Book Review

Molecular Biology in Reproductive Medicine

N Engl J Med 1999; 341:619-620August 19, 1999

Article

Molecular Biology in Reproductive Medicine
Edited by B.C.J.M. Fauser, with A.J. Rutherford, J.F. Strauss, III, and A. Van Steirteghem. 523 pp., illustrated. New York, Parthenon, 1999. $65. ISBN: 1-85070-994-7

Without doubt, molecular biology has changed the way in which we study biology and the way in which we solve problems in therapeutics and medicine. At the close of the second millennium, the sequencing of the entire human genome is well under way. This catalogue of our genes will be an indispensable tool for the diagnosis and treatment of inherited diseases. Molecular Biology in Reproductive Medicine provides a comprehensive yet easy-to-read account of the basics of molecular medicine. Several chapters are dedicated specifically to technical aspects, whereas other chapters provide details sufficient for understanding a particular application of diagnostic molecular biology. Such information is essential to the understanding of the rapidly changing field of reproductive medicine.

What is particularly appealing about this book is that it uses up-to-date examples of nonprimate models in which a particular process or function is best understood. In this way it differs from many textbooks designed for species-chauvinistic medical practitioners, and is a true reflection of ongoing research in reproductive biology, for which models are essential and, in fact, are widely used. Fruit flies and microscopic worms stand strong alongside “mice and men” as important contributors to our understanding of the diverse and complex processes necessary for successful reproduction. Because it takes this approach, the book will be useful to students of both biology and medicine.

This book also deals with various important topics in reproductive medicine such as growth factors, gonadotropins and their receptors, gametogenesis, and molecular carcinogenesis. Each chapter has a section on potential clinical relevance, and when they are known, the genes responsible for specific diseases are indicated. Particularly important in molecular medicine is the identification of single point mutations or polymorphisms in disease-related genes. Often a change in one codon will lead to a change in an amino acid, and then a deleterious mutation may occur. Several sections address how to detect mutations, which is by no means easy in certain situations.

Students and practitioners of reproductive medicine must be particularly diplomatic when dealing with the ethical problems associated with the genetics of reproductive disorders and assisted reproduction. The final third of the book deals with many aspects of clinical genetics, genetic counseling, and genetic diagnosis in preimplantation embryos. Many patients or their families may have moral, religious, or emotional objections to reproductive technology. Thus, the clinician must be made aware of these delicate issues.

Missing is a critical chapter dedicated to normal and abnormal sexual development. There are sections on female and male development, but this important subject is not covered adequately. Also not mentioned is the related issue of the effects of the “gender-bender” class of environmental pollutants, such as PCBs (polychlorinated biphenyls), DDT (dichlorodiphenyltrichloroethane), various other common pesticides, and persistent organic pollutants. Many of these substances are known to alter sexual development or function by binding to estrogen receptors that regulate gene transcription or by modulating sex-steroid synthesis during critical periods of development. Other pollutants are genotoxins, which modify DNA structure. Chemical exposure is believed by some researchers to be linked to the development of breast and prostate cancers or even to reductions in fertility and cognitive functions in certain human populations.

The diagrams and figures in this book are of reasonable quality; more color photographs would have been helpful. Several figures in the beginning technical chapters could have been edited more consistently. For example, there are some variations in the descriptions of the polymerase chain reaction, which may confuse the neophyte. There is also a difficult-to-understand diagram of untranslated regions and the organization of genes.

In all, however, Molecular Biology in Reproductive Medicine is a very useful book that is reasonably priced. The changing fields of molecular biology and reproductive physiology are combined in an easy-to-use format that will appeal to students, researchers, and clinicians alike.

Vance Trudeau, Ph.D.
University of Ottawa, Ottawa, ON K1N 6N5, Canada