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At least 307 records · Page 17Linked to original sources
PubMed1995

Sperm conservation and HIV infection.

In the course of preparing a medico-legal report in civil proceedings instituted by a couple contaminated by HIV, the case of Mr B. was brought to our attention. At the end of 1984 Mr B. had a serious accident in consequence of which he received a number of blood transfusions. The post-transfusion inquiry established blood contamination. Several years later (in 1990), and for reasons closely related to the above accident, Mr B. and his wife were having difficulty in having a child. They decided to resort to intraconjugal artificial insemination (IAI) first through a private laboratory and then through a CSCOS (Centre for the Study and Conservation of Human Ova and Sperm). In 1992 Mr B. and his wife were both found to be HIV positive; the infection was ascribed to the IAI, as the most plausible cause. In the face of such dramatic events, we wondered why neither the laboratory nor the CSCOS had checked whether the couple were HIV positive. Reflecting on this led us: (a) to make an inventory of the different organizations and facilities empowered to manipulate sperm for medically assisted procreation (MAP); (b) to investigate their obligation in terms of the prevention and control of specific diseases.

AIDS Serodiagnosis↗
PubMed2002

Increased bone mass is an unexpected phenotype associated with deletion of the calcitonin gene.

Calcitonin (CT) is a known inhibitor of bone resorption. Calcitonin gene-related peptide-alpha (CGRPalpha), produced by alternative RNA processing of the CT/CGRP gene, has no clearly defined role in bone. To better understand the physiologic role of the CT/CGRP gene we created a mouse in which the coding sequences for both CT and CGRPalpha were deleted by homologous recombination. The CT/CGRP(-/-) knockout (KO) mice procreated normally, there were no identifiable developmental defects at birth, and they had normal baseline calcium-related chemistry values. However, KO animals were more responsive to exogenous human parathyroid hormone as evidenced by a greater increase of the serum calcium concentration and urine deoxypyridinoline crosslinks, an effect reversed by CT and mediated by a greater increase in bone resorption than in controls. Surprisingly, KO mice have significantly greater trabecular bone volume and a 1.5- to 2-fold increase in bone formation at 1 and 3 months of age. This effect appears to be mediated by increased bone formation. In addition, KO mice maintain bone mass following ovariectomy, whereas wild-type mice lose approximately one-third of their bone mass over 2 months. These findings argue for dual roles for CT/CGRP gene products: prevention of bone resorption in hypercalcemic states and a regulatory role in bone formation.

Alternative Splicing↗
PubMed2000

Avoiding multiple pregnancies in ART: multiple pregnancies: a test case for the moral quality of medically assisted reproduction.

Although most professional societies have issued guidelines to diminish the number of embryos to be transferred during assisted reproduction techniques, the incidence of multiple pregnancies remains unacceptably high. The negative psychological, social and medical consequences for the patients and their offspring easily outweigh the benefits in terms of increased success rates. Multiple pregnancies would never be tolerated if the 'best interest of the child' standard was applied as strictly to these consequences, as it is to controversial family forms. The persistence of high multiple pregnancy rates is largely due to the pressure brought to bear on the physicians to increase the overall success rate. The fertility specialist should inform the patients about the risks and benefits of a multiple transfer but ultimately the specialist should decide how many embryos to transfer. Multifetal reduction is an ethically acceptable solution if, and only if, the physician has taken all reasonable steps to prevent the occurrence of a multiple pregnancy. Finally, an additional strategy to decrease the incidence of multiple pregnancies is proposed, i.e. to extend the professional responsibility of the fertility specialist to all steps of procreation including pregnancy, birth and neonatal care.

Child↗
PubMed1998

[Pregnancy, labor and puerperium in patients after surgery for ovarian tumors of borderline malignancy].

OBJECTIVES: The aim of the study was to assess procreation in patients treated surgically for borderline tumours of the ovary. DESIGN: The analysis included 114 patients operated for ovarian tumours of borderline malignancy in the Gynaecological Department, Medical University of Gdańsk between 1978-1997. Evaluated were: the incidence of pregnancy, age of patients, tumour pathology, type of surgery, the course of pregnancy, labour and puerperium. RESULTS: In the group of 37 stage Ia patients, who had undergone conservative surgical procedure, 7 patients conceived and 9 healthy children were born. All patients are free of disease. CONCLUSIONS: Conservative surgery for borderline ovarian tumours allows for retaining procreational potential and normal conception in young women.

Adolescent↗
PubMedDate not supplied

[Prenatal diagnosis: an attempt at evaluation of effectiveness and risk based on the experience of one center].

We present the results of prenatal diagnosis in 2241 women carried out in one centre in the period 1985-1994. Indications were cytogenetic in 84% of the cases, of those in 77% it was maternal age 35 years and over. The second most frequent indication was open neural tube defect in a previously born child (7.5%). Abnormal results of prenatal tests in whole material were obtained in 60 cases (2.4%); in 47 cases this was chromosomal aberration. Abnormal result of prenatal test did not necessarily mean selective termination of pregnancy. In 17.5% of chromosomal fetal aberrations pregnancy was continued (it concerned mostly aberrations involving sex chromosomes). The risk of prenatal diagnosis (miscarriage due to the procedure) according to our estimation was between 0.3 and 0.6% of the tested pregnancies. Sociological analysis of the tested group showed clearly that women with better education (secondary and higher level) in Poland have much better access to prenatal diagnosis. Most of the tested woman (72%) considered a prenatal test a sine qua non condition of their procreation.

Adult↗
PubMedDate not supplied

8q22-->qter duplication in a child with multiple congenital malformations: case report.

BACKGROUND: Congenital malformation syndromes are often caused by unbalanced chromosome translocations, which appear spontaneously or may be inherited from a healthy parent being the carrier of a balanced reciprocal translocation (rcp). Breakpoints, underlying chromosome fragment exchanges, may be located at any point of any chromosome and therefore, an infinite number of different translocations is possible. Special emphasis is placed both on the clinical characterization of every rare chromosomal aberration syndrome and on the determination of its breakpoints. OBJECTIVES: Diagnosis of a 8q22-->qter duplication in a child with multiple congenital malformations. MATERIAL AND METHODS: We determined the karyotypes of the five members of proband's family were established by using classical cytogenetic methods on whole blood obtained by venipuncture. RESULTS: We described a rare familial reciprocal translocation t(8; 14), observed in balanced form in mother and one healthy son, while being unbalanced in the son with congenital malformations. CONCLUSIONS: Balanced chromosome 8 aberration carriers should be aware of the procreation risks and need genetic counseling.

Abnormalities, Multiple↗
PubMed1976

[Results and experiences in the immunosuppressive therapy of rheumatoid arthritis].

An analysis of the results of treatment-in five different hospitals and with such immunosuppressants as cyclophosphamide, azathioprine, and trenimone - of 550 patients with rheumatoid arthritis showed an overall rate of improvement of 36%. Cyclophosphamide, because of the relatively small number of side effects and the excellent therapeutical results obtained, proved to be much better than the other two immunosuppressive agents. Also, because the dosage required is comparatively low, patients over procreative age could be included in the program of treatment with immunosuppressants.

Adult↗
PubMed1989

The right to be born: surrogacy and the legal control of human fertility.

South African law, in common with many other legal systems, has exercised a strong measure of control over the fertility of its citizens via the sanction of illegitimacy and the prohibition of marriage (and hence legitimate children) between certain persons, e.g. those who fall within the so-called prohibited degrees of relationship. Until last year, when the Mixed Marriages Act was abolished, marriage across the colour line was prohibited in South Africa. The requirement of a valid consent by both prospective spouses in order to enter into marriage further excludes certain categories of persons from procreating legitimate children, e.g. the insane and mentally feeble, while the requirement of consummation will exclude certain categories of paraplegics from solemnizing a valid marriage. Age restrictions on marriages and the requirement of parental consent for minors are further factors limiting the individual's freedom to procreate. These restrictions have a well-established historical basis extending over many hundreds of years. They can be broadly categorised as having as their objective the preservation of the family unit. The above provisions were formulated at a time when the law never contemplated the spectacular advances in human biology that have produced the numerous artificial forms of conception, such as AID, IVF and surrogacy. The legislature, both in South Africa and elsewhere, at first adopted a neutral approach to this new fertility revolution and watched the courts struggle to adapt outmoded principles to the new technology. Legislation relating to AID and IVF eventually appeared in many jurisdictions; as a result of its delayed introduction public opinion had been educated to accept the new techniques and the legislation is by and large favourable to these new techniques. Not so, however, as far as surrogacy is concerned. South Africa, England and Australia have produced essentially negative legislation on this subject. Certain American states, however, have adopted progressive legislation accepting surrogacy. The merits of surrogacy are discussed and it is submitted that it should be condoned by the South African legislature under certain circumstances, as it can fall in the scope of furthering the interests of the family unit.

Contracts↗
PubMed2005

Acting parentally: an argument against sex selection.

The Human Fertilisation and Embryology Authority's (HFEA) recent restrictive recommendations on sex selection have highlighted the need for consideration of the plausibility of ethical arguments against sex selection. In this paper, the author suggests a parental virtues approach to some questions of reproductive ethics (including sex selection) as a superior alternative to an exclusively harm focused approach such as the procreative liberty framework. The author formulates a virtue ethics argument against sex selection based on the idea that acceptance is a character trait of the good parent. It is concluded that, because the argument presented posits a wrong in the sex selecting agent's action that is not a harm, the argument could not function as a justification of the HFEA's restrictive position in light of their explicit commitment to procreative liberty; it does, however, suggest that ethical approaches focused exclusively on harm fail to capture all the relevant moral considerations and thus that we should look beyond such approaches.

Ethical Theory↗
PubMed2000

Ethics education in medical schools: the role of jurists.

Ethical thinking has always existed in the area of medicine. The oldest law case has known human experiment difficulties, but this comes from the doctor. The power of the practitioner relies on the lack of medical knowledge of the patient and often in practice, on the lack of information for the patient. The doctor has ethical difficulties when he considers the patient and the solution, in fact is dependent on his conscience. With the various medical discoveries, the doctor can create life (assisted procreation), manipulate life (gene therapy) and suppress life (abortion, suppression of frozen embroyos). These discoveries have increased the necessity for ethical reflection. Ethics committees have been created at local level (as part of special establishments or departments) rather than at national and international levels. The scope of the stakes (the development of the human race) give to this ethical reflection a multidisciplinary approach. There is a general tendency for the influence of law in these fields. Therefore, the jurist has a more and more important place on these ethics committees. Actually, the interaction from ethics to law is frequent. Also during legal proceedings, a jurist has and will have more and more need of a medical assessor. So, cooperation is necessary between doctors and jurists. The teaching of ethics in medical schools by the jurist can be important because it will recall the humanist mission of the doctor. The jurist must be able to increase the medical professions' awareness of essential notions such as respect for the fundamental rights of the human being.

Curriculum↗
PubMed2000

Procreation ability in Wilson's disease.

OBJECTIVES: The clinical manifestations of Wilson's disease (WD) take the form of hepatic, neurological, renal as well as hormonal disturbances. Infertility and amenorrhea are reported in women and hypogonadism in men with WD. Our study was designed to analyse the procreation abilities of patients with WD. MATERIAL AND METHODS: We investigated by a questionnaire the course of pregnancy and delivery in 31 untreated women (mean age 22.5 years, 82 pregnancies) and 15 women (mean age 26.2, 25 pregnancies,) treated with D-penicillamine (D-p) or zinc sulphate (ZnS). We studied also procreation ability of 27 men (mean age 27.2 years). We analysed the congenital abnormalities and frequency of WD in children of our patients. RESULTS: One of 10 untreated women had difficulties with conception. The number and type of pathology (imminent abortions, gestosis, stillbirth, preterm births) were similar in treated and untreated patients. In both mentioned groups the most frequent pathology were spontaneous abortions, which were found in 26% of untreated and in 26.6% of treated women. This percentage is higher than in general population. Most of deliveries in patients with WD were spontaneous. Neither developmental malformations nor serious disorders were noticed in the offspring of our treated patients, 3 children of untreated patients were born with congenital heart disease. In 78 of the 110 children of our patients we examined the copper metabolism and we diagnosed WD in 5 cases (from 3 families). Among 27 investigated men only 1 was impotent. CONCLUSION: The risk of complications during pregnancy in asymptomatic and treated patients is higher than in general population, but it does not make the procreation impossible.

Adolescent↗