The Reproductive System.

Male Sterility and Motility Disorders: Etiological Factors and Treatment

Summary:
This conference, dedicated to the etiology and treatment of motility disorders in spermatozoa and male sterility, attracted some of the finest investigators in the field. Standards were immensely high throughout, and discussions were meaningful and detailed. Analyses on disorders in sperm motility demand a broad-based approach, involving cytologists, geneticists, andrologists, and embryologists, because the topic has many clinical and scientific overtones. Human spermatozoa are at the mercy of so many factors as they form and mature in the testis and epididymis. Their survival and fundamental characteristics are essential for fertilization, and the male genome imposes its influence on the embryo as it becomes active in male pronuclei very soon after sperm entry into the oocyte. All of these fundamental aspects of sperm biology demanded a broad breadth of topics in the symposium. The opening session quickly got down to fundamentals with contributions from J.-L. Gatti, J.G. Alvarez, C. Gagnon, and H. Breitbart. They discussed the mechanism and regulation of motility, the metabolic strategy of human spermatozoa, the effects of exogenous factors such as antibodies, infections, and toxins, and finally the role of intracellular calcium on sperm motility. To these topics, the postcoffee session on the first morning described the genetics of motility disorders and the etiology and management of necrozoospermia. The excellent presentation provided the background detail of the symposium and opened the way for the discus sion of various clinical aspects of the topic.

Also, the book that follows is a very good reference source.

Psychological Aspects of Women’s Health Care: The Interface Between Psychiatry and Obstetrics and Gynecology

Summary:

In the decade since the first edition of this work was published, an incredible array of reproductive technologies and associated issues has emerged. Obstetricians and gynecologists are hard-pressed to deal with the startling breadth and depth of these issues, which require mastery over a daunting combination of ever-increasing scientific knowledge, technical skills, long hours, legal liability, and exposure to clinical situations of overwhelming emotional intensity.

Psychiatrists have a vital role to play in helping obstetricians and gynecologists cope with a host of problems whose resolutions require not just technical skill, but also knowledge of biology, psychology, sociology, anthropology, ethics, and law. For example, to design and implement strategies to reduce the transmission of HIV, psychiatrists could work with public health workers to incorporate the psychology, sociology, and anthropology of female reproductive behavior. Psychiatrists could likewise improve the diagnosis and treatment of breast and pelvic malignancies by elucidating the factors that deter women from self-examination and regular medical screening and enhance treatment compliance.

Divided into three sections, this clinical and theoretical sourcebook addresses every major area of contemporary concern. Pregnancy covers topics from the psychology of normal gestation to physical and psychiatric complications during and after pregnancy, including new prenatal diagnostic techniques and the dynamic issues that emerge when abnormalities are detected, and the use of psychotropic drugs and electroconvulsive therapy in pregnant and lactating patients. Gynecology discusses not only common gynecologic problems but also more controversial issues such as induced abortion and the new reproductive technologies, including the role of the menstrual cycle in exacerbating and precipitating psychologic symptoms, the psychiatric aspects of menopause, the assessment and management of chronic pelvic pain, the psychosocial concomitants of gynecologic malignancies and the emotional demands on the oncology team, and the special implications of HIV/AIDS. General Issues offers a broad, balanced view of topics rarely found in the literature, such as men’s reactions to women’s reproductive events, substance abuse and eating disorders, sexual and physical abuse (often part of the histories of patients with personality disorders and posttraumatic stress disorders), ethical and legal issues, and health care for lesbian patients. Of special significance is Dr. Stotland’s chapter on how consultation-liaison services are provided to obstetrics and gynecology services.

This practical and scholarly volume is exceptionally useful as a teaching reference for medical and other health care students and residents in psychiatry and obstetrics and gynecology. It also provides a valuable resource for the clinician working to improve the psychological well-being of women patients.