It is widely believed that reproductive cycles are very similar between human females. However, there are in fact considerable variations both between individuals and within the reproductive life of any given individual. 'Normal' reproductive cycles cover a wide range of eventualities, and the likelihood of successful monthly egg release and ensuing pregnancy can be modified by a large number of factors. In this book, the variability of human fertility is examined by first looking at the physiological processes regulating reproduction, and the roles of metabolic adaptation and metabolic load. Inter-population variation in normal ovarian function is then discussed, covering the importance of factors such as age, disease and breastfeeding in modifying ovarian function. First published in 1996, this is an important book for all those interested in human fertility.

Kisspeptin has been shown to be both necessary and sufficient for activation of the reproductive axis, during puberty and later in adulthood. This makes kisspeptin a fundamental component of the reproductive axis. Kisspeptin has been deemed the single most potent stimulator of GnRH neurons yet known. The importance of kisspeptin has been documented in humans as well as non-human animal models, ranging from monkeys, sheep, and rodents to numerous fish species, thus signifying a highly conserved nature of its reproductive function. Importantly, kisspeptin neurons seem to mediate many of the regulatory effects of other signals, whether they are metabolic, circadian, hormonal, or stress. This places kisspeptin neurons in a unique position to be key nodal points and conduits for conveying numerous endogenous and exogenous signals to the reproductive axis.

This concise guide to the often overlooked association between erectile dysfunction and hypertension/cardiovascular disease covers a wide range of aspects of importance to the clinician. It examines the impact of antihypertensive drug therapy on erectile function and explains how the management of erectile dysfunction in hypertensive patients depends on a variety of factors. Different treatment approaches are described, including lifestyle modification, PDE-5 inhibitors and other novel agents and behavioral therapy and helpful therapeutic algorithms are presented. A further focus of the book is the potential role of erectile dysfunction as an early diagnostic indicator of asymptomatic coronary artery disease and a prognostic marker for cardiovascular events. In addition, key background information is supplied on epidemiology and pathophysiology, and the significance of erectile dysfunction in different patient groups, such as the elderly and those with chronic kidney disease, is examined. Erectile dysfunction is a major public health problem affecting more than ten percent of the general male population and is now considered to be predominantly of vascular origin. This book will be informative and of practical value for all practitioners responsible for caring for the very many patients who experience erectile dysfunction in the setting of hypertension and cardiovascular disease.

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

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 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.

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.

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.

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.

The complete guide to getting pregnant and improving fertility naturally - even if you've been told your chances of conception are low

Worried about your ability to have children in the next five years? Have you been trying to get pregnant for a while now and it's just not happening? Does it seem like every woman you know is having a hard time getting pregnant and you don't want that to be you when you're ready? Do you want natural, non-invasive options to conceive?

If you answered "yes" to any one of these questions, "Yes, You Can Get Pregnant" is for you. A nationally renowned women's health and fertility expert, Aimee Raupp has helped hundreds of women optimize their fertility and get pregnant, even after age 40. Here, she provides her complete program for improving your chances of conceiving and overcoming infertility, including the most effective complementary and lifestyle approaches and the latest nutritional advice. Her remedies help you how to get in tune with your body, eat the best fertility-enhancing foods, and avoid environmental toxins to achieve a healthy and stress-free pregnancy.

In a friendly, understanding, and inspirational manner, "Yes, You Can Get Pregnant" provides hope, scientifically-backed knowledge, and emotional support to help you become the mother you want to be.

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.

This concise, truncated version of Parekattil and Agarwal's "Male Infertility: Contemporary Clinical Approaches, Andrology, ART & Antioxidants" is the first resource dedicated solely to antioxidants and male infertility. With select chapters that will prove invaluable to the practitioner of reproductive medicine, "Antioxidants in Male Infertility" addresses issues such as:

- Molecular mechanisms of antioxidants in male infertility

- Oxidative stress

- The impact of infection, aging, obesity, and injury on male infertility

- Natural and synthetic antioxidants and antioxidant therapy

- Antioxidants in ICSI and IMSI

Also included is a new chapter reviewing the physiological role of reactive oxygen species in sperm function.

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

In Taking Baby Steps, Jody Lynee Madeira takes readers inside the infertility experience, from dealing with infertility-related emotions through forming treatment relationships with medical professionals to confronting difficult medical decisions. Based on hundreds of interviews, this book investigates how women, men, and medical professionals negotiate infertility's rocky terrain to create life and build families-a journey across personal, medical, legal, and ethical minefields that can test mental and physical health, friendships and marriages, spirituality, and financial security.

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.

Ume Eder Bat (A beautiful child) (popular song from Basque folklore) The aim of this monograph is to introduce the postnatal development of morphological features that are relevant to readers interested in the neurobiology and pathology of the hippocampal formation in terms of the complex phenomena that underlie the progressive anatomical and functional maturation of this brain region. This review focuses on the morphological aspects, while more detailed basic phenomena associated with neuronal maturation-which are undoubtedly also of great interest-are only marginally referred to, although a selection of behavioral and clinical aspects will also be briefly addressed in an attempt to illustrate real situations in different clinical specialties. The creation of this monograph is justified by the increasing importance and growing awareness shown in recent years of neurodevelopmental disorders in children. This awareness is leading to increasing refinement in clinical exami- tions of patients that may suffer from different neurodevelopment-related diseases, such as autism, epilepsy, memory disorders, etc. To the best of our knowledge, this work is the first comprehensive description of the postnatal changes in the hip- campal formation in its different constituent fields. Given the growing sensitivity and accuracy of neuroradiological examinations, particularly MRI, we also sought to offer a glimpse at the MRI aspects related to the development of the hippocampal formation in the human infant.

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.

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.

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.

In Quest for Conception, Marcia C. Inhorn portrays the poignant struggles of poor, urban Egyptian women and their attempts to overcome infertility. The author draws upon fifteen months of fieldwork in urban Egypt to present moving stories of infertile Muslim women whose tumultuous medical pilgrimages - or their "search for children," as they call their quests for conception - have yet to produce the desired pregnancies. Inhorn examines the devastating impact of infertility on the lives of these women, who are threatened with divorce by their husbands, harassed by their husbands' families, and ostracized by neighbors. Beliefs about procreation and infertility causation and cure among the Egyptian urban poor derive from a five-thousand-year history of shifting medical pluralism. Although colonially produced Western biomedicine is the dominant system in Egypt today, it represents only one of an array of therapeutic alternatives. Infertile women seek help from both "biogynecologists" (practitioners of Western biomedicine) and "ethnogynecologists" (practitioners of indigenous ethnomedicine), often using the remedies of both simultaneously. Quest for Conception examines in detail the variety of ethnomedical and biomedical treatments for infertility and concludes that treatments of both types are often ineffective and sometimes harmful. Given this untherapeutic setting, the future of infertile Egyptian women is explored in light of needed changes in reproductive health policy and the introduction of new reproductive technologies. Quest for Conception is the first comprehensive account of non-Western women's experiences of infertility and is a novel study within the literature on Middle Easternwomen.

Meet Woody. Former journalist. Die-hard Oasis fan. High energy. Low sperm count. Training to be a vicar. Obviously. Matt Woodcock's frank, funny real-life diaries reveal what it was like for him to train as a vicar while struggling against all odds to become a father. In them he lays bare his joys and struggles as he attempts to reconcile his calling as a vicar with his life as a party-loving journalist, footie-freak and incorrigible extrovert. Becoming Reverend is a compelling and original account of how faith can work in the midst of a messy life, combining family, fertility, faith and friendship with the story of a divine - but unlikely - calling.

Surrogacy is India's new form of outsourcing, as couples from all over the world hire Indian women to bear their children for a fraction of the cost of surrogacy elsewhere with little to no government oversight or regulation. In the first detailed ethnography of India's surrogacy industry, Amrita Pande visits clinics and hostels and speaks with surrogates and their families, clients, doctors, brokers, and hostel matrons in order to shed light on this burgeoning business and the experiences of the laborers within it. From recruitment to training to delivery, Pande's research focuses on how reproduction meets production in surrogacy and how this reflects characteristics of India's larger labor system.

Pande's interviews prove surrogates are more than victims of disciplinary power, and she examines the strategies they deploy to retain control over their bodies and reproductive futures. While some women are coerced into the business by their families, others negotiate with clients and their clinics to gain access to technologies and networks otherwise closed to them. As surrogates, the women Pande meets get to know and make the most of advanced medical discoveries. They traverse borders and straddle relationships that test the boundaries of race, class, religion, and nationality. Those who focus on the inherent inequalities of India's surrogacy industry believe the practice should be either banned or strictly regulated. Pande instead advocates for a better understanding of this complex labor market, envisioning an international model of fair-trade surrogacy founded on openness and transparency in all business, medical, and emotional exchanges.