Oxford American Handbook of Reproductive Medicine

Description

Reproductive medicine is the most dynamic area within obstetrics and gynecology and, arguably, the most complicated. An explosion of scientific understanding and technological capabilities - particularly in contraception, infertility and menopause - has transformed the specialty into a high-profile subject that touches upon endocrinology, embryology, andrology, surgery, social science, and practical law and ethics. The Oxford American Handbook of Reproductive Medicine provides a practical overview of the reproductive system and a systematic approach to its disorders, covering diagnosis, assessment, and ongoing management with particular emphasis on common and important presentations. Concise, readable, and pocket-sized, this handbook is useful for medical students, primary care clinicians, and ob/gyn residents as a ready reference for daily practice. Cover Contents Symbols and abbreviations 1 Sexual differentiation Key stages of fetal sex differentiation The SRY gene Other genes involved in sex determination Abnormal embryological development—intersex conditions Hermaphroditism Müllerian anomalies Hand–foot–genital syndrome Incomplete regression of the Wolffian system 2 Steroid hormones Introduction Steroid hormone biosynthesis reactions Gonadal steroid hormones Steroid-binding proteins Further reading 3 Menarche and adolescent gynecology Introduction Hypothalamic–pituitary–gonadal axis Stages of puberty Precocious puberty Delayed puberty Further reading 4 Ovaries and the menstrual cycle Introduction Hormones The ovary Follicular development Causes of anovulation and oligo-ovulation 5 Polycystic ovary syndrome Introduction Definition Prevalence Etiology Pathophysiology Management Long-term health implications of PCOS Further reading 6 Hirsutism and virilization Introduction Pathophysiology History and examination Etiology Differential diagnosis Treatment 7 Amenorrhea and oligomenorrhea Introduction Etiology Investigations Management 8 Menopause and hormone replacement therapy Introduction Pathophysiology Other hormonal changes Symptoms Women’s Health Initiative (WHI) trial Risks and benefits of HRT HRT preparations Alternative treatment 9 Initial regarding delays in conception Prevalence of fertility problems Timing of the initial investigation Female partner’s age Frequency and timing of intercourse Environmental and dietary influences 10 Defining infertility Introduction General points before starting investigation 11 Investigation of fertility problems Introduction Investigation of the male partner Investigation of the female partner Investigation of a possible mechanical factor Further reading 12 Management strategies for fertility problems Principles Management of investigations Management strategies 13 Male infertility Introduction Etiology Investigation of the male Further reading and information 14 Ovulation induction Introduction Clomifene citrate Aromatase inhibitors Metformin Pulsatile gonadotropin-releasing hormone (gonadorelin) Gonadotropins Laparoscopic ovarian drilling (LOD) Further reading 15 Tubal and uterine disorders Introduction Tubal disorders Surgery to the fallopian tube Uterine disorders 16 Medical and surgical management of endometriosis Introduction Examination and investigations Endometriosis-associated infertility Surgical treatment of endometriosis Principles of surgery for infertility patients with endometriosis Medical treatment Further reading and information 17 Intrauterine insemination Introduction Methods Principle Indications IUI for mild male-factor infertility IUI for unexplained infertility Cost-effectiveness Conclusions Further reading 18 In vitro fertilization and associated assisted conception techniques Introduction Factors affecting the outcome of IVF Number of embryos transferred Procedures used during IVF Intracytoplasmic sperm injection Oocyte donation Complications of IVF Preimplantation genetic diagnosis (PGD)/preimplantation genetic screening (PGS) Follow-up of children born as a result of assisted reproduction Further reading and information 19 Fertility and fertility awareness Introduction Sex and relationships education (SRE) Sexually transmitted infections Features of the ideal contraceptive Relative effectiveness of the available methods Eligibility criteria for contraceptives Fertility awareness and methods for the natural regulation of fertility 20 Male contraception Coitus interruptus Male condoms The male pill Vasectomy 21 Vaginal methods Female condoms Caps and diaphragms Spermicide (nonoxinol) 22 The combined oral contraceptive (COC) Mechanism of action Benefits versus risks Tumor risk and COCs Cardiovascular disease Eligibility criteria for COCs The pill-free interval (PFI) Drug interactions Other relevant drugs Counseling and ongoing supervision Stopping COCs Other combined methods Pill follow-up Congenital abnormalities and fertility issues 23 The progestogen-only pill (POP) Mechanism of action and maintenance of effectiveness Risks and disadvantages Advantages and indications Problems and contraindications Counseling and ongoing supervision 24 Injectables Introduction Mechanism of action and effectiveness Indications Advantages Problems and disadvantages Contraindications Counseling and ongoing supervision 25 Contraceptive implants Introduction Mechanism of action, administration, and effectiveness Enzyme inducer drug (EID) treatment Reversibility and removal problems Indications Advantages Disadvantages and contraindications Counseling and ongoing supervision 26 Intrauterine contraception Introduction Copper-bearing devices The levonorgestrel-releasing intrauterine system (LNG-IUS) 27 Postcoital contraception Introduction Levonorgestrel emergency contraception (LNG-EC) Copper intrauterine devices (IUDs) Counseling and management Special indications for EC 28 Sterilization Introduction Efficacy considerations Potential reversibility Possible long-term side effects of female sterilization Comparison of methods 29 Special considerations How can a provider be reasonably sure of a woman not being pregnant? Contraception at the climacteric Appendix Essential Web sites in reproductive health Further reading and references Index A B C D E F G H I L M N O P Q R S T U V W X Y