Royal College of Obstetricians and Gynaecologists Study Group – serie

Reproductive ageing affects both individuals and wider society, and obstetricians and gynaecologists are witness to the impact of reproductive ageing and to some of the fears and misapprehensions of the general public. This book raises awareness of societal trends and their implications. The wider importance of the subject to the whole of society is emphasized by contributions from outside the world of obstetrics and gynaecology, both within and outside medicine. The 56th RCOG Study Group brought together a range of experts to examine reproductive ageing. This book presents the findings of the Study Group, with sections covering: • background to ageing and demographics • basic science of reproductive ageing • pregnancy: the ageing mother and medical needs • the outcomes: children and mothers • future fertility insurance: screening, cryopreservation or egg donors? • sex beyond and after fertility • fertility treatment: science and reality - the NHS and the market • the future: dreams and waking up.

Great progress has been made in genetics in recent years, with significant consequences for the field of reproductive genetics. The ability to identify genetic defects before implantation, to diagnose fetal abnormalities and to introduce screening programmes means that genetic testing now has a major role in preventive medicine. The 57th RCOG Study Group brought together a range of experts to examine the many clinical, ethical and societal issues around reproductive genetics. This book presents the findings of the Study Group, covering a range of disorders, advances in treatments and techniques, as well as the importance of educating the public and the potential ethical dilemmas that may arise as a result of new scientific findings and new methodologies.

Millennium Development Goals (MDGs) 4 and 5, created under the auspices of the United Nations, challenged political, financial, medical and civil society leaders to improve both child and maternal health. The 58th RCOG Study Group brought together a range of experts - including midwives, obstetricians and gynaecologists, anaesthetists and paediatricians - to provide an up-to-date review of progress to date and the challenges around meeting these MDGs. This book presents the findings of the Study Group, with sections covering: • the size of the problem • clinical problems and solutions - maternal • clinical problems and solutions - neonatal • training and development • specific challenges in specific countries (Afghanistan, Zimbabwe, Egypt and Sri Lanka).

Polycystic ovary syndrome (PCOS) is the most common endocrine disturbance, affecting 10-15% of women in the UK. The definition of PCOS has been much debated, while its pathophysiology appears to be multifactorial and is still being actively researched. There is no doubt that PCOS has a significant effect on quality of life and psychological morbidity and, as many specialists are involved in its management, a multidisciplinary approach is required. The 59th RCOG Study Group brought together a range of experts who treat women with PCOS. This book presents the findings of the Study Group, including: • A definition of PCOS • The accuracy of diagnostic interventions • The particular challenges of adolescent diagnosis and management • The correlation to ethnicity • Current approaches to therapy • The potential individualisation of therapy • The role of the alternative therapies used to manage some aspects of PCOS.

Gynaecological cancers are categorised as 'rare' diseases, although collectively they affect over 16,000 women each year in the UK alone. There is a lack of real understanding of these conditions compared with other malignancies, possibly owing to their relative rarity when viewed as individual diseases. The 60th RCOG Study Group brought together a range of experts to examine as many biological aspects of gynaecological cancers as possible, including both surgical and non-surgical therapies. This book presents the findings of the Study Group, with contents including: • current understanding of the biology of gynaecological cancers • translation of biology to the clinic • state of the art in imaging and therapy • current clinical trials • advances in multimodal therapy • individualised treatment.