This extensively updated new edition provides an indispensable account of modern in-vitro fertilization practice, building upon the popularity of previous editions. The authors initially give a comprehensive review of the biology of human gametes and embryos, before outlining basic to advanced IVF techniques. New developments in practical techniques and understanding are discussed, including in-vitro maturation, vitrification, preservation of fertility for cancer patients, stem cell technology, preimplantation genetic testing, and the role of epigenetics and imprinting. The revised introduction also incorporates a 'refresher' study review of fundamental principles of cell and molecular biology, now updated with current knowledge of meiosis in human oocytes, embryo metabolism and basic principles of genome editing. With high-quality illustrations and extensive, up-to-date reading lists, it is a must-have textbook for trainee and practising embryologists, as well as clinicians who are interested in the scientific principles that underpin successful IVF.

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.

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 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).

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.

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.

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.

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.

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."

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.

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.

Related link: Free Email Alerting
eBook available with sample pages: 0203359526

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."

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 rapid development of reproductive technologies has questioned many essential concepts belonging to our symbolic universe, such as human reproduction, motherhood and fatherhood; the transmission of the biological and cultural inheritance of mankind and the constitution of the psychic subject. These concepts, however, are supported by ideologies and value systems which hide that they are but theoretical constructions; consequently, they are taken as describing the "natural" function of reproduction. In this sense, the technological development takes the form of an increasing medicalization of the human body, of the life, sexuality and desire of people, especially of women. All this requires that we think critically about the conditions of possibility of these technologies and their psychological and ethical implications. In this book the author provides a detailed and rigorous analysis which locates the reproductive technologies in the historical context of the progressive technification of the management of human life, and their relation to the social and medical discourses on femininity, maternity and infertility. From a psychoanalytic point of view, culture and its discontents, violence, domination, are related intimately to the problematic character of sexuality, which includes the uncertainties of our desires. Social, medical, anthropological and literary discourses try to define "maternal desire" in order to control it: the definitions which capture it in their nets are means to dominate desire as an object and to "construct" the desiring subject. But psychoanalysis (through the associations of the subjects in question) shows that we face here an impossible question: one thing is the enunciated "demand", what is said about one's own desire ("I want a child"), and a very different one is the unconscious desire which disturbs the conscious discourse and shows that there can be psychological obstacles that interfere with the accomplishment of conscious wishes, conflicts and contradictions emerging through the women's words. In this book, the circulation of representations between the individual imaginary and collective myths is the basis of a multidisciplinary complex and original point of view, which confronts a variety of discourses arising from psychoanalysis, medicine, journalism, ethnology, mythology and literature.

Help your patients through the maze of infertility treatments

Infertility is suffered by around 1 in 7 couples and can be a source of confusion for both partners, providing high stress on relationships. 25% of cases are explained through male infertility, 50% through female infertility, whilst 25% are generally unexplained. The possible causes and solutions are many and complex.

Infertility, one of the first in the new Gynecology in Practice series, assists gynecologists and family practitioners to better care for their patients who have trouble conceiving. The authors provide a strong focus on effective diagnosis and management. Following a review of the factors that affect fertility, Infertility takes a practical approach to: Evaluation of fertilityManagement and treatmentComplicationsPre-implantation screeningFertility preservation

Gynecology in Practice

The Gynecology in Practice series provides clinical 'in the office' or 'at the bedside' guides to effective patient care for gynecologists. The tone is practical, not academic, with authors offering guidance on what might be done and what should be avoided. The books are informed by evidence-based practice and feature: Algorithms and guidelines where they are appropriate''Tips and Tricks' boxes - hints on improving outcomes'Caution' warning boxes - hints on avoiding complications'Science Revisited' - quick reminder of the basic science principlesSummaries of key evidence and suggestions for further reading

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.

At 11.47pm on July 25th 1978, Louise Brown was the first person ever to be born through science rather than as the result of two people having sex. The birth was hailed as a "miracle" by the world's media, making her instantly famous. For the first time Louise tells the story of her world changing birth and its impact on her life. The book contains many family photographs and letters which have never been published before. It was written by Louise with her long-term publicist Martin Powell of Empica PR.

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.

Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss Itthem ": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by of women is neither sought nor listened to. The men. So often the input and perspectives that women bring to the privileged insights consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by W omen" (EIR TAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.

Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.

This comprehensive text makes an important contribution to the study of surrogacy, developing a novel theoretical framework through which to understand the broader social contexts as well as individual decisions at play within surrogacy arrangements. Drawing on empirical research conducted by the authors and supplemented by secondary analyses of media, legislative and public accounts of surrogacy, the book engages with the key stakeholders involved in the practice of surrogacy. Specifically, it canvases the standpoints of women who act as surrogates, intending parents who commission surrogacy arrangements, children born through surrogacy, clinics that facilitate the arrangements, and politicians and journalists who engage with the topic. Through a focus on capitalism as a means of orientating ourselves to the topic of surrogacy, the book highlights the vulnerabilities that potentially arise in the context of surrogacy, as well as the claims to agency invoked by some parties in order to mitigate vulnerability. In so doing, the book demonstrates that the psychology of surrogacy must be broadly understood as an orientation to particular ways of thinking about children, reproduction and economies of labour.

Assisted Reproduction is a specialty undergoing rapid change as new technologies are introduced and new research challenges previous treatment options. This text examines a selection of controversial topics for both laboratory and clinical practice and tries to place them in perspective, so readers can understand how and why the current state of the question has come about and how future contributions to the debate should be measured. All physicians involved with the technologies concerned will learn from the expert contributions assembled here. CONTENTS: The use of ovarian markers * Use of molecular markers of endometrial receptivity * Use of GnRHa for triggering final oocyte maturation during ovarian stimulation cycles * Use of time-lapse embryo imaging in assisted reproductive technology practice * Use of cryopreservation for all embryos * Preimplantation genetic screening * The use of single embryo transfer * Use of luteal phase support * Measuring safety and efficiency in in vitro fertilization * To flush follicles during egg collection or not * Use of blastocyst culture * Use of mitochondrial donation * Controversies in recurrent implantation failure: From theory to practice * Fibroids: To remove or not? * Limitations of endometrioma surgery in in vitro fertilization: Possibilities of early disease control

Major advances in genetics, immunology, and endocrinology have necessitated a new edition of this best-selling text. However, despite the advances, recurrent pregnancy loss presents a frustrating clinical problem. There is still disagreement about the number of pregnancy losses which warrant investigation and treatment and about which investigations should be performed. This third edition provides an authoritative and comprehensive update on advances in the understanding and management of this troubling phenomenon, covering both basic scientific topics such as genetics and cytokines, and profiles major advances in immunology, endocrinology, and thrombotic mechanism. Clinical research is discussed, as is assessment of results when applying an evidence-based approach or a more personalised approach, which is now becoming possible due to advances in the diagnosis of cause. There are lively debates on the role of progestogens and immunotherapy, which remain controversial. Designed for specialists working in reproductive medicine clinics and those involved with maternal-fetal care, the book is also ideal for generalists and gynecologists seeking a comprehensive view of developments in the field.