Reproductive donation is the most contentious area of assisted reproduction. Even within Europe there are wide variations in what is permitted in each country. This multi-disciplinary book takes a fresh look at the practices of egg, sperm and embryo donation and surrogacy, bringing together ethical analysis and empirical research. New evidence is offered on aspects of assisted reproduction and the families these create, including non-traditional types. One of the key issues addressed is should children be told of their donor origin? If they do learn the identity of their donor, what kinds of relationships may be forged between families, the donor and other donor sibling families? Should donation involve a gift relationship? Is intra-familial donation too close for comfort? How should we understand the growing trend for 'reproductive tourism'? This lively and informed discussion offers new insights into reproductive donation and the resulting donor families.

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."

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.

'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.

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 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.

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

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.

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.

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.

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 insightful and thought-provoking 2002 collection of chapters describes the rapid advances that had revolutionised reproductive medicine in the years leading up to its publication. This transformation was the result of converging and overlapping developments in reproductive biology, molecular biology and genetics. These advances allied with remarkable technical developments pushed the boundaries of this discipline ever faster forward. This volume surveys this rapid expansion as it stood in 2002 and looks ahead at exciting prospects for the future that stand at the watershed between basic science and clinical application. From oogeneis and spermatogenesis, through to fertilisation, embryogenesis and cloning, this volume looks at scientific advances. Subsequent chapters focus on infertility and its diagnosis and treatment using the full armory of assisted reproductive technologies. A concluding section surveys the impact of these developments on the provision, regulation and financing of reproductive health care in the global community.

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.

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?

This practical, extensively illustrated handbook covers the procedures that are undertaken in andrology and ART laboratories to analyse and assess male-factor infertility, and to prepare spermatozoa for use in assisted conception therapy. The content is presented as brief, authoritative overviews of the relevant biological background for each area, plus detailed, step-by-step descriptions of the relevant analytical procedures. Each technical section includes quality control considerations and the optimum presentation of results. In addition to the comprehensive 'basic' semen analysis, incorporating careful analysis of sperm morphology, the handbook provides established techniques for the use of computer-aided sperm analysis and sperm functional assessment. The interpretation of laboratory results in the clinical context is highlighted throughout, and safe laboratory practice is emphasized. Fully revised, incorporating the new ISO TS 23162 on basic human semen analysis throughout, this is an invaluable resource to all scientists and technicians who perform diagnostic testing for male-factor infertility.

Human embryo research touches upon strongly felt moral convictions, and it raises such deep questions about the promise and perils of scientific progress that debate over its development has become a moral and political imperative. From in vitro fertilization to embryonic stem cell research, cloning, and gene editing, Americans have repeatedly struggled with how to define the moral status of the human embryo, whether to limit its experimental uses, and how to contend with sharply divided public moral perspectives on governing science. Experiments in Democracy presents a history of American debates over human embryo research from the late 1960s to the present, exploring their crucial role in shaping norms, practices, and institutions of deliberation governing the ethical challenges of modern bioscience. J. Benjamin Hurlbut details how scientists, bioethicists, policymakers, and other public figures have attempted to answer a question of great consequence: how should the public reason about aspects of science and technology that effect fundamental dimensions of human life? Through a study of one of the most significant science policy controversies in the history of the United States, Experiments in Democracy paints a portrait of the complex relationship between science and democracy, and of U.S. society's evolving approaches to evaluating and governing science's most challenging breakthroughs.

Reproductive Hazards of the Workplace Linda M. Frazier, MD, MPH Marvin L. Hage, MD In the face of rising medical costs, health care reform, intense media scrutiny, and the trend toward delayed pregnancies, the concern over on-the-job reproductive hazards is at an all-time high. The need to develop effective strategies for protecting the reproductive health of employees—female and male—is more critical than ever. Reproductive Hazards of the Workplace is designed to help managers, primary care physicians, and health and safety professionals manage and prevent occupational reproductive risks. Like other entries in Van Nostrand Reinhold’s Hazards of the Workplace series, the book offers a wealth of valuable, up-to-date information plus expert-tested methodologies and advice for handling risk exposure. Reproductive Hazards of the Workplace begins by covering basic reproductive and developmental biology and fundamentals of risk assessment and reduction. It shows readers how to take into account influencing factors such as the employee’s age, personal habits, and existing conditions (such as diabetes and hypertension). From this foundation, the text explains how to recognize and manage a wide range of potential threats to reproductive health, including:

• Chemical agents
• Physical agents
• Biologic agents
• Ergonomic factors
• Travel
• Stress

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.

Relevant to students, academics and practitioners across the globe, this original volume highlights contemporary issues associated with assisted reproduction and embryology and critically analyzes the law surrounding human reproduction in the light of case law and technological developments since the Human Fertilisation and Embryology Act (HFE Act) Act was passed in 1990.

Tackling issues from an interdisciplinary perspective, the authors identify and evaluate areas that have provoked intense public and academic debate as well as those where further or renewed regulation is needed. Focusing primarily on the legal and ethical issues involved in regulating this area in the UK, which is at the forefront of developing legislation in this area, this book has international relevance as many countries have used the UK as a model for their own legislation.

This text is suitable for a broad range of readers, including legal academics, law students and practitioners interested in the areas of medical/healthcare law and ethics, bioethics and moral philosophy, family law, sociology and reproductive medicine and genetics.

In order for new reproductive technologies to improve the health and well-being of women, they must be acceptable to and used by women. We need, therefore, to not only know about the technology itself; we also need to know about the individuals who intend to use the technology and factors that influence use. Accordingly, this issue focuses on the multiple determinants that influence acceptability of reproductive technologies and the policy, political and legal implications associated with their use. Topics include personal and contextual barriers to use, limited access for poor women and women of color, and the social controversy surrounding this area.

Founded in 1914, the Department of Embryology of the Carnegie Institution of Washington has made an unparalleled contribution to the biological understanding of embryos and their development. Originally much of the research was carried out through experimental embryology, but by the second half of the twentieth century, tissue and cell cultures were providing histological information about development, and biochemistry and molecular genetics have taken center stage. This final volume in a series of five histories of the Carnegie Institution of Washington provides a history of embryology and reproductive biology spanning a hundred years. It provides important insights into the evolution of both scientific ideas and the public perception of embryo research, concluding with a reflection on current debates.