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Ovarian Stimulation 1st Edition Mohamed Aboulghar Md
Digital Instant Download
Author(s): Mohamed Aboulghar MD, Botros Rizk
ISBN(s): 9780521197359, 052119735X
Edition: 1
File Details: PDF, 13.05 MB
Year: 2011
Language: english
Ovarian Stimulation
Ovarian Stimulation

Edited by
Mohamed Aboulghar
Cairo University and The Egyptian IVF-ET Center

and
Botros Rizk
University of South Alabama
c a mb rid g e u n iv e r si t y pres s
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore,
São Paulo, Delhi, Dubai, Tokyo, Mexico City

Cambridge University Press

The Edinburgh Building, Cambridge CB2 8RU, UK

Published in the United States of America by Cambridge University Press, New York

www.cambridge.org
Information on this title: www.cambridge.org/9780521197359

© Cambridge University Press 2011

This publication is in copyright. Subject to statutory exception

and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.

First published 2011

Printed in the United Kingdom at the University Press, Cambridge

A catalogue record for this publication is available from the British Library

Library of Congress Cataloguing in Publication data

Ovarian stimulation / edited by Mohamed Aboulghar, Botros Rizk.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-521-19735-9 (hardback)
1. Ovulation–Induction. 2. Fertilization in vitro, Human. 3. Infertility, Female–Treatment. 4. Human
reproduction–Endocrine aspects. 5. Ovaries. I. Aboulghar, Mohamed. II. Rizk, Botros.
[DNLM: 1. Ovulation Induction–methods. 2. Fertilization in Vitro–methods. 3. Infertility–therapy. WP 540]
RG133.7.O83 2011
618.1′7806–dc22
2010040405

ISBN 978-0-521-19735-9 Hardback

Cambridge University Press has no responsibility for the persistence or

accuracy of URLs for external or third-party internet websites referred to in
this publication, and does not guarantee that any content on such websites is,
or will remain, accurate or appropriate.

Every effort has been made in preparing this book to provide accurate and up-to-date information
which is in accord with accepted standards and practice at the time of publication. Although case
histories are drawn from actual cases, every effort has been made to disguise the identities of the
individuals involved. Nevertheless, the authors, editors, and publishers can make no warranties that
the information contained herein is totally free from error, not least because clinical standards are
constantly changing through research and regulation. The authors, editors, and publishers therefore
disclaim all liability for direct or consequential damages resulting from the use of material contained
in this book. Readers are strongly advised to pay careful attention to information provided by the
manufacturer of any drugs or equipment that they plan to use.
To a dear friend, an honorable man, a legendary scientist, a Nobel Prize
winner and a world renowned leader.
To Professor Robert Geoffrey Edwards, the father of IVF and four million
babies worldwide.
We dedicate this book to you in gratitude for your friendship, mentorship
and leadership.
The world, East and West, has respected you, and we loved you and honored
you.
Contents
List of contributors page ix
About the editors xiii
Foreword by Alan H. De Cherney xv
Preface xvi

Section 1 – Mild forms of ovarian Section 3 – Difficulties and complication

stimulation of ovarian stimulation
1 Oral agents for ovarian stimulation 1 9 Ovarian hyperstimulation for poor
Mohamed F. Mitwally and Robert F. Casper responders 77
William B. Schoolcraft and Eric S. Surrey
2 Ovulation induction for anovulatory
patients 14 10 Polycystic ovarian syndrome 87
Evert J. P. van Santbrink and Bart C. J. M. Fauser C. Coughlan and W. Ledger

3 Mild ovarian hyperstimulation in combination 11 Ovarian hyperstimulation syndrome 103

with intrauterine insemination 27 Botros Rizk and Mohamed Aboulghar
Ben J. Cohlen and Astrid E. P. Cantineau
12 How to select ovarian stimulation protocols to
4 Mild approaches in ovarian stimulation 34 avoid difficulties and complications 130
Geeta Nargund and Claire Basille Ziad Rafic Hubayter and Suheil J. Muasher

Section 2 – Ovarian hyperstimulation Section 4 – Non-conventional forms

for IVF used during ovarian stimulation
5 GnRH agonists for ovarian 13 Adjuncts for ovarian stimulation 143
hyperstimulation 42 David R. Meldrum
Richard Fleming
14 Chorionic gonadotropin and luteinizing
6 Role of GnRH antagonist in assisted hormone supplementation during ovarian
reproduction 49 stimulation 151
Mohamed Aboulghar M. Filicori, G.E. Cognigni, W. Ciampaglia,
P. Pocognoli, C. Tabarelli, L. Parmegiani, and
7 Gonadotropins in ovarian stimulation 61 A. Arnone
Madelon van Wely and Monique Mochtar
15 Ovulation induction for hypogonadotropic
8 Progesterone during controlled ovarian hypogonadism 162
hyperstimulation 67 Paraskevi Xekouki and George Tolis
Ernesto Bosch

vii
 Contents

Section 5 – Alternatives to ovarian Section 6 – Procedures before, during,

hyperstimulation and after ovarian stimulation
16 Natural cycle IVF 173 20 Ultrasound monitoring for ovulation
Mauro Schimberni, Marco Sbracia, Annalise induction: pitfalls and problems 217
Giallonardo, and Francesco Morgia Mona M. Aboulghar

17 In vitro maturation of oocytes 181 21 Triggering of final oocyte maturation in

Baris Ata, Dan Levin, Hananel Holzer, and Seang ovarian stimulation 233
Lin Tan Georg Griesinger and Efstratios Kolibianakis

18 Treatment of hyperprolactinemia 195 22 Luteal phase support in in vitro

Hany F. Moustafa, Botros Rizk, Ahmet fertilization 244
Helvacioglu, and Shannon Gilmore Biljana Popović-Todorović and Human Mousavi
Fatemi
19 Ovarian cautery for polycystic ovary
syndrome 209 23 Ovarian reserve as a guide for ovarian
Gabor T. Kovacs stimulation 255
Luciano G. Nardo and Lamiya Mohiyiddeen

Index 262

viii
Contributors

Mohamed Aboulghar Astrid E. P. Cantineau

Department of Obstetrics and Gynecology Fertility Centre Isala
Faculty of Medicine Isala Clinics Zwolle
Cairo University The Netherlands
Cairo
Robert F. Casper
Egypt
Division of Reproductive Sciences
The Egyptian IVF-ET Center Department of Obstetrics and Gynecology
Hadayek Al Maadi Mount Sinai Hospital
Cairo Toronto, Ontario
Egypt Canada
Mona M. Aboulghar W. Ciampaglia
Department of Obstetrics and Gynecology Medicine Unit
The Egyptian IVF Center Gynepro Medical Centers
Cairo Bologna
Egypt Italy
A. Arnone G. E. Cognigni
Medicine Unit Medicine Unit
Gynepro Medical Centers Gynepro Medical Centers
Bologna Bologna
Italy Italy
Baris Ata Ben J. Cohlen
McGill Reproductive Center Fertility Care Centre
Royal Victoria Hospital Isala Clinics Zwolle
Montreal, Quebec Location Sophia
Canada The Netherlands
Claire Basille C. Coughlan
Create Health Clinic Academic Unit of Reproductive and Developmental
West Wimbledon Medicine
UK University of Sheffield
UK
Ernesto Bosch
Ginecólogo Alan H DeCherney
IVI, Valencia Branch chief of Reproductive Biology and Medicine
Plaza Policia National Institute of Child Health and HumM
Valencia Development
Spain Bethesda , Maryland
USA

ix
 List of contributors

Human Mousavi Fatemi Division of Reproductive Endocrinology and

Centre for Reproductive Medicine Infertility
UZ Brussels Lutherville, MD
Belgium USA
Bart C. J. M. Fauser Efstratios Kolibianakis
Chair, Division Woman and Baby Unit for Human Reproduction
University Medical Center, Department of Obstetrics and Gynaecology
Utrecht Medical School, Aristotle University of Thessaloniki
The Netherlands Thessaloniki
Greece
M. Filicori
Medicine Unit Gabor T. Kovacs
Gynepro Medical Centers Monash IVF
Bologna Victoria
Italy Australia
Richard Fleming W. Ledger
GCRM Ltd Academic Unit of Reproductive and Developmental
Glasgow Medicine
UK University of Sheffield
Sheffield
Annalise Giallonardo
UK
Bioroma IVF Center
University of Rome Dan Levin
Rome McGill Reproductive Center
Italy Royal Victoria Hospital
Shannon Gilmore Montreal, Quebec
Gynecology and Infertility Associates Canada
Fairhope, AL David R. Meldrum
USA University of California at Los Angeles and
Georg Griesinger San Diego
University Hospital of Schleswig-Holstein Redondo Beach, CA
Campus Luebeck USA
Luebeck
Mohamed F. Mitwally
Germany
Division of Reproductive Sciences
Ahmet Helvacioglu Department of Obstetrics and Gynecology
Gynecology and Infertility Associates Mount Sinai Hospital
Fairhope, AL Toronto, Ontario
USA Canada
Hananel Holzer Monique Mochtar
McGill Reproductive Center Center for Reproductive Medicine
Royal Victoria Hospital Academic Medical Center
Montreal, Quebec University of Amsterdam
Canada Amsterdam
Ziad Rafic Hubayter The Netherlands
The Johns Hopkins University School of Medicine Lamiya Mohiyiddeen
Department of Gynecology and Obstetrics Department of Reproductive Medicine

x
 List of contributors

IVF Unit, St Mary’s Hospital Belgium

CMFT University Hospitals
Whitworth Park Botros Rizk
Manchester Department of Obstetrics and Gynecology
UK University of South Alabama College of Medicine
Mobile, AL
Francesco Morgia USA
Bioroma IVF Center
Marco Sbracia
University of Rome
Rome Bioroma IVF Center
Italy University of Rome
Rome
Hany F. Moustafa Italy
Department of Obstetrics and Gynecology
Mauro Schimberni
USA College of Medicine
Mobile, AL Bioroma IVF Center
USA University of Rome
Rome
Suheil J. Muasher Italy
The Muasher Center for Fertility and IVF William B. Schoolcraft
Fairfax, VA
Colorado Center for Reproductive Medicine
USA
Lone Tree, CO
Luciano G. Nardo USA
Department of Reproductive Medicine Eric S. Surrey
IVF Unit, St Mary’s Hospital Colorado Center for Reproductive Medicine
CMFT University Hospitals Lone Tree, CO
Whitworth Park USA
Manchester
UK C. Tabarelli
Medicine Unit
Geeta Nargund Gynepro Medical Centers
Department of Obstetrics and Gynecology Bologna
St George’s Hospital Italy
London
UK Seang Lin Tan
McGill Reproductive Center
L. Parmegiani Royal Victoria Hospital
Medicine Unit Montreal, Quebec
Gynepro Medical Centers Canada
Bologna
Italy George Tolis
Department of Internal Medicine
P. Pocognoli Division of Endocrinology and Metabolism
Medicine Unit Hippocratio General Hospital
Gynepro Medical Centers Athens
Bologna Greece
Italy
Evert J. P. van Santbrink
Biljana Popović-Todorović Erasmus Medical Center
Centre for Reproductive Medicine Rotterdam
UZ Brussels The Netherlands

xi
 List of contributors

Madelon van Wely Paraskevi Xekouki

Center for Reproductive Medicine Clinical Associate
Academic Medical Center Division of Endocrinology and Metabolism
University of Amsterdam Department of Medicine
Amsterdam Athens University
The Netherlands Athens
Greece

xii
About the editors

Mohamed Aboulghar Membership of the European Society of Human

Mohamed Aboulghar, M.D. is Professor of Obstetrics Reproduction and Embryology (Berlin 2004).
and Gynecology, Faculty of Medicine, Cairo University For several years, he has been an associate edi-
and Clinical Director and founder of The Egyptian tor for Human Reproduction and the American
IVF-ET Center, Maadi, Cairo, Egypt, (the first IVF cen- Journal of Obstetrics and Gynecology. He is also cur-
ter in Egypt). He is also the founder and first president rently a reviewer for Human Reproduction, Human
of the Middle East Fertility Society (MEFS) and Editor- Reproduction Update, Fertility and Sterility and many
in-Chief and founder of the Middle East Fertility Society more international journals.
Journal (since 1996). He has organized 20 international conferences in
He has published over 200 papers in top inter- the Middle East, and chaired 3 pre-congress courses
national and regional medical journals, and over 20 in the American Society for Reproductive Medicine
chapters in international books. (ASRM) annual conference.
He received the Egyptian National Award for
Botros Rizk
Excellency in Medical Sciences in 2000 and Honorary
Botros Rizk, M.D. is Professor and Chief of the Division
of Reproductive Endocrinology and Infertility of
the Department of Obstetrics and Gynecology at
the University of South Alabama, Mobile, Alabama,

xiii
 About the editors

USA. He is also Program Director and Medical and has edited and authored ten medical textbooks on
Scientific Director of the USA IVF and ART Program, ovarian hyperstimulation syndrome, infertility and
and Laboratory Director and Clinical Consultant at assisted reproduction, endometriosis, ultrasonog-
the Reproductive Endocrinology Laboratory of the raphy in reproductive medicine, ovarian stimulation
University of South Alabama. and the futue of ART.
Professor Rizk has worked as a research scien- He is past chair of the ASRM international mem-
tist and clinician in reproductive medicine for more bersip committee, member of the scientific advisory
than 25 years. His main research interests include the board of the Mediterranean Society for Reproductive
modern management, prediction and the genetics of Medicine, the editorial board of the Middle East Fertility
ovarian hyperstimulation syndrome (OHSS), as well Society Journal and reviewer for several national and
as the role of vascular endothelial growth factor and international journals, as well as for the European
interleukins in the pathogenesis of severe OHSS. He Society of Human Reproduction and Embryology Task
has authored more than 300 peer-reviewed published Force on perinatal outcome and congenital malforma-
papers, book chapters and abstracts. Professor Rizk tions of intracytoplasmic sperm injection.

xiv
Foreword
Alan H. DeCherney
National Institute of Child Health and HumM Development

Ovarian Stimulation is a text that is comprehensive, of novel agents in order to treat the entity, including
insightful, contains a great deal of new information, early aspiration of ascites.
and is well organized, making it easy to read. The book is Individual patient scenarios are also addressed,
divided into 6 sections and 23 chapters and is authored including polycystic ovarian syndrome and the “poor
by leaders in the field from the global community, with responder.” The discussion of the risk, benefits, and
representatives from such places as Canada, Europe, effectiveness of hCG versus LH is included. Of course,
the United States, Egypt, and Australia, to name a few. much of the data, application, and in-depth under-
The chapters evolve from ovarian stimulation standing come from the author’s experience with in
through procedures before, during, and after stimu- vitro fertilization (IVF), which is covered extensively
lation. Oral and injectable agents for ovulation induc- by looking at natural cycle IVF, in vitro maturation of
tion are discussed in great depth, incorporating a fair oocytes, as well as a more traditional approach.
amount of new material. In addition, therapies, such Techniques for monitoring, such as ultrasound and
as intrauterine insemination and laparoscopic ovarian serum estrodiol levels are also discussed in depth.
drilling are critically evaluated. The text is a comprehensive approach for under-
Ovarian Stimulation also addresses the utilization standing ovarian stimulation. There is no lack of infor-
of GnRH, for both solitary use in ovarian stimulation mation as far as this topic is concerned. It is up to date
and for use in combination with other agents. The with contemporary, excellent and established refer-
occasionally serious adverse effect of ovulation induc- ences. The book is a monumental contribution that
tion (i.e., desecrated hyperstimulation syndrome), is enriches our knowledge about a very important topic
looked at in terms of the diagnosis therapy and the use in reproductive endocrinology and infertility.

xv
 Preface

Ovarian stimulation has become an integral part of the The book covers in its different sections and chap-
management of infertility and assisted reproduction. A ters all aspects of ovarian stimulation: the different
glance through scientific journals would demonstrate stimulation protocols from which to choose, the man-
an explosion of publications related to ovarian stimula- agement of poor responders and hyper-responders,
tion. In every world congress and international infertil- triggering ovulation and luteal phase support.
ity meeting the ovarian stimulation session is the most We have thoroughly enjoyed putting this book
popular and lively session of the entire meeting. together and we take this opportunity to thank all
This book was authored by the world leaders in the authors for their friendship and most valuable
infertility and reproductive endocrinology from the contributions.
United States, Canada, Europe, Australia, the Middle To our readers, we put into your hands a concise
East, and Africa. Each contributor has been the pioneer and global book that we hope that you will thoroughly
of the respective area of clinical research and practice. enjoy.

xvi
 Section 1 Mild forms of ovarian stimulation
Chapter

Oral agents for ovarian stimulation

1 Mohamed F. Mitwally and Robert F. Casper

Ovarian stimulation aims at the development of one pituitary gonadotropins in 1958, and the first preg-
or more of the ovarian follicles to reach the stage of nancy was reported two years later [1;2]. One year later,
maturity culminating in the release of one or more in 1961, Bettendorf and his group reported a similar
mature oocytes ready for fertilization. Ovarian follicu- experience [3]. In the same year, Greenblatt and his co-
lar development is under the control of local factors workers published the first results of ovarian stimula-
inside the ovaries (most of it is poorly understood), as tion by an oral agent called at that time MRL/41, later
well as hormones produced from extraovarian sources, known as clomiphene citrate [4]. Over the last two
mainly pituitary gonadotropins. Other hormones may decades, insulin sensitizers have been introduced into
play a role in ovarian follicular development; the extent clinical practice for ovulation induction in polycystic
and details of such a role are not fully understood. ovary syndrome (PCOS) patients with significant insu-
There are two mechanisms for ovarian stimula- lin resistance. The last decade introduced the success
tion: the first involves applying pharmacological agents of a new group of oral agents for ovarian stimulation,
that mimic endogenous gonadotropins (injectable the aromatase inhibitors. The aromatase inhibitor,
gonadotropins) that directly stimulate ovarian follicu- letrozole has been suggested as an alternative to clomi-
lar development through gonadotropin receptors. The phene citrate as an agent for ovulation induction and
second involves pharmacological agents that manipu- to improve the outcome of controlled ovarian stimu-
late and moderate endogenous gonadotropin produc- lation with gonadotropins. In 2000, we presented the
tion. Those agents are oral ovulation induction agents first report in the literature on the success of letrozole
that are believed to stimulate ovulation through moder- in inducing ovulation in anovulatory women with
ating estrogen action, a major regulator of endogenous PCOS [5].
gonadotropin production. This chapter reviews those
agents with a focus on the clinical aspects of their use. Clomiphene citrate
There are two groups of pharmacological agents For more than half a century, clomiphene citrate (CC)
for ovarian stimulation: the first group includes inject- has been the most commonly used agent for ovarian
able gonadotropins and the second group includes oral stimulation. Interestingly, since first reports in the
agents that are estrogen modulators. Oral agents modu- early 1960s, results of CC treatment (ovulation and
late estrogen action, and hence endogenous gonado- pregnancy rates) have not changed appreciably, des-
tropin production through a direct effect on estrogen pite the advent of modern immunoassays for steroid
receptors, i.e., selective estrogen receptor modulators hormones, advances in ultrasound technology for
(SERMs), or through modulation of estrogen produc- cycle monitoring, and the introduction of commercial
tion (inhibition), i.e., aromatase inhibitors, or inhibi- ovulation predictor kits that allow accurate identifica-
tors of the estrogen synthesis enzyme (the aromatase tion of the mid-cycle LH surge. It has been puzzling
enzyme). Clomiphene citrate is the most commonly that CC use has continued all those years as an ovar-
used and known SERM and letrozole is the most com- ian stimulation agent despite the fact that CC citrate is
monly used and known aromatase inhibitor. known as a pregnancy risk category X. This is particu-
The first successful ovarian stimulation case was larly important when considering the relatively long
reported by Gemzell and his co-workers using human half-life of about 5–21 days (depending on the isomer).

Ovarian Stimulation, ed. Mohamed Aboulghar and Botros Rizk. Published by Cambridge University Press. © Cambridge
University Press 2011.

1
 Section 1: Mild forms of ovarian stimulation

Moreover, CC can be stored in body fat. Those facts levels, i.e. estrogen concentrations are falsely perceived
allow CC to accumulate in the body around crucial as low leading to reduced estrogen negative feedback
times of implantation, organogenesis, and embryo- on GnRH production by the hypothalamus and gona-
genesis [6–8]. dotropins (FSH and LH) by the pituitary. During CC
treatment, levels of both LH and FSH rise, then fall
Chemical structure and pharmacokinetics again after the typical 5-day course of therapy is com-
pleted. In successful treatment cycles, one or more
Clomiphene citrate is a nonsteroidal triphenylethyl-
dominant follicles emerge and mature, generating a
ene derivative that exhibits both estrogen agonist and
rising tide of estrogen that ultimately triggers the mid-
antagonist properties, i.e. selective estrogen receptor
cycle LH surge and ovulation [9;10]. It is important to
modulator. Estrogen agonist properties are manifest
stress the two main prerequisites for the success of CC
only when endogenous estrogen levels are extremely
ovarian stimulation: presence of reasonable estrogen
low. Otherwise, CC acts mainly as an antiestrogen [6].
levels in the body and an intact hypothalamic/pituitary
Clomiphene citrate is a racemic mixture of two distinct
axis capable of producing endogenous gonadotropins.
stereoisomers, enclomiphene and zuclomiphene, hav-
ing different properties. Enclomiphene is the more
potent antiestrogenic isomer and the one primarily Regimens of clomiphene citrate
responsible for the ovulation-stimulation actions of administration for ovarian stimulation
CC [6–8]. Enclomiphene has a half-life of few days Clomiphene citrate regimens for ovarian stimulation
while the other isomer, zuclomiphene, is cleared far usually start on the 2nd to 5th day after the onset of
more slowly with levels detectable in the circulation for spontaneous or progestin-induced menses. Treatment
more than one month after treatment and may actu- typically begins with a single 50 mg tablet daily for 5
ally accumulate over consecutive treatment cycles [8]. consecutive days, increasing by 50 mg increments in
Clomiphene citrate is cleared through the liver and subsequent cycles until ovulation is induced. Once the
excreted in the stool. About 85 percent of an admin- effective dose of CC for ovarian stimulation is estab-
istered dose is eliminated after approximately 6 days, lished, there is no indication for further increments
although traces may remain in the circulation for much unless the ovulatory response is lost, i.e. higher doses
longer [7]. will not improve the probability of pregnancy. The day
of starting CC treatment has not been shown to affect
Mechanism of action the ovulation rates, conception rates, or pregnancy
Clomiphene citrate’s structural similarity to estrogen outcome in anovulatory women.
allows it to bind to estrogen receptors (ER) throughout The dose required for achieving ovulation is cor-
the body. Such binding lasts for an extended period of related with body weight. However, there is no reliable
time, up to weeks rather than hours as is the case with way to predict what dose will be required in an individ-
natural estrogen. Such extended binding ultimately ual woman. Although the effective dose of CC ranges
depletes ER concentrations by interfering with the nor- from 50 to 250 mg/day, lower doses (e.g. 12.5 to 25 mg/
mal process of ER replenishment [4]. day) may be tried in some women who are very sen-
It is believed that the hypothalamus is the main site sitive to CC. Most women respond to treatment with
of action because in normally ovulatory women, CC 50 mg (52%) or 100 mg (22%). Although higher doses
treatment was found to increase gonadotropin-releas- are sometimes required, the success rates are usually
ing hormone (GnRH) pulse frequency [9]. However, very low (150 mg, 12%; 200 mg, 7%; 250 mg, 5%). Most
actions at the pituitary level may also be involved since women who fail to respond to 150 mg of CC will ulti-
CC treatment increased pulse amplitude, but not fre- mately require alternative or combination treatments
quency in anovulatory women with polycystic ovar- [11;12].
ian syndrome, in whom the GnRH pulse frequency Pregnancy rates are highest in the early cycles of CC
is already abnormally high [10]. The antiestrogenic treatment (first three cycles) with a significant decline
effect on the hypothalamus, and possibly the pituit- in the chance of achieving pregnancy beyond the third
ary, is believed to be the main mechanism of action for treatment cycle down to a very low chance beyond the
ovarian stimulation. Depletion of hypothalamic ER sixth treatment cycle. For that reason, it is not advisable
prevents correct interpretation of circulating estrogen to continue CC treatment beyond six treatment cycles

2
 Chapter 1: Oral agents for ovarian stimulation

[11]. It is important to mention here that the above soon after treatment ends. Other important side effects
mentioned data come from studies in anovulatory include visual disturbances, e.g. blurred or double
women when CC was used to induce ovulation. On the vision, scotomata, and light sensitivity are generally
other hand, the value of CC treatment in enhancing the uncommon (<2% prevalence) and reversible. However,
chance of achieving pregnancy in cases with ovulatory there are isolated reports of persistent symptoms long
infertility has been questioned [12]. after treatment is discontinued, with more severe com-
plications such as optic neuropathy. Those visual side
Outcome of clomiphene citrate ovarian effects are contraindication for the use of CC that war-
rants stopping treatment and considering alternative
stimulation methods of ovarian stimulation. Other fairly common
In anovulatory women with WHO Type II anovula- but less serious side effects include breast tenderness,
tion, CC has been reported to induce ovulation in 60% pelvic discomfort, and nausea, all observed in 2% to 5%
to 80% of patients with almost two-thirds responding of CC-treated women [14]. In addition, we have noted
to 50 mg or 100 mg dosage levels. After up to three ovu- relatively common reports of premenstrual syndrome-
latory cycles, cumulative conception was encountered type symptoms in women on clomiphene citrate [15].
in a little less than two-thirds of patients (about 60%).
Up to 85% pregnancy rate has been reported after five Multiple-gestation pregnancy
ovulatory cycles with fecundity of about 15% in ovu-
With clomiphene, citrate ovarian stimulation multi-
latory cycles [11]. It is important to realize that these
follicular development is relatively common, which
figures were reported in anovulatory, young women
increases the risk of multiple gestation, reported to be
in whom anovulation was the sole infertility factor.
approximately 8%. However, the overwhelming major-
Interestingly, amenorrheic women are more likely to
ity of multiple gestations that result from CC treatment
conceive than oligomenorrheic women after CC ovar-
are twins. Triplet and higher-order pregnancies are
ian stimulation. This is probably because those who
rare [16]. Several studies have shown that the number
already ovulate, albeit inconsistently (oligomenor-
of multiple-gestation pregnancies can be decreased by
rheic), are more likely to have other coexisting infer-
the more judicious use of ovarian stimulation agents
tility factors. Generally speaking, failure to conceive
and by increased monitoring [17;18].
within six ovulatory cycles of CC treatment should be
regarded as a clear indication to expand the diagnos-
tic evaluation to exclude other infertility factors or to
Severe ovarian hyperstimulation syndrome
change the overall treatment strategy when evaluation The incidence of severe ovarian hyperstimulation syn-
is already complete [13]. drome (OHSS) after clomiphene citrate treatment is dif-
ficult to determine, as definitions of the syndrome vary
widely among studies. Mild OHSS (moderate ovarian
Adverse effects and drawbacks of enlargement) is relatively common, but also does not
clomiphene citrate treatment require active management. When CC induction of
Clomiphene citrate is in general a safe medication and ovulation proceeds in the recommended incremental
usually well tolerated, with most of the side effects being fashion designed to establish the minimum effective
relatively mild. Side effects are rarely severe enough dosage, the risk of severe OHSS is remote [13].
to prevent continuation of treatment. Side effects are
generally divided into those related to medication Ovarian cancer
itself and other side effects that are related to ovarian There is an uncertain association of ovarian cancer
stimulation in general, such as ovarian hyperstimula- with clomiphene citrate treatment that has been sug-
tion syndrome and multiple gestation. Other serious gested by two epidemiologic studies published early in
long-term adverse effects of CC treatment have been the last decade. The first was a case-control study con-
suggested, including increased risk of ovarian cancer. cluding that ovarian cancer risk was increased nearly
Hot flashes, the most common side effect occur- threefold overall in women receiving various infer-
ring in about 10% of all women, is due to the antiestro- tility treatments including CC [19]. The study meth-
genic property of CC and seems to be dose-dependent. odology had several problems. The study compared
They are transient, rarely severe, and typically resolve infertile treated women to fertile women rather than to

3
 Section 1: Mild forms of ovarian stimulation

infertile untreated women, even though infertility and losses were increased by CC treatment (5.8% vs. 3.9%,
nulliparity have long been recognized as risk factors P < 0.01) and for age > or = 30 years (8.0% vs. 4.9%,
for ovarian cancer. In addition, there was no apparent P < 0.001), but not for age < 30 years (3.7% vs. 3.0%).
increase in ovarian cancer risk in treated women who Clinical miscarriages were increased by CC for women
conceived. The second study was a cohort study con- younger than 30 years (15.9% vs. 11.2%) (P < 0.01), but
cluding that risk of ovarian tumors was increased in not for age > or = 30 years (20.1% vs. 22.3%) or overall
women treated with CC [20]. Comparisons within the (18.0% vs. 16.4%) [34].
CC ovarian stimulation cohort showed no increase in A more recent study looking at rates of spontaneous
risk with fewer than 12 cycles of treatment. This study miscarriage in 62 228 clinical pregnancies resulting
too was widely criticized, primarily because it included from assisted reproductive technology procedures ini-
cancers of varying types and tumors of low malignant tiated in 1996–1998 in US clinics, also found that spon-
potential (e.g. epithelial, germ cell, stromal), where the taneous miscarriage risk was increased among women
pathophysiology of each is likely very different. who used CC [35]. However, the results of these studies
The results of subsequent studies have been reassur- are not definitive. Pregnancy loss after infertility treat-
ing, but the question of whether treatment with ovula- ment is a complex matter, influenced by several signifi-
tion-inducing drugs increases risk of ovarian tumors cant confounding factors such as insulin resistance and
or cancer remains unsettled and cannot be summarily other genetic factors related to PCOS, the presence of
dismissed [21–28]. endometriosis or unexplained infertility, and advan-
cing maternal age [36].
Congenital anomalies
There is no evidence that clomiphene citrate treatment Failure of clomiphene citrate treatment
increases the overall risk of birth defects or of any spe-
In anovulatory infertility, clomiphene citrate treat-
cific malformation. Several large series have examined
ment failure is defined into two groups. The first group,
the question and have drawn the same conclusion
ovulation failure (clomiphene resistance), includes
[29;30]. Earlier suggestions that the incidence of neural
patients who fail to ovulate in response to CC ovarian
tube defects might be higher in pregnancies conceived
stimulation. The second group, clomiphene pregnancy
during CC treatment have not been confirmed by more
failure, includes patients who ovulate in response to
recent studies [31]. A small study of pregnancy outcome
CC ovarian stimulation but fail to achieve pregnancy.
in women inadvertently exposed to CC during the first
This second group also includes women with ovulatory
trimester also found no increase in the prevalence of
infertility who failed to achieve pregnancy after CC
congenital anomalies [32]. However, most recently,
treatment.
an increase in the risk of congenital malformations
Clomiphene citrate resistance (failure to achieve
of the heart has been suggested, though the study was
ovulation) is believed to be due to one of two main
not designed or powered to answer that question and
reasons: insulin resistance (women with PCOS) and
further studies are needed to confirm or negate such a
inappropriate indication for CC treatment, e.g. use
finding [33].
in women with WHO Type I or III anovulation or
women with ovulatory dysfunction due to medical
Pregnancy loss disorders that require specific treatments such as thy-
A fairly large study reviewed outcomes of 1744 clomi- roid disorders, congenital adrenal hyperplasia, and
phene pregnancies compared with outcomes of 3245 hyperprolactinemia.
spontaneous pregnancies. Pregnancy loss was defined The reasons for clomiphene pregnancy failure
as clinical if a sac was seen on ultrasound or if it (women who ovulate in response to CC ovarian stimu-
occurred after 6 weeks’ gestation, and as preclinical if lation but do not achieve pregnancy) may be related to
a quantitative human chorionic gonadotropin (hCG) a wide variety of underlying infertility factors such as
was > or = 25 IU/L and no sac was seen or pregnancy male factor, endometriosis, undiagnosed tubal factor,
loss occurred earlier. The overall incidence of preg- or endometrial receptivity factors. However, the suc-
nancy loss was slightly higher, but not significant, for cess of many of these women in achieving pregnancy
clomiphene pregnancies (23.7%), compared with spon- with alternative ovarian stimulation protocols using
taneous pregnancies (20.4%). Preclinical pregnancy injectable gonadotropins or aromatase inhibitors

4
Random documents with unrelated
content Scribd suggests to you:
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cent that boys were of girls in high schools; (6) average annual
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employed; (9) expenditure per pupil for purposes other than
teachers’ salaries: and (10) expenditure per teacher for salaries. The
publication includes tables giving the index numbers of the several
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several items and the final index, and the correlation between the
average of the five items that are based on attendance and the
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School R 28:709 N ’20 420w

Springf’d Republican p11a Je 13 ’20
360w
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AYRES, RUBY MILDRED. Richard Chatterton,

V. C. il *$1.75 Watt
20–1371

“One fails to fathom the reason why handsome, indifferent

Richard Chatterton, jilted as a slacker by millionairess Sonia, should
extort an iron-clad promise from a nice old gentleman, never to tell
of his departure as a private in the Blank brigade to France where he
chums with his own valet and performs the double deed of heroism
which wins him the most coveted of English decorations. One word
of that and Sonia would never have thrown herself into the artful
arms of his false friend Montague. When unavoidable evidence jams
upon her slow credence the facts about Richard, she sees him in
London, invalided home, and insane jealousy of his pretty nurse
makes her conduct still more complicated. Later, the mistaken report
of the hero’s death, the showing up of the villain in lurid tints and
Sonia’s abrupt disappearance, get things into a grand tangle. The
lovers show a genius for miscomprehension that keeps the action
going strong until the pallid convalescent is accidentally discovered
by Sonia in a convenient sitting-room, where fate and the author
have to get behind the two and push them into each other’s arms.”—
Pub W

“The triteness of the story is unrelieved by any felicity of style; this

is the sort of novel dashed off in a hurry to meet an uncritical
demand.”

− N Y Times 25:287 My 30 ’20 260w

“There are vivid scenes of departing troops, trench warfare and

base hospitals, contrasted with gay glimpses of London society and
country life. And pleasant is the mellow romance of the plump
chaperone and the ‘God bless my soul’ old family friend—they at
least have the saving grace of humor.” Katherine Perry

+ Pub W 97:177 Ja 17 ’20 300w

AYSCOUGH, JOHN, pseud. (BP. FRANCIS

BROWNING DREW BICKERSTAFFE-DREW).
Abbotscourt. $2 (2c) Kenedy
(Eng ed 20–8732)
 This is preeminently a story of human kindness with enough of
harshness in it to throw the kindly people and their doings into relief.
The two sides of the picture are represented by two branches of the
same family: the clerical, younger son side in spiritual and worldly
prosperity throughout successive generations; and the baronet side
in as steady degeneration. At last there is a reversion to type in
Eleanor, the physically and mentally sound and beautiful daughter of
the ramshackle Sir Anthony Abbot of Abbotspark, whom the Rev.
Thomas Abbot of Abbotscourt heroically resolves to adopt into his
family on her father’s death. The story revolves around poor
Eleanor’s plight as a misfit both in the vicar’s family, surrounded by
kindness, and in her dissolute brother’s house, exposed to his low
designs. To escape both she flees into an unknown world and when
her trials have reached their climax a veritable conspiracy of
kindness and good will bring her back to life and love.

“The story is a vivid picture, drawn with the author’s customary

skill, of provincial social life in ecclesiastical circles and interest is
well-maintained.”

+ Ath p1168 N 7 ’19 100w

“There is something delicately feminine about John Ayscough’s

handling of his theme, his humor, his almost imperceptible irony.
‘Abbotscourt’ cannot be called a great book, nor would its author
claim such a distinction for it. But it is worth reading for its style, its
purity, and for that fragrance as of lavender and old lace which
permeates its pages.”

+ Cath World 112:258 N ’20 220w

+ Cleveland p105 D ’20 80w
Spec 123:819 D 13 ’19 60w
 “It is worth dwelling on the method of approach to the characters;
it differs so greatly from much that passes for character drawings
now. It is open perhaps to a smile here and a shrug there, but it is
supported nevertheless upon a basis of thought which though
delicate is secure.”

+ − The Times [London] Lit Sup p629 N 6

’19 580w

AYUSAWA, IWAO FREDERICK. International

labor legislation. (Columbia univ. studies in history,
economics, and public law) pa *$2 Longmans 331
20–18736

“This book traces the origin and development of international

labor legislation from the time of Owen (1818), with chapters on
progress toward international agreements (1890–1900), labor
conferences and treaties (1900–1913) and the labor development of
the world war. Part 2 deals with the difficulties in international labor
legislation and Part 3 with the Washington conference of 1919
including a summary of the discussion of the eight-hour day and the
employment of women and children.”—Am Econ R

Am Econ R 10:839 D ’20 70w

“The assembled material will be useful to the student in the field of

labor, even though he may be puzzled by several indefinite references
and by some errors (possibly typographical).” Amy Hewes
 + − Am Hist R 26:361 Ja ’21 310w

Reviewed by J: B. Andrews

+ Survey 45:287 N 20 ’20 180w

 B

BABSON, ROGER WARD. Central American

journey. (Interamerican geographical readers) il
$1.20 (3c) World bk. 917.28
20–4903

This is the story of the Carroll family in their travels through

Central America—an attempt to combine in the form of a story for
children and an account of travel, certain information on our
commercial relations with our southern neighbors. Its aim is to teach
children that, in the process of linking nation with nation the world
over, friendly trade relations contain the romance of the immediate
future, that they imply human relations, fair dealing, and honorable
business standards. Among the contents are: Castles in New Spain;
The gateway of the world; The great waterway; On the trail of
Columbus; A plantation in Costa Rica; Mules and mountain trails;
The ancient land of Nicaragua; The wonders of a wilderness; The
treasure of San Juancito; The small republic of Salvador. The book
has an index and many illustrations.

Booklist 17:120 D ’20

+ N Y Evening Post p2 My 1 ’20 250w
 [2]
BABSON, ROGER WARD. Fundamentals of
prosperity; what they are and whence they come. *$2
Revell 174
20–20936

“In this book the statistician of Wellesley Hills holds that we must
look to religion and not to modern efficiency methods to insure
national prosperity. He contends that down to this hour, mankind
(or humanity—or the world at large) has lost its way, chiefly because
of its refusal to accept the golden rule as the basis of true living.”—
Springf’d Republican

“It is a courageous book, inspired by an unshakable faith in the

pricelessness of character, filled with wholesome advice to business
men, and garnished with anecdotes that would be equally
appropriate at a meeting of the stock exchange and a dinner party.”

+ N Y Evening Post p8 N 6 ’20 190w

“It is a business man’s call to business to change its aim, a sermon

of a high order of eloquence that if heeded would change the course
of civilization.”

+ Springf’d Republican p6 D 13 ’20 200w

BABSON, ROGER WARD. W. B. Wilson and

the Department of labor. *$2 Brentano’s 353
20–1493
 “The present head of the Department of labor at Washington has
had the kind of life history that is often described as ‘typically
American,’ but it happens that he was born and passed his childhood
days in Scotland. He was taken from school at the age of eight and
sent to the mines. As he grew up he worked as a common laborer,
iron miner, locomotive fireman, lumber-jack, log-driver, farmer, and
union organizer. He was sent to Congress from Pennsylvania for
three terms, and when the Department of labor was created he
became by President Wilson’s appointment the first Secretary of
labor. All this and much more is told in the present volume by Roger
W. Babson, the statistician, who was himself formerly chief of the
Information service of the Department of labor. Mr Babson’s book
describes and analyzes the machinery and policy of the
department.”—R of Rs

+ Am Econ R 10:363 Je ’20 80w

Booklist 17:28 O ’20
+ Cleveland p77 Ag ’20 60w

“A well-constructed and interesting biography.”

+ N Y Times p30 Ag 1 ’20 160w

“It is a little hard to tell where Babson begins and Wilson leaves
off, for the biographer has not been quite able to play the part of
Boswell to his Johnson.” J. E. Le Rossignol

+ − Review 2:333 Ap 3 ’20 420w

 R of Rs 61:334 Mr ’20 150w
Springf’d Republican p8 Ag 6 ’20 290w

“Mr Babson has both succeeded and failed. He has done effectively
what he set out to do. He has failed to do the much greater thing,
such for example, as that which Graham Wallas has accomplished in
his life of Francis Place. In a word, his book is not a biography
insofar as biography is an art.” W. L. C.

+ − Survey 44:89 Ap 10 ’20 600w

BACON, FRANK. Lightnin’; after the play of the

same name by Winchell Smith and Frank Bacon. il
*$1.75 (3c) Harper
20–4438

A novel made from a popular play of the same name in which Mr

Bacon has been playing the title part. Lightnin’ Bill Jones, so-called
because it doesn’t describe him, is a gentle, genial old humorist who
keeps a hotel in Calivada, on the California-Nevada line. In fact the
state line runs thru the house, so that divorcees wishing to obtain the
advantages of the easy divorce laws of one state might do so and at
the same time enjoy the privileges of a California resort. Two land
sharks, who for reasons of their own, wish to get control of the
property, talk Bill’s wife and adopted daughter into their scheme,
and then, unable to win Bill’s consent, persuade the wife to get a
divorce. But their plans are foiled, and Bill with his genius for
“fixing” things also brings about a happy ending to the love romance
of two young people.
 Booklist 16:280 My ’20

“The pathos and humor of the play seem dry and forced in the
story. Still the charm of old ‘Lightnin’ Bill’ Jones stands to some
extent.”

+ − Boston Transcript p4 Ap 21 ’20 220w

“The author continually insists that Jones is a ‘lovable character,’

but to the reader he seems no more than a lazy, shiftless, old
drunkard, who looks to his wife and daughter for sustenance. Mr
Bacon does not succeed in freeing the narrative from the atmosphere
of the footlights.”

− Springf’d Republican p8a Ap 4 ’20 150w

BACON, SIR REGINALD HUGH SPENCER.

Dover patrol, 1915–1917. 2v il *$10 (4½c) Doran
940.45
19–19869

“At Dover during 1915, 1916 and 1917, more operations were
initiated and carried out than under any naval command since the
wars at the beginning of last century.” (Preface) The author
enumerates his reasons for writing the book: to write while memory
is still accurate; to fill the need for an adequate account of the work
of the Dover patrol; to contradict the untrue statements of the press
anent his dismissal. Contents of volume 1: Historical; The ships of
the Dover patrol; Matters of strategy; Coastal bombardments; The
work of the trawlers and paddle mine-sweepers; The Belgian coast,
its patrol and barrages; Landing the guns on the Belgian coast; A
proposed attack on Ostend; Preparations for a great landing; Plans
for blocking Zeebrugge and Ostend; The control and protection of
traffic. Contents of volume 2: The incomparable sixth flotilla; The
downs and merchant shipping; The barrages in the channel; The
drifters and their tasks; The French coast; C.M.B.’s, M.L.’s,
submarines and smoke; Operations; The air services of the Dover
patrol; Dover harbour and dockyard; Epilogue; Appendixes; Index.
Each volume is abundantly illustrated and supplied with charts and
diagrams.

“An important contribution from the standpoint of historical

truth.”

+ Booklist 16:273 My ’20

“As a question of strategy one of the most interesting parts of the

book is that dealing with the plans drawn for a joint army and navy
effort to turn the enemy out of his Belgian bases.” C. C. Gill

+ Bookm 51:477 Je ’20 1700w

“Admiral Bacon’s book has in it much matter for the layman and
much for the expert. For that reason it is more shapeless than have
been many books written about the war. For that reason also, it is a
truer presentment of the conditions obtaining.” Muriel Harris

+ Nation 110:657 My 15 ’20 750w

+ Outlook 126:768 D 29 ’20 6Ow
 “For this lucid and sailor-like account of an essential service
Admiral Bacon deserves praise.”

+ Review 3:707 Jl 7 ’20 1400w

“This notable book wavers a little between treatise and narrative,

but it is well worth reading all the same. A certain sense of grievance
animates Sir Reginald Bacon’s pages. But it only obtrudes itself here
and there, for instance, in a tendency to belittle the method of
Admiral Keyes’s attack on Zeebrugge.”

+ Sat R 128:sup13 N 29 ’19 1050w

“Sir Reginald Bacon’s detailed narrative of the Dover patrol is a

well-written and highly interesting book, which will rank with Lord
Jellicoe’s history of the grand fleet among the chief authorities on the
naval side of the war.”

+ Spec 123:582 N 1 ’19 1600w

“It is a striking and interesting narrative, gracefully related, with a

thousand sidelights on this little-known field of naval operations.”

+ Springf’d Republican p6 Je 21 ’20 720w

“The 633 pages of ‘The Dover patrol’ are crowded with statements
of fact, criticisms not indeed of persons (for, apart from his official
enemy, and vague indications of contradicting sinners, Admiral
Bacon is generous in his tone to his colleagues and subordinates),
but of principles and the methods of the art of war at sea. Admiral
Bacon sometimes writes expressly for the professional reader, but he
remembers the little knowledge of most of us, avoids pedantry, and
has a respectable share of the blessed faculty for making things
clear.”

+ The Times [London] Lit Sup p599 O 30

’19 2150w
+ Yale R n s 10:437 Ja ’21 270w

BADEN-POWELL, SIR ROBERT

STEPHENSON SMYTH. Scoutmastership. *$1.50
Putnam 369.4
20–26747

This “handbook for scoutmasters on the theory of scout training”

is the American edition of the author’s book on British scout training
with a few alterations by way of adaptation. Its arguments are
elaborations on the four main principles on which, according to the
author, scout training is based, and which require of the scoutmaster
that “(1) He must have the boy spirit in him; and must be able to
place himself on a right plane with his pupils as a first step; (2) He
must realize the psychology of the different ages of boy life; (3) He
must deal with the individual pupil rather than with the mass; and
(4) He then needs to promote a corporate spirit among his
individuals to gain the best results.” After the introductory exposition
of these principles the contents are: How to train the boy; Character;
Health and physical development; Making a career; Service for
others; Reconstruction; The education act and the Boy scout; The
attitude of labour towards scouting; Be ye prepared; Appendix.

“A readable handbook.”
 + Booklist 17:9 O ’20
+ Review 3:215 S 8 ’20 80w

BAFF, WILLIAM E. Inventions, their

development, purchase and sale. *$2 Van Nostrand
608
20–6991

“This book is essentially a manual on the marketing of

inventions.... In its broader aspect it is a book on business policy and
is sent out on its mission of enlightening inventors and others about
plans by the aid of which inventions may be profitably exploited....
The problems discussed are the manufacturers’ problems as well as
those of the individual inventor.” (Preface) Among the subjects
covered are: Value and price of patents; Gauging the merits of an
invention; Developing inventions; The market for inventions;
Patents as property; Inventor and capitalist; Elementary contract
laws. The final chapter consists of Suggestions from the author on
every phase of selling inventions. There is an index.

“It should prove of essential service to the inventor who is about to

market his ideas.”

+ N Y Evening Post p15 My 8 ’20 250w

BAILEY, CAROLYN SHERWIN. Broad stripes

and bright stars. (For the children’s hour ser.) il
$1.50 (3½c) Bradley, M. 973
19–13373

A series of stories from American history. The author says, “I have

written this book because I believe that the story of the American
people as it is embodied in the history of our United States supplies
the most important material for character building in the entire field
of elementary education, and should be offered to children in a new,
humanitarian way as a means of helping them to understand the
present.” (Preface) The stories are arranged chronologically and
include: Pilgrims for freedom; The first fight; The freeman’s charter;
Following the beaver’s trail; At the gate of old Harvard; Ringing in
the fourth of July; In the wake of the first steamboat, etc. A
chronology of main events referred to comes at the close.

“The stories are well told.”

+ Springf’d Republican p6 My 25 ’20

100w

BAILEY, CAROLYN SHERWIN. Wonder

stories. il $2.50 (3½c) Bradley, M. 292
20–12815

All the well-known myths are here retold for boys and girls. There
is an introduction on How the myths began, followed by the stories
of Prometheus, Pandora (Hawthorne’s “Paradise of children”),
Vulcan, Orion, Perseus, Pegasus, Phaeton, Apollo, Mercury,
Proserpine, Jason, the golden apples, the wooden horse, and others.
There are six pictures in color by Clara M. Burd.
 “An attractive collection.”

+ Ind 104:380 D 11 ’20 30w

BAILEY, HENRY CHRISTOPHER. Barry

Leroy. *$2 Dutton
20–4707

“When the story opens Barry is a spy in the service of Napoleon;

the war is on between France and England. Barry had learned to
believe in the people who were fighting for liberty and equality. But
there comes a time when Barry’s regard for the French consul is
turned to contempt and hatred. The abduction and execution of the
Duc d’Enghien, whom Barry knew to be loyal to Napoleon, was the
cause of his revolt. Asserting that he would never forgive the Little
Corsican for his cold-blooded treachery, he goes over to the other
side and offers his services to the British. He forces a duel on Nelson
at one moment and saves his life at the risk of his own at another.”—
N Y Times

“Rather disconnected and has not quite the charm or vivacity of

‘The gamesters’ or ‘The highwaymen.’”

+ − Booklist 16:345 Jl ’20

“In criticizing Mr Bailey’s methods in portraying his most difficult

figures, I would not subtract from the extent of his accomplishment.
He has, we must admit, failed in Napoleon and Nelson. ‘Barry Leroy’
is an excellent story in spite of this lack. It possesses the fine dash,
the romance, the joy of adventure for itself, that we have come to
associate with other times than our own.” D. L. M.

+ − Boston Transcript p6 Ag 4 ’20 1050w

“Throughout the book the action never lags; there are no dull
moments. As a spy-story having an historic background and
interwoven with a charming love affair, ‘Barry Leroy’ is above the
average in construction and sustained interest.”

+ N Y Times 25:168 Ap 11 ’20 500w

“The fantastic vein of the story is well sustained, though

necessarily told in episodes with little organic connection, as if
written for serial publication.”

+ Sat R 129:234 Mr 6 ’20 80w

BAILEY, LIBERTY HYDE. Nursery-manual; a

complete guide to the multiplication of plants. (Rural
manuals) il *$2.50 Macmillan 631.5
20–1758

“Rewritten and reset, L. H. Bailey’s ‘The nursery-manual’ is off the

press in its 22d edition. It deals fully with seeds, layers, cuttings,
buds, grafts and otherwise. To those who are acquainted with the
earlier editions—the first having been issued early in 1891—little
introduction is needed, save to say that the material is brought up to
date with addition of observations gained in further research. An
extended alphabetic list of plants with full directions for each is
included. The volume also includes an illustrated account of the main
diseases and insects of nursery stock, valuable to the commercial
grower.”—Springf’d Republican

Booklist 16:231 Ap ’20

R of Rs 61:448 Ap ’20 50w
+ Springf’d Republican p10 Mr 12 ’20
240w
The Times [London] Lit Sup p242 Ap
15 ’20 40w

BAILEY, TEMPLE. Trumpeter swan. il *$1.90

Penn
20–17175

“The hero, a young soldier, returns from France to face changes of

fortune and soon to realize that the girl he loves has lost her heart to
another man. How Randy makes good, writes the romance of ‘The
trumpeter swan,’ and wins back the wandering heart of his lady, is all
set down. Interwoven is the minor story of baby Fiddle Flippen.”—
Boston Transcript

+ Booklist 17:115 D ’20

 “The plot of Temple Bailey’s latest story is practically nil, but its
settings are wonderfully picturesque. The hills of old Virginia and the
moors of Nantucket are powerfully contrasted to furnish a
background for a readable light tale.” C. K. H.

+ − Boston Transcript p6 N 3 ’20 500w

+ Cleveland p105 D ’20 50w

“Her readers will like this new book. The love passages are
wholesome, strike the note of sincerity, and therefore cannot but be
acceptable.”

+ N Y Times p25 Ja 16 ’21 430w

Reviewed by Marguerite Fellows

+ Pub W 98:658 S 18 ’20 190w

“A good simple natural harmless story.”

+ Springf’d Republican p5a Ja 2 ’21 230w

BAIN, FRANCIS WILLIAM. Substance of a

dream. il *$1.75 (3½c) Putnam
19–19598

The author disclaims all responsibility for his stories which he says
come to him “suddenly, like a flash of lightning all together.... I never
know, the day before, when one is coming: it arrives, as if shot out of
a pistol.” (Introd.) This exotic Hindu tale is half love-story, half fairy
tale, and depicts in the extraordinary queen, Táráwalí, a being half
male half female. It is in three parts: On the banks of Ganges; The
heart of a woman; and A story without an end.

Reviewed by H. W. Boynton

+ Bookm 51:240 My ’20 450w

Lit D p91 S 4 ’20 1300w

“Those who have read Mr Bain’s other Hindu stories will not need
to be told of the unique place he now occupies in the world of letters.
Here the exigencies of space will permit us to say only that ‘The
substance of a dream’ is a worthy successor to the other and earlier
volumes.”

+ N Y Times 25:145 Mr 28 ’20 600w

N Y Times 25:190 Ap 18 ’20 20w

“‘The substance of a dream’ will please those whom the other

books of the author have pleased. It is very feminine; sensuous to the
point of orgies of kissing; sensual with soulhuntings and langours
and faintings; fleshly in artistic ecstasies; and psychological in
imaginative suggestion.”

− + Review 2:682 Je 30 ’20 280w

“By no means the least delightful of Mr Bain’s long series of Indian

romances.”
 + Spec 124:179 F 7 ’20 550w

“You cannot say whether his style is artful or artless; but the words
make new associations for us, create an unfamiliar state of being,
though they are familiar words.”

+ The Times [London] Lit Sup p669 N 20

’19 1000w

[2]
BAIRNSFATHER, BRUCE. Bairnsfather case;
as tried before Mr Justice Busby; defence by Bruce
Bairnsfather; prosecution by W. A. Mutch. il *$2.50
Putnam 827
20–21304

In alternating chapters Bruce Bairnsfather and W. A. Mutch tell

the story of Mr Bairnsfather’s life and struggles for success. There are
illustrations from Bairnsfather drawings.

+ Booklist 17:145 Ja ’21

“If anything in late years has been more amusing than Mr

Bairnsfather’s adventures in print, it is his adventures in black and
white as drawn by himself. Forty drawings grace the book, and many
of them are better than the original ‘fragments.’”
 + Boston Transcript p4 D 24 ’20 250w

“It has that satirical note without which a whole book of humour is
apt to be sticky reading.”

+ Spec 135:818 D 18 ’20 60w

“The whole book is a happy means of bettering one’s acquaintance,

book fashion, with the delightful Bairnsfather.”

+ Springf’d Republican p10 Ja 18 ’21 330w

The Times [London] Lit Sup p685 O 21
’20 40w

BAKER, ERNEST. Life and explorations of

Frederick Stanley Arnot. il *$5 Dutton

“Mr Arnot died in May, 1914, at Johannesburg, having just

completed his ‘Missionary travels in Central Africa.’ He first went to
Africa, inspired by the story of Livingstone, in 1881, and during his
seven years’ residence gained the friendship of the King of the
Barotse and was held in much esteem by the natives. Altogether he
made nine journeys to the centre of Africa, and his self-devotion and
the vast distances he traversed give him a high place among
travellers and among missionaries. His life story is worth telling and
it is given almost entirely in extracts from his own letters and
diaries.”—The Times [London] Lit Sup
 “A valuable contribution to the literature of brotherhood and
religious democracy.”

+ Boston Transcript p7 N 20 ’20 430w

“Arnot was a noble character, and deserves a much better

biography.”

− + N Y Evening Post p18 O 23 ’20 300w

The Times [London] Lit Sup p602 S 16
’20 90w

BAKER, GEORGE PIERCE, comp. Modern

American plays. *$2.25 Harcourt 812.08
20–14860

Professor Baker has in this volume collected five American plays

chosen from the output of the last ten years because decided success
has been theirs, and they are worthy of professional revival, and
because the selection shows the greatest possible variety. In his
introduction he briefly analyzes each of the plays and ends his
general remarks on American play-writing with the assurance that
“We have the right to hope that the next decade will give us an
American drama which, in its mirroring of American life, will be even
more varied in form, even richer in content.” The plays are: As a man
thinks, by Augustus Thomas; The return of Peter Grimm, by David
Belasco; Romance, by Edward Sheldon; The unchastened woman, by
Louis Kaufman Anspacher; Plots and playwrights, by Edward
Massey.
 Booklist 17:104 D ’20

“All the plays collected here are significant—all have added to the
pleasure of playgoing. This book makes their remembrance the
richer.” W. S. B.

+ Boston Transcript p6 O 13 ’20 390w

“Most decidedly, these are not the measure of American drama.

They are just five American plays. When a man has done what
Professor Baker has done at Harvard, it is disappointing to find him
fathering so trivial a venture as the collecting of these five dramas
into a single volume.” K. M.

+ − Freeman 2:310 D 8 ’20 190w

“All these pieces, probably, profit by being printed in their entirety,

but a somewhat deliberate study of them leads to the conclusion that,
judged by any moderately critical standard, only two of them would
be marked for revival on account of their actual merits. The best of
them, by all odds, is the somewhat awkwardly named ‘As a man
thinks.’ Of the other pieces in the list, ‘The unchastened woman’ is
the only one that has substantial or abiding value.” J. R. Towse

+ − N Y Evening Post p4 O 23 ’20 1150w

“Four out of the five at least have interesting stories, and are
flawless in their adaptation to the theatre; but gayly as they trip on
the stage, they drag a little in the reading.”
 + − Review 3:389 O 27 ’20 350w

“This book is intended to interest both readers and amateur

players. It has, perhaps, no great significance as a compendium of
modern American drama but it should serve its purpose.”

+ Springf’d Republican p6 S 13 ’20 240w

Wis Lib Bul 16:234 D ’20 60w

BAKER, KARLE (WILSON) (MRS THOMAS

ELLIS BAKER) (CHARLOTTE WILSON,
pseud.). Blue smoke. *$1.50 Yale univ. press 811
19–14952

“The poems have been written ‘at intervals since 1901,’ the author
says, and consequently their moods are various.” (Springf’d
Republican) “Love, children, the cause of woman all move her to
song. Among other pieces we have specially noted the well-handled
conceit called ‘Winter secrets’; the happy introspective fancy called
‘The lost one’; the truly heartfelt elegy for ‘The dead fore-runner’ of
the woman’s movement; and the delightful literary reverie called
‘The love of Elia.’” (The Times [London] Lit Sup)

“These poems are not all smoke. There are many glowing embers
and a few blazing coals. Mrs Baker shows something of antique
restraint and not a little of the newer and freer impulse.” C. M.
Greene
 + Bookm 50:634 F ’20 140w

“Not ambitious in manner, Mrs Baker has the soundness and

felicity of art to make her themes poetically alive.” W. S. B.

+ Boston Transcript p5 S 17 ’19 1400w

+ Cleveland p85 S ’20 20w

“Hers is a gentle gracefulness, a light timidity that succeeds most

when it is least emphasized.” L: Untermeyer

+ Dial 68:532 Ap ’20 150w

“Mrs Baker’s metaphors from nature have an almost unexampled

finesse. She draws down trees, birds, stars, prints them on her page
with a diamond delicacy, heats and lights them into a tender, fiery
transparency. Her ideas are often second-hand, and her ardors,
sweet and genuine though some of them, particularly those for her
children, may be, are not perhaps distinguished enough to wear well.
The solid core of her work, however, though small, is fine.” M. V. D.

+ − Nation 110:76 Ja 17 ’20 220w

“‘Blue smoke’ is a book of happiness and hope. It is unpretentious,

modest, and sincere. The poems read as though publication had been
an afterthought; they were not written to catch an exclusive or
‘appreciative’ audience.”
 + Springf’d Republican p10 Ja 23 ’20
260w

“Mrs Baker, an American writer, is a craftswoman of much skill,

who is never at a loss for ideas, various and fruitful, and can fit them
to apt expression. Hence her book is always interesting, though it
does not succeed in giving us the thrill of beautiful utterance.”

+ − The Times [London] Lit Sup p174 Mr 11

’20 120w

“Possibly given overmuch to introspection, at times a little over-

wistful, this poet gives only her best. Her style is simple, vivid, never
précieuse; there is perfect ease in all the beauty of these songs.” E: B.
Reed

+ Yale R n s 10:204 O ’20 170w

BAKER, RAY PALMER, ed. Engineering

education. *$1.25 Wiley 620.7
19–14693

“These fourteen selected articles, written during the past decade by

eminent engineers and scientists, are designed not only to inform
engineering undergraduates concerning the broad aspects of their
profession, but to serve as examples of good English. Simon
Newcomb and Sir J. J. Thomson discuss the origins of engineering
education; J. B. Johnson and Howard McClenahan deal with the
types of engineering education; the relation of language to the
profession is considered by J. J. L. Harrington and C. P. Steinmetz.
The place of mathematics is discussed by Sir W. H. White and Arthur
Ranum; physics by M. A. Hunter and R. A. Millikan; chemistry by J.
B. C. Kershaw and Alfred Senier; and the role of the imagination in
engineering by Isham Randolph and J. C. Smallwood. The editor is
professor of English in the Rensselaer Polytechnic institute.”—N Y P
L New Tech Bks

Booklist 16:76 D ’19

“Each is not only well chosen for its primary purpose of use in
engineering schools but might also be read, or read anew, by
engineers in practice.”

+ Engin-News Rec 83:891 N 13 ’19 240w

“It strikes a reader that these addresses, each advocating the claim
of some one branch of science, interesting as they are, would have
been more useful if there had been a recognition of the distinction
between what should be included in the school course preceding the
technical course, in the technical course itself necessarily restricted,
and what extra academic self-education should be expected to
accompany and follow it.” W. C. U.

+ − Nature 105:258 Ap 29 ’20 700w

N Y P L New Tech Bks p15 O ’19 150w
Pratt p18 Ja ’20 30w
 BAKER, RAY STANNARD (DAVID
GRAYSON, pseud.). New industrial unrest; reasons
and remedies. *$2 (4c) Doubleday 331
20–8811

“The battle is on” between employers and employees, says the

author in explaining the raison d’etre of the present volume whose
object it is to “present a survey, for the general reader, of the present
industrial crisis, and the various reconstructive experiments now
under way to meet it.” It is the author’s conviction that the problems
are very pressing, very real and intensely human and that, if the
American people can only be made to see and know and understand
where truly reconstructive experimentation is going on and who are
the thoughtful leaders on both sides, they will decide aright
regarding them. Some of the contents are: The industrial crisis as it
appears from above to the capitalist-employer; The industrial crisis
as it appears from below to the worker; The imputed causes of the
unrest; The real causes of the unrest; Awakening of the public to the
industrial crisis; Approaches to a solution of the problem—by
political action, as suggested by the workers—the new labor party;
The new shop-council system as applied in a typical small industry—
the Dutchess bleachery at Wappingers Falls, New York; Development
of the shop-council system in America—method of organization—the
movement in England and Germany; Foundations of the new co-
operative movement in industry: the new profession of management,
and the labor manager.

+ Booklist 16:327 Jl ’20

 “As a trained journalist, he sees the problem clearly, without that
hard definiteness such as an economist who is more reliable but less
readable, usually believes essential to correct understanding.”

+ Boston Transcript p7 O 9 ’20 280w

“Combining the lucidity of the trained writer, the quick eye of the
reporter and the orderly reflectiveness of the born philosopher, Mr
Baker’s birdseye view of what is wrong with American industry is the
best book of its kind which has yet appeared.”

+ Ind 103:319 S 11 ’20 200w

“There is nothing the matter with Mr Baker’s observation, as far as

it penetrates, but it does not penetrate to the causes which maintain
the struggle in spite of anyone’s reasonableness or good intentions.”
G: Soule

+ − Nation 111:534 N 10 ’20 190w

“He is always the reporter standing outside, trying to understand a

technical problem and to help his audience to understand.” Ordway
Tead

+ − New Repub 25:208 Ja 12 ’21 410w

Reviewed by J. E. Le Rossignol

Review 3:504 N 24 ’20 350w

R of Rs 62:110 Jl ’20 30w
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