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.

The first IVF conceived birth in 1978 resulted in a significant growth of third party reproductive options which continue to raise ethical, legal, and psychological questions. Third party reproduction procedures can involve as many as five people: sperm donor, egg donor, gestational carrier, and intended parents. Third-Party Reproduction: A Comprehensive Guide utilizes experts in the field to address the medical, psychological, ethical and legal aspects of sperm donation, egg donation, embryo donation, and the use of gestational carriers. In addition, there are chapters on the medical and ethical aspects of posthumous reproduction, religious aspects of third party reproduction, and how to avoid pitfalls of third party reproduction. Aimed at physicians, trainees, psychologists, nurses, and social workers whose practices may include patients considering third party reproduction, the intent of this book is to provide a comprehensive and practical overview of the many aspects of third party reproduction to help all those involved to better understand them. Patients considering third party reproduction may also find value in this book.

The average physician and even cancer care-givers are not knowledgeable about the effects of cancer treatment on sex and reproductive life. They are even less aware of the options available for treatment of such patients. Cancer and Sexual Health fills a great need for a reference work devoted to the link between cancer and human sexuality. The volume is designed to give a comprehensive and state-of-the-art review of the sexual and reproductive consequences of cancer diagnosis and treatment. It will prove an invaluable resource for those clinicians caring for cancer patients as well as acting as a reference text for the sexual medicine clinician who may not see a large number of cancer patients.

This book is on ovulation induction and controlled ovarian stimulation which is an integral part of most infertility therapies like intrauterine insemination and in vitro fertilization. It would deal with causes of anovulation and indications for ovarian stimulation. This book deals with basics as well as current and advanced practices. It provides a step by step protocol for ovarian stimulation. It gives a clear understanding of the science of reproductive endocrinology behind these stimulation protocols and roadmaps the latest therapies, defining their current relevance to treatment. Besides the practical guidance it also covers latest research work done in this field. In this day of information overload it is an attempt to integrate relevant information in a manner which can be applied in infertility practice in evidence based manner, making it rational, logical and rewarding for the reader.

In this third volume, the Biennial Review of Infertility brings together the most up-to-date research and clinical information on male and female infertility, emerging assisted reproductive techniques, and controversial issues in reproductive medicine. An impressive panel of contributors presents cutting-edge information in a clear and well-balanced manner. This volume includes hot topics in reproductive medicine including age and its impact on fertility, lifestyle factors and reproductive health, fertility preservation for cancer patients, reproductive tourism and a discussion of clinical research design. The expanded section on controversies allows for point/counterpoint discussion between experts with differing opinions on topics like safety of the ICSI procedure and the role of IUI in modern reproductive medicine. Created to provide an ongoing appraisal of current knowledge, the Biennial Review of Infertility stimulates communication amongst all those working to help couples resolve their infertility.

Chronic vulvar pain, or 'vulvodynia', is a common problem that can have a considerable impact on the wellbeing of patients. Despite being seen routinely in everyday clinical practice, it remains a neglected disorder that may take many years to diagnose. This book eases the way for physicians, including General Practitioners and Gynecologists, who are motivated to improve the lives of women suffering from vulvodynia. By offering a concise overview of the latest information on the diagnosis and management of vulvodynia, and its numerous comorbidities, in an easy to read, 'tips and tricks' format, the book empowers physicians to rapidly and effectively address the complex and sensitive issues surrounding the disorder.

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.

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 unique textbook is designed to provide a summary of state of the art developments in both male and female fertility and its association with cancer for both new and experienced practitioners. Clear, concise and readable, the text allows the reader to obtain rapid answers to this challenging medical issue. Special emphasis is placed on diagnostic and treatment algorithms. Topics covered include demographics of cancer in the reproductive age male, fertility conditions which predispose to cancer development, the role of assisted reproduction for fertility management, as well as fertility preservation strategies for the male and female cancer patients. Cancer and Fertility will be of great value to general urologists, uro-oncologists, gynecologists, medical oncologists, obstetricians, primary care providers, allied health providers.

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.

For many years, the focus of fertility research and treatment has been the female. In reality, at least half of all infertility cases have a male factor as a major or contributing cause. Recent advances in the diagnosis and treatment of male infertility have enabled pregnancies in cases where the male partner was previously considered to be untreatable or even sterile. With contributions from world- renowned experts, this comprehensive overview of male infertility covers anatomy, evaluation, treatment and prevention. The elucidation of the molecular genetics underpinning spermatogenesis and the development of new sperm function tests have increased our understanding of male infertility and led to new treatments which are discussed and evaluated. This volume presents the latest scientific developments in a clinically useful and practical format. The book is packaged with a high-quality surgical atlas on CD- ROM. This text will be valuable for urologists and reproductive endocrinologists at all levels.

A proactive and comprehensive resource that answers every question about fertility health and helps women understand and preserve their fertility options. Does stress affect your fertility? Should you avoid materials made with plastic? How does diet affect your chance of conception? Does acupuncture increase your chances? How old is too old? In The Whole Life Fertility Plan, Kyra Phillips and Dr. Jamie Grifo answer all your pressing questions about fertility health-and address things you didn't even know to ask-whether you're planning to wait to have kids or are starting the process now. Phillips spent her 20s and 30s building her career, and wasn't ready to start a family until she turned 40. She met with Dr. Grifo, the director at the renowned NYU Fertility Health Center, and after an uphill (but ultimately successful) battle on the road to conception, she learned that there were a number of things-simple things-she could have been doing differently over the years. For too long, women have believed that when it comes to their fertility, their bodies will cooperate when the time is right. But fertility is not unlike heart health; it's important to be proactive. As women are becoming increasingly aware of their fertility health and waiting longer to have children, they are starting to take control of their fertility long before they are ready to start trying. Whether you're in your 20s, 30s or 40s, and want to start a family now or down the line, don't leave it up to chance-educate yourself about what affects your fertility.

Introduced in Phnom Penh around 1990, at the twilight of socialism and after two decades of conflict and upheaval, ultrasound took root in humanitarian and then privatized medicine. Services have since multiplied, promising diagnostic information and better prenatal and general health care. In Fixing the Image Jenna Grant draws on years of ethnographic and archival research to theorize the force and appeal of medical imaging in the urban landscape of Phnom Penh. Set within long genealogies of technology as tool of postcolonial modernity, and vision as central to skilled diagnosis in medicine and Theravada Buddhism, ultrasound offers stabilizing knowledge and elicits desire and pleasure, particularly for pregnant women. Grant offers the concept of "fixing"-which invokes repair, stabilization, and a dose of something to which one is addicted-to illuminate how ultrasound is entangled with practices of care and neglect across different domains. Fixing the Image thus provides a method for studying technological practice in terms of specific materialities and capacities of technologies-in this case, image production and the permeability of the body-illuminating how images are a material form of engagement between patients, between patients and their doctors, and between patients and their bodies.

Providing a comprehensive review of the interactions between exercise and human reproduction, this unique text focuses on both the positive and negative consequences of sport and physical activity on male and female fertility and infertility and the biological mechanisms and processes behind them. Beginning with a review of the structure and function of the male and female reproductive systems as well as fertilization and gestation, the discussion then turns to the physiology and endocrinology of sport and exercise, which is further elaborated in subsequent chapters on the impact of physical activity, hormonal changes, pathologies, and consequences of drug use for active men and women. Additional chapters address related topics, such as the impact of sport on young athletes and developing reproductive potential, physical activity and pregnancy, the use of oral contraceptives in athletes, oxidative stress, and the impact of nutritional deficiencies on athletes' fertility, with a final chapter providing recommendations and therapeutic guidelines for exercise-related reproductive disorders. Covering everything from the fundamental principles of sports physiology and human reproductive potential to the interaction between physical exercise and the endocrinology of the reproductive system, Exercise and Human Reproduction is an authoritative resource for helping clinicians understand how the reproductive system adapts to activity and exercise and offers strategies to avoid potential harm to human reproduction.

In the 1960s thousands of poor women of color on the (post)colonial French island of Reunion had their pregnancies forcefully terminated by white doctors; the doctors operated under the pretext of performing benign surgeries, for which they sought government compensation. When the scandal broke in 1970, the doctors claimed to have been encouraged to perform these abortions by French politicians who sought to curtail reproduction on the island, even though abortion was illegal in France. In The Wombs of Women-first published in French and appearing here in English for the first time-Francoise Verges traces the long history of colonial state intervention in black women's wombs during the slave trade and postslavery imperialism as well as in current birth control politics. She examines the women's liberation movement in France in the 1960s and 1970s, showing that by choosing to ignore the history of the racialization of women's wombs, French feminists inevitably ended up defending the rights of white women at the expense of women of color. Ultimately, Verges demonstrates how the forced abortions on Reunion were manifestations of the legacies of the racialized violence of slavery and colonialism.

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.

Now in its fourth volume, the Biennial Review of Infertility brings together the most up-to-date research and clinical information on male and female infertility, emerging assisted reproductive techniques and evolving controversies in reproductive medicine. An impressive panel of contributors presents cutting-edge information in a clear and well-balanced manner. Volume 4 discusses hot topics in contemporary reproductive medicine, including stem cell technologies for male infertility, the current state of ovarian tissue cryopreservation and time-lapse video microscopy of embryos. The expanded section on controversies allows for point/counterpoint discussion between experts with differing opinions on topics like eSET and the use and role of dietary supplements in IVF cycles. Created to provide an ongoing appraisal of current knowledge, the Biennial Review of Infertility stimulates communication amongst all clinicians and researchers working to help couples resolve their infertility.

This book outlines the current understanding of how obesity affects female reproductive function across the lifespan. Topics include physiology of the menstrual cycle and early pregnancy, best practices in the delivery of contraceptive and prenatal care and healthcare policy that weighs the evidence in appropriate balance with principles that respect women's rights. Special attention is devoted to the idea that obesity's adverse effects are likely trans-generational; that is, children born to obese mothers are at increased risk for obesity, diabetes and cardiovascular disease later in life. Patients and their physicians need to be aware of the additional risks obesity confers in pregnancy and outline a plan of care that includes counseling preconceptionally, antepartum, intrapartum and postpartum in order to decrease morbidity. Obesity and Fertility provides advice for reproductive medicine physicians and gynecologists to help guide obese patients toward improved reproductive health and outcomes.

This book provides a comprehensive overview on issues surrounding fertility in patients who have been diagnosed with breast cancer or belong to a high-risk population. The impact of breast cancer treatment on fertility is clearly explained and all the available options for fertility preservation are discussed, including the use of assisted reproduction technologies. Guidance is offered on family planning and on management options when breast cancer arises during pregnancy and when pregnancy occurs after breast cancer. Answers are provided to a wide range of key questions, including: What is the impact of pregnancy after breast cancer on prognosis? What advice should be given on the timing of pregnancy in relation to chemotherapy and endocrine treatment? What is the effect of reducing the duration of endocrine treatment to allow an earlier attempt at pregnancy? Is breast feeding possible? Medical treatments of breast cancer have a huge impact on fertility. While many procedures can be applied to preserve fertility, all must be put into action within the very short time available before starting treatment. Any delay in referral of a woman wishing to preserve her fertility to an ART center with experience in oncologic patients may preclude the possibility of a future pregnancy. In addition, an increasing number of high-risk patients are asking questions about their reproductive life, from choice of contraception to the risks of assisted reproduction techniques. Physicians will find this book an invaluable aid in providing flawless counseling to their patients and ensuring that they receive optimal management.

Comprised exclusively of clinical cases covering ectopic pregnancy, this concise, practical casebook will provide clinicians in reproductive medicine and obstetrics/gynecology with the best real-world strategies to properly diagnose and treat the various forms of the condition they may encounter. Each chapter is a case that opens with a unique clinical presentation, followed by a description of the diagnosis, assessment and management techniques used to treat it, as well as the case outcome and clinical pearls and pitfalls. Cases included illustrate different management strategies - from treatment with methotrexate to surgical interventions - as well as types of ectopic pregnancy, such as ovarian, interstitial, heterotopic and abdominal forms, among others. Pragmatic and reader-friendly, Ectopic Pregnancy: A Clinical Casebook will be an excellent resource for reproductive medicine specialists, obstetricians and gynecologists, and family and emergency medicine physicians alike.

Rapid population aging, once associated with only a select group of modern industrialized nations, has now become a topic of increasing global concern. This volume reframes aging on a global scale by illustrating the multiple ways it is embedded within individual, social, and cultural life courses. It presents a broad range of ethnographic work, introducing a variety of conceptual and methodological approaches to studying life-course transitions in conjunction with broader sociocultural transformations. Through detailed accounts, in such diverse settings as nursing homes in Sri Lanka, a factory in Massachusetts, cemeteries in Japan and clinics in Mexico, the authors explore not simply our understandings of growing older, but the interweaving of individual maturity and intergenerational relationships, social and economic institutions, and intimate experiences of gender, identity, and the body.

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.

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.