Family Practice Vol. 19, No. 5, 572-573
© Oxford University Press 2002
Book review |
The Cambridge guide to infertility management and assisted reproduction.
Godwin I Meniru. (289 pages, £32.95, US$47.95.) Cambridge University Press, 2001. ISBN 0-521-01071-3.
Senior Research Fellow in the Cancer Research UK General Practice Research Group in Oxford
Infertility is believed to affect some 60–80 million couples worldwide. This book is intended to be a practical, accessible guide to infertility and its treatments. The sequence is logical: the first chapters provide an overview of male and female reproductive physiology and the process of fertilization, implantation and early development. Next come chapters on the causes of infertility and the clinical evaluation of the infertile couple. These are followed by chapters describing techniques of assisted reproduction including intra-cytoplasmic sperm injection, surgical sperm retrieval, intra-tubal replacement of gametes and embryos (GIFT, ZIFT), intrauterine insemination, cryo-preservation techniques and frozen embryo replacement and assisted hatching. There is a final chapter on pre-implantation genetic diagnosis (PGD) of diseases.
The chapters on treatments all have a brief conclusion in which Meniru assesses the contribution of the treatment. Each has a bibliography, although the length of these ranges from two references for the chapter on fertilization, implantation and early development, to a four page bibliography on intrauterine insemination—which was the subject of a 1997 edited collection by the author. There are many illustrations—almost every page has a photograph or diagram.
Those with basic knowledge about reproductive physiology will probably skim the first few chapters, but from Chapter 6 (on evaluation of the infertile couple) onwards Meniru’s expertise comes to the fore. He stresses the importance of carrying out investigations that do not waste what may be precious time to the couple, and demonstrates how delays are unnecessary since all of the basic infertility investigations can take place within 1 month.
The sections on treatments include step by step instructions for the procedures, including a sometimes surprising level of detail (e.g. a reminder to note the mobile phone numbers of the couple). The author states in his Preface that there are "institutional as well as regional differences in the manner of evaluating and treating infertile couples" and hopes that these will diminish when evidence-based protocols become more widely used.
This guide is intended primarily for health professionals and students, but, as the author notes, couples who are affected by infertility may find it helpful in dealing with the problem and making decisions about treatments. Meniru does describe what some procedures may be like from the patients’ perspective, but a useful addition to this (and many other medical text books too) would be interview excerpts from men and women who had been through the investigations and treatments. While Meniru writes as a concerned and sympathetic clinician, the inclusion of the couple’s perspective would enhance the guide, not only for those seeking treatment but also for the professional audience.
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