Book Review

Reproductive Medicine and Surgery

N Engl J Med 1995; 333:1363November 16, 1995

Article

Reproductive Medicine and Surgery
Edited by Edward E. Wallach and Howard A. Zacur. 1182 pp., illustrated. St. Louis, Mosby, 1995. $135. ISBN: 0-8016-7504-9

To date, there have been only two comprehensive textbooks in the field of reproductive medicine: Clinical Gynecologic Endocrinology and Infertility, edited by Leon Speroff, Robert H. Glass, and Nathan G. Case (5th ed. Baltimore: Williams and Wilkins, 1994), and Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management, edited by Samuel S.C. Yen and Robert B. Jaffe (3rd ed. Philadelphia: W.B. Saunders, 1991). The former is generally regarded as an excellent textbook for medical students, residents in obstetrics and gynecology, and general gynecologists, whereas the latter is more appropriate for fellows and subspecialists in reproductive endocrinology. This first edition of Reproductive Medicine and Surgery nicely bridges the gap between the two earlier books. It is versatile in that it can be read from cover to cover by gynecology residents, yet is sufficiently detailed and referenced to be useful for practicing physicians in general gynecology or reproductive endocrinology.

Reproductive Medicine and Surgery consists of 62 chapters by 88 authors, most of whom are well-respected experts. It has nine sections, on reproductive physiology, disorders of the reproductive cycle, contraception, the evaluation of infertility, therapy for infertility, techniques of assisted reproduction, problems with pregnancy, menopause, and specialized procedures. The title of the book suggests that there is an equal emphasis on reproductive medicine and reproductive surgery, but only 10 of the 62 chapters actually focus on surgery.

The strengths of the book are in its medical chapters. Appropriately, it begins with a thorough review of the molecular genetics of reproductive endocrinology, written by two leaders in the field, Lawrence Layman and Paul McDonough. The remainder of the section on reproductive physiology is equally strong, with exceptional chapters on reproductive embryology by Gustafson and Donahoe and on ovarian follicular growth and maturation by Toth and Hodgen.

Reproductive-cycle disorders and contraception are well covered in this book, as they are in most standard textbooks of endocrinology. Unfortunately, there is little about adolescent gynecology, a topic important to both the general gynecologist and the reproductive endocrinologist.

What set Reproductive Medicine and Surgery apart from other books on this subject are the sections on the evaluation and treatment of infertility. Twenty-three of the 62 chapters address this topic. An entire chapter deals with almost all the common causes of infertility, aside from tubal factor, which accounts for 30 to 50 percent of all infertility, according to Jewelewicz and Wallach. The review of the ovarian hyperstimulation syndrome is one of the most comprehensive I have seen. Overall, the information in these two sections is extremely practical and relevant for physicians in the field of infertility.

Because of the rapid advances in techniques of assisted reproduction, it is difficult for a comprehensive textbook to be completely current. In this book, the chapters on gamete and embryo cryopreservation and microscopical assessment of human oocytes are excellent, and the information is not likely to change dramatically with time. However, the subject of micromanipulation is conspicuously absent, because it developed only within the past year.

In agreeing to review this book, I anticipated that there would finally be a reference work in the field of reproductive endocrinology that thoroughly examined the indications, techniques, and outcomes of reproductive surgery. I was hoping for a book that would discuss both the detailed medical aspects of the field, as this book does, and the equally detailed surgical aspects, which this book does not. The discussions of surgery are limited and scattered throughout the book. What I hoped for but did not find was a book covering specific topics in reproductive surgery, in the way David H. Nichols and Clyde L. Randall covered specific topics in their Vaginal Surgery (3rd ed. Baltimore: Williams and Wilkins, 1989).

I highly recommend Reproductive Medicine and Surgery to those needing an excellent textbook in reproductive endocrinology. Because of its unique combination of discussions of reproductive physiology and practical medicine, this book has become required reading for our fellows in reproductive endocrinology. It is an excellent resource, not only for medical students, residents, and fellows, but also for any physician caring for infertile couples.

Keith B. Isaacson, M.D.
Massachusetts General Hospital, Boston, MA 02114