Reproductive Endocrinology and Infertility: Current Trends and Developments PDF

Preface

Because reproductive medicine is a rapidly evolving science, dogma that is widely accepted one year might not be applicable the next. Since 1996, the Department of Obstetrics and Gynecology at McGill University has organized an annual international symposium on reproductive endocrinology and infertility with a stellar cast of world-renowned speakers who have addressed many of the latest advances in the field. This book is a compilation of key topics that have been covered at the annual meetings and reflects the latest thinking in contraception, hormone replacement therapy, assisted reproductive technologies, and reproductive surgery.

The contributors are physicians and scientists who are leaders in the field. Michael Cho, Judi Marraccini, and Brian Little review a topic of great importance to women as they approach the menopausal transition, namely, the choice and risks associated with various forms of contraception. In the past few years, a number of oral contraceptive formulations have been introduced that contain markedly lower hormonal doses. Sally Perlman and Joseph Sanfilippo discuss the indications for use of these ultralow-dose oral contraceptive preparations in comparison with conventional oral contraceptives. Although androgen therapy for menopausal women has been used for many years, it remains an area of considerable debate and there is no consensus regarding its use. Camille Sylvestre and Morrie Gelfand, who have long championed the use of androgen treatment for menopausal women, discuss this controversial topic. Although the benefits of short-term hormone replacement therapy in symptomatic women are well recognized, the use of long-term hormone replacement therapy to prevent osteoporosis and cardiovascular disease has been increasingly challenged over the past 2 years. In part, this is due to the underlying concern about any association between hormone replacement therapy and cancer. Elene Strates and Charles Coddington elegantly review this topical subject. Richard Kremer and David Goltzman discuss the plethora of alternative therapies for the prevention of osteoporosis that have recently become available.

Chapters 6, 7, and 8 focus on recent advances in assisted reproductive technologies. Although in vitro fertilization is a very successful treatment, its use is associated with a risk of ovarian hyperstimulation syndrome, and the only reliable way to prevent this complication is to avoid use of this treatment. In the past few years, a number of studies have indicated that in vitro maturation of oocytes may be an appropriate alternative treatment for selected patients. Timothy Child and Seang Lin Tan discuss how this technology can be optimally used for infertility treatment today. In the past decade, a few hundred babies have been born after preimplantation genetic diagnosis. Asangla Ao discusses recent advances in this fascinating area. Hang Yin, Roger Gosden, and Ahmad Kamal Abdul-Jalil review the state of the art in human oocyte cryopreservation.

The last three chapters deal with surgical aspects of reproductive medicine. Carla Roberts and John Rock review the treatment of uterine anomalies, and Mazen Bisharah and Togas Tulandi lucidly delineate the principles of practical management of ectopic pregnancy. Pelvic pain afflicts a large number of women and in the last chapter Christopher Sutton discusses the use of laparoscopic surgery for the management of this dehabilitating condition.

In the past decade, there has been an explosion of advances in the field of clinical reproductive medicine. This book focuses on many aspects of treatment and care in which these advances have touched the lives of many women seeking help from their physicians. This book is valuable for both physicians in training and practicing obstetricians and gynecologists. We are grateful to our contributors for their comprehensive and authoritative reviews, which we hope you will find both stimulating and beneficial to your clinical practice.