Contributors.- 1 A Historical Perspective of Obstetrics and Gynecology: A Backdrop for Reproductive Technology.- 2 Medical Evaluation and Treatment of the Infertile Couple.- Surgical Advances.- 3 The Laser and Infertility: Present and Future.- 4 Operative Laparoscopy: Patient Selection and Instrumentation.- 5 Operative Pelviscopy: Techniques and Results.- 6 Hysteroscopy in Infertility.- 7 Surgical Advances for Male Infertility.- 8 Epididymal Sperm in Obstructive Azoospermia for In Vitro Fertilization.- Radiologic Advances.- 9 Gamete Intrafallopian Transfer and Ultrasound-Guided Transcervical Fallopian Tube Canalization.- 10 Transcervical Fallopian Tube Catheterization for Diagnosis and Treatment of Female Infertility.- 11 The Natural Cycle for In Vitro Fertilization.- 12 The Natural Cycle for In Vitro Fertilization: A French Experience.- Cellular and Molecular Advances.- 13 Expression of Proto-Oncogenes in Mammalian Gametes and Embryos.- 14 In Vitro Coculture of Mammalian Embryos.- 15 The Intraovarian Insulinlike Growth Factor System: Basic and Clinical Implications.- Nonsurgical Advances in Infertility.- 16 Medical Treatment of Ectopic Pregnancy.- 17 GnRH Agonists in the Treatment of Fibroids.- 18 GnRH Agonists in the Treatment of Endometriosis.- 19 GnRH Agonists in the Treatment of Hyperandrogenism.- 20 The Neuroendocrine Basis of Infertility.- Alternatives to Reproductive Failure.- 21 Oocyte Donation.- 22 New Animal Embryo Engineering Technology.- 23 The Role of the Embryo in Prenatal Diagnosis.- Psychosocial Aspects.- 24 Historical Perspective of the Infertile Experience.- 25 Psychological Issues in Infertility: An Historical Overview.- 26 Psychological Evaluation of the Infertile Couple.- 27 Male Infertility: The Psychologic Issues.- 28 Paradise Lost: Sexual Function and Infertility.- 29 Secondary Infertility.- 30 Coping with Pregnancy Loss: Ectopic Pregnancy, Recurrent Abortion, and Stillbirth.- 31 Implementation of Ovum Donation Technology: Start-up Decisions, Challenges, and Problems.- 32 The Long-Term Psychologic and Social Effects of Gamete Donation.- 33 Individual Psychotherapy for Infertile Patients.- 34 Management of Patients with Preexisting Psychiatric Illness.- 35 Application of Behavioral Medicine Techniques to the Treatment of Infertility.- 36 Psychotherapy with Infertile Couples.- 37 Support Groups.- 38 Psychological Experience of Medical Professionals on the IVF Team.- 39 When to Call It Quits.- 40 The Adoptee's Search: Who Are the Real Parents of Adopted Children?.- 41 Parenting After Infertility.- Legal Aspects.- 42 Public Policy and the New Technologies.- 43 The Legal Response to the New Reproductive Technologies.- 44 Diethylstilbestrol and Infertility: The Past, the Present, and the Relevance for the Future.- Ethical Aspects.- 45 Ethics of the New Technologies: A Discussion of Case Histories.
Medicine is changing at a speed never witnessed before in history. With each passing year, medical technology achieves the capacity to provide cures and improve treatments that even a short time before were difficult to con ceptualize and impossible to provide. Reproductive technology personifies this concept perhaps better than any other field of medicine. The 1990s have seen an explosion in endoscopic and ambulatory procedures, the application of molecular biology to clinical conditions, and the refinement of assisted reproduction to allow third parties (donors and surrogates) into the process of family building. More than ever before, comprehensive medical care requires a team approach. However, the team comprises not only medical and scientific personnel, but also mental health professionals, lawyers, and ethicists. This integrated and multidisciplinary approach to medical care will become even more necessary as medical capabilities continue to develop faster than society can respond. This book reflects such an approach. It is based on a Harvard Postgraduate Course in June 1990 entitled Infertility in the 1990s: Technological Advances and Their Psychosocial Implications that was sponsored by the Faulkner Centre for Reproductive Medicine. The first half of the course was directed by Drs. M. Seibel, A. Kiessling, and C. Richards. The second half of the course was directed by Dr. M. Seibel, J. Bernstein, R. N. and S. Levin, LICSW.
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