A book review by Emily Hill, Clinical Embryologistat Shropshire & Mid-Wales Fertility Centre
Clinical Reproductive Science: Edited by Michael Carroll
“The more that you read, the more things you will know. The more that you learn, the more places you’ll go.” – Dr. Seuss
As a recent graduate of the NHS Scientist Training Programme, many hours of the past few years have been spent with my head in many text books; perusing and analysing what is currently known across the broad world of reproductive science. This time was necessary to fulfil the needs of competencies, case-based discussions and MSc assignments. Many textbooks have been keystones to aid in my understanding of essential concepts. When I was asked, therefore, to review one of the most recently published compendiums of clinical reproductive science, I began by asking myself two questions:
1. Would this book have been of help to me if I had been given it on day one of the STP?
2. Now, as a clinical scientist, does this book offer to further my own knowledge and professional development?
When first opening the book, the first thing I noticed was how logical the layout is. From page one to 410, the book walks through the essential concepts in a manner conducive to learning for those who are both new and experienced. Complex concepts are explained in an understandable - yet concise – way, with different sections building upon one and other. With the extensive list of many experienced and knowledgeable contributing authors in the world of reproductive science, it could only make for an interesting read.
Section one covers the topics fundamental for every reproductive scientist: from explaining sexual differentiation and male and female anatomy, to gametogenesis, fertilisation and early embryo development. This provides a solid base upon which to build in the subsequent sections. One of the chapters I enjoyed the most in this section concerned the endocrinology of the reproductive system, which can be quite difficult to get to grips with and which I thought was very well explained and presented in both the male and female.
Section two covers the disorders of male and female infertility, providing thorough, yet easy to understand descriptions of the broad range of aetiologies. It encompasses many aspects, including disorders of endocrinology, oocyte aneuploidy and maternal age, pathologies, infections, nutrition and lifestyle. There are many well-presented figures which aid in understanding, some of which you may not want to see before lunch! Overall, this chapter builds an in-depth clinical picture of many of our patients and brings largely biological concepts firmly into the clinical setting.
Section three encompasses IVF and Assisted Reproductive Technologies (ART): from assessing the infertile couple, stimulation regimes, oocyte retrieval, sperm preparation, IVF and ICSI, culture, incubators, embryo transfer, cryopreservation, PGD and long term follow up. What I personally liked about this section was the bringing together the pieces of the infertility puzzle from section two, with helpful flow diagrams of different current treatment options. During my training, one of the biggest headaches was in fully understanding the different stimulation regimes and their clinical application to different patient cohorts. In this book, there is a chapter dedicated to this, explaining the choice of gonadotropins as well as a useful visual application timeline, which is most welcome for those who may often question “which is the antagonist protocol again?!”.
In this section, I was also pleased and interested to see a chapter on the embryonic environment in vivo and in vitro and how this can impact on not just the development of embryos, but health of subsequent children. As embryologists, I feel we may sometimes be so very focussed on culturing the ‘prettiest’ embryos and achieving a pregnancy that we forget the impact our practice may have beneath the embryos surface. This chapter is a reminder of the potential environmentally-induced embryonic programming and how much we still have to learn about the effect culture conditions may have on future generations.
In summary, the answer to both of my opening questions is a big YES! I thoroughly recommend this book both for trainees as well as those who would like an updated reference on what is known of clinical reproductive science in 2018. As much as one can ‘enjoy’ reading a textbook, I must say that I did enjoy both reading and reviewing (however strange that may sound). It is both well written, well presented. I feel as though I have come away with a broader understanding of concepts I already thought I knew, and with an aspiration to find out more for myself.