Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reproductive Technologies”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed2003

Funding fertility: issues in the allocation and distribution of resources to assisted reproduction technologies.

The appropriate level and source of funds for assisted reproduction technologies (ARTs), in particular IVF, have been controversial in most developed economies. Funding of fertility services internationally is characterized by low public (or other third party) funding, a greater reliance on user-pays than in most other health services, and variations in funding and provision. This article describes the characteristics of infertility as a condition and its treatment that have been used as a rationale for its exclusion from an otherwise comprehensive coverage of health services. The challenges these characteristics pose for the use of economic evaluation to inform resource allocation are discussed. Most economic evaluations have focused on the cost effectiveness of alternative infertility treatments. These evaluations provide important information, but do not inform the real issue at stake: what is the appropriate allocation of funds to ARTs, given that it involves sacrificing improvements in health in other areas? Cost utility analysis - the method of economic appraisal preferred by most agencies charged with making such decisions (including the National Institute of Clinical Excellence in the UK) - is ill-equipped to deal with the benefits produced by ARTs. Alternative methods are available, but require decision makers to weigh up very different sorts of evidence. Demonstration of the willingness to pay for the benefits of ARTs can be used to support public decisions but, conversely, also implies that those who can pay will pay in a private market. Ultimately, decisions about the inclusion or otherwise of ARTs in collectively funded health systems probably rest as much on judgments about equity in access as value for money. Given that this is the case, public funding of IVF should be accompanied by the development of agreed criteria for the prioritization of potential recipients, to ensure treatment is targeted at those for whom it is most effective and that access is consistent and fair.

Adult↗
PubMed2004

Use of assisted reproductive technologies in the propagation of rhesus macaque offspring.

The assisted reproductive technologies (ARTs) as tailored to the production of rhesus monkeys at the Oregon National Primate Research Center (ONPRC) are described. Efficient fertilization of mature oocytes recovered by aspiration from females subjected to follicular stimulation was achieved with fresh or frozen sperm by intracytoplasmic sperm injection (ICSI). Embryo development to the early cleavage stage occurred at high frequency. Cryopreserved embryos showed high postthaw survival and were also transferred in efforts to establish pregnancies. Three methods of transfer were evaluated, two involving embryo placement into the oviduct, laparoscopy and minilaparotomy, and a nonsurgical, transcervical approach that resulted in uterine deposition. Early cleaving embryos (Days 1-4) were transferred into the oviducts of synchronized recipients with optimal results and pregnancy rates of up to 36%. Pregnancy rates were similar when two fresh or frozen embryos were transferred (28- 30%), although more than two embryos had to be thawed to compensate for embryo loss during freeze-thawing. Normal gestational lengths, birth weights, and growth curves were seen with ART-produced infants compared with infants produced by natural mating in the timed mated breeding (TMB) colony at the ONPRC. In 72 singleton pregnancies established following the transfer of ART-produced embryos, the live-birth rate, at 87.5%, was statistically identical to that for the TMB colony. Further development of the ARTs should result in increasing use of these techniques to augment conventional approaches to propagating monkeys, especially those of defined genotypes.

Animals↗
PubMed2002

Epigenetic risks related to assisted reproductive technologies: risk analysis and epigenetic inheritance.

A broad spectrum of assisted reproductive technologies has become available for couples with fertility problems. Follow-up studies of children born as a result of assisted reproduction have shown that neonatal outcome and malformation rates are not different from those of the general population, except for a low birthweight and a slight increase in chromosomal abnormalities. The safety aspect of assisted reproduction at the epigenetic level has not been well studied. Epigenetics refers to phenomena where modifications of DNA methylation and/or chromatin structure underlie changes in gene expression and phenotype characteristics. This article intends to analyse epigenetic risks related to assisted reproduction on the basis of an overview of epigenetic reprogramming events in the gamete and early embryo. Two epigenetic modifications, methylation and imprinting, are considered in more detail. The interference of in-vitro embryo culture, immature sperm cells and nuclear transfer with epigenetic reprogramming is discussed, as well as the possibility of epigenetic inheritance.

Animals↗
PubMed1996

Community and justice: the challenges of bicultural partnership to policy on assisted reproductive technology.

Listening to other cultures offers challenges to our fundamental assumptions and worldviews. In New Zealand public policy on Assisted Reproductive Technology (ART) is being worked out in a society committed to the development of bicultural partnership honouring the Treaty of Waitangi, a treaty with the indigenous people. Strong claims to the cultural significance of genetic heritage by Maori have made apparent to non-Maori (Pakeha) their own assumptions. These claims also resist reductive understandings of genetics. In this paper I review, as a Pakeha ethicist, initiatives taken in New Zealand, and the impact of bicultural development on public policy on ART. I also discuss some of the issues this raises for western bioethics as it relates to non-western approaches and include reference to the significance of genetic heritage as it is affecting guidelines for donor insemination and surrogacy.

Advisory Committees↗
PubMed2000

Impact of assisted reproductive technology on modern medicine.

A surge in knowledge and interest in reproductive biology has occurred since the advent of assisted reproductive technology (ART) in the 1960s. These innovative medical advances soon challenged societies and invited criticism. Nevertheless, ART has superseded older therapies and serves as a back-up when all else fails. There are currently 61 ART clinics in Taiwan. Thanks to a group of young physicians and scientists who have devoted great effort in catching up with the modern advances in assisted reproduction, most of the important advances in ART have been introduced to Taiwan promptly and resulted in good success rates. The complications of multifetal pregnancies as well as controversies regarding gestational surrogacy and new technologies such as intracytoplasmic sperm injection, preimplantation genetic diagnosis, and cloning have challenged conventional wisdom, ethics, laws, and religions. Society now faces a dilemma in striking a balance among science, ethics, and human rights. It is, thus, advisable that we stand back once in a while and carefully consider where we should go next.

Ethics, Medical↗
PubMed2005

[Consequences on women's fecundity and on assisted reproductive technology].

Knowledge of the detrimental role of cigarette smoking on human reproduction is constantly improving. In natural fertility, time to pregnancy is longer, frequency of infertility is increased and fertility rate declines 10% to 20% with a dose-effect relationship. Moreover, women exposed in utero also have lower fertility. Cigarette smoking is also a risk factor for menstrual disorders and for early menopause. In assisted reproductive technology, where many parameters are controlled, the deleterious effects of smoking on fertility have been clearly demonstrated: lower estradiol levels, decreased pregnancy and implantation rates, and poorer oocyte morphology. The two published meta-analyses have concluded that the effects are the same in natural and assisted reproduction. These results are in accordance with biological hypotheses on the local and general effect of tobacco and other cigarettes components. In conclusion, women should be informed about the effect of cigarette smoking on their fertility. Education is very important since in many countries, like France, the percentage of smokers is increasing among women, especially among young women.

Adult↗
PubMed2005

The new Italian law on assisted reproduction technology (Law 40/2004).

The Italian parliament passed the law on assisted reproduction after a heated debate. The promulgation of this law (Law 40/2004) is the end point of a long and troubled journey that has seen many bills come and go, all of which have failed. The law consists of a whole set of regulations that will have a great impact on health and on society in general. The law is against many of the technical practices of assisted reproduction; several such practices are banned. This paper outlines ethical and medicolegal issues arising in connection with the law. The law states that no more than three embryos must be created at any one time and all the embryos created must be transferred together even if the couple does not need all the embryos. Embryo cryopreservation is also forbidden, as is assisted reproductive technology (ART), which uses a third party in any way, and the screening of embryos for genetic defects.

Cryopreservation↗
PubMed2005

Risk of birth defects among children conceived with assisted reproductive technology: providing an epidemiologic context to the data.

Studies of assisted reproductive technology (ART) and birth defects must be scrutinized and appropriately interpreted in the context of their limitations. The recent findings reported by Klemetti et al. are compelling, given the study's many strengths, and add to the accumulating evidence suggestive of an association between ART and birth defects.

Abnormalities, Multiple↗
PubMed1995

The regulation of assisted reproductive technology in Australia: issues and solutions.

The legislative response to assisted reproduction technology had been inappropriate and inflexible for such a rapidly developing area of medicine. A national system of regulation, consisting of a merger of components of already established committees and based on the United Kingdom system introduced in 1990, would overcome the legislative differences between States, and provide a more responsible and responsive regulatory system.

Australia↗
PubMed2005

Dizygotic twin pregnancy conceived with assisted reproductive technology associated with chromosomal anomaly, imprinting disorder, and monochorionic placentation.

Assisted reproductive technology (ART) has now become a cornerstone of treatment for involuntary infertility. Recent studies have raised concern regarding potential associations between ART and chromosomal aneuploidy, imprinting anomalies, and monochorionic placentation in dizygotic (DZ) twins. We report a case of DZ twins conceived by ART in which all three problems coexist.

Beckwith-Wiedemann Syndrome↗
PubMed2007

Impact of assisted reproductive technologies: a mitochondrial perspective of cytoplasmic transplantation.

Many of the assisted reproductive techniques associated with maternal aging, disease states, or implantation failure aim to correct poor developmental capacity. These techniques are highly invasive and require the exchange of nuclear or cytoplasmic material from a donor oocyte to compensate for deficiencies inherent in the affected individual. These techniques are based on the assumption that the cytoplasm of the donor oocyte can effectively substitute the necessary component(s) to enable development to proceed. Several studies have attempted to inject cytoplasm from "normal" (young) donors, into aged eggs, again assuming that beneficial components of the cytoplasm are transferred to restore developmental capacity. These invasive assisted reproduction technology (ART) procedures aim to eliminate chromosomal abnormalities, improve the quality of oocytes deficient in some important cytoplasmic factors necessary for maturation and/or subsequent development, and eliminate maternally inherited diseases (particularly mitochondrial myopathies). However, in order to develop such ART, understanding the processes involving mitochondrial DNA replication and transcription is imperative, as asynchrony between mitochondrial and nuclear genomes may cause problems in mitochondrial function, localization, and biogenesis.

Animals↗
PubMed2005

Assisted reproductive technologies and birth defects.

In vitro fertilization (IVF) and other assisted reproductive technologies (ART) are effective treatments for infertility and are widely provided at infertility clinics. Although IVF and related ART procedures are generally considered safe, some studies have suggested an excess occurrence of major malformations, low birth-weight and other perinatal complications in babies conceived by ART. Further, it was recently reported that IVF and intracytoplasmic sperm injection (ICSI) are associated with imprinting disorders in the offspring such as Beckwith-Wiedemann syndrome and Angelman syndrome. Here we review the human and animal studies investigating the potential risks of ART, and discuss the need for further investigation.

Animals↗
PubMed1993

[Ectopic pregnancy risk factors after assisted reproductive technology].

Ectopic pregnancies are more frequent among pregnancies resulting from assisted reproductive technology (ART) than in natural conceptions (6% to 7% vs 1%). Fivnat registry has allowed us to analyse 349 ectopics among 6049 clinical pregnancies collected from 1986 to 1990. Ectopic rate decreased with increasing women's age, and since 1986. The risk was also decreased in infertilities of non tubal origin, except for those of unknown origin in which it was at the same level than for tubal infertility. The risk was increased by 65% in stimulation regimens involving clomiphene citrate (CC). The observed decrease from 1986 to 1990 was strongly related to the decrease in use of CC.

Adult↗
PubMed2005

Uses and limitations of two molecular cytogenetic techniques for the study of arrested embryos obtained through assisted reproduction technology.

We studied chromosomal abnormalities in arrested embryos produced by assisted reproductive technology with fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH) in order to determine the best technique for evaluating chromosomal aneusomies to be implemented in different situations. We examined individual blastomeres from arrested embryos by FISH and arrested whole embryos by CGH. All of the 10 FISH-analyzed embryos gave results, while only 7 of the 30 embryos analyzed by CGH were usable. Fifteen of the 17 embryos were chromosomally abnormal. CGH provided more accurate data for arrested embryos; however, FISH is the technique of choice for screening in preimplantation genetic diagnosis, because the results can be obtained within a day, while the embryos are still in culture.

Chromosome Disorders↗
PubMed2003

Global infertility and the globalization of new reproductive technologies: illustrations from Egypt.

Infertility is a problem of global proportions, affecting on average 8-12 percent of couples worldwide. In some societies, however-particularly those in the "infertility belt" of sub-Saharan Africa-as many as one-third of all couples are unable to conceive. Factors causing high rates of tubal infertility in parts of the developing world include sexually transmitted, postpartum, and postabortion infections; however, male infertility, which is rarely acknowledged, contributes to more than half of all cases. Unfortunately, the new reproductive technologies (NRTs) such as in vitro fertilization (IVF), which are prohibitively expensive and difficult to implement in many parts of the developing world, represent the only solution to most cases of tubal and male infertility. Not surprisingly, these technologies are rapidly globalizing to pronatalist developing societies, where children are highly desired, parenthood is culturally mandatory, and childlessness socially unacceptable. Using Egypt as an illustrative case study, this paper examines five of the major forces fueling the global demand for NRTs; these include demographic and epidemiological factors, the fertility-infertility dialectic, problems in health care seeking, gendered suffering, and adoption restrictions. Following this overview, a detailed examination of the implications of the rapid global spread of NRTs to the developing world will be offered. By focusing on Egypt, where nearly 40 IVF centers are in operation, this article will demonstrate the considerable constraints on the practice and utilization of NRTs in a developing country on the "receiving end" of global reproductive technology transfer. The article concludes by stressing the need for primary prevention of infections leading to infertility, thereby reducing global reliance on NRTs.

Anthropology, Cultural↗
PubMed2005

Outcome of assisted reproductive technologies after different embryo transfer strategies.

The outcomes of 1028 assisted reproductive technology cycles were studied retrospectively, considering two different periods of embryo transfer. In the first period, 262 cycles in women < 36 years old were studied, in which three embryos were transferred, followed by 157 cycles in women > or = 36 years, in which four embryos were transferred. In the second period, 332 cycles were evaluated in women < 36 years and 277 cycles in women > or = 36 years old, reducing the number of embryos transferred to two and three respectively. Embryos were only scored morphologically, and the best embryos were chosen for transfer. In the first period, in women < 36 years old, a clinical pregnancy rate of 55.7% was achieved, compared with 42.5% in the second period (P < 0.01). In women > or = 36 years old, the first period of embryo transfer showed a clinical pregnancy rate of 39.5%, compared with 28.5% in the second period (P < 0.01). The number of twin pregnancies in the three groups of patients in whom one to four embryos were transferred was not significantly different (24.2, 28.4, 24.8%). It is concluded that even with the biases induced by a retrospective study, the reduction in the number of embryos transferred, from three to two in women < 36 years of age, and from four to three in women > or = 36 years of age, without any selection other than pre-transfer morphological score, adversely affects the outcome of treatment, without a significant reduction in twin gestation rate. Other strategies are to be implemented in gametes and embryo selection, and patients must be aware that, even with a reduction in pregnancy rate, the goal is to achieve a high cumulative pregnancy rate, reducing the complications induced by multiple pregnancies.

Adult↗