new type VI intermediate filament protein, nestin, has been described in the developing nervous system (Lendahl et al. 1990), and is initially co- expressed with vimentin in neuroepithelial stem cells (Steinert and Liem 1990). The cytokeratins are the most complex subgroup of intermediate filament proteins.

This work attempts to sketch a coherent picture of the amniotic fluid com partment, its borders, and the interactions occurring between fetus and amniotic fluid, for it is this compartment which for 10 months provides the habitat in which the fetus and its functions develop. As a matter of course, our mor phological studies had to be limited to the situation prevailing at the full term of pregnancy. This portrayal purposely neglects the placenta, which is already the subject of an extraordinary profusion of literature. The other aspects of the embryonic sac have been overshadowed to date by the preeminent role 2 of the placenta, although they represent around 1200cm of contact surface in the maternal compartment. From our point of view, the fetal membranes not only act as a seal or simply a diffusion barrier, but actively participate in the exchange processes between compartments. The author also took pains to compile (albeit incompletely) the widely scattered findings reported in clinical journals in order to present them as a well-rounded summary of the mor phological picture and the functional happenings involved in fetal develop ment. The author's own studies of a specifically histomorphological nature provided the groundwork for this synopsis. A special branch of embryology, embryonal physiology, is treated only incidentally in today's embryology textbooks. This work offers several encounters with this field, which should help make it the focus of greater interest. 2 Definition of Terms Fig. 1.

This book delineates how systems biology, pharmacogenomic, and behavioral approaches, as applied to neurodevelopmental toxicology, provide a structure to arrange information in a biological model. The text reviews and discusses approaches that can be used as effective tools to dissect mechanisms underlying pharmacological and toxicological phenomena associated with the exposure to drugs or environmental toxicants during development. The book intends to elaborate functional outcomes of component-to-component relationships using rodent and nonhuman primate in vitro and in vivo models that allow for the directional and quantitative description of the complete organism in response to environmental perturbations. In addition, attention has also been directed to some of the more recent methodologies, including genomics, proteomics and metabolomics, applied in the evolutionary neurobiological field.

1. 1 Historical Perspective In the nineteenth century, knowledge of the events leading to ovulation, fertilization, and implantation was very limited, so much so that Seiler (1832), in his book The Uterus and the Human Egg, wrote: ." . . in the left ovary the first signs of fertilization, namely a Graaf vesicle could be seen. The right ovary shows proof of a second successful copulation: a fresh scar from the ovulated egg and the beginning of a corpus luteum. " In fact all nineteenth century authors strictly divide the female cycle into two phases: the menstrual period and the intermenstruum (ct. Hitschmann and Adler 1908). The generally accepted histology of the endometrium in those days was that of the late proliferative phase. Deviations from this were considered to be pathological (Von Ebner 1902). As Gebhard (1899) expressly put it: "As a rule, it can be said that in the mature woman the endometrial glands run straight; an irregular course of the glands is to be regarded as pathological. " The same author describes the changes occurring during the secretory phase of the cycle as "endometritis glandularis" which he believed to arise from a local nutritional disturbance. The uterine stroma was believed to be lymphoid (Toldt 1877), and the uterine glands were compared to the crypts of Lieberkiihn (Von Ebner 1902).

In the mid-1990s, the international community pronounced prenatal sex selection via abortion an "act of violence against women" and "unethical." At the same time, new developments in reproductive technology in the United States led to a method of sex selection before conception; its US inventor marketed the practice as "family balancing" and defended it with the rhetoric of freedom of choice. In Gender before Birth, Rajani Bhatia takes on the double standard of how similar practices in the West and non-West are divergently named and framed. Bhatia's extensive fieldwork includes interviews with clinicians, scientists, biomedical service providers, and feminist activists, and her resulting analysis extends both feminist theory on reproduction and feminist science and technology studies. She argues that we are at the beginning of a changing transnational terrain that presents new challenges to theorized inequality in reproduction, demonstrating how the technosciences often get embroiled in colonial gender and racial politics.

Reproduction in Mammals is intended to meet the needs of undergraduates reading zoology, biology, biochemistry, physiology, medicine, veterinary science and agriculture, and to be a source of information for advanced students and research workers. It is published as a series of small textbooks dealing with all major aspects of mammalian reproduction. Each of the component books is designed to cover independently fairly distinct subdivisions of the subject, so that readers can select texts relevant to their particular interests and needs. This volume consists of a series of thought-provoking essays by people with a number of very different backgrounds, including biology, comparative anatomy, psychology, psychiatry and moral philosophy. They discuss the physiology mechanisms, adaptive significance, clinical picture and social impact of a variety of patterns of human sexual behaviour, thereby providing a balanced and informative account of a highly sensitive and emotive subject.

Reproduction in Mammals is intended to meet the needs of undergraduates reading zoology, biology, biochemistry, physiology, medicine, veterinary science and agriculture, and to be a source of information for advanced students and research workers. It is published as a series of small textbooks dealing with all major aspects of mammalian reproduction. Each of the component books is designed to cover independently fairly distinct subdivisions of the subject, so that readers can select texts relevant to their particular interests and needs. This volume consists of a series of thought-provoking essays by people with a number of very different backgrounds, including biology, comparative anatomy, psychology, psychiatry and moral philosophy. They discuss the physiology mechanisms, adaptive significance, clinical picture and social impact of a variety of patterns of human sexual behaviour, thereby providing a balanced and informative account of a highly sensitive and emotive subject.

Part of a new series on reproductive medicine, this book is a complete guide to the diagnosis and management of infertility. Beginning with an overview of infertility in both women and men, the next chapters discuss assessment and ultrasound. The following chapters cover numerous causes of infertility, and their diagnosis and treatment, examining both medical and lifestyle issues. The book presents the latest advances in the field and each chapter includes key points and references for further reading. Clinical photographs, diagrams and tables further enhance the comprehensive text. Other titles in the series include: Practical Guide in Reproductive Surgery, Practical Guide in Assisted Reproductive Technology and Practical Guide in Andrology and Embryology. Key points Comprehensive guide to diagnosis and management of infertility Part of new series on reproductive medicine Covers numerous causes of infertility, and their diagnosis and treatment Chapters include key points and detailed references for further reading

Endorphins and other endogenous opioids appear to be the connecting link between reproductive functions and stress adaption of the human organism. This book contains the con- tributions of an international group of biologists, bioche- mists, and endocrinologists on the opioidergic control me- chanisms in reproduction and stress physiology. Main topics covered are: endogeneous opioids and the pituitary-gonadal system; ovarian endorphinsecretion; pregnancy-associated changes of plasma endorphin; and opioid control of the hypo- thalamo-pituitary-adrenal axis. Although all chapters give an excellent review on various studies in basic opioid re- search, there are numerous clinical implications mentioned in this book.

In the USA, severe psychiatric illness after childbirth strikes one woman for every 1000 births, or about 3500 women each year. An unrecorded number of new mothers experience lesser degrees of postpartum illness, and two distinct forms of severe illness can be distinguished. One form, called postpartum psychosis, is an agitated, very changeable condition, often characterized by confusion, hallucinations, delusions and sometimes episodes of violent behaviour. The other condition, major postpartum depression, begins two or three weeks after childbirth, and is characterized by confusion, depression of mood, and often with exhaustion, headache and digestive upset. Mixtures of the two severe disorders occur frequently. This volume contains a number of essays which support the position that postpartum disorders are primarily organic and are mainly disorders of hormonal deficit. They develop as the endocrine system falls back from the hyperactivity of pregnancy toward or beyond the levels of the prior non-pregnant state. Tremendous therapeutic opportunities exist or are imminent for both the organic and the psychological components of postpartum mental illness.

Doppler ultrasound is a hot topic at the present time. This is because studies of the uteroplacental and fetal circulation give fundamental information as to the physiology or pathology of placental function and the response of the fetal circulation to hypoxaemia. Dr. Arabin's clinical studies which are described in this book are an important contribution to knowledge in this field and will be of enormous interest not only to researches but also to clini cians interested in learning how this latest technology can be integrated into their clinical practice. London STUART CAMPBELL Foreword Although only three decades old, the field of perinatal medicine is marked by continuous new advances. Ultrasound diagnostic techniques comprise an important element of this new field. Dr. Arabin has taken the initiative to investigate the functional-diagnostic aspects of ultrasound. Among other things, she has further developed and refined the concept of "oxygen-con serving adaptation of fetal circulation" which originated in the Department of Obstetrics and Gynecology at the Neukolln Hospital Center in 1966. She thus has been able to show that the most reliable Doppler blood flow meas urement predictors of a high risk to the fetus are (1) a decrease in the flow volume of the descending thoracic aorta and the umbilical artery and (2) an increase in the flow volume of the common carotid arteries."

During the past 20 years, endometrial carcinoma has continued to increase in frequency and it is quite possible that this carcinoma will become the major gynecologic malignancy in the future. For many years, endometrial carcinoma was considered less malignant than other gynecologic malignancies, simple hysterectomy and bil ateral salpingo-oophorectomy or surgery combined with radiation being effective in certain circumstances. It is unfortunate to note that the global 5-year survival rate for patients with advanced or recurrent endometrial carcinoma has improved only slightly. Therefore any complacency regarding this 'benign malignancy' should be reconsidered. There is a growing awareness of the nature of end ometrial carcinoma, with advances in our knowledge ranging from its etiology through its epidemiology to its clinical findings. This volume has been designed to fill a hiatus in the literature in China. To achieve this aim, we have attempted to review the world-wide advances on endometrial carcinoma and summarize systematically and comprehensively this common gynecologic malig nancy, including the clinical experiences gathered at the Cancer Institute (Hospital) of the Chinese Academy of Medical Sciences since 1958 as well as a brief description of the psychological problems in patients with gyneco logic cancers."

A potential crisis in human fertility is brewing. As societies become more affluent, they experience changes that have a dramatic impact on reproduction. As average family sizes fall, the selection pressure for high-fertility genes decreases; exacerbated by the IVF industry which allows infertility-linked genes to pass into the next generation. Male fertility rates are low, for many reasons including genetics and exposure to environmental toxins. So, a perfect storm of factors is contriving to drive fertility rates down at unprecedented rates. If we do not recognize the reality of our situation and react accordingly, an uncontrollable decline in population numbers is likely, which we'll be unable to reverse. This book will address, in a unique and multi-faceted way, how the consequences of modern life affects fertility, so that we can consider behavioural, social, medical and environmental changes which could reduce the severity of what is about to come.

The Project on Reproductive Laws for the 1990s began in 1985 with the realization that reports of scientific developments and new technologies were stimulating debates and discussions among bioethicists and policymakers, and that women had little part in those discussions either as participants or as a group with interests to be considered. With the help of a planning grant from the Rutgers University Institute for Research on Women, the Women's Rights Litigation Clinic at Rutgers University Law School-Newark held a planning meeting that June attended by approximately 20 theorists and activists in the area of reproductive rights. Project purposes, methods, and general shape took form at the meeting. Two goals have characterized the Project's work since then: first, to generate discussion, debate, and, where possible, consensus among those committed to reproductive autonomy and gender equality as to how best to respond to the questions raised by re ported advances in reproductive and neonatal technology and new modes of reproduction; and second, to ensure that those shaping reproductive law and policy appreciate the ramifications of these developments for gender equality. In meeting this twofold agenda, the Project focused on six areas: time limits on abortion; prenatal screening; fetus as patient; reproductive hazards in the workplace; interference with reproductive choice; and alternative modes of reproduction. The Project identified individuals to take respon sibility for drafting model legislation and position papers in the six areas (for the drafters, see the Appendix)."

The advent of ultrasound scans has made it possible to observe the fetus undisturbed in its natural surroundings. In this remarkable book, Dr Alessandra Piontelli describes in moving detail her observations of the behaviour of several children from very early stages in the womb, through birth, to infancy and childhood. By drawing on her experiences as a child psychotherapist and psychoanalyst as well as on her observational research, she is able to investigate issues relating to individuality, psychological birth and the influence of maternal emotions during pregnancy.
The first study of its kind, From Fetus to Child shows how observational and psychoanalytic data can offer different but complementary insights in attempting to answer fundamental questions about human development.

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The examination for Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG) remains one of the most internationally recognised postgraduate examinations in the specialty. Over the years, the examination has evolved in keeping with changes in medical education; the Part 2 examination now consists of two papers made up of Single Best Answer (SBA) questions and Extended Matching Questions (EMQ). This invaluable resource consists of 400 SBA questions (200 in Obstetrics and 200 in Gynaecology), followed by 400 EMQs (200 in Obstetrics and 200 in Gynaecology), grouped into papers, to provide enough material to guide preparations and to give some practice experience of the examination formats. All the questions have answers with explanations and sources of evidence. In preparing for the examination, candidates should make repeated references to these sources of evidence. There is also general advice on how to prepare for the examination and discussion of the reasons why trainees fail the examination.

How is growth controlled in normal cells? How are the growth control mechanisms perturbed in cancer cells? This book provides an up-to-date description of research aimed at resolving these questions. It is organized into four sections, each containing a series of short reviews written by experts in the field. The general headings are: growth factors, receptors, and related oncogenes: transduction of mitogenic signals and "ras" oncogenes; nuclear oncogenes and regulation of gene expression; and multiple steps involved in malignant transformation. The articles emphasize concepts rather than detailed facts and are intended not only for specialists in the field but also for interested readers, such as physicians and advanced students, who wish to stay abreast of developments in one of the most exciting fields in current biomedical research.

Although impotence may be the most widely recognized manifestation of male sexual dysfunction, many other forms of sexual disorders do not involve the erectile mechanism, from deficiencies of desire to disturbances in ejaculatory function to the failure of detumescence. With such a myriad-and often co-existing-number of disorders, the successful treatment of male sexual dysfunction requires not only a thorough understanding of the underlying physiology and pathophysiology, but also the coordinated efforts of multiple specialties, including endocrinology, andrology, urology, radiology, sex therapy, and even sometimes psychiatry, cardiology, or oncology. Male Sexual Dysfunction: Pathophysiology and Treatment presents the collective expertise of more than 60 international authorities in a single landmark text. From foundations in the anatomy of the male genital tract to the latest neuroimaging data, readers will appreciate the comprehensive information detailing the tremendous advances made in the delineation of sexual function and its disorders as well as the expert descriptions of practical and cost-effective medical, surgical, and psychological strategies for the treatment of all forms of male sexual dysfunction.

This open access edited book brings together new research on the mechanisms by which maternal and reproductive health policies are formed and implemented in diverse locales around the world, from global policy spaces to sites of practice. The authors - both internationally respected anthropologists and new voices - demonstrate the value of ethnography and the utility of reproduction as a lens through which to generate rich insights into professionals' and lay people's intimate encounters with policy. Authors look closely at core policy debates in the history of global maternal health across six different continents, including: Women's use of misoprostol for abortion in Burkina Faso The place of traditional birth attendants in global maternal health Donor-driven maternal health programs in Tanzania Efforts to integrate qualitative evidence in WHO maternal and child health policy-making Anthropologies of Global Maternal and Reproductive Health will engage readers interested in critical conversations about global health policy today. The broad range of foci makes it a valuable resource for teaching in medical anthropology, anthropology of reproduction, and interdisciplinary global health programs. The book will also find readership amongst critical public health scholars, health policy and systems researchers, and global public health practitioners.

The first book to take an integrative approach to the treatment of male infertility issues, this easily digestible guide uses graphics and visual aids to help explain key concepts in diagnosis, anatomy and treatment from a Western and Chinese medicine perspective. Dr Olivia Pojer, a Western medical doctor and Chinese medicine practitioner, uses a dual approach to the largely unexplored treatment of male infertility. The book covers common causes of the topic, the microbiome of the testes, and how to encourage better sperm production. It also includes chapters on nutraceuticals and laser therapy, as well as herbal formulas and acupuncture protocols to implement in clinical practice, along with Chinese medical lifestyle and nutrition. Addressing the so-called male factor in reproduction and its underrepresentation in treatment, this book provides a complete overview for acupuncturists and Chinese medicine practitioners treating male infertility issues.

In 1953, at the grand age of 92, Ferdinand Hochstetter submitted his famous collection of photographs of human embryos entitled: "Uber die Entwicklung der Formverhaltnisse des menschlichen Antlitzes." Together with others papers, this contribution was published in 1955, a year after Hochstetter's death. In unbroken combativeness, Hochstetter discussed his results with regard to those of earlier embryologists and to those of his own lifetime. Thus, in an obituary, Elze (1956) reported about one of Hochstetter's letters from the year of his death (1954): "nur einige blodsinnige Behauptungen, die Fischel in seiner Ent- wicklung des Menschen verzapft hat, mochte ich vielleicht noch annageln," which may be translated as: "I would just like to pin down a few silly assertions that Fischel made in his Entwicklung des Menschen." In the first two paragraphs of his paper Hochstetter stated (in German, here translated freely): When I decided to write a detailed paper about the development of the morphology of the human face, too [in addition to a paper about morphology of the extremities in human embryos], I was especially moved by the fact that in none of the German manuals and textbooks on embryology known to me is there to be found a presentation of the development of the human face which could be considered - eveJ;l to a limited extent - rich in details, true, sufficiently illustrated, easy to understand by students as well as by scien-

Everyone involved in obstetric practice at the present time will be well aware oft he complexities of drug interactions in the mother and fetus, and newborn infant. Perhaps the most spectacular manifestations of these drug interactions are those that result in teratogenic effects, but the implications of drug therapy generally in pregnancy range far wider than the hazards of inducing fetal malformation. It must also be realised that there are hazards in withholding some therapeutic agents from pregnant women, and these hazards have to be weighed against the dangers of indiscriminate drug therapy. It is often very difficult to obtain relevant information about any given compound in relation to its use in pregnancy, and it is therefore appropriate to provide a handbook which brings together information about a wide variety of drugs in a form which allows ready access for the practising clinician. Rodney Ledward first discussed this project with me some years ago, and it seemed to me at the time that with his background as both a pharmaceutical chemist and an obstetrician that his talents were particularly well suited to this task. In conjunction with Professor Hawkins, he has produced a concise reference book for use in clinical practice, which I feel confident will prove to be invaluable to all those practising obstetrics at all levels of seniority. The book covers the use of drugs during pregnancy, but it also includes sections on the transfer of drugs into breast milk.