Within 10 chapters this book addresses the whole gamut of questions that may arise in the context of pregnancy resulting from assisted reproduction. Incidence of abortion, extrauterine pregnancy or chromosomal abnormalities, pregnancy complications, problems regarding mode of delivery and the health status of children at birth are covered as well as the further development of the children and the social structure of the families. Topics such as follow-up of families in lesbian relationships and following gamete donations are also discussed.

Despite France and Belgium sharing and interacting constantly with similar culinary tastes, music and pop culture, access to Assisted Reproductive Technologies are strikingly different. Discrimination written into French law acutely contrasts with non-discriminatory access to ART in Belgium. The contributors of this volume are social scientists from France, Belgium, England and the United States, representing different disciplines: law, political science, philosophy, sociology and anthropology. Each author has attempted, through the prism of their specialties, to demonstrate and analyse how and why this striking difference in access to ART exists.

What is expected of 21st Century egg and sperm donors, and how does being a donor impact on men and women's own personal lives and relationships? How do donors navigate connections and relationships created by donation? What do these connections mean to them, and to the people around them -their partners, parents, siblings and children? Donor conception is becoming increasingly widespread and since the new millennium, we have witnessed a dramatic shift in the way that donor conception is regulated and practiced in many jurisdictions around the world. In the past, donor conception has often been a family secret and donors were, almost by definition, anonymous. Now, 'openness' is seen as the ideal and donors can expect to be traced or contacted by those born from their donations. But what does this shift mean for donors, and their families? This path-breaking book draws on in-depth interviews with donors, their kin and fertility counsellors, and addresses these questions by analysing how understandings of donation are shaped by the regulatory, cultural and relational contexts in which they are formed. The authors also discuss what donation stories can tell us about contemporary understandings of connectedness, time and morality in the context of reproduction and family life, and consider how reproductive 'openness' might be done differently.

A cutting-edge analysis of the global issues surrounding modern reproductive technologies Advances in assisted reproductive technologies have sparked global policy debates since the birth of the first so-called "test tube baby" in 1978. Today, mitochondrial replacement therapies represent the most recent advancement in assisted reproductive technologies, allowing some women with mitochondrial diseases to birth babies without those diseases. In the past decade, mitochondrial replacement therapies have captured public sentiment, reigniting debates around social views of reproductive rights and the appropriate legal and political response. Reproduction Reborn guides readers through the history and science of mitochondrial replacement therapies and the various attempts to control them. Leading experts from medicine, genetics, ethics, law, and policy explore the influence of public debate on the evolving shape of these technologies and their subsequent regulation. They highlight case studies from both developed and developing countries across the globe, including recent legislation in Australia and China. They further identify the ethical, legal, and societal norms that need to be addressed by policymakers and communities as more and more people seek to gain access to these treatments. Given the importance of reproduction in family life and cultural identity, clinicians and policymakers must understand how regulatory regimes around mitochondrial replacement therapies have evolved to illuminate the processes and challenges of governing reproduction in a fast-moving world. Informative and global in scope, Reproduction Reborn explores how advancements in assisted reproductive technologies challenge core values surrounding the rights and responsibilities of modern-day family units.

A geneticist tells the stories of men, women, and children whose genes have shaped their lives in unexpected ways.

It was while listening to a colleague tell the parents of a newborn girl that their daughter was going to die that a lifelong interest in genetic medicine was sparked in Dr Edwin Kirk. Warmth and gentleness tempered a direct, sure manner - this was the medicine he wanted to practise, where the most advanced science and the most deeply human meet. Twenty-five years later, Dr Kirk works both with patients and in the lab, and he spearheads a campaign that will change the way we think about having babies. His experience is without parallel, but it is his humour and insight that make all the difference.

Find out why Dr Kirk found himself among hundreds of people, each with a glass of poison in front of them - and how you might perform the same experiment yourself (without the poison). Learn how the realisation that a young boy wasn't short ended up saving the life of his mother - and how Angelina Jolie has saved the lives of many more. Sit in the room with Dr Kirk and his patients as they navigate the world of heartbreaking uncertainties, tantalising possibilities, and thorny questions of morality. In genetics, it is the particularities of an individual's history that matter, and here, in clear and considerate writing, those individual stories are given voice.

Epigenetics is the study of how certain genes are activated without modification at the DNA sequence level, resulting in genetically similar individuals having different clinical outcomes. As contemporary medicine increasingly aims to personalize the medical approach to a patient's genetic profile, the factors that can affect which genes are expressed also increase in importance and relevance to the clinician. This text from experts will give the clinician in Reproductive Medicine a reliable grounding in current thinking and research on this fast-moving topic, with many clinical implications.

Investigations on anatomical specimens have demonstrated that the subchondral mineralization does indeed show regular distribution patterns from which conclusions about the mechanical situation within an individual joint may be drawn. Since radiographical densitometry and histological methods are only available for determining the adaptive reaction of the bone to the mechanical situation in a joint after death, the information obtained applies only to an end situation and tells us nothing about the development of the changes with time. Furthermore, investigations carried out on human specimens by radiographical densitometry mostly apply to samples of a particular age, since such specimens can be acquired only from departments of pathology, forensic medicine or anatomy.

Male infertility is a clinician-orientied book aimed at the clinician dealing with the infertile couple because rational, effective management is only possible if the couple are considered together. The aim of the work is to provide advice to the clinician and to give reference to the underlying science. This will not only enable clinicians to understand the underlying science but will also give scientists an insight to clinical work. This blend of science and clinical work is reflected in the contributors who are experts drawn from both fields.

Preventing Misdiagnosis of Women is a crucial resource for all therapists who treat women. Not only will the information further the well-being of women clients, but it could literally save lives. Interesting, readable, and well-organized, this book belongs on the shelf next to the DSM-IV. The case examples will grip the reader whether professional or lay audience. --Natalie Porter, Ph.D., California School of Professional Psychology "I am greatly impressed with the book. It is a brand new idea, one that is long overdue." --Hannah Lerman, Ph.D., Clinical Psychologist, Los Angeles Some clients don't respond to a therapist's chosen treatment for a specific mental disorder. Could there be a physical disorder that is causing psychiatric symptoms? How can a therapist distinguish between similar psychiatric and physical disorders to arrive at the correct diagnosis, refer on, and/or suggest appropriate treatment? Preventing Misdiagnosis of Women gives the therapist the foundation for identifying those physiological disorders that may be at the root of the mental problems presented by women clients. Hyperthyroidism, for example, can result in depression and anxiety, and temporal lobe epilepsy can manifest itself with the same symptoms as bipolar disorder. This special guidebook sorts out potential mix-ups by providing detailed cases and illustrations, a quick reference table for checking symptoms, and a glossary. Making technical information clear and concise, the authors cover endocrinological--including thyroid, adrenal, pituitary, and parathyroid systems--and brain seizure problems as well as other diseases--such as multiple sclerosis, mitral heart valve prolapse, and lupus erythematosus. They offer a basic overview of the systems and organs involved and focus on how particular malfunctions can result in serious behavioral problems. A guide to providing the best and most effective care to women clients, Preventing Misdiagnosis of Women presents important information about assessment and interfacing with medical professionals. All mental health and helping professionals will find this book invaluable, as will students in clinical/counseling psychology, health psychology, social work, and gender studies. "This book is informative and interesting to read. This is a text that can be read more than once and be that much more helpful in subsequent readings. . . . Preventing Misdiagnosis of Women will certainly have an impact on feminist assessment, theory, and therapy. In a broader context, it provides a foundation to spawn research hypotheses on women's health and to reconnect the mind and body. Written accessibly even for reader without a background in physiological psychology, it fills a gap in the clinical and counseling literature. This text has far-reaching implications about the origin of psychiatric symptoms and possibly for explaining some differential rates in sex ratios for prevalence of certain psychologically based clinical syndromes. I found the text a humbling reminder of how easy it can be to miss the obvious and how easy it can be to attribute psychological explanations to symptom clusters one doesn't understand. This book could easily become a 'required' text for graduate students in mental health professions and mental health professionals. . . . This text will undoubtedly have an impact." --Maria P. P. Root, Ph.D., University of Washington "Preventing Misdiagnosis of Women is very good and will make an important contribution to the field. . . . The book's message--that it is critical that differential diagnosis include consideration of both psychiatric disorders--is convincing and important to emphasize to students in graduate programs." --Helene Jackson, Ph.D., The Columbia University School of Social Work

Covering the essentials of normal and abnormal human development for students in a variety of health science disciplines, Before We Are Born: Essentials of Embryology and Birth Defects, 10th Edition, reflects new research findings and current clinical practice through concise text and abundant illustrations. This edition has been fully updated by the world's foremost embryologists and is based on the popular text, The Developing Human, written by the same author team. It provides an easily accessible understanding of all of the latest advances in embryology, including normal and abnormal embryogenesis, causes of birth defects, and the role of genes in human development. Features streamlined content throughout, numerous photographs of common clinical cases and embryological explanations, didactic illustrations, and nearly 700 USMLE-style questions with full answers and explanations to help prepare for professional exams. Includes interactive clinical cases in every chapter that make important connections between human development and clinical practice-ideal for preparing for USMLE Step 1. Features access to 18 full-color, expertly narrated animations that guide students through key concepts in learning the complexities of embryologic development. Includes many new color photographs, new diagnostic images (3D ultrasound, CT scans, and MR images), an updated teratology section, revised and highlighted information on molecular aspects of developmental biology, and new information on the cellular and molecular basis of embryonic development. Follows the official international list of embryological terms (Terminologia Embryonica, 2013). Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Master the effective evaluation, analysis and management of placental-fetal growth restriction (PFGR), developing strategies to reduce the risk of perinatal mortality and morbidity in patients worldwide. Extensively researched by international experts, this manual provides practitioners with a detailed, hands-on approach to the practical 'pearls' for direct patient management. This authoritative volume advises on matters such as the correct evaluation and management of high-risk patients in danger of PFGR through to delivery. Extensive and wide-ranging, this book is an invaluable companion to the developing research interest and clinical applications in PFGR, including developmental outcomes in early childhood. Featuring a critical evaluation of a variety of abnormal conditions, such as fetal hypoxia and extreme prematurity, which are clearly displayed through extensive illustrations, this essential toolkit ensures that practitioners at all levels can effectively limit adverse outcome and reach the correct diagnosis.

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

Erectile dysfunction is a complex syndrome associated and determined by several separate vascular and nonvascular factors. In recent years, the evolution of noninvasive vascular technology used to investigate macro- and microcirculation in vascular disorders has produced a large amount of information and increased our knowledge of vascular pathophysiology. Andrea Ledda and his clinical research group, well known to their international colleagues, describe new developments in andrology and stress the importance of vascular disorders in erectile dysfunction. This volume will be very useful to andrologists, vascular surgeons, and angiologists, and to all specialists interested in the diagnostic evaluation of erectile disorders and varicocele.

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.

Fibrin sealant is used for numerous indications in gynecology, especially for the McIndoe Operation and Cohn biopsy, the Marshall-Marchetti-Krantz-Hirsch-Stoll-Operation, urethrocysopexy, or in vitro fertilization for embryo transfer. The use of fibrin sealant in urology has also been extended, especially in operations of the spermatic cord, reconstruction of the urethra and closing of nephrotomies.

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.

The German verbs verwerfen, nicht implantieren or abtAten have the same denotations when used in reference to dealing with artificially-inseminated embryos; however, the meanings of these words are respectively different. The book examines, against the background of the debate about the introduction of pre-implantation diagnostics in Germany, the role of linguistic naminga " so-called thematizationsa " in the public sphere. The study shows that these thematizations not only reflect linguistic controversy, but at the same time, precisely mirror the current societal debates.

Based on the gold standard procedures and protocols developed at Boston IVF, this new edition of a bestselling text continues to provide a structured approach to treating the infertile couple that can be of benefit to the gynecologist, reproductive endocrinologist, and reproductive medicine nurse alike. Both clinical and laboratory techniques are included, with material on preconception care. New to this edition are chapters on fertility care for the LGBT community, endometriosis, elective egg freezing, and effective nursing.

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.

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.

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).

Management of Infertility: A Practical Approach offers an accurate and complete reference for the management of infertility and a robust step-by-step guide for assisted reproduction technologies (ARTs), including how to plan, design and organize a clinical setting and laboratory. The book also provides an evidence-based, complete and practical description of the available methods for diagnosis and management of male and female infertility. This will be an ideal resource for researchers, students and clinicians who want to gain complete knowledge about both basic and advanced information surrounding the diagnosis and management of infertility and related disorders.

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.

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.