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At least 325 records · Page 18Linked to original sources
PubMed2003

Future regulation of fertility banking in the UK.

The storage of embryos and mature gametes is regulated by the Human Fertilisation and Embryology Authority (HFEA) and the laboratories concerned are generally in assisted conception centres. The HFEA does not regulate storage of immature gametes, such as oocytes in ovarian cortex, where no mature gametes are present. Under the Department of Health Code of Practice on Tissue Banking, since 1 April 2003, immature gametes must be stored in accredited tissue banks only. Most IVF units are unable to comply with this code, and many have stopped storing ovarian tissue. In the future, when patients request transplantation of tissue stored in non-accredited banks, individual Trusts will decide whether it is safe to be used. The Department of Health Code of Practice does not apply to mature gametes and embryos. Consequently, these may now be stored in conditions less stringent than those of other tissues used therapeutically. However, an EU directive covering all banked tissues used in therapy, specifically including gametes, embryos and stem cells, may soon eliminate this inconsistency. The standards used in fertility banking must therefore be improved if current practice in embryo and gamete cryopreservation is to continue. This article examines the present situation and the issues raised.

Accreditation↗
PubMed2004

Demographic, medical and treatment characteristics associated with couples' decisions to donate fresh spare embryos for research.

BACKGROUND: Isolation of human embryonic stem cell lines has opened a promising and pioneering area of basic and applied medical research. The issues in relation to a couples' decision in donating their supernumerary embryos for research need to be investigated further. METHODS: We carried out a prospective study of 300 couples who underwent IVF/ICSI treatment cycles in our unit. We analysed various factors contributing to their decision to consent to donate spare embryos for stem cell or preimplantation genetic diagnosis research. RESULTS: The majority of couples (54%) consented to donate their surplus embryos for research. Couples of ethnic minority origin were less willing to consent for research compared to Caucasian couples. The number of ovarian follicles at pre-hCG scan and the number of embryos obtained were significantly higher in couples consenting for research. The funding source of treatment did not appear to influence the decision to donate. Couples with previous failed fertilization were less likely to consent to embryo research. CONCLUSIONS: Physical characteristics based on ovarian response during a treatment cycle may positively influence a couple's decision to donate embryos. Further studies are needed to identify those couples who are likely to agree to research so that counselling for research can be directed efficiently.

Adult↗
PubMed2004

When to avoid creating surplus human embryos.

The advice that should be given to a couple considering assisted reproductive technologies for the treatment of their infertility, when they are completely opposed to the destruction of surplus embryos, is discussed. It is urged that they do not use treatments that generate surplus embryos. They should be given the options of declining IVF and considering adoption, or less efficient treatments, namely limited ovarian stimulation, limited insemination of available ova or natural cycle IVF where no surplus embryos are generated.

Counseling↗
PubMed2005

Parent identity and 'virtual' children: why patients discard rather than donate unused embryos.

BACKGROUND: Many patients prefer to donate unused embryos when surveyed. However, it is a source of frustration and curiosity that clinical audits of embryo outcomes show the majority changed their minds. In many clinics, the number of recipients continues to outweigh the number of donors. To plan effective counselling practices, it is important to understand the dynamics of decision-making for patients when determining outcomes for unused embryos. METHODS: Twelve couples and nine women (n = 33) who had discarded unused embryos were interviewed using a narrative structure and various interview techniques. Interview transcripts underwent qualitative analysis through which data were grouped thematically according to similarities. Differences were also examined. RESULTS: Participants described their initial choice to donate embryos as an idealistic plan rather than a purposeful decision. Their change of mind was due to two factors: (i) a change in their standpoint from a childless couple to parents; and (ii) a change in the symbolism of the embryo from representing a chance to become pregnant to representing a 'virtual' child in cryo-storage. The meaning of embryo donation was likened to child relinquishment. CONCLUSION: Counselling and social policy need to take account of the symbolism of the embryo and reform current practices.

Cryopreservation↗
PubMedDate not supplied

Cloning.

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Abortion, Induced↗
PubMedDate not supplied

Reproducing to order.

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Bioethical Issues↗
PubMedDate not supplied

[A commentary on the Ruling of the Tribuna Constitucional 212/1996 of 19 December 1996 (I)].

This article is a commentary on Spain's Constitutional Court's ruling of 19 December 1996 (STC 212/1996), on the challenge (596/89) on grounds of alleged unconstitutionality made against Law 42/1988, 28 December, which regulates the donation of human embryos and foetuses or the cells, tissues and organs therefrom. The article is structured as follows: it opens with a summary of Law 42/1988, since this is felt necessary to understand the subsequent challenge made on grounds of alleged unconstitutionality. We then provide specific details of the challenge and the resulting ruling, before concluding with some critical remarks on the aforementioned Law and ruling.

Constitution and Bylaws↗
PubMed1998

[Human in vitro fertilization: technics and ethics].

IVF is certainly one of the new medical technologies where ethical debates are the most frequent and heavy. Three illustrations will be presented: The improvement of ovulation induction techniques have increased the number of supernumerary embryos. How to deal with these embryos, on which principles and what do the patients think about it? Introduction in the early 90' of assisted fertilization techniques (ICSI) have largely extended IVF indications and improved the success++ rate. Nevertheless, it will be demonstrated that it's implementation was a hard process for which the creation of embryos for research was a crucial step, opening another passionate ethical debate. Oocyte donation which came true thanks to IVF, will give the opportunity to illustrate an unusual consequence of ethics on technical aspect; due to an ethical choice (anonymous donation) we have been able to improve by a factor 3 the clinical efficiency of our oocyte donation program. An example of enhancement of the technique due to ethics, a very important fact in the situation of shortage of oocytes for donation. In conclusion, it appears that the ethical debate does not only focus on the legitimacy of this "medicine of desire" but also demonstrate that the development as well as the daily practice of IVF makes a clear vision of ethical choices mandatory and indissociable of technical aspects themselves.

Attitude to Health↗
PubMed2000

[Cloning: applications in humans. II. Ethical considerations].

Reproductive cloning in adults/children evokes unfavourable reactions. Direct objections are that cloning is unnatural, that it affects human dignity and violates the individual's right to genetic uniqueness. Consequential objections concern unjustified health risks for the progeny, unjustified psychosocial risks for the clone child and the risk of cloning for eugenetic purposes. There is consensus that reproductive cloning of existing persons is unjustifiable as yet because of the health risks for the offspring. Reproductive cloning of embryos is possible by means of nucleus transplantation and of embryo splitting. The ethical analysis of reproductive cloning of embryos depends on the purposes and applications. At least some of the moral objections against cloning of adults/children are not or not completely applicable to reproductive cloning of embryos. Conditions to be put to reproductive cloning of embryos are efficacy, safety and, at least for the time being, avoidance of asynchrony in transferring identical embryos. The ethical aspects of its application in the context of genetical reproductive techniques must be evaluated separately. Therapeutic cloning may be acceptable if alternatives are lacking.

Cloning, Organism↗