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The Menstrual Cycle: Physiology, Reproductive Disorders, and Infertility
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Michel Ferin, Raphael Jewelewicz, and Michelle Warren. 250 pages. New York: Oxford University Press; 1993. $59.95.
The events that govern the menstrual cycle during a woman's life are among the most complex. This book highlights the current knowledge of the regulation of the coordinated steps in the menstrual cycle and is a welcome addition to the literature on reproductive medicine. Until now, it was a common practice to find this subject dispersed as chapters in textbooks or works devoted to broad areas such as endocrinology, reproduction, the pituitary gland, the ovary, or menopause.
The three authors are seasoned investigators in reproductive endocrinology from Columbia University. They logically describe the dynamic relations among the neural, hormonal, environmental, and nutritional factors involved in the menstrual cycle. Particularly useful to the student and budding clinical researcher is the textbook style of introducing concepts and discussion of the contributions of each major player in the drama—the hypothalamus, pituitary gland, ovary, and uterus. The book describes the relevant hormones produced by each gland, including their chemistry and general mode of action. The authors also stress the need for synchrony of events so that orderly ovulation occurs at monthly intervals. Aspects such as follicular development, maturation, ovulation, and corpus luteum function are covered at length. Appropriately, the reader is also made aware that a large body of our knowledge on basic mechanisms derives from research on animal models and that nature has much to offer for study in the intricate variations present in different species. Evidence to this can be found in the many examples and citations.
A substantial part of the book is devoted to the discussion of what could go wrong in the chain of events, thereby causing disturbances and infertility. Various strategies for diagnosis and currently available therapies are also discussed. Each chapter includes several informative illustrations that are easy to follow, but histologic pictures are used sparingly. A few color pictures illustrating the dramatic hormonal effects on the endometrium would have provided additional impact, but unfortunately none was included.
The experienced researcher will find some inaccuracies and outdated statements. In discussions of rapidly evolving areas such as intragonadal factors, the authors choose a safe ground and refrain from treading on controversial issues, leaving it up to the reader to sift through the literature. Most of the literature covered is current to 1989, with a few published works from 1990 and 1991 included in some chapters. It is unfortunate that a book published in 1993 does not mention some new and important findings on recombinant gonadotropins and receptors. Much new knowledge is expected to be forthcoming in these areas. The authors also do not discuss the renin-angiotensin system in the ovary or even mention important topics of recent concern such as ovarian cancer.
The book will be useful, particularly for teaching in reproductive medicine, fertility and infertility centers, and research laboratories. For the clinical researcher, the book will be a source of basic knowledge, whereas the basic researcher can extract essential clinical information of normal and physiopathologic states.
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