BOOK REVIEW: Subfertility, Reproductive Endocrinology and Assisted Reproduction, by Jane Stewart
Reviewed by: Pietro Bortoletto, M.D.
The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine
It is not often that you find a clinical textbook that gets it "just right". At 33 chapters long, “Subfertility, Reproductive Endocrinology and Assisted Reproduction” by Dr. Jane A. Stewart covers a lot of ground. However, its 8.5 page per chapter average makes the text a very easy and enjoyable read - particularly as a trainee with limited time to pour over the more traditional 80 page chapters of other books. Written by some of the luminaries in the field of reproductive medicine, this U.K. centric text offers a "what you need to know" review of every aspect of assisted reproductive technology while curating key references for classic article and highlighting non-traditional topic areas.
One of the most telling signs that this is a thoughtfully written book is that it starts with a chapter entitled “The Patient’s Perspective” written by Journalist and former IVF patient, Kate Brian. By centering the patient experience this book starts by tackling the negative media portrayal of IVF, addresses the rise of untested therapies, and highlights the importance of how patients cope with cycle failure. Once it acknowledges how integral the patient is to everything we do, the book builds on this ethos with every chapter that follows. Towards the end of the text, patients are again drawn into the fold with a thoughtful discussion about gamete donation, donor recruitment, and fertility preservation in a way that is less scientific but more of an acknowledgement of partnering with patients for treatment success. These chapters are a refreshing break from some of the more dense content areas such as assessment of tubal patency.
This book reads more like practice bulletin than review article. For the reader looking for quick bits of information, the chapters on congenital uterine anomalies, tubal factor infertility, and endometriosis offer more than enough to enter a counseling session armed with data and context. In fact, the chapter on evaluation and management of recurrent miscarriage has already become my go-to text for the patient who wants a data-driven understanding of the path ahead in their diagnosis and management. If you are looking for a little controversy – the chapters on PGT and add-on therapies is enough to satiate any critical student of the modern IVF literature.
In addition to the core topics, this textbook also covers non-traditional, but entirely important and helpful content areas. I have never read a text that highlights training paths within reproductive medicine in addition to discussing the regulatory & quality management aspects of the IVF clinic. This text does and goes a step further to really cover topics often relegated to other books. The chapters on the physiology, evaluation, and management of male infertility really round out the value of this book junior learners. Perhaps the best chapter is an in-depth review of the semen analysis and other adjunctive sperm tests, in a way that the any practitioner in the realm of assisted reproduction should clearly understand.
While this book certainly doesn’t cover everything with the depth it deserves – it makes an effort to skim several surfaces. For the learner looking to better understand ovarian stimulation, oocyte retrieval, embryo transfer, and the IVF lab – ASRM and ESHRE documents are likely to be of more use. However, despite the lack of shiny photographs, elaborate figures, and online portals that others offer, this book offers its own brand of thoroughness. If you are a medical student, Ob/Gyn resident, REI fellow or REI nurse - this is a great first place to start. I enjoyed it immensely and plan to share my copy with trainees entering our field.
Stewart, Jane A. Subfertility, Reproductive Endocrinology and Assisted Reproduction. 1st ed., Cambridge University Press, 2019.