This book offers a highly informative guide to treating unexplained infertility and recurrent miscarriage (RM). In particular, it provides detailed treatment strategies for infertility or RM derived from uterine circumstance such as chronic endometritis and perturbation of endometrial decidualization, as well as maternal immunological rejection of an embryo as semi-allograft. Unexplained infertility refers to those types that cannot be detected by the general screening test. The causes are sometimes detected in the course of treatment with assisted reproductive technology including IVF. However, some unexplained infertility is intractable even after intracytoplasmic sperm injection or repeated implantation of morphologically suitable embryos. Patients with unexplained RM also have a high likelihood of undetectable risk factors of miscarriage. As a result, gynecologists often repeatedly provide these couples with general treatments for infertility and miscarriage or even discontinue treatment because they cannot detect the reason, which places serious financial, physical and mental burdens on the couples affected. This book offers gynecologists essential insights into the pathological condition of unexplained infertility and RM, equipping them to identify it, explain it to patients, and consider further examinations and more aggressive fertility treatments.

Written and edited by leading, internationally recognized clinicians and scientists in reproductive medicine and related fields, this unique text is a practical and comprehensive review of the clinical and scientific significance of unexplained male and female infertility and its management. The book is divided into thematic sections to ensure the most useful presentation of topics, opening with definitions and epidemiology of unexplained infertility, including discussion of the WHO’s cutoff values for human semen characteristics and its ramifications. Sections covering male and female reproductive pathophysiology follow respectively, covering biological, genetic and environmental causative factors, with a subsequent section on evaluative techniques for male and female patients. Expectant, medical and surgical treatment strategies comprise the fifth section of the book, where active interventions and outcomes of each treatment modality are carefully considered. The final section discusses assisted reproductive techniques to manage unexplained infertility, such as intrauterine insemination and in vitro fertilization, as well as future perspectives. Thoughtful and enlightening, Unexplained Infertility: Pathophysiology, Evaluation and Treatment will be an invaluable resource for all clinicians and scientists working in the fields of reproductive medicine and infertility.

Reproductive medicine and surgery is a major subspecialty in the practice of obstetrics and gynaecology. This textbook provides an introduction to the field of subfertility and reproductive endocrinology, with contributions written by leading experts in the field. This book is based on and compliments a training programme run jointly by the British Fertility Society and the Royal College of Obstetricians and Gynaecologists, making it an indispensable handbook for medical trainees. It will also appeal to clinicians embarking on a career in obstetrics and gynaecology who want an excellent grounding in this area. Specialist nurses will also find the book a valuable resource, and scientists specialising in reproductive medicine and embryology will gain insight into the related clinical areas.

Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.

Reviews contemporary approaches to the assessment, diagnosis and management of infertility, giving essential information for Part 2 MRCOG candidates.

The first few months of any pregnancy are of supreme importance to the success of that pregnancy. This statement is so obvious as to be almost a platitude, yet it must be said that no aspect of pregnancy has been more neglected in the human than the first three months. Little is known of the morphological changes that occur at that time and our knowledge of the mechanisms that control this vital stage of pregnancy is almost non-existent. The explanation for this neglect of what is an obvious area for study is the difficulty of obtaining normal material. It is rare to have material to study from a healthy first trimester pregnancy and the study by Hertig and Rock!l) of early conception found by chance in hysterectomy speci mens must be unique. The information that we do have about early pregnancy is mostly gained from animal studies or single miscarriages in humans. Chromosomal defects are common but are not an explanation for the majority of recurrent miscarriages. Obstetricians have hypothesised many causes for this condition and have deve loped numerous metQods for treating it, but the studies have been poorly con trolled so that our understanding of the cause(s) has not advanced. Treatment of women with a history of recurrent miscarriage by paternal leuco cyte infusion (immunotherapy) may be yet another form of treatment that is hailed as a new advance only to be rejected when subject to rigorous testing.