As early as 1500 BC, history records women using a variety of drugs, devices and manoeuvres in an attempt to prevent pregnancy after intercourse has taken place. It was not until the 1960s however that scientific efforts were made to develop effective postcoital contraception (PCC). Whilst it had been known for over thirty years that a variety of compounds would inhibit implantation and embryonic development and interrupt pregnancy in the rabbit and the rat, experiments with primates had been less successful. In 1966 however, Morris and Van Wagenen reported the prevention of pregnancy in 28 macaque monkeys treated with oestradiol, diethylstilboestrol or a synthetic compound (ORF 3858), administered after mating. In the same paper – and confessing that they embarked upon human experimentation ‘with some trepidation’ – the authors reported that 50 mg diethylstilboestrol (DES) given for four to six days appeared to be effective in preventing pregnancy after intercourse had taken place in an undisclosed number of women who were the victims of rape.

Lasers have now been used laparoscopically in infertility surgery for over a decase. Use of the CO2 laser at laparoscopy began independently in France, Israel and North America. Investigators have subsequently reported use of the argon, Nd-YAG, and the KTP lasers for laparoscopic laser surgery. All of these surgical lasers are now widely available and have been used clinically for many laparoscopic procedures. This review will examine the laparoscopic use of both infrared and visible laser light energy in the treatment of infertility and endometriosis.

Since the discovery of the structure and function of steroids over 60 years ago, it has long been recognized that synthetic antagonists of the natural hormones would have potential therapeutic uses. Antagonists of mineralocorticoids, androgens and oestrogens, for example spironolactine, cyproterone, flutamide and tamoxifen, have already found a place in the management of hormone dependent conditions. In 1982, chemists at Roussel UCLAF announced that they had synthesized mifepristone (RU486) 17β-hydroxy-11(p-(dimethylamino)phenyl)-17-(1-propynyl) estra-411, 9-dien-3-one) a derivative of norethindrone which had potent antiprogestogenic as well as antiglucocorticoid activity. Although it was immediately realised that this compound would potentially have wide clinical application, its development in the last 10 years has been dominated by its abortifacient action. In the original clinical report by Herrman and colleagues it was shown that bleeding occurred when it was given to female volunteers in the second half of the menstrual cycle. In addition, complete abortion occurred in eight of 11 women who took the drug in the early weeks of pregnancy. These findings, which demonstrated that mifepristone could be used as the basis of a medical method of inducing abortion, were immediately made the focus of groups opposed to abortion on moral grounds. Experience over the last 10 years has confirmed the promise of these early studies and mifepristone, in combination with a suitable prostaglandin, is now licensed in France, UK and Sweden for use as a medical method of inducing abortion in early pregnancy.

The aim of this article is to review our knowledge of the status of human relaxin in reproductive medicine.

Relaxin has a particular interest for obstetricians and gynaecologists for its potential to ripen the uterine cervix in order to promote effective labour. Despite research activity over approximately sixty years in the relaxin field since the original observation of Hisaw, there is still a considerable gap in our understanding of the role of relaxin in reproductive medicine. As pointed out by Sherwood in a comprehensive review of the relaxin literature, the accumulation of knowledge concerning the hormone is in its infancy.

Following the isolation, and subsequent synthesis of the decapeptide gonadotrophin-releasing hormone (GnRH) in the laboratories of Schally and Guillemin in 1971, a more physiological treatment for hypogonadotrophic women became available. It was not, however, until 1980 that a successful, pulsatile mode of administration was established.