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Prelims-P088465 2/28/06 3:58 PM Page xiixiiContentsEndocrine SystemFetal DisordersGenetic and Chromosomal DisordersRhesus DiseaseTeratogens, Mutagens, and OtherAgents That Damage the Fetus277The Birth Process305277Stage 1: Cervical Effacementand Dilation305277Stage 2: Expulsion of the Fetus310Stage 3: Expulsion of the Placenta311277278Premature Births312Viruses and Bacteria278Multiple Births313Environmental Pollutants279Difficult Fetal Positions314Drugs, Alcohol, and Tobacco279Handling Difficult Births315Forceps Delivery315281Vacuum Extraction315Radiation283Cesarean Delivery316High Altitude283Use of Medications during Labor317Fetal Evaluation283Natural Birthing Methods319The Pregnant Woman285Maternal Nutrition285Box 2: Why Is Human Birth SoDifficult?320Physiological Changes during Pregnancy286Chapter Summary322The Endocrinology of Pregnancy286Further Reading323Maternal Complications of Pregnancy289Advanced Reading324Box 3: The Adaptive Value of MorningSicknessToxemia289Diabetes Mellitus290Ectopic Pregnancies290Hydatidiform Moles291Septic Pregnancy291Hemorrhage291Miscarriage291Sex during Pregnancy292Chances for a Successful Pregnancy292Chapter Summary293Further Reading294Advanced Reading295CHAPTER ELEVENC H A P T E R T W E LV EThe Neonate and the NewParents325Introduction325Treatment of the Newborn325Apgar Score325Leboyer Method326Circumcision326Adaptations of the Newborn327The Respiratory System327The Circulatory System328The Digestive Tract328Thermoregulation329The Nervous System and Behavior329Labor and Birth297Introduction297What a Newborn Looks Like330Time of Birth297Disorders of the Newborn331Hormones and Birth300Box 1: Back to Sleep332Delayed Birth in Sheep300Hormonal Initiation of Human Birth301Birth Weight and Adult DiseaseCondition of the New Mother334335Box 1: The Placental Clock301Physical Changes335Induced Labor304Psychological Changes335Preparation for Labor305Breast-Feeding336

Prelims-P088465 2/28/06 3:58 PM Page xiiixiiiContentsPostpartum Endocrine Changesand LactationBox 2: The Duration ofBreast-FeedingAdvantages and Disadvantagesof Breast- and Bottle-Feeding336Population Growth in UnderdevelopedCountries363339Overall View of Human PopulationGrowth365Effects of Overpopulation365341Illiteracy365Chapter Summary343Food Production and Hunger366Further Reading345Natural Resources and Energy366Advanced Reading346Pollution and Environmental Illness367Crowding and Stress367Quality of Life368PA R T F O U RFertility and its Control349Will Science and Technology Save Us?368Family Planning and Population Control369Family Planning Programs369Barriers to Family Planning370CHAPTER THIRTEENCultural Barriers370Human Population Growthand Family PlanningReligious Barriers371Other Barriers371351Introduction351The Biology of Population Growth351Basic Principles of PopulationBiology351Birth Rate351Death Rate352Emigration and Immigration352Population Growth Rate352Reproductive Potential353Biotic Potential353Environmental Resistance353Population Crashes354Doubling Time355Human Population Growth356The Prediction of Thomas Malthus356Human Population Growth on Earth356Age DistributionBirth Rate, Death Rate, and FertilityRateBox 1: World Contraceptive Useand Fertility RatesLife ExpectancyPopulation Growth in DevelopedCountriesU.S. Population Growth358358361362362362Family Planning in the United States372Individual Freedom and FamilyPlanning374Box 2: Government-Enforced PopulationControl in China374Chapter Summary376Further Reading377Advanced Reading378CHAPTER FOURTEENContraception379Introduction379Combination Pill381Ingredients382How the Combination Pill Works382Use of the Combination Pill382Failure Rate383Side Effects383Mild Side Effects383Serious Side Effects384Beneficial Side Effects385Costs and Benefits385Minipill389Box 1: Where Is the Male BirthControl Pill?389

Prelims-P088465 2/28/06 3:58 PM Page xivxivContentsIntradermal Progestogen Implants391Injectable Hormones392Vacuum Aspiration424Transdermal Hormone Delivery392Dilation and Curettage426Emergency Contraception393Prostaglandins427Intrauterine Devices393Spermicides395Medication Abortion: Mifepristone,Methotrexate, and Misoprostol427Box 2: Future Contraceptive Methods396Diaphragm398Cervical Cap399Sponge Contraceptive399Male and Female Condoms400Male Condom400Female Condom400Coitus Interruptus401Coitus Reservatus and Coitus Obstructus401Natural Family Planning402First Trimester-Induced Abortions423Box 2: The Early Abortion Pill inthe United States428Second Trimester Induced Abortions429Why a Second Trimester Abortion?429Intraamnionic Saline430Prostaglandin Injections430Dilation and Evacuation431Dilation and Extraction431Third Trimester-Induced Abortions431Folk Abortifacients432Safety and Consequences of InducedAbortion432Calendar Method402Basal Body Temperature Method402Cervical Mucus MethodChapter Summary433403Sympto-Thermal MethodFurther Reading434403Advanced Reading434Is Breast-Feeding a ContraceptiveMeasure?403Surgical Sterilization403Tubal Sterilization404Hysterectomy407VasectomyCHAPTER SIXTEENInfertility437407Introduction437Psychology of Contraceptive Avoidance409Seeking Medical Help for Infertility437Choosing a Contraceptive410Female Infertility438Chapter Summary410Failure to Ovulate438Further Reading411Tubal Blockage439Advanced Reading413Absence of Implantation440Reduced Sperm Transport or Antibodiesto Sperm440CHAPTER FIFTEENInduced Abortion417Introduction417Induced Abortion in the United States418History of Abortion Legislation inthe United States418Present-Day Abortion Statistics inthe United States419Why Women Have AbortionsBox 1: The History and Ethicsof Induced Abortion420422Box 1: Seasonal Changes in the Abilityto ConceivePregnancy Loss (Miscarriage)Male Infertility441442443Low Sperm Count443Sperm Transport444Environmental Factors444Assisted Reproductive Techniques (ART)445Gamete Storage and ArtificialInsemination (AI)445In Vitro Fertilization (IVF)447

Prelims-P088465 2/28/06 3:58 PM Page xvxvContentsOvarian Stimulation and EggRetrievalConclusion485447Chapter Summary485Fertilization and Embryo Transfer447Further Reading486Risks of IVF449Advanced Reading487Box 2: Costs of Assisted ReproductiveTechnologies450Preimplantation Genetic Diagnosis(PGD)452Egg Donation453Gamete or Zygote IntrafallopianTransfer453Surrogate Mothers and GestationalCarriers454Cloning and Ethical Issues in AssistedReproductionCHAPTER EIGHTEENSexually Transmitted Diseases491Introduction491Bacteria and Viruses491Gonorrhea493Cause of the Gonorrhea Epidemic493454Cause of Gonorrhea493Adoption457Transmission494Chapter Summary457Symptoms in Females494Further Reading458Complications in Females494Advanced Reading459PA R T F I V ESpecial Topics in HumanReproductive BiologyDiagnosis495Treatment495Theoretical Origins461463495495SyphilisCHAPTER SEVENTEENBrain SexPregnancy and GonorrheaSymptoms in Males496496Columbian Theory496Evolutionary Theory497Syphilis as Distinct fromGonorrhea497Transmission497Stages of the Disease497Introduction463Primary Stage497Biological Causes of Brain Sex Differences463Secondary Stage498Sex Differences in Neonatal Behavior467Latent Stage498Sex Differences in Childhood Behavior467Tertiary Stage498Sex Differences in Adult Cognitionand Motor SkillsCongenital Syphilis498468Box 1: Evolution of Sex Differencesin Problem-Solving SkillsDiagnosis499473Treatment499Brain Sex Differences inthe “Surge Center”476Chlamydia499Genital Herpes500477Cause501477Symptoms501Brain Sex and Gender Identity482Diagnosis502Sex Differences in Aggression483Brain Sex and Human Sexual BehaviorSexual OrientationBox 2: The Meaning ofBrain Measurements483Treatment502Genital Warts502Trichomoniasis503

Prelims-P088465 2/28/06 3:58 PM Page xvixviContentsViral Hepatitis B504Pediculosis Pubis504Scabies505Vulvitis525Lymphogranuloma Venereum505Vaginitis525Chancroid505Urethritis and Cystitis527Molluscum Contagiosum506Cervicitis527Granuloma Inguinale506Pelvic Inflammatory Disease527Prostatitis528Acquired Immunodeficiency Syndrome(AIDS)StatisticsBox 1: Origins of the HIV VirusesTransmissionSome General Aspects of Venereal DiseaseInfections525506Psychological Aspects of SexuallyTransmitted Disease528510Preventing Sexually Transmitted Disease529512Chapter Summary529Further Reading530Advanced Reading531506Who Is Most Susceptible to HIVInfection?514Life Cycle of the HIV Virus515Symptoms of HIV Disease and AIDS516Glossary533Long-Term HIV Survivors518Illustration and Table Credits581Treatments of AIDS519Index589Box 2: Attacking the HIV VirusPrecautions Against HIV Transmission522524

Prelims-P088465 2/28/06 3:58 PM Page xviiPrefaceA New Contraceptive in the Works! Hormone Replacement Therapy forMenopause Increases the Risk of Heart Disease! Anabolic Steroids Linked toPsychiatric Disorders! Headlines such as these appear in the media almost everyday as advances in the field of human reproductive biology are made.Reproductive biology and biomedicine are of primary concern to people of allages. One goal of this third edition of Human Reproductive Biology is to give college students a solid foundation in understanding the human reproductive systemso that they can critically evaluate and interpret new findings as they prepare forcareers in reproductive biology and medicine, or for their own personal interest.Scientific research in this area is proceeding with great rapidity. The timebetween publication of the second edition of Human Reproductive Biology andthe present (2006) has been loaded with new research findings that have profound influence on our basic understanding in this scientific discipline. In turn,advances in basic biology has a major impact on the practice of reproductivemedicine. So the third edition is “pregnant” with new information and has beenupdated throughout. Our goal is to give you the latest available findings.In addition to adding new and exciting facts, this edition has been changedin ways that add to the teaching value of the book. Eighteen new HighlightBoxes,” presenting especially intriguing topics or areas of special interest, havebeen added. For the first time, the figures are in full color to help the studentinterpret and understand the structure and function of the reproductive system.A new chapter on Reproductive Aging has been added. The references at theend of each chapter have been expanded to help the student research a topic forwriting term papers or to follow up on a topic of interest in the literature. A dedicated student in a class using this text should know and understand more abouthuman reproduction than about 95% of adults! This book will help prepare students who are considering careers as health care professionals or biomedicalresearchers. The students will also derive benefit in their personal lives, regardless of career choice. It is our experience that a student would need at least oneyear of college general biology to gain the greatest benefit from taking a courseusing Human Reproductive Biology.We have chosen illustrations and tables that offer clear examples of phenomena discussed in the text. Furthermore, we explain each figure fully in thelegend, thus saving the reader from searching the text for clarification. A list ofillustration and table credits appears at the back of the book. Within the text,key terms are italicized the first time they are used and are also defined in theGlossary.We are, by profession, reproductive biologists and endocrinologists, and wehave used our training and knowledge to the best of our abilities to make thisxvii

Prelims-P088465 2/28/06 3:58 PM Page xviiixviiiPrefacebook as scientifically accurate and up-to-date as possible. Although we are notmedical doctors, we have attempted to present valid medical information.However, we do not take legal responsibility for any medical information oradvice in this book; that is, the readers of this book use medical information andadvice contained herein at their own risk, and should always check with theirphysicians regarding any health or medical problems or treatments.We wish to note that it is our intention to provide new Highlight Boxes forreaders, particularly course instructors and students. Any updates, as warrantedby major developments in the field, will be made available on the publisher’sInternet site, under the book’s dedicated Web pages (http://books.elsevier.com).We would like to extend our appreciation to the staff at AcademicPress/Elsevier for their help and enthusiastic support in the production of thisthird edition, especially Nancy Maragioglio, Kelly Sonnack, and Philip Korn.A special warm thanks to our colleague and friend Dr. Leif Saul, who used hisartistic skill and scientific knowledge to provide us with the many new colorfigures in this edition.R.E.J.K.H.L.

Chance of Pregnancy 182 Box 2: The Evolution of Menopause in Humans 183 Osteoporosis and Other Postmenopausal Disorders 184 Treatments for Menopause: Benefits and Risks 185 Andropause 187 Testicular Function in Old Age 187 Chapter Summary 188 Further Reading 189 Advanced Reading 189 x Contents PART THREE Procreation 191 CHAPTER EIGHT