Psychological aspects of artificial procreation.
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Despite considerable basic research effort, the therapeutic possibilities to improve impaired male fertility are still limited. This is partly because the cause of reduced fertility is unknown in many cases and, consequently, no specific therapy is available. Approaches to andrological therapy at different levels include stimulation of spermatogenesis, improvement of epididymal function or sperm transport within the male genital tract, and stimulation of sperm metabolism. Medical therapy of male fertility disturbances has to distinguish between specific and empirical treatment procedures. Specific treatment is based on a pathophysiological concept and implies accurate patient selection; the therapeutic success is predictable. In contrast, empirical treatment involves no patient selection according to specific criteria; thus, the therapeutic success is unpredictable. Hormonal treatment is the main choice in andrological therapy, including pulsatile administration of gonadotrophin-releasing hormone (GnRH), human gonadotrophins, anti-oestrogens and testosterone. Non-hormonal treatment is carried out using different pharmaceutical compounds such as alpha-sympathomimetics, antibiotics, antiphlogistics, corticosteroids, mast cell blockers, pentoxifylline, kallikrein, captopril, vitamins and zinc. In patients with severe male factor who are resistant to therapy, procreation problems may be solved by the method of intracytoplasmic sperm injection (ICSI).
This study was conducted to evaluate the preimplantation embryonic potential of adult somatic cells from an infertile man using an interspecies bioassay for quality control and also to create human embryos via somatic cell nuclear transfer (SCNT). Skin tissue was biopsied from infertile man to obtain fibroblast cells. These cells were fused with both enucleated bovine oocytes obtained commercially and human oocytes obtained from his wife. SCNT-reconstructed oocytes were cultured in-vitro. Interspecies SCNT embryos were prepared for PCR and DNA analysis. From 13 SCNT-reconstructed bovine oocytes, 7 embryos developed (54%). DNA sequencing of these interspecies embryos showed the presence of human genomic DNA specific for the fibroblast cells of the man. From three SCNT-reconstructed human oocytes, one developed to the 4-cell stage and was subsequently transferred into the patient's uterus. Blood ss-hCG levels showed a negative pregnancy result. Human fibroblast cells from an infertile patient can promote embryonic development in interspecies SCNT. This is the first evidence of the creation and transfer of a human cloned embryo for reproductive purposes. Even though no pregnancy was established, human reproduction via SCNT may be possible and applicable in the future for patients with severe male or female infertility that have no other alternative options for procreating their own offspring.
The article discusses the legal status of human gametes and embryos produced by in vitro fertilization. The author concludes that sperm, ova and embryos are not part of the estate of the procreators. However, the originators of gametes and embryos are granted the full disposition on their germ cells and the embryos resulting thereof.
The use of modern reproductive technology, such as in-vitro fertilization and its related procedures, has opened new areas of legal, religious and public concern. Thirty years ago, the development of effective methods to control procreation generated a debate on whether couples had the right to enjoy sex in the absence of its procreative effect. Today, assisted reproductive technology (ART) allows couples to have their own children in the absence of a direct intermediation of sex. The Catholic Church has reacted against both contraception and ART, and specific instructions have been directed to the public, the medical profession and legislators. In a recent survey, 88.4% of the population in Latin America claims to be Catholic; therefore, bioethical considerations and legal implications concerning intervention in reproduction are strongly permeated by the moral teachings of Catholicism. In 1996, 83 medical doctors and scientists, participating in the Latin American Network of Assisted Reproduction, produced a consensus document on ethical aspects and legal implications of ART. The document contains minimal ethical guidelines that Latin American professionals have decided to adhere to, even in the absence of legal regulations. This article examines how the medical profession, legislators and the public react to religious influence when confronted by difficult bioethical decisions such as the right to procreate.
OBJECTIVE: In Western societies, menopause has negative connotations with variable effects for women at midlife. To assess the power of the stereotype, selected popular print media were surveyed for their depiction of menopause. METHOD: Ten years' output of two daily newspapers and four women's magazines was surveyed for menopause-related copy. Both content and discourse analyses were applied to quantify retrieved copy (using SPSS) and identify dominant discourse (using NUD.IST). RESULTS: A database of 302 items was analysed. No consistency in reporting trends was found although there were thematic peaks for 'menopause' in the late 1980s and 'hormone replacement therapy' three years later. With few exceptions, discourse about menopause drew on and reinforced schemata of ill-health, psychological disturbance, vulnerability, decrepitude, biological determinism and disease management. CONCLUSIONS: The limited discourse about menopause in the surveyed media was characterised by strong themes of illness, medical management and fear. A general perception that menopause affects women's health and competence from midlife was reflected by this public discourse. IMPLICATIONS: Public health awareness that menopause is not synonymous with dysfunction will contribute to a paradigmatic shift in public discourse that affords value to all of women's lifespan, not just the procreative.
This Article suggests that the time has come to reconsider the safety and effectiveness of fertility drugs in order to combat some of the continuing problems arising from the overly aggressive use of assisted reproductive technologies, especially the health hazards associated with multifetal pregnancies. After critically assessing the arguments made by some commentators about the power of malpractice law to curb any abuses of fertility clinics and specialists, the Article concludes that the Food and Drug Administration should consider restricting or withdrawing pharmaceutical products used to induce ovulation. Although such a drastic move would not prevent the continued use of in vitro fertilization and other advanced fertility treatments, it would dramatically reduce the frequency of multifetal pregnancies, and it should not run afoul of any constitutional protections of procreative liberty.
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