171 results
Search Results
2. Legal parenthood in surrogacy: shifting the focus to the surrogate's negative intention.
- Author
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Lima, Dafni
- Subjects
- *
PARENTHOOD , *BIRTHPARENTS , *INTENTION , *CONTRACTS , *INFORMED consent (Medical law) , *MOTHERHOOD - Abstract
This paper examines how legal parenthood should be allocated in surrogacy under English law. I argue that we need to shift the focus of the discussion to the surrogate's negative intention to not be a parent as the key to move away from the current gestational model of motherhood. This has three main benefits that are explored in this paper. First, it respects surrogates' voices and construes them in terms of their autonomy and agency, rather than solely in terms of their vulnerability. Second, it provides a conceptually robust basis for recognising legal parenthood of the intended parents at birth, since the surrogate's negative intention is construed as the trigger for the application of specialised rules on parenthood. Third, it serves as a guiding principle in developing appropriate and comprehensive protections for the surrogate, including recognising the intended parents as the legal parents at birth, the parameters of the surrogate's right to withdraw consent, and further safeguarding requirements and checks before entering into a surrogacy agreement. Overall, focusing on the surrogate's negative intention allows us to view surrogacy in a nuanced way, away from false dichotomies, and contributes to a more compelling case in favour of actively facilitating surrogacy. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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3. Progesterone Hypersensitivity in Assisted Reproductive Technologies: Implications for Safety and Efficacy.
- Author
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Sandru, Florica, Dumitrascu, Mihai Cristian, Petca, Aida, Petca, Razvan-Cosmin, and Roman, Alexandra-Maria
- Subjects
URTICARIA ,REPRODUCTIVE technology ,PROGESTERONE ,ALLERGIES ,PREGNANCY outcomes ,CHILDBEARING age - Abstract
The global rise in the age of childbirth, influenced by changing sociodemographic patterns, has had a notable impact on fertility rates. Simultaneously, assisted reproductive techniques (ARTs) have become increasingly prevalent due to advancements in reproductive medicine. The paper explores the intersection between the surge in ARTs and the rising number of iatrogenic autoimmune progesterone dermatitis (APD). Autoimmune progesterone dermatitis, commonly known as progesterone hypersensitivity, manifests itself as a mucocutaneous hypersensitivity syndrome. It is characterized by a wide range of dermatological symptoms, with urticaria and maculopapular rashes being the most prominent signs. Concurrently, systemic symptoms, such as fever, angioedema, and, in severe instances, anaphylaxis, may ensue. This dermatologic condition poses a significant challenge to women of childbearing age. This intricate syndrome frequently manifests itself in conjunction with menstruation or pregnancy as a reaction to physiological fluctuations in endogenous progesterone. However, given that exposure to exogenous progesterone is an integral component of various modern therapies, secondary APD has also been described. Our findings unveil a heightened likelihood of developing secondary progesterone hypersensitivity in ART patients that is attributed to the administration of exogenous progesterone through intramuscular, intravaginal, and oral routes. The study also explores available therapeutic interventions for facilitating viable pregnancies in individuals grappling with autoimmune progesterone dermatitis within the context of ARTs. This comprehensive analysis contributes valuable insights into the intricate relationship between reproductive technologies, dermatological challenges, and successful pregnancy outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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4. Medically assisted reproduction and non-normative family forms: legislation and public opinion in Europe.
- Subjects
FEMALE infertility ,PUBLIC opinion ,REPRODUCTIVE technology ,LESBIAN couples ,WOMEN'S health - Abstract
This article explores the relationship between legislation on medically assisted reproduction (MAR) and public attitudes towards non-normative family structures in Europe. The study focuses on the access granted to single women and lesbian couples for MAR and how it aligns with attitudes towards single motherhood and same-sex parenthood. The findings suggest that MAR access for lesbian couples is more likely in contexts where same-sex parenthood is accepted, while access for single women seems disconnected from public opinion towards single motherhood. The paper highlights the potential for the combination of social acceptance and legal permissibility of MAR to facilitate the formation of new family forms. [Extracted from the article]
- Published
- 2024
5. SARS-CoV-2, fertility and assisted reproduction.
- Author
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Ata, Baris, Vermeulen, Nathalie, Mocanu, Edgar, Gianaroli, Luca, Lundin, Kersti, Rautakallio-Hokkanen, Satu, Tapanainen, Juha S, and Veiga, Anna
- Subjects
REPRODUCTIVE technology ,MEDICAL personnel ,HUMAN reproductive technology ,SARS-CoV-2 ,SEXUALLY transmitted diseases ,FERTILITY clinics ,MAYER-Rokitansky-Kuster-Hauser syndrome ,FLUID intelligence - Abstract
Background: In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain.Objective and Rationale: This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals.Search Methods: PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible.Outcomes: From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients.Wider Implications: This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil. [ABSTRACT FROM AUTHOR]- Published
- 2023
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6. Spermbots: A Promising Futuristic Innovation in Assisted Reproductive Technology.
- Author
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Bhat, Ghulam Rasool, Lone, Farooz Ahmad, and Assad, Nafis Ibni
- Subjects
REPRODUCTIVE technology ,DRUG delivery systems ,ARTIFICIAL cells ,BIOLOGICAL networks ,SPERMATOZOA ,ELECTRIC fields ,OVUM - Abstract
Spermbots are robotic sperms formed out of sperm cells conjugated to artificial microstructures, having potential applications ranging from biomedical processes, drug delivery systems, in situ real time imagery and assisted reproduction. The robotic sperm can act as an exploratory microdevice in biological networks. Incorporation of a biological entity like sperm into microstructures under the environment of magnetic or electric fields helps in shape templating and carrying chemotherapeutic agents to target sites. Besides its role in drug delivery systems, spermbots can potentially contribute in combating infertility, especially in oligo-zoospermia and necro-zoospermia in males. Numerous checkpoints may impede sperm cells to reach the oocyte in vivo. Spermbots bypass these sites and carry sperm to oocyte. Targeted delivery always requires interventions of natural functional aspects of living systems. Sperm flagellum, being a biological motor in nature, can be harnessed as a driving force in spermbots to ensure delivery of fertile sperm cells with impaired motile machinery to the target. Moreover, the technology has a potential to unravel sperm migration patterns and understanding the processes in vivo. After a review of documented literature on possible use of spermbot technology in assisted reproduction, we hereby discuss the application of this new and innovative technology in humans and animals. The paper also highlights certain shortfalls in the widespread application of this cargo delivery technology in assisted reproduction. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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7. Double‐donor surrogacy and the intention to parent.
- Author
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Baron, Teresa
- Subjects
- *
HUMAN reproductive technology laws , *PARENTS , *BIOETHICS , *HUMAN reproductive technology , *OVUM donation , *INTENTION , *SPERM donation - Abstract
Assisted reproduction often involves biological contributions by third parties such as egg/sperm donors, mitochondrial DNA donors, and surrogate mothers. However, these arrangements are also characterised by a biological relationship between the child and at least one intending parent. For example, one or both intending parents might use their own eggs/sperm in surrogacy, or an intending mother might conceive using donor sperm or gestate a donor embryo. What happens when this relationship is absent, as in the case of 'double‐donor surrogacy' arrangements (DDS)? Here, a child is conceived using both donor eggs and sperm, carried by a surrogate, and raised by the commissioning parents. In this paper, I critically examine proposals to allow DDS in the United Kingdom, and the intentionalist justification for treating this practice distinctly (morally and legally speaking) from private adoption. I argue that the intentionalist approach cannot plausibly justify such a distinction and that other approaches to moral parenthood are also unlikely to succeed. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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8. The Role of Vitrification in Spanish Reproductive Labs: A Cryo-revolution Led by Strategic Freezing.
- Author
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Lafuente-Funes, Sara
- Subjects
VITRIFICATION ,FREEZING ,FERTILITY preservation ,OVUM ,REPRODUCTIVE technology ,THAWING ,MEDICALIZATION - Abstract
Assisted reproductive technologies have expanded vastly and are frequently addressed using the language of revolution. The last two decades witnessed important transformations in Spanish repromarkets, some of which are linked to one freezing technique: vitrification. This cryotechnique tends to be presented by professionals as revolutionary as well, even if in a humbler way: a technique with the capacity to revolutionize reproductive labs. Celebrated for its ability to freeze oocytes, the introduction and assimilation of vitrification have implied many transformations in Spanish clinics and the broader reproductive industry in Spain. This paper describes the role of vitrification from the point of view of the labs, drawing on interviews with professionals and observations of laboratory work, and focusing on the changes, which include but are not restricted to freezing oocytes. I argue that vitrification has increased the role of cryopreservation in reproductive labs overall in Spain, expanding the use of strategic, short-term freezing of embryos. This is discussed as part of a "cryomedicalized" turn, using Charlotte Kroløkke and Anna Sofie Bach's term, which enlarges the scope of medicalization through optimization and prevention, in the context of late reproduction and a strong reproductive market. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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9. La evolución de la terminología sobre reproducción asistida en los diccionarios y el corpus de lengua española.
- Author
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DOMÈNECH-BAGARIA, ONA and PÉREZ, MARÍA ISABEL SANTAMARÍA
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MEDICAL terminology ,ENCYCLOPEDIAS & dictionaries ,SPANISH language ,REPRODUCTIVE technology ,SOCIOCULTURAL factors - Abstract
Copyright of Culture, Language & Representation / Cultura, Lenguaje y Representación is the property of Universitat Jaume I and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
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10. Public funding of uterus transplantation: Deepening the socio‐moral critique.
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UTERUS ,HUMAN reproductive technology ,GOVERNMENT aid ,BIOETHICS - Abstract
Human uterus transplantation (UTx)—the most radical and experimental of all current forms of assisted reproduction—gives rise to a range of complex ethical questions, including those related to individual safety, risk, and informed consent. I have argued elsewhere that the wider social impacts and implications of UTx provision must form part of a comprehensive ethical analysis. My socio‐moral critique of UTx provision has been responded to with a number of defences of possible public funding of UTx. In this paper I examine a select number of those defences. These include: that UTx provision would address harms and needs that already exist and as such have priority; that UTx provision is fully compatible with the needed reform of the procreative context in which it would be offered; that UTx provision would not necessarily involve legitimation or endorsement of what are widely agreed to be problematic pronatalist or geneticist norms; and that UTx provision is required as a matter of justice and consistency with other practices. Importantly, defenders are not proposing a ceteris paribus justification of UTx provision; nor do my responses to their arguments represent a comprehensive opposition to UTx. Rather, my more limited purpose here is to show that whatever other defences may be given of publicly funded UTx provision, those considered here do not ultimately succeed and therefore do not allay the concerns underpinning the original socio‐moral critique. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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11. The Future of Assisted Reproductive Technology Live Births in the United States
- Author
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Tierney, Katherine
- Published
- 2022
- Full Text
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12. What Is A Family? A Constitutive-Affirmative Account
- Author
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Lee, J. Y., Bentzon, R., and Di Nucci, E.
- Published
- 2024
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13. “Being useful, I think it's the result of a sick society”: Critical reflections on reproductive politics and markets by women freezing their eggs in Spain
- Author
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Lafuente-Funes, Sara
- Published
- 2024
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14. Archiving the work of Dr. Subhas Mukherjee: The architect of India’s test tube baby
- Author
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Mukherjee, Srabani and Mehta, Rajvi
- Published
- 2024
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15. Legal Regulation of Preimplantation Genetic Diagnosis: A Comparative Analysis of the Baltic Sea Region and the Nordic Countries.
- Author
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Grubliauskienė, Nastė
- Abstract
Copyright of Law / Teise is the property of Vilnius University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
- Full Text
- View/download PDF
16. Three-year follow-up results of two children born from a transplanted uterus
- Author
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Jan Janota, Ekaterina Orlova, Marta Novackova, Roman Chmel, Radim Brabec, and Zlatko Pastor
- Subjects
absolute uterine factor infertility ,assisted reproduction ,bayley-iii scales ,neurodevelopment ,uterus transplantation ,Medicine - Abstract
Aims. To evaluate the 3-year follow-up results of two children delivered at our institution in 2019 from mothers with a transplanted uterus. Methods. Observational data on pregnancy outcomes, neonatal course, and growth trajectory in two children born to mothers after uterus transplantation, including 3-year follow-up and neurodevelopmental status assessed using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III). Results. Both children were born prematurely via uneventful caesarean sections, to mothers with Mayer-Rokitansky-Küster-Hauser syndrome and a transplanted uterus. An acute caesarean section was performed in one mother because of the onset of regular uterine contractions at 34 weeks and 6 days of pregnancy; in the other mother, an elective caesarean section was performed at 36 weeks and 2 days of gestation. The children were born healthy with no congenital malformations. They had an uneventful postnatal course and showed a normal growth trajectory during 3 years of follow-up. The Bayley-III neurodevelopmental scores of both children were within the normal ranges at ages 2 and 3 years. Conclusion. Though pregnancy after uterus transplantation is associated with the risk of premature delivery, no abnormalities were observed in the neonatal course and 3-year follow-up results, including the neurodevelopmental status, of two children born prematurely to mothers with a transplanted uterus. This is the first report on neurodevelopmental outcomes in children born after uterus transplantation. More data on children born after this radical procedure of uterine factor infertility treatment are required to support our promising results.
- Published
- 2023
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17. Queer Couples Trying to Conceive: Sexual Minority Women Couples' Experiences with Assisted Reproduction.
- Author
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Topper, Patrina Sexton and Bauermeister, José A.
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LGBTQ+ couples ,SEXUAL minority women ,REPRODUCTIVE technology ,COUPLES ,GAY couples ,THEMATIC analysis ,SAME-sex marriage - Abstract
Introduction: Clinically assisted reproduction has created opportunities for pregnancy and parenthood for many who experience fertility challenges. For decades, sexual minority women (SMW; defined in this article as non-heterosexual cisgender females) in same-sex couples have used assisted reproduction to help them form families of their own. Yet, little research has described SMW's couple-level, shared experiences in the context of clinically intensive approaches to family expansion. Methods: This paper examines couples' shared experiences with assisted reproduction through qualitative analysis of 30 in-depth interviews conducted between June and August 2019. We recruited 20 sexual minority women who comprised 10 same-sex couples to participate in in-depth interviews and a brief survey. We applied thematic analysis to interviews (20 individual interviews, 10 dyadic interviews) to better understand couples' shared experiences with assisted reproduction. Using four sorting groups based on relative experience with assisted reproduction (i.e., first timers; staying-the-course; pivoters; finally pregnant), we identified three themes that highlight dimensions of couple-level, shared experiences. Results: Three broad themes were identified across the sample: (1) normative assumptions, (2) physical asymmetries in efforts to conceive, and (3) emotional dimensions of clinically assisted reproduction within couples. Conclusions: Expanded understanding of SMW couples' shared experiences suggests the need for policy modifications and tailored interventions to assist SMW couples navigating assisted reproduction. Policy Implications: Multilevel approaches, for example, regulatory policies and health systems operational updates, may provide meaningful shifts in care for SMW couples. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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18. Why uterine transplantation requires us to rethink the role of the pre-conception welfare principle.
- Author
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O'Donovan, Laura
- Subjects
REPRODUCTIVE technology ,INFERTILITY ,PATIENT autonomy ,GAMETES ,FERTILITY ,CHILD welfare - Abstract
Uterine transplantation (UTx) is a programme of treatment aimed at providing a unique solution to absolute uterine factor infertility, enabling patients to have children as a result of their own pregnancies. As a transplant procedure performed for fertility purposes it may be thought obvious that the welfare of any children created should be assessed prior to treatment provision. However, major concerns about the breadth and scope of such requirements, and the potential threat they pose to patients' reproductive autonomy, have been raised. In this paper, I analyse novel questions regarding the role of the pre-conception welfare principle in UTx. After outlining traditional critiques of the principle, I focus on the unique issues raised by its application in the two areas of medicine occupied by UTx. As a treatment for a particular form of infertility, I explore whether law and policy regulating traditional assisted reproductive technologies applies equally to the case of UTx, and whether a distinction (in welfare terms) does and should exist between fertility treatment involving gametes and embryos and gynaecological surgery for fertility purposes. As a quality-of-life-enhancing transplant, I consider and reject proposals in favour of using pre-conception welfare considerations to inform patient listing and the allocation of deceased donor uteri on the grounds that such assessments may both compromise patient autonomy and lead to unjust discrimination against particular patients or groups of patients. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
19. Gifting the womb : a legal and ethical analysis of uterine transplantation
- Author
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O'Donovan, Laura, Brassington, Iain, and Mullock, Alexandra
- Subjects
Reproductive Autonomy ,Fertility Regulation ,Reproductive Technology ,Uterine Transplantation ,Uterus Transplant ,Assisted Reproduction - Abstract
This PhD thesis considers legal and ethical questions raised by the prospect of uterine transplantation (UTx). Over the course of recent years various scientific advances in the realm of reproduction have changed the reproductive landscape, enhancing the reproductive freedoms of those diagnosed with infertility, and increasing the choices available to them. Uterus transplants are the latest of such medical innovations aimed at providing an additional, and experientially unique, option in the management of absolute uterine factor infertility (AUFI). Unlike other options for family building such as surrogacy and adoption, UTx offers those diagnosed with AUFI the chance to not only have their own child, but to have this as a result of their own pregnancy. Since proof-of-concept was established in Sweden in 2014 when the world's first baby was born following UTx, research has progressed rapidly. UTx is now being conducted at centres across Africa, North and South America, Asia, Australia, Europe, and the Middle East. As a technology at the intersection of two distinct medical specialties: reproductive and transplantation medicine, UTx raises distinct legal, ethical and social challenges. This thesis identifies and addresses a number of conceptual and practical concerns posed by the introduction of UTx in a series of four papers that form the main body of this work. Paper One provides an overview of some of the key areas of controversy arising in the debates about UTx, focussing in particular on three main ethical and policy issues. These concern: the purported value of gestation, the choice between living and deceased donors, and access to UTx. In Paper Two, I consider the extent to which we should respect the reproductive autonomy of patients who choose to pursue UTx and uterus donation in the light of considerable medical risk posed by the treatment. I argue that for as long as the benefits of UTx continue to outweigh the harms associated with donation and transplantation, we ought to respect the reproductive autonomy of recipients and donors who choose to pursue it. In Paper Three, I examine the question of the public funding of UTx in the context of the NHS. I contend that the dual commissioning system for medical treatment means that NHS-commissioned UTx could give rise to the creation of inequalities of access to treatment between different groups of infertile patients, and that UTx has the potential to raise an important political perspective regarding treatment access and the wider funding landscape for assisted reproduction. Paper Four asks what role child welfare considerations should have in our ethical and legal reasoning about UTx. I argue that proposals to use pre-conception welfare considerations as a threshold tool to determine patient access to transplant waiting lists and/or as a tool to optimise the allocation of deceased donor uteri should be categorically rejected on the grounds that this would constitute an unjust burden on prospective patients, that it would unjustifiably infringe their reproductive autonomy and may result in unjust discrimination.
- Published
- 2022
20. Magnetic-Activated Cell Sorting as a Method to Improve Necrozoospermia-Related Asthenozoospermic Samples.
- Author
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Máté, Gábor, Balló, András, Márk, László, Czétány, Péter, Szántó, Árpád, and Török, Attila
- Abstract
According to some statistics, absolute asthenozoospermia affects every 1 in 5000 men. Although this incidence rate does not appear to be too high, it is extremely important to address the phenomenon because it can drastically reduce the chances of pregnancy, even with assisted reproduction. The biggest problem with absolute asthenozoospermia is that it is difficult to distinguish between live and dead sperm cells, and fertilization with non-viable spermatozoa may contribute to the failure of an assisted reproduction cycle. Nowadays, DNA fragmentation (DF) is a crucial parameter of semen analysis, and in this paper, we provide evidence of the correlation between DF and vitality. For this purpose, the main semen parameters were investigated by a CASA system (concentration, motility, progressive motility, vitality and DF). In the necrozoospermic group (vitality < 58%), all the measured parameters showed significant differences compared to normal vitality. Concentration (30.1 M mL
−1 vs. 13.6 M mL−1 ), motility (31.9% vs. 18.3%), and progressive motility (24.3% vs. 12.7%) were significantly decreased, while DF was significantly increased (17.4% vs. 23.7%). Based on the connection between vitality decrement and DF increment, DF lowering methods, such as magnetic-activated cell sorting, have been hypothesized as novel methods for the elimination of dead spermatozoa. [ABSTRACT FROM AUTHOR]- Published
- 2022
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21. The ethical gene.
- Subjects
GENETIC engineering laws ,HEALTH policy ,DNA ,GENETIC mutation ,GOVERNMENT regulation ,GERM cells ,MEDICAL care ,GENETIC engineering ,HUMAN reproductive technology ,BIOETHICS - Abstract
In this paper I argue that current law and policy governing germline genetic modification are overly broad and in fact prohibit medical interventions normally considered unobjectionable. The root of the problem lies in the fact law and policy tend to espouse a near categorical ban on medical interventions that alter germline DNA. However, if we pay close attention to the biological mechanisms at play we see that many standard medical interventions result in alterations to DNA that can be transmitted to future generations. The correct focus of policy and regulation thus ought to be determining which kinds of transmissible genetic modifications ought to be permitted, and not whether they should be permitted at all. Given that the scientific classification of biological structures involved in the inheritance of traits is unlikely to be in itself ethically significant, ethicists ought to develop a definition of 'gene' fit for ethical purposes. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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22. Global Fertility Chains: An Integrative Political Economy Approach to Understanding the Reproductive Bioeconomy.
- Author
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Vertommen, Sigrid, Pavone, Vincenzo, and Nahman, Michal
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FERTILITY ,SOCIAL scientists ,COMMODITY chains ,NATION-state ,BIOLOGY - Abstract
Over the last two decades, social scientists across disciplines have been researching how value is extracted and governed in the reproductive bioeconomy, which broadly refers to the various ways reproductive tissues, bodies, services, customers, workers, and data are inserted into capitalist modes of accumulation. While many of these studies are empirically grounded in single country–based analyses, this paper proposes an integrative political economy framework, structured around the concept of "global fertility chains." The latter articulates the reproductive bioeconomy as a nexus of intraconnected practices, operations, and transactions between enterprises, states, and households across the globe, through which reproductive services and commodities are produced, distributed, and consumed. Employing a diffractive reading of the literature on commodity chains and care chains, this unified approach scrutinizes the coproduction of value, biology, and technoscience and their governance mechanisms in the accumulation of capital by taking into account (1) the unevenly developed geographies of global fertility chains, (2) their reliance on women's waged and unwaged reproductive labor, and (3) the networked role of multiple actors at multiple scales without losing sight of the (4) constitutive role of (supra)national states in creating demand, organizing supply, and accommodating the distribution of surplus value. We empirically ground this integrative political economy approach of the reproductive bioeconomy through collaborative, multisited fieldwork on transnational reproduction networks in Israel/Palestine, Romania, Georgia, and Spain. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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23. Current status of fertility and family formation in men with cystic fibrosis.
- Author
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Bourke, Stephen J., Anderson, Alan, Briggs, Jonathan, Doe, Simon, Echevarria, Carlos, Choudhary, Meenakshi, McEleny, Kevin, and Stewart, Jane
- Subjects
FATHERHOOD ,VAS deferens ,MEN ,GENETIC testing ,CYSTIC fibrosis ,INFERTILITY ,HUMAN reproductive technology ,FORCED expiratory volume ,REPRODUCTIVE health ,SEXUAL health - Abstract
Men with cystic fibrosis are nearly always infertile due to congenital bilateral absence of the vas deferens, but can undergo assisted reproduction. Ill health may influence reproductive choices. This paper reports data on fertility and family formation in CF including the use of assisted reproduction in a total cohort of 205 men (mean age 30.9, range 16.6–64.3 years) studied over a 10-year period. Overall 102 (49.5%) were single, 52 (25.7%) were married, 48 (23.3%) were in long-term heterosexual relationships, and 3 (1.5%) were in same-sex relationships. One (0.5%) was fertile naturally. In total, 30 children were born to 23 (11%) men by assisted reproduction: 4 used donor sperm and 19 had sperm retrieval and intracytoplasmic sperm injection (ICSI). Two men each adopted two children; 15 (7.3%) men were acting as step-fathers to 20 children from their partners' previous relationships. Overall 41 (20%) men had fatherhood roles. ICSI was unsuccessful in 4 men. A further 16 men were referred for fertility treatment but did not proceed. Of the 19 men having children by ICSI, 3 died leaving 4 children. Men with CF face complex decisions when considering their relationships, fertility and fatherhood. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
24. Experiences of gestational surrogacy for gay men in Canada.
- Author
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Fantus, Sophia
- Subjects
SURROGATE motherhood ,SAME-sex parents ,GAY men ,FERTILITY clinics ,PARENTHOOD ,GAY couples ,DOCUMENTATION - Abstract
This paper reports on findings from a qualitative study that examined how Canada's socio-political context influenced gestational surrogacy for same-sex male couples. Semi-structured interviews were conducted with gay fathers and gestational surrogates to investigate supports and barriers of pursuing surrogacy. Questions explored publicly available information, policies and practices of fertility clinics and hospitals, post-birth resources and cultural attitudes regarding same-sex parenthood. Findings suggest that in Canada, a global leader in LGBT rights and inclusive same-sex parenting legislation, participants encountered inadequate same-sex inclusive resources and insufficient provider competencies. The aim of this study was to inform individual and institutional recommendations to counteract biases in fertility care and post-birth services. Following interview analysis, five key strategies were identified: (1) more accessible information on paths to same-sex parenthood; (2) more inclusive fertility clinic and hospital practices; (3) recognition of same-sex fatherhood in formal documentation; (4) post-birth resources such as formula feeding, play groups and first aid courses intended for same-sex parent families; and (5) shifts in cultural attitudes of same-sex parenthood and, specifically, gay fatherhood. Approaches that subvert heteronormative discourses embedded in fertility and reproduction are required to legitimise and support same-sex parent families. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
25. Clinical trials of germline gene editing: The exploitation problem.
- Subjects
CLINICAL trials ,GERM cells ,RESEARCH ethics ,GENETIC engineering ,HUMAN reproductive technology ,CRISPRS ,GENETIC techniques ,BIOETHICS - Abstract
The birth of the world's first genetically edited babies in 2018 provoked considerable ethical outrage. Nonetheless, many scientists and bioethicists now advocate the pursuit of clinical uses of human germline gene editing. Progress towards this goal will require research, including clinical trials where genetically edited embryos are implanted into a woman's uterus, gestated, and brought to term. This paper argues that such trials would likely conflict with the fundamental research ethical requirement of non‐exploitation. This is because they would expose people who are in a vulnerable situation to risks and burdens that are substantial and not obviously offset by compensating benefits. I consider how the potential for exploitation in such trials might be mitigated, arguing that a feasible and justifiable approach is not easily found. If this analysis is correct, there is a significant ethical obstacle on the path towards clinical use of human germline gene editing. [ABSTRACT FROM AUTHOR]
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- 2021
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26. �Comaternidad�, por adopci�n e inseminaci�n artificial, en parejas de mujeres: �novedad o aclaraci�n?
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SAME-sex marriage ,SEXUAL orientation ,PARENT-child relationships ,EQUALITY ,COUPLES ,TRANSLATORS - Abstract
Copyright of Revista General de Legislacion y Jurisprudencia is the property of Editorial Reus and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
27. Why ovarian stimulation should be aimed to maximize oocyte yield.
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Ata, Baris
- Subjects
- *
INDUCED ovulation , *OVARIAN hyperstimulation syndrome , *OVARIES , *OVUM , *MENSTRUAL cycle , *FROZEN human embryos - Abstract
The ultimate measure of success of assisted reproductive technology (ART) is the cumulative live birth rate (CLBR) per ovarian stimulation cycle, which increases with every oocyte collected. However, the adverse effects of ovarian stimulation on endometrial receptivity, as well as the risks of ovarian hyperstimulation syndrome (OHSS) and adverse obstetric and neonatal outcomes, are observed to increase with ovarian response to stimulation. To mitigate these risks, mild stimulation has been hailed as the safer patient-friendly approach with the additional benefit of cutting the cost of gonadotrophins. Yet accumulating data demonstrate the absence of an adverse effect of ovarian stimulation on oocytes as well as on obstetric and neonatal outcomes, and multiple preventive strategies have been introduced for OHSS. The widespread use of vitrification revolutionized ART by enabling the liberal use of cycle segmentation to minimize the risk of OHSS and avoid impaired endometrial receptivity due to ovarian stimulation. Vitrification also allowed every oocyte to contribute to the CLBR. Thus, it is questionable whether the cost savings from gonadotrophins during the index ovarian stimulation offset the cost saving by preventing repeat ovarian stimulation and repeat laboratory procedures per live birth. This paper aims to prove by contradiction that ovarian stimulation should be aimed to maximize oocyte yield. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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28. Moral considerations on infertility and artificial reproductive technics
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Paul Negrut and Tiberiu Pop
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Artificial insemination ,Assisted reproduction ,In vitro fertilization ,Intracytoplasmic injection ,Natural procreation ,Surrogacy ,Technology (General) ,T1-995 ,Ethics ,BJ1-1725 - Abstract
Purpose – The purpose of this paper is to offer a Christian perspective on the ethical issues related to natural procreation and artificial reproduction methods. Design/methodology/approach – This paper uses descriptive and comparative methodology between the ethical aspects specific to natural procreation and artificial reproduction. Findings – Religious beliefs play a significant role in shaping the moral perspective when an infertile couple is confronted with the choice between natural procreation and artificial reproduction. Originality/value – This paper survey a broad bibliography and offers a critical evaluation of the moral aspects specific to different methods of reproductive technologies compared to the natural procreation approach.
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- 2022
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29. Assisted Reproductive Technologies: Comparing Abrahamic Monotheistic Religions
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Farid, Md Shaikh and Tasnim, Sumaia
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- 2023
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30. Common goals, different stages: the state of the ARTs for reptile and amphibian conservation.
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Clulow, Simon, Clulow, John, Marcec-Greaves, Ruth, Della Togna, Gina, and Calatayud, Natalie E.
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REPTILES ,AMPHIBIANS ,CRYOPRESERVATION of cells ,NUMBERS of species ,ARTIFICIAL insemination ,REPRODUCTIVE technology ,BIOLOGICAL extinction - Abstract
Amphibians and reptiles are highly threatened vertebrate taxa with large numbers of species threatened with extinction. With so many species at risk, conservation requires the efficient and cost-effective application of all the tools available so that as many species as possible are assisted. Biobanking of genetic material in genetic resource banks (GRBs) in combination with assisted reproductive technologies (ARTs) to retrieve live animals from stored materials are two powerful, complementary tools in the conservation toolbox for arresting and reversing biodiversity decline for both amphibians and reptiles. However, the degree of development of the ARTs and cryopreservation technologies differ markedly between these two groups. These differences are explained in part by different perceptions of the taxa, but also to differing reproductive anatomy and biology between the amphibians and reptiles. Artificial fertilisation with cryopreserved sperm is becoming a more widely developed and utilised technology for amphibians. However, in contrast, artificial insemination with production of live progeny has been reported in few reptiles, and while sperm have been successfully cryopreserved, there are still no reports of the production of live offspring generated from cryopreserved sperm. In both amphibians and reptiles, a focus on sperm cryopreservation and artificial fertilisation or artificial insemination has been at the expense of the development and application of more advanced technologies such as cryopreservation of the female germline and embryonic genome, or the use of sophisticated stem cell/primordial germ cell cryopreservation and transplantation approaches. This review accompanies the publication of ten papers on amphibians and twelve papers on reptiles reporting advances in ARTs and biobanking for the herpetological taxa. [ABSTRACT FROM AUTHOR]
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- 2022
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31. Beyond secrecy and openness: telling a relational story about children’s best interests in donor-conceived families
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Dempsey, Deborah, Nordqvist, Petra, and Kelly, Fiona
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- 2022
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32. Influence of COVID-19 infection on early pregnancy outcomes in different periods around frozen embryo transfer.
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Ko, Yiling, Chen, Luting, Zhou, Chengliang, Xi, Ji, Xiao, Yu, and Chen, Xiaojun
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PREGNANCY outcomes ,COVID-19 ,EMBRYO transfer ,EMBRYO implantation ,COVID-19 pandemic - Abstract
Purpose: The study aimed to investigate the potential influence of COVID-19 infection on embryo implantation and early development in women undergoing frozen embryo transfer (FET), with a specific focus on infections occurring at different periods around FET. Methods: A retrospective analysis was performed on women who had undergone FET during a period marked by a significant surge in COVID-19 infection in Shanghai. All enrolled women experienced their first documented COVID-19 infection around the time of FET, ensuring that infections did not occur prior to oocyte retrieval. Participants were categorized into six groups based on the timing of infection: uninfected, ≥ 60 days, < 60 days before FET, 0–14 days, 15–28 days, and 29–70 days after FET. Clinical outcomes were compared across these groups. Results: The infection rate among the total of 709 cases was 78.28%. Infected individuals exhibited either asymptomatic or mild symptoms. The ongoing pregnancy rates for the first four groups were 40.7%, 44.4%, 40.5%, and 34.2% (P = 0.709) respectively, biochemical pregnancy rates (59.1% vs. 61.1% vs. 67.6% vs. 55.7%, P = 0.471) and clinical pregnancy rates (49.6% vs. 55.6% vs. 55.4% vs. 48.1%, P = 0.749), all showed no significant differences. Early spontaneous abortion rates across all six groups were 18.3%, 20.0%, 25.0%, 28.9%, 5.4%, and 19.0% respectively, with no significant differences (P = 0.113). Multivariable logistic analysis revealed no significant correlation between the infection and ongoing pregnancy. Conclusion: Asymptomatic or mild COVID-19 infections occurring around FET do not appear to have a significant adverse impact on early pregnancy outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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33. Prevalence of adenomyosis features in women scheduled for assisted reproductive treatment, using the Morphological Uterus Sonographic Assessment group definitions.
- Author
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Alson, Sara, Jokubkiene, Ligita, Henic, Emir, and Sladkevicius, Povilas
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ENDOMETRIOSIS ,TRANSVAGINAL ultrasonography ,UTERUS ,PELVIC pain ,UNIVERSITY hospitals ,CONFIDENCE intervals - Abstract
Introduction: Studies that use standardized ultrasonographic criteria to diagnose adenomyosis in subfertile women are needed. These would improve the understanding of the disease burden and enable further studies on its impact on fertility and assisted reproductive treatment (ART) outcome. The aim of this study was to determine the prevalence of different features of adenomyosis in women scheduled for their first ART, diagnosed at two (2D) and three‐dimensional (3D) transvaginal ultrasonography (TVUS) using the revised Morphological Uterus Sonographic Assessment (MUSA) group definitions. Material and methods: This was a prospective, observational cross‐sectional study of subfertile women aged 25 to ≤39 years, that were referred to a university hospital for their first ART between December 2018 and May 2021. Of 1224 eligible women, 1160 women fulfilled the inclusion criteria and consented to participate in the study. All women underwent a systematic 2D and 3D TVUS examination. The primary outcome was the presence of direct and indirect features of adenomyosis, as proposed by the MUSA group. Secondary outcomes were to describe the ultrasonographic characteristics of the different features, as well as any difference in the diagnostics at 2D or 3D TVUS and any association with clinical characteristics such as endometriosis. Results: At least one direct or indirect feature of adenomyosis was observed in 272 (23.4%, 95% confidence interval [CI] 21.0–25.9) women. Direct features that are pathognomonic for the disease were observed in 111 (9.6%, 95% CI, 7.9–11.3) women. Direct features were visible only at 3D TVUS in 56 (4.8%, 95% CI 3.6–6.1) women, that is, 56/111 (50.5%) of women with at least one direct adenomyosis feature. Direct features were more common in women with endometriosis (OR 2.8, 95% CI 1.8–4.3). Conclusions: We found than one in 10 women scheduled for ART had direct features of adenomyosis at ultrasound examination. The present study suggests that the use of 3D TVUS is an important complement to 2D in the diagnostics of adenomyosis. Our results may further improve the counseling of women scheduled for ART and enables future studies on the impact of different features of adenomyosis on subfertility, ART results and obstetric outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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34. Troubling 'the norm'? Or, how to become a recognisable, visible gay parent through surrogacy: A comparative analysis of Israeli and German gay couples.
- Author
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Teschlade, Julia
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SURROGATE mothers ,LGBTQ+ parents ,SOCIAL norms ,LGBTQ+ families ,SAME-sex relationships ,COUPLES ,GAY couples - Abstract
Over the past two decades, recognition of same-sex relationships and non-normative families has increased alongside greater access to reproductive technologies. Despite this progress, surrogacy, a potential path to parenthood for gay couples, remains banned in many countries. Research indicates that gay couples, facing legal restrictions, often seek reproductive services abroad, navigating complex legal, political and sociocultural contexts in both their home and destination countries. However, existing research lacks cross-country comparisons that explore how different contexts shape gay couples' reproductive practices. This study enhances our theoretical understanding of the intricate interplay between social structure and social interactions. It explores how normative family conceptions, ingrained in legal frameworks, societal norms and cultural values at the macro level, profoundly influence the (normalising) practices of couples at the micro level. Empirically, this study compares Germany and Israel, where gay couples face starkly different challenges. Germany universally prohibits surrogacy, while Israel permits it, although not for gay men during my interviews. Drawing on interviews with couples from both countries who engaged surrogates abroad, this study analyses their struggles for legal recognition and social visibility as 'gay father families'. In both countries, couples navigate legal, political and sociocultural contexts differently, encapsulated in a process termed 'becoming a gay father family', involving concealing surrogacy and appropriating heteronormative family narratives. The data indicate that the couples' social interactions reflect and reinforce a discernible normative shift from heteronormativity to repronormativity in the context of assisted reproduction. [ABSTRACT FROM AUTHOR]
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- 2024
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- View/download PDF
35. An Alternative Application of Magnetic-Activated Cell Sorting: CD45 and CD235a Based Purification of Semen and Testicular Tissue Samples.
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Czétány, Péter, Balló, András, Márk, László, Török, Attila, Szántó, Árpád, and Máté, Gábor
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CD45 antigen ,FERTILIZATION in vitro ,LEUKOCYTE count ,SEMEN ,SPERMATOZOA ,ERYTHROCYTES ,TISSUES ,LEUCOCYTES - Abstract
Magnetic activated cell sorting (MACS) is a well-known sperm selection technique, which is able to remove apoptotic spermatozoa from semen samples using the classic annexinV based method. Leukocytes and erythrocytes in semen samples or in testicular tissue processed for in vitro fertilization (IVF) could exert detrimental effects on sperm. In the current study, we rethought the aforementioned technique and used magnetic microbeads conjugated with anti-CD45/CD235a antibodies to eliminate contaminating leukocytes and erythrocytes from leukocytospermic semen samples and testicular tissue samples gained via testicular sperm extraction (TESE). With this technique, a 15.7- and a 30.8-fold reduction could be achieved in the ratio of leukocytes in semen and in the number of erythrocytes in TESE samples, respectively. Our results show that MACS is a method worth to reconsider, with more potential alternative applications. Investigations to find molecules labeling high-quality sperm population and the development of positive selection procedures based on these might be a direction of future research. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
36. The Inferto-Sex Syndrome (ISS): sexual dysfunction in fertility care setting and assisted reproduction
- Author
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Luca, G., Parrettini, S., Sansone, A., Calafiore, R., and Jannini, E. A.
- Published
- 2021
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37. Association Between Vitamin D Level and Clinical Outcomes of Assisted Reproductive Treatment: A Systematic Review and Dose-Response Meta-Analysis
- Author
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Xu, Chenhao, An, Xinqi, Tang, Xiumei, Yang, Yunxiao, Deng, Qi, Kong, Quanling, Hu, Ying, and Yuan, Dongzhi
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- 2024
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38. A novel machine-learning framework based on early embryo morphokinetics identifies a feature signature associated with blastocyst development.
- Author
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Canosa, S., Licheri, N., Bergandi, L., Gennarelli, G., Paschero, C., Beccuti, M., Cimadomo, D., Coticchio, G., Rienzi, L., Benedetto, C., Cordero, F., and Revelli, A.
- Subjects
MACHINE learning ,HUMAN embryo transfer ,BLASTOCYST ,EMBRYO transfer ,EMBRYOS ,HUMAN embryos ,ARTIFICIAL intelligence ,FEATURE selection - Abstract
Background: Artificial Intelligence entails the application of computer algorithms to the huge and heterogeneous amount of morphodynamic data produced by Time-Lapse Technology. In this context, Machine Learning (ML) methods were developed in order to assist embryologists with automatized and objective predictive models able to standardize human embryo assessment. In this study, we aimed at developing a novel ML-based strategy to identify relevant patterns associated with the prediction of blastocyst development stage on day 5. Methods: We retrospectively analysed the morphokinetics of 575 embryos obtained from 80 women who underwent IVF at our Unit. Embryo morphokinetics was registered using the Geri plus® time-lapse system. Overall, 30 clinical, morphological and morphokinetic variables related to women and embryos were recorded and combined. Some embryos reached the expanded blastocyst stage on day 5 (BL Group, n = 210), some others did not (nBL Group, n = 365). Results: The novel EmbryoMLSelection framework was developed following four-steps: Feature Selection, Rules Extraction, Rules Selection and Rules Evaluation. Six rules composed by a combination of 8 variables were finally selected, and provided a predictive power described by an AUC of 0.84 and an accuracy of 81%. Conclusions: We provided herein a new feature-signature able to identify with an high performance embryos with the best developmental competence to reach the expanded blastocyst stage on day 5. Clear and clinically relevant cut-offs were identified for each considered variable, providing an objective tool for early embryo developmental assessment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
39. Openness in donor conception families.
- Author
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Macmillan, Caitlin M.
- Subjects
FAMILIES ,MODERN society ,FAMILY relations ,HUMAN artificial insemination ,SOCIAL context - Abstract
Dempsey, Nordqvist and Kelly's recent publication in BioSocieties highlights the complexity of disclosure in donor conception, which is legally, ethically, and morally challenging. However, contemporary society means that donor-conceived people's awareness of their conception history can no longer be controlled by their parents. Late, accidental, and non-parent disclosure is becoming more prevalent and can be distressing. Research has consistently found that openness in donor conception families from an early age is optimal, and that disclosure positively impacts rather than threatens family relationships. Despite this, disclosure can be difficult for parents, particularly if they perceive an unsupportive social context. Both donor conception and adoption literature has found more positive outcomes among disclosing families compared to non-disclosing families and interestingly, parents who have chosen to disclose have not reported regret. This response briefly discussed these important considerations and also notes some instances of inaccurate reporting and misleading information in their article. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
40. Age-based restrictions on reproductive care: discerning the arbitrary from the necessary
- Author
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Piek, Steven R., Pennings, Guido, and Provoost, Veerle
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- 2024
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41. A Systematic Review of Genetics and Reproductive Health Outcomes: Asian Perspective
- Author
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Long, Cheryl, Benny, Paula, Yap, Jeannie, Lee, Jovin, and Huang, Zhongwei
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- 2024
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42. Wirkung von COVID-19-Infektionen und -Impfungen auf Ovarialfunktion und Fertilität
- Author
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Seifert-Klauss, Vanadin and Tropschuh, Katharina
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- 2024
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43. Unraveling the Impact of Sperm DNA Fragmentation on Reproductive Outcomes.
- Author
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Nielsen, Jeanett L.M., Majzoub, Ahmad, Esteves, Sandro, and Humaidan, Peter
- Subjects
REPRODUCTIVE health ,GENITALIA ,SPERMATOZOA ,REPRODUCTIVE technology ,MALE infertility ,CELL death ,MALE reproductive health - Abstract
In recent years, there has been a growing interest in identifying subcellular causes of male infertility, and sperm DNA fragmentation (SDF) research has been at the forefront of this focus. DNA damage can occur during spermatogenesis due to faulty chromatin compaction or excessive abortive apoptosis. It can also happen as sperm transit through the genital tract, often induced by oxidative stress. There are several methods for SDF testing, with the sperm chromatin structure assay, terminal deoxynucleotidyl transferase d-UTI nick end labeling (TUNEL) assay, comet assay, and sperm chromatin dispersion test being the most commonly used. Numerous studies strongly support the negative impact of SDF on male fertility potential. DNA damage has been linked to various morphological and functional sperm abnormalities, ultimately affecting natural conception and assisted reproductive technology outcomes. This evidence-based review aims to explore how SDF influences male reproduction and provide insights into available therapeutic options to minimize its detrimental impact. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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44. L’adoption simple : une institution française au potentiel insuffisamment exploité
- Author
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Guillaume Kessler
- Subjects
parenthood ,France ,assisted reproduction ,maternity ,parentage ,paternity ,Ethnology. Social and cultural anthropology ,GN301-674 ,The family. Marriage. Woman ,HQ1-2044 - Abstract
Research framework : The aspiration of sexual minorities to gain access to a kinship from which they were once excluded, the decline in the average age of first pregnancies and the multifactorial phenomenon of a decreasing number of adoptable children all point to the need to think differently about adoption, accepting that it needs not be exclusive of maintaining ties with the parents of origin. Objectives : The aim of this paper is to identify what adjustments could be made to enable simple adoption to realize its full potential in contemporary society.Methodology: The study was based primarily on an analysis of French legislation and jurisprudence, as well as theoretical insights, while also making allowance for comparative law (Canada, the United States and Cuba). Results: It appears that, despite the obvious need for greater recognition of elective filiation in a context of disconnection between biology and kinship, the idea of recognizing genuine pluriparentage remains difficult for the French legislature to accept, and that simple adoption remains devalued as a secondary source of filiation. Conclusions : To unleash the potential of simple adoption, it would suffice to make a few simple adjustments: equivalence of rights in terms of parental authority or inheritance taxation, use in the context of child protection and extension to all situations of multiple kinship, where it is in the child’s interest to have an additive parent recognized. Contribution : This article shows that the persistent difficulty of the French legislator to draw the consequences of recent societal evolutions, that it has nevertheless accompanied, is essentially linked to the tenacity of the myth of begetting, and that major evolutions could be achieved without much effort, for the benefit of children.
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- 2024
45. Responsabilitat civil per la no detecció de malalties genètiques transmeses a persones concebudes amb donació de cèlul·les reproductores
- Author
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Rosa García, Ricard
- Subjects
Responsabilitat civil ,Assisted reproduction ,Negligència mèdica ,Hereditary disease ,Gamete donation ,Diagnòstic genètic ,Genetic diagnosis ,Treball de fi de grau – Curs 2022-2023 ,Donació de material reproductiu ,Consentiment informat ,Reproducció assistida ,Malaltia hereditària ,Informed consent ,Civil liability ,Medical malpractice - Abstract
Treball de Fi de Grau en Dret. Curs 2022-2023 Tutora: Sonia Ramos González El present treball té per objectiu l’estudi de la responsabilitat civil en el context de la donació de material reproductiu destinat a ser usat en tècniques de reproducció assistida, pel cas que el centre responsable no hagués detectat, segons la lex artis de la medicina, una malaltia hereditària que posteriorment es transmet al fetus. En les següents pàgines s’estudiarà quins són els estàndards que han de delimitar les possibles responsabilitats, el marc regulador de les donacions i els estudis genètics, el paper del consentiment informat i les regles aplicables. The purpose of this paper is to study civil liability in the context of the donation of reproductive material intended to be used in assisted reproduction techniques in the event that a hereditary disease has not been identified by the health center that had the obligation to do so, attending the lex artis of medicine, and such a disease is subsequently transmitted to the fetus. The following pages will cover the standards that should delimit possible liabilities, the regulatory framework governing donations and genetic studies, the role of the informed consent document and the applicable rules.
- Published
- 2023
46. Can endometrial compaction predict live birth rates in assisted reproductive technology cycles? A systematic review and meta-analysis
- Author
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Turkgeldi, E., Yildiz, S, Kalafat, E., Keles, I., Ata, B., and Bozdag, G.
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- 2023
- Full Text
- View/download PDF
47. SARS-CoV-2, fertility and assisted reproduction
- Author
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Baris Ata, Nathalie Vermeulen, Edgar Mocanu, Luca Gianaroli, Kersti Lundin, Satu Rautakallio-Hokkanen, Juha S Tapanainen, Anna Veiga, HUS Gynecology and Obstetrics, Reproductive Disease Modeling, Department of Obstetrics and Gynecology, Clinicum, University of Helsinki, Ata, Mustafa Barış (ORCID 0000-0003-1106-3747 & YÖK ID 182910), Vermeulen, Nathalie, Mocanu, Edgar, Gianaroli, Luca, Lundin, Kersti, Rautakallio-Hokkanen, Satu, Tapanainen, Juha S., Veiga, Anna, and School of Medicine
- Subjects
COVID-19 ,Embryo ,Assisted reproduction ,Infertility ,Vaccination ,Clinical practice ,Reproductive Medicine ,3123 Gynaecology and paediatrics ,Obstetrics and Gynecology ,Obstetrics and gynecology ,Reproductive biology ,Covid-19 - Abstract
Background: in 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. Onjective and rationale: This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. Search/methods: PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. Outcomes: from the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. Wider implication: this review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil., There was no funding for the current paper, apart from technical support from ESHRE.
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- 2023
48. The role of serum vitamin D in patients with normal ovarian reserve undergoing the first IVF/ICSI cycle.
- Author
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Rong Luo, Jiahui Wang, Yu Yang, Cen Xu, Minyan Yang, Dandan Zhu, Jia Wang, Ping Zhang, and Hongshan Ge
- Subjects
INTRACYTOPLASMIC sperm injection ,HUMAN in vitro fertilization ,OVARIAN reserve ,VITAMIN D ,FERTILIZATION in vitro ,VITAMIN D deficiency ,SLEEP-wake cycle ,LUTEINIZING hormone releasing hormone - Abstract
Background: The debate over the impact of vitamin D in assisted reproduction continues. The purpose of our study was to assess embryo quality and pregnancy outcomes among groups with different levels of vitamin D after the first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle in patients with normal ovarian reserve (NOR). Methods: Patients in this retrospective cohort study were divided into three groups: severe vitamin D deficiency group (25OH-D < 10 ng/ml), vitamin D deficiency group (10 ng/ml ≤ 25OH-D < 20 ng/ml), and non-vitamin D deficiency group (25OH-D ≥ 20 ng/ml). The primary outcome was clinical pregnancy, while the secondary outcomes were mature oocytes, oocyte fertilization, available cleavage embryos, available blastocysts, biochemical pregnancy, early abortion, and embryo implantation. A modified Poisson regression model and multiple linear regression analysis were conducted for the multivariate analysis. Results: 264 NOR patients undergoing the first IVF/ICSI cycles were included. For the primary outcome, there was no significant difference in clinical pregnancy between the severe vitamin D deficiency group and the other two groups (vitamin D deficiency group: adjusted RR = 1.026; 0.780 - 1.350; P = 0.854; non-vitamin D deficiency group: adjusted RR = 1.092; 0.743 - 1.605; P = 0.652). For all secondary outcomes, no significant differences were observed among the severe vitamin D deficiency, vitamin D deficiency, and non-vitamin D deficiency groups (P > 0.05). Exploratory subgroup analyses concerning the season of embryo transfer, phase of embryo transferred, and endometrial thickness, as well as the sensitivity analysis using logistic regression models for the primary outcome, revealed comparable clinical pregnancy rates among the groups (P > 0.05). Subgroup analysis concerning ovarian stimulation protocol indicated that in the subgroup of gonadotrophin-releasing hormone (GnRH) antagonist protocol, the clinical pregnancy rate of the non-vitamin D deficiency group was significantly higher than that of the other two groups (P < 0.05). Conclusion: Serum vitamin D level was not associated with embryo quality and pregnancy outcomes for patients with NOR. Further studies with greater sample sizes and a longer follow-up period are needed to elucidate the relationships between vitamin D levels and IVF outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
49. Uterus transplantation: from research, through human trials and into the future.
- Author
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Brännström, Mats, Racowsky, Catherine, Carbonnel, Marie, Wu, Joseph, Gargiulo, Antonio, Adashi, Eli Y, and Ayoubi, Jean Marc
- Subjects
UTERUS ,OOCYTE retrieval ,EMBRYO transfer ,SURROGATE motherhood ,FALLOPIAN tubes ,KIDNEY transplantation ,HOMOGRAFTS - Abstract
Women suffering from absolute uterine factor infertility (AUFI) had no hope of childbearing until clinical feasibility of uterus transplantation (UTx) was documented in 2014 with the birth of a healthy baby. This landmark accomplishment followed extensive foundational work with a wide range of animal species including higher primates. In the present review, we provide a summary of the animal research and describe the results of cases and clinical trials on UTx. Surgical advances for graft removal from live donors and transplantation to recipients are improving, with a recent trend away from laparotomy to robotic approaches, although challenges persist regarding optimum immunosuppressive therapies and tests for graft rejection. Because UTx does not involve transplantation of the Fallopian tubes, IVF is required as part of the UTx process. We provide a unique focus on the intersection between these two processes, with consideration of when oocyte retrieval should be performed, whether, and for whom, preimplantation genetic testing for aneuploidy should be used, whether oocytes or embryos should be frozen and when the first embryo transfer should be performed post-UTx. We also address the utility of an international society UTx (ISUTx) registry for assessing overall UTx success rates, complications, and live births. The long-term health outcomes of all parties involved—the uterus donor (if live donor), the recipient, her partner and any children born from the transplanted graft—are also reviewed. Unlike traditional solid organ transplantation procedures, UTx is not lifesaving, but is life-giving, although as with traditional types of transplantation, costs, and ethical considerations are inevitable. We discuss the likelihood that costs will decrease as efficiency and efficacy improve, and that ethical complexities for and against acceptability of the procedure sharpen the distinctions between genetic, gestational, and social parenthood. As more programs wish to offer the procedure, we suggest a scheme for setting up a UTx program as well as future directions of this rapidly evolving field. In our 2010 review, we described the future of clinical UTx based on development of the procedure in animal models. This Grand Theme Review offers a closing loop to this previous review of more than a decade ago. The clinical feasibility of UTx has now been proved. Advancements include widening the criteria for acceptance of donors and recipients, improving surgery, shortening time to pregnancy, and improving post-UTx management. Together, these improvements catalyze the transition of UTx from experimental into mainstream clinical practice. The procedure will then represent a realistic and accessible alternative to gestational surrogacy for the treatment of AUFI and should become part of the armamentarium of reproductive specialists worldwide. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
50. Mitochondrial Replacement Therapy: An Islamic Perspective.
- Author
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Ibrahim, Abdul Halim, Rahman, Noor Naemah Abdul, and Saifuddeen, Shaikh Mohd
- Subjects
ISLAM ,MARRIAGE ,MITOCHONDRIAL DNA ,MITOCHONDRIAL pathology ,FAMILIES ,MOTHERHOOD ,HUMAN reproductive technology ,INTERPERSONAL relations ,FERTILIZATION in vitro ,BIOETHICS - Abstract
Mitochondrial replacement technology (MRT) is an emerging and complex bioethical issue. This treatment aims to eliminate maternal inherited mitochondrial DNA (mtDNA) disorders. For Muslims, its introduction affects every aspect of human life, especially the five essential interests of human beings—namely, religion, life, lineage, intellect, and property. Thus, this technology must be assessed using a comprehensive and holistic approach addressing these human essential interests. Consequently, this article analyses and assesses tri-parent baby technology from the perspective of Maqasidic bioethics—that is, Islamic bioethics based on the framework of Maqasid al-Shariah. Using this analysis, this article suggests that tri-parent baby technology should not be permitted for Muslims due to the existence of third-party cell gametes which lead to lineage mixing and due to the uncertain safety of the therapy itself and because the major aim of the technology is to fulfil the affected couples interest to conceive their own genetically healthy child, not to treat and cure mtDNA disorders sufferers. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
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