Reproductive medicine
Encyclopedia
Reproductive medicine is a branch of medicine
that deals with prevention, diagnosis and management of reproductive problems; goals include improving or maintaining reproductive health
and allowing people to have children at a time of their choosing. It is founded on knowledge of reproductive anatomy
, physiology
, and endocrinology
, and incorporates relevant aspects of molecular biology
, biochemistry
and pathology
.
, family planning
, birth control
, infertility
, reproductive system disease
(including sexually transmitted disease
s) and sexual dysfunction
. In women, reproductive medicine also covers menstruation
, ovulation
, pregnancy
and menopause
, as well as gynecologic disorders that affect fertility.
The field cooperates with and overlaps mainly with reproductive endocrinology and infertility
, sexual medicine
and andrology
, but also to some degree with gynecology, obstetrics
, urology
, genitourinary medicine
, medical endocrinology
, pediatric endocrinology
, genetics
, and psychiatry
.
may be needed. Treatment methods include counseling, pharmacology (e.g. fertility medication
), surgery, and other methods.
In vitro fertilization has evolved as a major treatment modality that has enabled the study of the embryo
prior to implantation.
, or in urology followed by training in andrology
. For reproductive medicine specialists in contraception, other methods of training are possible. Specialists tend to be organized in specialty organizations such as American Society of Reproductive Medicine
(ASRM) and European Society of Human Reproduction and Embryology
(ESHRE).
may be inhibited by a reluctance of the patient to disclose intimate or uncomfortable information. Even if such an issue is on the patient's mind, he or she often doesn't start talking about such an issue without the physician initiating the subject by a specific question about sexual or reproductive health
. Some familiarity with the doctor generally makes it easier for patients to talk about intimate issues such as sexual subjects, but for some patients, a very high degree of familiarity may make the patient reluctant to reveal such intimate issues. When visiting a health provider about sexual issues, having both partners of a couple present is often necessary, and is typically a good thing, but may also prevent the disclosure of certain subjects, and, according to one report, increases the stress level.
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
that deals with prevention, diagnosis and management of reproductive problems; goals include improving or maintaining reproductive health
Reproductive health
Within the framework of the World Health Organization's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system...
and allowing people to have children at a time of their choosing. It is founded on knowledge of reproductive anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
, physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
, and endocrinology
Endocrinology
Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation and the coordination of...
, and incorporates relevant aspects of molecular biology
Molecular biology
Molecular biology is the branch of biology that deals with the molecular basis of biological activity. This field overlaps with other areas of biology and chemistry, particularly genetics and biochemistry...
, biochemistry
Biochemistry
Biochemistry, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...
and pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
.
Scope
Reproductive medicine addresses issues of sexual education, pubertyPuberty
Puberty is the process of physical changes by which a child's body matures into an adult body capable of reproduction, as initiated by hormonal signals from the brain to the gonads; the ovaries in a girl, the testes in a boy...
, family planning
Family planning
Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...
, birth control
Birth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...
, infertility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
, reproductive system disease
Reproductive system disease
A reproductive system disease is any disease that impairs the ability to reproduce.Such diseases may arise from genetic or congenital abnormalities, such as hermaphroditism, from functional problems such as impotence or infertility or reproductive tract infections, such as sexually transmitted...
(including sexually transmitted disease
Sexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
s) and sexual dysfunction
Sexual dysfunction
Sexual dysfunction or sexual malfunction refers to a difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including desire, arousal or orgasm....
. In women, reproductive medicine also covers menstruation
Menstruation
Menstruation is the shedding of the uterine lining . It occurs on a regular basis in sexually reproductive-age females of certain mammal species. This article focuses on human menstruation.-Overview:...
, ovulation
Ovulation
Ovulation is the process in a female's menstrual cycle by which a mature ovarian follicle ruptures and discharges an ovum . Ovulation also occurs in the estrous cycle of other female mammals, which differs in many fundamental ways from the menstrual cycle...
, pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
and menopause
Menopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...
, as well as gynecologic disorders that affect fertility.
The field cooperates with and overlaps mainly with reproductive endocrinology and infertility
Reproductive endocrinology and infertility
Reproductive endocrinology and infertility is a surgical subspecialty of obstetrics and gynecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility...
, sexual medicine
Sexual medicine
Sexual medicine is a medical specialty that deals with sexual health. At times heavily influenced by current local views on morality, with heavy cultural overlay, in broad terms this specialty is concerned with diagnosing, assessing and treating all aspects which relate to sexuality.Issues can be...
and andrology
Andrology
Andrology is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. It is the counterpart to gynaecology, which deals with medical issues which are specific to the female reproductive...
, but also to some degree with gynecology, obstetrics
Obstetrics
Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...
, urology
Urology
Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological...
, genitourinary medicine
Genitourinary medicine
Genitourinary medicine is a portmanteau that includes aspects of andrology, gynecology and urology. It is primarily related to medicine dealing with sexually transmitted diseases.- References :...
, medical endocrinology
Endocrinology
Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation and the coordination of...
, pediatric endocrinology
Pediatric endocrinology
Pediatric endocrinology is a medical subspecialty dealing with variations of physical growth and sexual development in childhood, as well as diabetes and other disorders of the endocrine glands....
, genetics
Genetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
, and psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
.
Methods
In the assessment of patients imaging techniques, laboratory methods and reproductive surgeryReproductive surgery
Reproductive surgery is using surgery in the field of reproductive medicine. It can be used for contraception, e.g. in vasectomy, wherein the vasa deferentia of a man are severed, but is also used plentifully in assisted reproductive technology....
may be needed. Treatment methods include counseling, pharmacology (e.g. fertility medication
Fertility medication
Fertility medication are drugs which enhance reproductive fertility. For women, fertility medication is used to stimulate follicle development of the ovary...
), surgery, and other methods.
In vitro fertilization has evolved as a major treatment modality that has enabled the study of the embryo
Embryo
An embryo is a multicellular diploid eukaryote in its earliest stage of development, from the time of first cell division until birth, hatching, or germination...
prior to implantation.
Education and training
Specialists in reproductive medicine usually undergo training in obstetrics and gynecology followed by training in reproductive endocrinology and infertilityReproductive endocrinology and infertility
Reproductive endocrinology and infertility is a surgical subspecialty of obstetrics and gynecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility...
, or in urology followed by training in andrology
Andrology
Andrology is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. It is the counterpart to gynaecology, which deals with medical issues which are specific to the female reproductive...
. For reproductive medicine specialists in contraception, other methods of training are possible. Specialists tend to be organized in specialty organizations such as American Society of Reproductive Medicine
American Society of Reproductive Medicine
The American Society for Reproductive Medicine is an organization that wants to advance the "art, science, and practice of reproductive medicine". It provides a forum for lay public, researchers, physicians and affiliated health workers through education, publications, and meetings...
(ASRM) and European Society of Human Reproduction and Embryology
European Society of Human Reproduction and Embryology
The European Society of Human Reproduction and Embryology was founded in 1985 by Robert Edwards and J. Cohen , who felt that the study and research in the field of reproduction needed to be encouraged and recognized.- Aims :...
(ESHRE).
Anamnesis
The anamnesis or medical history taking of issues related to reproductive or sexual medicineSexual medicine
Sexual medicine is a medical specialty that deals with sexual health. At times heavily influenced by current local views on morality, with heavy cultural overlay, in broad terms this specialty is concerned with diagnosing, assessing and treating all aspects which relate to sexuality.Issues can be...
may be inhibited by a reluctance of the patient to disclose intimate or uncomfortable information. Even if such an issue is on the patient's mind, he or she often doesn't start talking about such an issue without the physician initiating the subject by a specific question about sexual or reproductive health
Reproductive health
Within the framework of the World Health Organization's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system...
. Some familiarity with the doctor generally makes it easier for patients to talk about intimate issues such as sexual subjects, but for some patients, a very high degree of familiarity may make the patient reluctant to reveal such intimate issues. When visiting a health provider about sexual issues, having both partners of a couple present is often necessary, and is typically a good thing, but may also prevent the disclosure of certain subjects, and, according to one report, increases the stress level.
Literature
- Lipshultz LI, Khera M, Atwal DT. Urology and the Primary Care Practitioner. Philadelphia: Elsevier, 2008.
- Naomi Pfeffer: The Stork and the Syringe: A Political History of Reproductive Medicine (Feminist Perspectives) Polity Press 1993, ISBN 0745611877
- Speroff L, Glass RH, Kase NG. Clinical Gynecologic Endocrinology and Infertility. Fifth Edition. Williams and Wilkins, Baltimore MD, 1994 ISBN 0-683-07899-2