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AbstractThis article examines the interplay of queer reproduction and private assisted reproductive technologies (ART) companies in urban China. While same-sex marriage has not gained legal recognition in mainland China and childbirth outside heterosexual marriage has been restricted, queer parents who have children through ART have gradually become visible. ART has emerged as an ideal way for Chinese queer citizens to have children, though they are not legally permitted to use ART services in domestic hospitals. Consequently, an increasing number of queer intended parents turned to underground ART businesses, with some of them becoming salespeople or business owners themselves. My ethnographic analysis comes from fieldworks conducted in Guangdong province, China, from 2018 to 2021. This paper shows that the legal and moral debates brought by queer people’s use of ART are perceived differently among diverse gender and sexual groups in Chinese society. It founds that queer parents’ participation in the ART industry has demonstrated the potential for queer forms of parenthood and family, while reinforcing stratified reproduction and gender inequalities. The tendency to reduce IVF/surrogacy to “womb-for-rent” business among Chinese ART businesses continues to impact queer people’s reproductive and parenting rights. This paper hopes to offer insights into queer reproductive justice and reproductive technologies across the globe. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this narrative review paper was to review the state and development of the field of donor gametes in Kazakhstan, compare its legislative and technical capabilities with other countries and identify key steps towards the establishment of a unified register of donor gametes in the Republic. Materials and Methods. The narrative review paper conducted an analysis of scientific publications and legal documents to examine the implementation of Assisted Reproductive Technologies (ART), focusing on Donor Sexual Gametes (DSG), globally. It utilized medical publications from 2019 to 2023, legal acts, and recommendations from global health organizations to analyze eligibility criteria, legal regulations, and the social aspects of ART across different regions. Results. In Kazakhstan, ART is regulated by legislation, with DSG procedures governed by age limits, medical screening, and restrictions on the number of children born from donated gametes. Worldwide, practices vary, but there is growing interest in establishing a unified register of reproductive donor material to enhance transparency and accountability. However, legal gaps and ethical considerations must be addressed. Conclusion. The study identifies gaps in Kazakhstan's legislation compared to Western countries, emphasizing the necessity for enhanced legal rights for donors and recipients, including options for anonymity. Ethical concerns highlight the importance of confidentiality and data security in accessing the donor registry. Overall, implementing such a register promises to enhance transparency, safety, and accountability in reproductive medicine. [ABSTRACT FROM AUTHOR]

The article dwells upon topical demographic problems of infertility in the context of their national specifics and institutional features. The purpose of the study was to analyze the impact of infertility correction on the annual number of births in Russia through identifying reproductive disorders and expanding assisted reproduction programs as effective tools of the pronatal fertility policy. The material for the analysis is statistical data of the Russian Federal State Statistics Service, official information from the Russian Association of Human Reproduction published in the National Registers of Assisted Reproductive Technologies in 2000-2021, materials of the World Health Organization and international professional associations of reproductive health professionals, domestic and foreign themed publications. The paper casts light on the economic, psychological, medical, social, professional, financial and gender changes in society associated with the development of assisted reproduction as the most effective way to correct infertility. A currently prevailing global trend towards universal access to assisted reproduction programs as the realization of everyone's right to the highest level of health, regardless of income, marital status, gender identity, etc., is limited in some countries by cost-effectiveness and "threshold of utility" of in vitro fertilization in treating infertility. In Russia, the main concern is the programs involving "third parties" and reproductive donors, especially surrogacy, therefore, it is necessary to strengthen state regulation to make the assisted reproductive technologies most similar to the natural processes and traditional ethical standards. [ABSTRACT FROM AUTHOR]

This paper studies the optimal fiscal treatment of assisted reproductive technologies (ART) in an economy where individuals differ in their reproductive capacity (or fecundity) and in their wage. We find that the optimal ART tax policy varies with the postulated social welfare criterion. Utilitarianism redistributes only between individuals with unequal fecundity and wages but not between parents and childless individuals. To the opposite, ex post egalitarianism (which gives absolute priority to the worst‐off in realized terms) redistributes from individuals with children toward those without children, and from individuals with high fecundity toward those with low fecundity, so as to compensate for both the monetary cost of ART and the disutility from involuntary childlessness resulting from unsuccessful ART investments. Under asymmetric information and in order to solve for the incentive problem, utilitarianism recommends to either tax or subsidize ART investments of low‐fecundity‐low‐productivity individuals at the margin, depending on the degree of complementarity between fecundity and ART in the fertility technology. On the opposite, ex post egalitarianism always recommends marginal taxation of ART. [ABSTRACT FROM AUTHOR]

Evidence suggests that one reason doctors provide certain interventions in assisted reproductive technologies (ART) is because of patient demand. This is particularly the case when it comes to unproven interventions such as 'add‐ons' to in vitro fertilisation (IVF) cycles, or providing IVF cycles that are highly unlikely to succeed. Doctors tend to accede to demands for such interventions because patients are willing to do and pay 'whatever it takes' to have a baby. However, there is uncertainty as to what moral weight should be placed on patient‐led demands in ART, including whether it is acceptable for such demands to be invoked as a justification for intervention. We address this issue in this paper. We start by elucidating what we mean by 'patient‐led demand' and synthesise some of the evidence for this phenomenon. We then argue that a doctor's professional role morality (PRM) yields special responsibilities, particularly in commercialised healthcare settings such as ART, because of the nature of professions as social institutions that are distinct from markets. We argue on this basis that, while there may be reasons (consistent with PRM) for doctors to accede to patient demand, this is not always the case. There is often a gap in justification between acceding to patient‐led demands and providing contested interventions, particularly in commercial settings. As a result, acceding to demand in such settings needs a strong justification to be consistent with PRM. [ABSTRACT FROM AUTHOR]

Requests for perimortem gamete procurement (PGP) typically arise by a surrogate decision maker after the unexpected death or incapacitation of a reproductive-aged individual. Palliative care clinicians should have a working knowledge of the medical, ethical, and practical considerations pertaining to such requests. In this paper, we describe a case in which the PGP request originated from an incapacitated patient's parents. We review the technologies associated with PGP and posthumous assisted reproduction (PAR) and discuss the ethical and legal issues involved in such cases, including recent position statements from national and international reproductive health groups. Finally, we provider readers with a stepwise approach for considering requests for PGP. [ABSTRACT FROM AUTHOR]

Simple Summary: Gynecological cancers affect many women of reproductive age, necessitating the development of fertility preservation methods to fulfill family planning. Consequently, providing treatment options that preserve fertility in women diagnosed with gynecological cancers has become a crucial component of care for survivors. This leads to improved quality of life, allowing survivors to become mothers even in the seemingly adverse circumstances posed by cancers. However, although there are guidelines on fertility preservation in the context of neoplasms, physicians do not routinely consider it and do not discuss these options with their patients. It is important for patients to be informed about the available options for fertility preservation and to be encouraged to make informed decisions in collaboration with their medical team. Standardized guideline recommendations for onco-fertility should be considered in the future. We explore possible methods that can be employed for obtaining a pregnancy after gynecologic cancer treatment, including more exotic ones like uterine transplant. (1) Background: Currently, an increasing number of women postpone pregnancy beyond the age of 35. Gynecological cancers affect a significant proportion of women of reproductive age, necessitating the development of fertility preservation methods to fulfill family planning. Consequently, providing treatment options that preserve fertility in women diagnosed with gynecological cancers has become a crucial component of care for survivors. (2) Methods: We conducted an extensive search of relevant scientific publications in PubMed and Embase databases and performed a narrative review, including high-quality peer-reviewed research on fertility after being treated for gynecologic cancers, reporting pregnancy rates, birth rates, and pregnancy outcomes in cancer survivors as well as therapeutic options which partially preserve fertility and methods for obtaining a pregnancy in survivors. (3) Discussion: The medicine practiced today is focused on both treating the neoplasm and preserving the quality of life of the patients, with fertility preservation being an important element of this quality. This leads to an improved quality of life, allowing these women to become mothers even in the seemingly adverse circumstances posed by such a pathology. However, although there are guidelines on female fertility preservation in the context of neoplasms, an analysis shows that physicians do not routinely consider it and do not discuss these options with their patients. (4) Conclusions: Advancements in medicine have led to a better understanding and management of gynecological neoplasms, resulting in increased survival rates. Once the battle against these neoplasms is won, the issue of preserving the quality of life for these women arises, with fertility preservation being an important aspect for women who have not yet fulfilled their family planning desires at the time of diagnosis. It is important for patients to be informed about the available options for fertility preservation and to be encouraged to make informed decisions in collaboration with their medical team. Standardized recommendations for onco-fertility into guidelines should be taken into consideration in the future. [ABSTRACT FROM AUTHOR]

Background: In Egypt, where research into the underlying cytogenetic and molecular causes of infertility is scarce, unexplained infertility presents a substantial clinical and emotional difficulty for many couples. This study attempts to fill a gap in knowledge on the chromosomal disorders that cause infertility in Egyptian couples. Methods: In order to compile research on cytogenetic and molecular anomalies in Egyptian couples with unexplained infertility, an extensive database search was performed. Translocations, inversions, and aneuploidies were the primary focus of this study. Studies discussing the diagnostic utility of chromosomal analysis and molecular markers were considered and critically appraised up to April 2023 for this review. Results: The results suggest that cytogenetic and molecular abnormalities are responsible for a significant proportion of unexplained infertility in Egypt. Disruption of gametogenesis, abnormal embryonic development, and problems with genomic imprinting have all been linked to chromosomal abnormalities, which are typically missed in routine infertility examinations. Improved understanding of the causes of infertility and the potential for individualized therapies has resulted from the development of genetic testing. Conclusions: There is a strong correlation between cytogenetic and molecular abnormalities and unexplained infertility in Egypt. It becomes clear that karyotypic and molecular chromosomal examination are essential parts of the diagnostic process for afflicted couples. This analysis highlights the need for improved diagnosis techniques and the creation of individualized treatments. The ethical implications of genetic testing and Assisted reproductive technology are substantial, calling for a careful weighing of technology advantages and moral issues. New genetic and chromosomal therapies show promise in reducing infertility problems, and they fit in with current trends in ethics, medicine, and scientific inquiry. Future Directions: Future research in reproductive genetics should aim to improve diagnosis accuracy and provide therapies that are targeted to individual genetic profiles. There is a need for both ethical norms and instructional initiatives to help couples make informed choices about genetic testing and reproductive treatments. [ABSTRACT FROM AUTHOR]

Background: In recent years, preimplantation genetic testing for aneuploidies (PGT-A) has become widespread in assisted reproduction. However, contrary to expectations, PGT-A does not significantly improve the clinical outcomes of assisted reproductive technologies. One of the underlying reasons is the discordance between the PGT-A results and the true chromosomal constitution of the blastocyst. In this case series, we re-examined the PGT-A results in trophectoderm (TE) re-biopsies and in the two isolated blastocyst compartments—the TE and the inner cell mass (ICM). Methods: This study enrolled 23 human blastocysts from 17 couples who were referred for assisted reproduction. The blastocysts were unsuitable for uterine transfer due to the chromosomal imbalance revealed by PGT-A using array comparative genomic hybridization (aCGH) (n = 11) or next-generation sequencing (NGS) (n = 12). The re-examination of the PGT results involved two steps: (1) a TE re-biopsy with subsequent aCGH and (2) blastocyst separation into the TE and the ICM with a subsequent cell-by-cell analysis of each isolated compartment by fluorescence in situ hybridization (FISH) with the DNA probes to chromosomes 13, 16, 18, 21, and 22 as well as to the PGT-A detected imbalanced chromosomes. Results: In 8 out of 23 cases, the PGT-A results were concordant with both the re-biopsy and the isolated TE and ICM analyses. The latter included the diagnoses of full non-mosaic aneuploidies (five cases of trisomies and two cases of monosomies). In one case, the results of PGT-A, aCGH on the TE re-biopsy, and FISH on the isolated TE showed Xp tetrasomy, which contrasted with the FISH results on the isolated ICM, where this chromosomal pathology was not detected. This case was classified as a confined mosaicism. In 4 out of 23 cases, the results were partially discordant. The latter included one case of trisomy 12, which was detected as non-mosaic by PGT-A and the re-biopsy and as mosaic by FISH on the isolated TE and ICM. This case was classified as a true mosaicism with a false negative PGT-A result. In 11 out of 23 cases, the re-examination results were not concordant with the PGT-A results. In one of these discordant cases, non-mosaic tetraploidy was detected by FISH in the isolated TE and ICM, whereas the PGT-A and the TE re-biopsy failed to detect any abnormality, which advocated for their false negative result. In two cases, the re-examination did not confirm full aneuploidies. In eight cases, full or partial mosaic aneuploidies as well as chaotic mosacism were not confirmed in the isolated TE nor the isolated ICM. Thus, in 47.8% of cases, the PGT-A results did not reflect the true chromosomal constitution of a blastocyst. Conclusions: The PGT results may have different prognostic value in the characterization of the chromosomal constitution of a blastocyst. The detected non-mosaic aneuploidies have the highest prognostic value. In stark contrast, most PGT-identified mosaic aneuploidies fail to characterize the true chromosomal constitution of a blastocyst. Once detected, a differential diagnosis is needed. [ABSTRACT FROM AUTHOR]

Male infertility has affected an increasingly large population over the past few decades, affecting over 186 million people globally. The advent of assisted reproductive technologies (ARTs) and artificial intelligence (AI) has changed the landscape of diagnosis and treatment of male infertility. Through an extensive literature review encompassing the PubMed, Google Scholar, and Scopus databases, various AI techniques such as machine learning (ML), artificial neural networks (ANNs), deep learning (DL), and natural language processing (NLP) were examined in the context of evaluating seminal quality, predicting fertility potential, and improving semen analysis. Research indicates that AI models can accurately estimate the quality of semen, diagnose problems with sperm, and provide guidance on reproductive health decisions. In addition, developments in smartphone-based semen analyzers and computer-assisted semen analysis (CASA) are indicative of initiatives to improve the price, portability, and accuracy of results. Future directions point to possible uses for AI in ultrasonography assessment, microsurgical testicular sperm extraction (microTESE), and home-based semen analysis. Overall, AI holds significant promise in revolutionizing the diagnosis and treatment of male infertility, offering standardized, objective, and efficient approaches to addressing this global health challenge. [ABSTRACT FROM AUTHOR]

As global demographics shift toward increasing paternal age, the realm of assisted reproductive technologies (ARTs), particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), faces new challenges and opportunities. This study provides a comprehensive exploration of the implications of advanced paternal age on ART outcomes. Background research highlights the social, cultural, and economic factors driving men toward later fatherhood, with a focus on the impact of delayed paternity on reproductive outcomes. Methods involve a thorough review of existing literature, centering on changes in testicular function, semen quality, and genetic and epigenetic shifts associated with advancing age. Study results point to intricate associations between the father's age and ART outcomes, with older age being linked to diminished semen quality, potential genetic risks, and varied impacts on embryo quality, implantation rates, and birth outcomes. The conclusions drawn from the current study suggest that while advanced paternal age presents certain risks and challenges, understanding and mitigating these through strategies such as sperm cryopreservation, lifestyle modifications, and preimplantation genetic testing can optimize ART outcomes. Future research directions are identified to further comprehend the epigenetic mechanisms and long-term effects of the older father on offspring health. This study underscores the need for a comprehensive approach in navigating the intricacies of delayed fatherhood within the context of ART, aiming for the best possible outcomes for couples and their children. [ABSTRACT FROM AUTHOR]

Infertility affects approximately 15% of couples trying to conceive. Male-related causes account for roughly 50% of cases, with obesity emerging as a possible significant factor. Obesity, defined as a body mass index of 30.0 or higher, has become a widespread epidemic associated with numerous health issues, including a decrease of fertility. This review discusses the relationship between obesity and male infertility, particularly focusing on sperm quality and function. An overview of the literature suggests that obesity may influence the male reproductive system via disruptions in hormonal profiles, oxidative stress, and inflammation, leading to changes in sperm parameters. Several studies have discussed if obesity causes a decrease in sperm concentration, motility, and normal morphology, so far without a consensus being reached. However, available evidence suggests an impairment of sperm function in obese men, due to an increase in DNA damage and oxidative stress, impaired mitochondrial function and acrosome reaction in response to progesterone. Finally, the relationship between obesity and assisted reproductive technologies outcomes remains debatable, with conflicting evidence regarding the influence on fertilisation, pregnancy, and live birth rates. Therefore, the actual impact of obesity on human spermatozoa still needs to be clarified, due to the multiple factors potentially in play. This review focuses on the potential impact of male obesity on sperm quality and function – a long-debated topic. The adverse effects of obesity on sperm parameters can significantly impair male and couple fertility, resulting in an increased necessity for fertility assistance among obese men. Furthermore, although more definitive research is needed, these individuals often experience poorer outcomes in assisted reproductive technologies. Image by João Ramalho-Santos. This article belongs to the Collection Dedication to Jim Cummins. [ABSTRACT FROM AUTHOR]

In vitro fertilization (IVF) has transformed the sector of assisted reproductive technology (ART) by presenting hope to couples facing infertility challenges. However, conventional IVF strategies include their own set of problems such as success rates, invasive procedures, and ethical issues. The integration of micro/nanorobotics into IVF provides a prospect to address these challenging issues. This article provides an outline of the use of micro/nanorobotics in IVF specializing in advancing sperm manipulation, egg retrieval, embryo culture, and capacity future improvements in this swiftly evolving discipline. The article additionally explores the challenges and obstacles associated with the integration of micro/nanorobotics into IVF, in addition to the ethical concerns and regulatory elements related to the usage of advanced technologies in ART. A comprehensive discussion of the risk and safety considerations related to using micro/nanorobotics in IVF techniques is likewise presented. Through this exploration, we delve into the core principles, benefits, challenges, and potential impact of micro/nanorobotics in revolutionizing IVF procedures and enhancing affected person outcomes. [ABSTRACT FROM AUTHOR]

In 2022, the Society for Reproductive Biology came together in Christchurch New Zealand (NZ), for its first face-to-face meeting since the global COVID-19 pandemic. The meeting showcased recent advancements in reproductive research across a diverse range of themes relevant to human health and fertility, exotic species conservation, and agricultural breeding practices. Here, we highlight the key advances presented across the main themes of the meeting, including advances in addressing opportunities and challenges in reproductive health related to First Nations people in Australia and NZ; increasing conservation success of exotic species, including ethical management of invasive species; improvements in our understanding of developmental biology, specifically seminal fluid signalling, ovarian development and effects of environmental impacts such as endocrine-disrupting chemicals; and leveraging scientific breakthroughs in reproductive engineering to drive solutions for fertility, including in assisted reproductive technologies in humans and agricultural industries, and for regenerative medicine. [ABSTRACT FROM AUTHOR]

The permissiveness of Ukrainian legislation toward surrogate motherhood makes Ukraine one of the world’s centers for surrogacy. The paper discusses the solution to the issue of ensuring the implementation of human reproductive rights in the international and national legislation of Ukraine. Attention is drawn to the need to consider the norms of morality, ethics, and religion. The purpose of the article is to substantiate the issue of legal support for the implementation of reproductive human rights by considering the theoretical and applied aspects of the violation of the rights of a surrogate mother, a child born to her in the context of the fourth generation of human rights. The authors analyzed international experience in regulating relations in the field of surrogacy (by the example of the USA, Germany, Italy, Spain, and other countries). The authors researched judicial practice, which began to form in Ukraine. Concern was expressed about the lack of effective government response to cases of violation of the rights of a surrogate mother and child on the territory of the state. The authors formulated a proposal on the need for constant state control over organizations that provide mediation and medical services in the field of surrogacy.