,Speroff’s
CLINICAL GYNECOLOGIC
ENDOCRINOLOGY AND INFERTILITY
,Speroff’s
CLINICAL GYNECOLOGIC
ENDOCRINOLOGY AND INFERTILITY
Ninth Edition
Hugh S. Taylor, MD
Lubna Pal, MBBS, MS
Emre Seli, MD
Department of Obstetrics, Gynecology and
Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
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Development Editor: Ashley Fischer
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Ninth edition
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,Associate Contributors
Baris Ata, MD, MSc
Visiting Professor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
Stephen Collins, MD, PhD
Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
Valerie Flores, MD
Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
Olga Grechukhina, MD
Clinical Instructor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
Pinar Kodaman, MD, PhD
Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
Alexander M. Kotlyar, MD
Clinical Instructor
,Department of Reproductive Endocrinology and Infertility
Yale School of Medicine
New Haven, Connecticut
Amir Mor, MD, PhD
Clinical Instructor
Department of Reproductive Endocrinology and Infertility
Yale School of Medicine
New Haven, Connecticut
Samantha Simpson, MD
Clinical Instructor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
Reshef Tal, MD, PhD
Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale School of Medicine
New Haven, Connecticut
Saioa Torrealday, MD
Assistant ProfessorUniformed Services University of the Health Sciences
Walter Reed National Military Medical Center
Bethesda, Maryland
,Foreword
I was extremely pleased when I learned that the ninth edition of this textbook would
once again be coming from Yale. And I reacted with a strong sense of honor and
gratitude when I saw my name on the cover. It was 47 years ago at Yale when Bob
Glass and Nathan Kase invited me to join them in writing a textbook on infertility and
reproductive endocrinology. That manuscript, typed on a Royal portable typewriter,
appeared a year later, 273 pages long for a price of $17. Each edition grew in weight,
size, and price, and so did the challenge and amount of work required.
Being associated with this book has been one of the best and most rewarding
experiences in my career. It opened doors for me, not only in our own country but all
over the world. Because of this book, I and my family made many new friends and
visited places that otherwise would have existed only in my dreams.
It is good to see Yale Blue once again on the cover. It is also with great emotional
warmth that I view the Macedonian Star on the cover, a feature that was introduced with
the sixth edition of the book. The Macedonian Star is a symbol that dates from the days
of Philip of Macedon and Alexander the Great. How I wish that my grandparents and
father, who came from Macedonia to America in 1921, could see the cover of the ninth
edition.
In the Preface to the last edition, I told a story that bears repeating. In 1999, I was
standing on a street corner in New York City waiting for the change in the light. For
unknown reasons, I was struck in that moment with a thought that was so strong, I was
frozen in my tracks. I stood there thinking, while everyone else crossed the street, that
what was written in this book could have an impact on individual patients. The force
behind this thought was a sudden appreciation for the enormity of the responsibility that
comes with writing a clinical book to transmit accurately the knowledge that is based on
all available evidence. This important task has grown progressively larger in its scope
with the explosion of scientific and medical reports in each passing decade. And yet, as
always, there are physiologic events and pathologic disturbances that are not currently
understood. For this reason, authors writing a clinical book must still draw upon their
own experiences and offer judgments regarding the understanding and care of patients.
I hope this book, dedicated to the care of patients, continues to be used by students,
residents, and clinicians. If anyone appreciates how much work goes into clinical
writing, I certainly do. And so, a heart-felt thank you to my Yale colleagues for their
commitment and effort in bringing the ninth edition to publication.
, Leon Speroff, MD
Professor Emeritus of Obstetrics and Gynecology
Oregon Health & Science University
Portland, Oregon
,Preface
It is a tremendous honor for us to author Speroff’s Gynecologic Endocrinology and
Infertility. This text has been considered the classic in the field. It is the resource that
most of us initially used to learn reproductive physiology and endocrinology. How does
one rewrite a text that is the classic in the field? Rather than be so presumptuous as to
try and improve on Dr. Speroff’s writing, we took the approach of updating a classic
text by adding new information; we focused on changes and advances that have occurred
in the field since prior editions. These include new chapters on transgender medicine
and fertility preservation. We left as much as Dr. Speroff’s original prose as possible.
We are indebted to Dr. Speroff for entrusting us with his treatise.
This text originated in the Department of Obstetrics and Gynecology at the Yale
School of Medicine. Drs. Speroff, Glass, and Kase were all faculty in the department at
the time and all contributed. However, Dr. Speroff’s passion for writing and education
allowed him to persist through the multiple editions of the book, continually improving
and expanding on the text. The book travelled with him to numerous academic
institutions. Speroff’s Gynecologic Endocrinology and Infertility now triumphantly
returns to Yale, its place of birth, with a new set of authors on the Yale faculty.
Discussion surrounding the transition occurred originally at a meeting of the Yale
Obstetrics and Gynecologic Society in New Haven. At that meeting, we honored Dr.
Speroff with our distinguished alumni award. When he suggested returning the book to
its rightful home, we were eager to take on the challenge.
The book is indeed a group effort of all the authors and many other contributors. In
addition to Dr. Speroff, the authors would like to thank Dr. Marc Fritz who led this text
through several prior editions. His contributions clearly helped to keep the book current
over the past several years. We also want to thank our publisher, Wolters Kluwer, for
their persistence, dedication, and encouragement along the way. In particular, we thank
Chris Teja and Ashley Fischer for their leadership and organizational skills without
which this book would not be in print until well after its current publication date.
We hope that the readers of this book will gain as much from it as each of us
previously has during our careers. Nothing will bring us more satisfaction than to
inspire the next generation of women’s health professionals.
Hugh S. Taylor, MD
Lubna Pal, MBBS, MS
Emre Seli, MD
, Yale School of Medicine
New Haven, Connecticut
