This textbook takes a new, dynamic approach to the basic sciences in obstetrics and gynaecology. It teaches candidates all they need to know for the MRCOG Part 1 examination by extending the understanding of the basic medical sciences and their relevance to obstetrics and gynaecology. Like conventional textbooks it teaches what is 'true', but it also what is 'false', and why. The most complex concepts are discussed in a problem-based format so that the relevant basic sciences are taught and drawn together in context.

There is no clearer testament to the importance and efficacy of in vitro fertilization in the treatmentof the infertilepatient than the fact that over one million babies have been born since its clinical introduction in 1978. The successof this worldwideendeavorhas evolvedto treat some of the formerly most intractable forms of infertility and requires individuals with different skills and insights whose activities are often compartmentalized into clinical, laboratory and research functions. The intent of Essential lVF is to present current issues in clinical IVF that encompass the varied activities of those engaged in this enterprise. By integrating clinical, basic research and laboratory-related aspects of human reproduction, readers with diverse interests should obtain a more complete understanding of the impact, importance and inter-relatedness of each in the progress of infertility treatment, and an appreciation of whether emerging technologies will or should contribute to this progress in the near future. The topics selected for this volume include research that has begun to explain the origins of differential follicular, gamete, embryo and uterine competence, and specific laboratory procedures and protocols that may have important clinical implications forthe generation ofdevelopmentally viable embryos. Human embryoresearchoverthe past 25 years has notonly confirmed that the developmental potential of each embryo is unique, but more importantly, demonstrated how genetic and nongenetic factors for sperm and oocyte determineembryo competencewell before fertilization. Several chapters deal with the origins of normal and compromised gametes and how those with high competence can be identified and isolated for fertilization.

Ovulation induction and controlled ovarian stimulation lie at the very heart of treatment for infertility, but have been subject to a bewildering variety of variations and improvements over recent years. The Second Edition of this highly successful book updates the reader on the progress and developments in this area. Furthermore, it provides the busy clinician with a reliable overview of the principles involved and the management needed. As with the previous edition, the emphasis throughout this book is on logical evidence and evidence-based solutions supplemented with Professor Homburg's extensive clinical experience gleaned from more than forty years working in the field. A number of highly useful algorithms and explanatory tables reinforce this approach, ensuring that the reader is presented with easy-to-grasp, well-presented information that maximizes clarity and understanding. This book offers a concise, no-nonsense, practical guide to ovulation induction and controlled ovarian stimulation and will be an essential resource for the general gynaecologists, fertility specialists and trainees, health workers and students.

With reproductive medical technologies becoming more accessible, assisted donor conception is raising new and important questions about family life. Using in-depth interviews, Petra Nordqvist and Carol Smart explore the lived reality of donor conception and offer insights into the complexities of these new family relationships.

This book contributes in an important way to the psychoanalytic understanding and impact of Assisted Reproductive Technology on a majority of patients who have difficulties starting new families. Recent advances in reproductive technology and the increased use of techniques based upon it have created a need for psychoanalytic thinking and understanding of the psychological implications of Assisted reproductive procedures, in-vitro fertilization and other similar procedures.The recent and rapid advances in medical technologies confront us with a mandate in our clinical work to understand their complex impact on women, men, and children. However, attention to the intra psychic conflicts, traumatic experience of the use of such techniques has not been addressed in psychoanalytic literature. The developmental trauma and intra psychic conflicts of individuals using reproductive technologies are ubiquitous, yet it has been neglected as a topic of special interest in our clinical work.The centerpiece of these collective chapters deal with psychic trauma of infertility, the compulsion to repeat through persistent repeated use of assisted reproductive technology, anxiety about motherhood, and finally the lives of children who are born and do not know from where they came.These poignant topics deal with family complexes and the Oedipal circle, repetition compulsion, trials and failures, anxiety related to motherhood, egg and sperm donors, parental identity formation, infertility, trauma, and discussion of a contemporary film depicting the challenging and newly defined family structure.

How do rapid social and technological changes shape reproductive realms today? This book considers the complex choices, anxieties and challenges that come alongside postmodern reproduction for women and men in the West. Topics include surrogacy, fatherhood, sperm banking, egg donation, contraception, breastfeeding, and postpartum body image.

Historically, sperm have been seen as simply a mechanism of transferring a haploid set of chromosomes to the oocyte. However, data from assisted reproduction therapies (ART) have demonstrated that in many couples the sperm appears to be responsible for abnormal embryogenesis. Recent advances in genetic and epigenetic techniques have identified key mechanisms by which the sperm, and the DNA carried by the sperm, can affect early embryonic development. Paternal Influences on Human Reproductive Success examines the genetic and epigenetic influences on embryogenesis, as well as practical clinical factors related to the male contribution to reproductive success. It also provides 'cutting edge' data and analysis of recent evaluations of the role of advanced paternal age, environmental influences and lifestyle factors on male reproductive fitness, making this an invaluable text for physicians treating patients for infertility, recurrent pregnancy loss, and developmental anomalies, as well as basic scientists studying embryogenesis and spermatogenesis.

This concise, truncated version of Nagy, Varghese and Agarwal's Practical Manual of In Vitro Fertilization is comprised of select practical chapters for a portable, affordable and up-to-date resource. Building and Managing an IVF Laboratory covers a variety of topics, including: - Setting up and running an IVF laboratory - IVF laboratory equipment and culture systems - Organization of the IVF unit - Licensing and regulation in the ART laboratory - Quality control and troubleshooting Practical for both clinicians and researchers alike, Building and Managing an IVF Laboratory brings together all of the need-to-know information about these important topics in reproductive medicine.

The development of the placenta was a pivotal event in evolution. Without it, we would still be laying eggs instead of giving birth to live offspring. It represents the critical link between the foetus and the mother, but its character is extraordinary - it is, in effect, a foreign tissue that invades the mother's body. Compared to many other animals, the human placenta represents a particularly aggressive body. But how is it managed and controlled? How did such an organ evolve in the first place? And why is it tolerated by the mother? Y.W. Loke, a highly respected expert in the placenta and its development, explores the nature of the placenta and what it can tell us about evolution, development, and genetics.

This concise, truncated version of Zini and Agarwal's Sperm Chromatin: Biological and Clinical Applications in Male Infertility and Assisted Reproduction offers select, clinical chapters for a handy, more affordable, state-of-the-art resource. Sperm Chromatin for the Clinician addresses such vital issues as: -Male subfertility and sperm chromatin damage -Aging and sperm DNA damage -Cancer and implications for sperm quality -Environmental factors -Cryopreservation and sperm DNA integrity -Postnatal effects of sperm chromatin damage Practical for clinicians and researchers alike, Sperm Chromatin for the Clinician contains all of the need-to-know information about this cutting-edge topic in reproductive medicine. "

This concise, truncated version of Parekattil and Agarwal's" Male Infertility: Contemporary Clinical Approaches, Andrology, ART & Antioxidants" is the first resource dedicated solely to clinicalissues of infertility. With select chapters that will prove invaluable to the reproductive medicine clinician, "Male Infertility for the Clinician"addresses issues like:

- Diagnosis and management of male infertility conditions such as varicocele, ejaculatory duct obstruction and congenital epididymal obstruction

- New approaches to Klinefelter's syndrome

- A concise structured approach to the genetics of male infertility

- Management of cancer patients (oncofertility) and ethical considerations in special male infertility circumstances

-New advances in biomaterials for reconstruction and new robotic-assisted microsurgical techniques

Practical for clinicians and researchers alike, "Male Infertility for the Clinician"contains all of the need-to-know information about these cutting-edge topics in reproductive medicine.

Human oocyte cryopreservation has undergone rapid growth, with technical improvement and increasing clinical application over the last ten years. Storing eggs is ethical and gives many young women their most realistic chance of conception. Cryopreservation, however, is still considered by many as an experimental technique and conflicting reports are published as to its efficacy. For these reasons, it is necessary to give reproductive researchers and practitioners comprehensive and systematic information about the field. This book describes and analyses the history of human oocyte freezing, the main steps of technical evolution, and the pros and cons of different techniques. In addition, the clinical applications, long-term outcome, efficiency and safety of oocyte cryopreservation are detailed. The Handbook of Human Oocyte Cryopreservation gives a complete picture of the field today and is a valuable text for embryologists, cryobiologists, reproductive medicine practitioners and anyone involved in researching and implementing the technique.

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.

This practical 2003 handbook provides an extremely comprehensive and highly illustrated guide to micromanipulation techniques in assisted conception in a clinical setting. It includes detailed, illustrated descriptions of all the common micromanipulation systems currently in use in IVF laboratories around the world and clearly explains how to optimise their successful use. The volume covers state-of-the-art techniques including intracytoplasmic sperm injection (ICSI), and procedures such as assisted hatching and the blastomere biopsy (for preimplantation genetic diagnosis PGD). Valuable information on troubleshooting the potential mechanical and technical difficulties that can arise is provided to help all the practitioners of these techniques, including trainee embryologists and consultant obstetricians, and technicians and scientists involved in animal transgenesis and cloning. It will undoubtedly be of immense value to all doctors and scientists working with assisted reproductive technologies.

The Biotechnology Act in Norway, one of the most restrictive in Europe, forbids egg donation and surrogacy and has rescinded the anonymity clause with respect to donor insemination. Thus, it limits people's choice as to how they can procreate within the boundaries of the nation state. The author pursues this significant datum ethnographically and addresses the issues surrounding contemporary biopolitics in Norway. This involves investigating such fundamental questions as the relation between individual and society, meanings of kinship and relatedness, the moral status of the embryo and the role of science, religion and ethics in state policies. Even though the book takes reproductive technologies as its focus, it reveals much about vital processes that are central to contemporary Norwegian society.

How and to what extent have Islamic legal scholars and Middle Eastern lawmakers, as well as Middle Eastern Muslim physicians and patients, grappled with the complex bioethical, legal and social issues that are raised in the process of attempting to conceive life in the face of infertility? This path-breaking volume explores the influence of Islamic attitudes on assisted reproductive technologies (ARTs) and reveals the variations in both the Islamic jurisprudence and the cultural responses to ARTs.

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.

In vitro fertilization and other forms of assisted reproduction are no longer experimental procedures. Indeed, in Denmark in 2004, 4% of all babies born were conceived by IVF. In the near future, every kindergarten classroom will quite possibly have at least one IVF child.
In this fascinating account, two of the world's leading authorities present a detailed and readable account of assisted reproduction, describing how this technique is applied to help infertile couples have a baby. Bart Fauser and Paul Devroey describe the latest technologies, placing them in their scientific and clinical settings, outlining such procedures as IVF, sperm injection techniques, egg donation, fertility preservation, single embryo transfer, and reproductive surgery. Fauser and Devroey also discuss fertility treatments in patients who are not infertile (such as single women or lesbians). One of the great controversies swirling around assisted reproduction is the furor over "designer babies" (manipulating genetic material to produce babies with blue eyes or a high IQ, or of a particular sex), but the authors contend that the only acceptable aim in "designing" a baby is to insure a safe pregnancy and delivery. The book also reveals that a key challenge of fertility research is to perfect a treatment that avoids multiple pregnancy, a trend that has blighted IVF throughout its thirty-year history. Fauser and Devroey also discuss the issue of increasing age-related infertility ("the infertility epidemic") and the possible use of IVF to meet this challenge and improve birth rates. The final chapter looks to the future and proposes that the limits to assisted reproduction will be set more by ethical considerations than by scientific progress.

Originally published in 2006, this book provides an in-depth account of trophoblast: the tissue derived from the fertilised egg that nourishes and protects the developing fetus. The cells of the trophoblast have many unique qualities, and exhibit great variability across different species. It has a fascinating role in the development of the placenta and as a regulator during early growth of the embryo. These aspects are all fully covered as well as studies on why it is not rejected by the mother as 'foreign' tissue. Disorders of trophoblast during development also manifest themselves in several clinical conditions during pregnancy, including gestational trophoblastic disease and pre-eclampsia. From stem cells through to epigenetics, implantation and X-chromosome inactivation, there is a lot to be learned about trophoblast, this volume provides a detailed summary of knowledge regarding the subject.

IVF is now established worldwide as a clinical service. Units are striving to improve their success rates, and many treatments are being advocated as 'yet another breakthrough'. The purpose of this book is to help clinicians to evaluate each of these new treatments. Each chapter is written by a recognized international expert in the field and the chapters are short and succinct, summarizing the latest evidence-based information for each topic and treatment. Sections cover patient selection and preparation, the role of AIH before IVF, stimulation, monitoring, laboratory techniques, embryo transfer, ancillary treatments and assessment of results. How to Improve your ART Success Rates: An Evidence-Based Review of Adjuncts to IVF is essential reading for all clinicians working with infertility and assisted reproduction, and is also a valuable addition to any medical library.

The phenomenon of bleeding has been shown to appear in up to 22% of all pregnancies and is associated with significant maternal and fetal morbidities, and even mortality. Although vaginal bleeding occurs mainly during the first trimester, it can appear at any stage of pregnancy and in the postpartum period. This sometimes life-threatening event requires an extensive work-up in order to recognize its cause and establish a rapid and effective therapeutic approach. This book is a comprehensive appraisal of this critical condition. It draws on evidence-based data and brings together, in a single volume, updated information on all aspects of pregnancy-related bleeding. A global group of interdisciplinary experts contributed chapters on: bleeding during early pregnancy (early pregnancy loss, ectopic pregnancy, gestational trophoblastic disease, and cancer of the reproductive tract during pregnancy); bleeding in late pregnancy (preterm delivery, placental abruption, placenta previa, vasa previa and uterine rupture); and postpartum hemorrhage.

Central to the book are Gbigbil women's experiences with different ""reproductive interruptions"": miscarriages, stillbirths, child deaths, induced abortions, and infertility. Rather than consider these events as inherently dissimilar, as women do in Western countries, the Gbigbil women of eastern Cameroon see them all as instances of ""wasted wombs"" that leave their reproductive trajectories hanging in the balance. The women must navigate this uncertainty while negotiating their social positions, aspirations for the future, and the current workings of their bodies. Providing an intimate look into these processes, Wasted Wombs shows how Gbigbil women constantly shift their interpretations of when a pregnancy starts, what it contains, and what is lost in case of a reproductive interruption, in contrast to Western conceptions of fertility and loss. Depending on the context and on their life aspirations-be it marriage and motherhood, or rather an educational trajectory, employment, or profitable sexual affairs with so-called ""big fish""-women negotiate and manipulate the meanings and effects of reproductive interruptions. Paradoxically, they often do so while portraying themselves as powerless. Wasted Wombs carefully analyzes such tactics in relation to the various social predicaments that emerge around reproductive interruptions, as well as the capricious workings of women's physical bodies.