Oxford American Handbook of Reproductive Medicine (Oxford American Handbooks of Medicine)

"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"--Provided by publisher. Cover 1 Contents 14 Symbols and abbreviations 22 1 Sexual differentiation 28 Key stages of fetal sex differentiation 29 The SRY gene 30 Other genes involved in sex determination 31 Abnormal embryological development—intersex conditions 32 Hermaphroditism 34 Müllerian anomalies 35 Hand–foot–genital syndrome 37 Incomplete regression of the Wolffian system 38 2 Steroid hormones 40 Introduction 41 Steroid hormone biosynthesis reactions 43 Gonadal steroid hormones 46 Steroid-binding proteins 47 Further reading 47 3 Menarche and adolescent gynecology 48 Introduction 49 Hypothalamic–pituitary–gonadal axis 50 Stages of puberty 52 Precocious puberty 53 Delayed puberty 54 Further reading 55 4 Ovaries and the menstrual cycle 56 Introduction 57 Hormones 59 The ovary 61 Follicular development 62 Causes of anovulation and oligo-ovulation 63 5 Polycystic ovary syndrome 66 Introduction 67 Definition 68 Prevalence 69 Etiology 69 Pathophysiology 70 Management 72 Long-term health implications of PCOS 75 Further reading 75 6 Hirsutism and virilization 76 Introduction 77 Pathophysiology 78 History and examination 79 Etiology 80 Differential diagnosis 81 Treatment 83 7 Amenorrhea and oligomenorrhea 86 Introduction 87 Etiology 88 Investigations 92 Management 95 8 Menopause and hormone replacement therapy 98 Introduction 99 Pathophysiology 99 Other hormonal changes 100 Symptoms 101 Women’s Health Initiative (WHI) trial 104 Risks and benefits of HRT 105 HRT preparations 106 Alternative treatment 107 9 Initial regarding delays in conception 108 Prevalence of fertility problems 109 Timing of the initial investigation 109 Female partner’s age 110 Frequency and timing of intercourse 110 Environmental and dietary influences 111 10 Defining infertility 112 Introduction 113 General points before starting investigation 114 11 Investigation of fertility problems 116 Introduction 117 Investigation of the male partner 120 Investigation of the female partner 123 Investigation of a possible mechanical factor 125 Further reading 127 12 Management strategies for fertility problems 128 Principles 129 Management of investigations 130 Management strategies 131 13 Male infertility 136 Introduction 137 Etiology 138 Investigation of the male 141 Further reading and information 145 14 Ovulation induction 146 Introduction 147 Clomifene citrate 148 Aromatase inhibitors 150 Metformin 151 Pulsatile gonadotropin-releasing hormone (gonadorelin) 152 Gonadotropins 153 Laparoscopic ovarian drilling (LOD) 158 Further reading 158 15 Tubal and uterine disorders 160 Introduction 161 Tubal disorders 162 Surgery to the fallopian tube 164 Uterine disorders 165 16 Medical and surgical management of endometriosis 166 Introduction 167 Examination and investigations 168 Endometriosis-associated infertility 169 Surgical treatment of endometriosis 170 Principles of surgery for infertility patients with endometriosis 172 Medical treatment 173 Further reading and information 175 17 Intrauterine insemination 176 Introduction 177 Methods 177 Principle 177 Indications 178 IUI for mild male-factor infertility 178 IUI for unexplained infertility 178 Cost-effectiveness 179 Conclusions 179 Further reading 179 18 In vitro fertilization and associated assisted conception techniques 180 Introduction 181 Factors affecting the outcome of IVF 182 Number of embryos transferred 183 Procedures used during IVF 184 Intracytoplasmic sperm injection 188 Oocyte donation 188 Complications of IVF 189 Preimplantation genetic diagnosis (PGD)/preimplantation genetic screening (PGS) 190 Follow-up of children born as a result of assisted reproduction 191 Further reading and information 191 19 Fertility and fertility awareness 194 Introduction 195 Sex and relationships education (SRE) 195 Sexually transmitted infections 196 Features of the ideal contraceptive 197 Relative effectiveness of the available methods 198 Eligibility criteria for contraceptives 200 Fertility awareness and methods for the natural regulation of fertility 201 20 Male contraception 206 Coitus interruptus 207 Male condoms 208 The male pill 209 Vasectomy 210 21 Vaginal methods 212 Female condoms 213 Caps and diaphragms 214 Spermicide (nonoxinol) 215 22 The combined oral contraceptive (COC) 218 Mechanism of action 219 Benefits versus risks 220 Tumor risk and COCs 221 Cardiovascular disease 224 Eligibility criteria for COCs 230 The pill-free interval (PFI) 235 Drug interactions 237 Other relevant drugs 238 Counseling and ongoing supervision 241 Stopping COCs 245 Other combined methods 246 Pill follow-up 246 Congenital abnormalities and fertility issues 247 23 The progestogen-only pill (POP) 248 Mechanism of action and maintenance of effectiveness 249 Risks and disadvantages 250 Advantages and indications 251 Problems and contraindications 252 Counseling and ongoing supervision 253 24 Injectables 256 Introduction 257 Mechanism of action and effectiveness 258 Indications 259 Advantages 259 Problems and disadvantages 260 Contraindications 262 Counseling and ongoing supervision 263 25 Contraceptive implants 264 Introduction 265 Mechanism of action, administration, and effectiveness 266 Enzyme inducer drug (EID) treatment 267 Reversibility and removal problems 267 Indications 268 Advantages 268 Disadvantages and contraindications 269 Counseling and ongoing supervision 270 26 Intrauterine contraception 272 Introduction 273 Copper-bearing devices 274 The levonorgestrel-releasing intrauterine system (LNG-IUS) 280 27 Postcoital contraception 286 Introduction 287 Levonorgestrel emergency contraception (LNG-EC) 288 Copper intrauterine devices (IUDs) 289 Counseling and management 290 Special indications for EC 292 28 Sterilization 294 Introduction 295 Efficacy considerations 296 Potential reversibility 297 Possible long-term side effects of female sterilization 298 Comparison of methods 299 29 Special considerations 300 How can a provider be reasonably sure of a woman not being pregnant? 301 Contraception at the climacteric 303 Appendix 306 Essential Web sites in reproductive health 307 Further reading and references 307 Index 308 A 308 B 308 C 308 D 309 E 310 F 310 G 310 H 311 I 311 L 312 M 312 N 313 O 313 P 313 Q 314 R 314 S 314 T 314 U 315 V 315 W 315 X 315 Y 315 Machine generated contents note: Part 1: Reproductive Medicine1. Sexual differentiation2. Steroid hormones3. Menarche and adolescent gynecology4. Ovaries and the menstrual cycle5. Polycystic ovary syndrome6. Hirsutism and virilization7. Amenorrhea and oligomenorrhea8. Menopause and hormone replacement therapy9. Initial advice to those concerned about delays in conception10. Defining infertility11. Investigation of fertility problems12. Management strategies for fertility problems13. Male infertility14. Ovulation induction15. Tubal and uterine disorders16. Medical and surgical management of endometriosis17. Intra-uterine insemination18. In vitro fertilization (IVF) and associated assisted conception techniquesPart 2: Contraception and Family Planning19. Fertility and fertility awareness20. Male contraception21. Vaginal methods22. The combined oral contraceptive (COC)23. Progestogen-only pill (POP)24. Injectables25. Contraceptive implants26. Intra-uterine contraception27. Postcoital contraception28. Sterilization29. Special considerationsAppendixIndex.