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This essay develops a framework for thinking about the moral basis for the commodification of human reproductive materials. It argues that selling and buying gametes and genes is morally acceptable although there should not be a market for zygotes, embryos, or genomes. Also a market in gametes and genes should be regulated in order to address concerns about the adverse social consequences of commodification. Keywords: Commodification; markets; gametes; zygotes; embryos; genomes; genes

Holistic nursing techniques and interventions have been developed to reduce the discomfort level of infertile families who have pursued assisted reproductive technology (ART) to have children and for families using ART to reduce the risk of conceiving children with genetic disorders. This concept of care provides four dimensions of comfort that fall under the domain of nursing.

Micromanipulative strategies for assisted reproductive technology (ART), including subzonal insemination and direct intracytoplasmic sperm injection (DICSI), may be used when standard in vitro fertilization (IVF) has failed. The two types of patients that may have the greatest risk of fertilization failure are those with severe male factor infertility and those whose in vitro fertilization attempts have failed before. Micromanipulation may be most useful when assisted fertilization is a last resort. Subzonal insemination may yield fairly good results, but direct intracytoplasmic sperm injection using single sperm may be better, although more invasive. Less invasive techniques of retrieving sperm from men with very low levels of sperm may be combined with DICSI technology and enable more couples to benefit from IVF in the future.

In the recent UK debate on the Human Fertilisation and Embryology Bill, there have been conflicting claims about the extent of public support for, or opposition to, human-animal hybrids. Self-selecting polls tend to show opposition to hybrids. Representative-sample polling shows spontaneous opposition but can elicit conditional approval of research, combined with underlying unease. Public opinion is very finely divided, with people generally opposed to this research unless it is likely to lead to medical advances.

The human zona pellucida is a structure consisting of carbohydrate and protein that surrounds the unfertilized egg and embryo. This structure enhances the binding of a single sperm to the egg and prevents attachment of additional sperm. It may also serve as a physical barrier to protect the egg and embryo from immunological, physical, or biochemical damage. The role of the zona pellucida has become more important since the development of artificial fertilization techniques. The zona pellucida must be penetrated to allow the sperm to come into contact with the egg. Holes that have been made in the zona pellucida of fertilized eggs for purposes of genetic analysis have not prevented live births. It was suggested that a hole in the zona pellucida may help the embryo to shed its zona pellucida structure when it implants in the uterus during in vitro fertilization. In vitro fertilization is the fertilization of the egg outside of the female genital tract, usually in a test tube. This is then followed by placement of the fertilized egg back into the uterus. The effect of partially dissecting the zona pellucida of fertilized eggs on the success of implantation in the uterus was assessed. Of 65 attempts at implantation, 32 involved partial dissection of the zona pellucida (also referred to as assisted hatching). Implantation of the embryo into the uterus was successful in 16 percent of embryos treated by assisted hatching and in 9 percent of untreated embryos. Larger study groups are needed to confirm the benefits of assisted hatching in improving implantation rates for in vitro fertilization. (Consumer Summary produced by Reliance Medical Information, Inc.)

Couples having difficulty conceiving may resort to in vitro fertilization (IVF), in which the woman's eggs are retrieved, fertilized with sperm outside the body so that embryo cell multiplication begins, and transferred back to the uterus, hopefully to be followed by embryo implantation into the uterine wall and subsequent development of the placenta and other important structures necessary for pregnancy. However, the majority of IVF procedures do not succeed, chiefly due to low rates of implantation. The pregnancy rate, and therefore implantation, improves when multiple embryos are transferred to the uterus. To better describe the likelihood of embryo implantation following IVF, a mathematical model has been developed and is discussed in this article. In this model, embryo implantation is presented as the outcome of interaction between embryo quality, endometrial (uterine lining) receptivity, and transfer efficiency. Each of these factors is discussed. Using this model, embryo implantation data from an IVF program were analyzed; three groups of patients were described. The donor program uses donated eggs for women without ovaries. In addition, participants were selected from a standard IVF program and an IVF program which does not use the same program of hormonal stimulation. The donor group had an implantation rate of 35 percent and a clinical pregnancy rate of 67 percent. The standard group had an implantation rate of 11 percent and a pregnancy rate of 39 percent. The unstimulated group had a 21 percent implantation rate and a 21 percent pregnancy rate. These results are scrutinized in terms of the mathematical model, and the idea of endometrial receptivity or embryo quality being limiting factors for implantation, depending on the type of IVF program, is discussed. Further development of this type of analysis is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Allowing human embryos to grow to the blastocyst stage may improve pregnancy rates and lower the rate of multiple pregnancies during in vitro fertilization. This may occur because the blastocysts are of higher quality, which means that only one or two embryos are needed.

Gestational surrogacy, whereby an embryo conceived in vitro is planted in the womb of a woman who has contracted with one or both of the child's genetic parents, holds out [...]

A new fertility treatment called IVM may take over from IVF. Rachel Liddle reports. What is the story? Women struggling to conceive could benefit from a rival method to IVF [...]

An Israeli committee of leading experts in science, medicine, civil and Jewish law, philosophy, and ethics has agreed guidelines approving the therapeutic use of human embryonic stem cells. The bioethics [...]

2001 AUG 9 - (NewsRx Network) -- A team of scientists and physicians in the U.S. has developed a preconception sex-sorting technique for humans that can dramatically increase the percentage [...]

In his testimony before the National Bioethics Advisory Commission on stem cell research, Gilbert Meilaender urged the commission to be honest in its recommendations. If you endorse federal funding of [...]

Recent scientific advances in human stem cell research have brought into fresh focus the dignity and status of the human embryo. These advances have prompted a decision by the Department [...]

2000 NOV 23 - (NewsRx.com) -- Contrary to official figures, two methods of fertilization - implanting the embryo in the uterus or in the Fallopian tube - yield comparable success [...]

The uneasy morality of rescuing spare humans created in vitro. WITH ONE PIECE OF BAD NEWS rapidly following another on the technological reproduction front--the latest being that aging rock star [...]

Biological limitations on maternal age are nonexistent in the era of oocyte donation. Although the technique initially was intended for women with premature ovarian failure, it has been more broadly [...]

Yes. You're only as old as you feel. The advent of assisted reproductive technologies (ART) and the ability to manipulate and cryopreserve gametes and embryos has given women in our [...]

BOSTON -- The rate of pregnancies resulting from the use of fresh, nondonor eggs in assisted reproductive technology procedures is 24%, according to preliminary data from the Centers for Disease [...]

Competition and patient demand are pushing some US fertility clinics to implant three or more embryos, obtained from in vitro fertilization (IVF), into mothers, according to The Wall Street Journal. [...]

IVF clinics worldwide are reporting increasing numbers of 'test-tube baby' conceptions for the purpose of selecting a particular embryo. Why do people wish to select embryos? One reason is to […]

The ethical and moral issues regarding embryo donation are presented. Specific legislation covering embryo donation exists in Victoria, South Australia and Western Australia.