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The psychological features of anonymous, personalized oocyte donation are examined. The specific psychological profiles of recipients and donors are described, as well as the psychological experience of patients undergoing fertilization attempts. Preliminary data from an ongoing 3-year longitudinal study of children born by these medically assisted procreation techniques are reported.
Taking as a starting point, papers on sexuality of disabled people and papers on attitudes and representations toward their sexuality, we have demonstrated that the coping of those people is directed by an ideology of rationalisation of sexuality. This ideology is expressed in different ways, with physically disabled and mentally retarded people. This fact makes clear the importance of the handicapped referent over the coping. Procreation is strongly supported for the physically disabled people (paraplegics). Mentally retarded people are strictly forbidden to procreate: this appears especially with the sterilisation of mentally retarded women.
The practice of informed consent in biomedicine is so widely spread that it must be considered the most important principle within bioethics, and the most universally appealed to within recent legislation. There seems to be a consensus as to its value in research on autonomous persons, but also a problem concerning its application when dealing with people having a serious mental, social or even physical disability. Within the field of artificial procreation there are even more problems. Informed written consent is often demanded from anonymous donors of gametes in order to ensure their consent to the legal and moral consequences of their anonymity. The child resulting from the artificial procreation, on the contrary, cannot consent to, nor be informed before being conceived, of the secrecy laid on the identity of its genetic parents. Some countries resolve this problem by allowing the children, when they reach their majority, to obtain some information pertaining to the health or the identity of their genetic parents. This presents ethical problems. It can be argued that the anonymity of the parents chiefly affects the children, so that an agreement on this point among parents, doctors and others must be regarded as invalid. The paper will argue that a law ensuring the complete anonymity of the parents is disregarding the informed consent and the interests of the children resulting from artificial procreation, and is thus doing more damage to society than good.
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52 taps have been carried out for a "gamete intra fallopian transfer" or GIFT. 15 pregnancies (29 p. cent) were obtained, including 2 twin pregnancies, with 3 early miscarriages and no ectopic pregnancy. These results are similar to those published in large international series. The indications of GIFT are reported, as well as its place among other methods of medically assisted procreation. The future of GIFT is discussed.
An old rumor - lately substantiated by statistical examinations from England - to the effect that pilots of high-performance military aircraft are "girl-fathers", could be reduced to absurdity through a comprehensive questionnaire investigation in the German Federal Armed Forces. Spermiogenesis does not seem to be disturbed by professional-specific influences (Radar radiation, G-forces etc.), as implied by the questionnaire findings. In times of high flying and personal stress (first 1000 flying hours) military jet pilots are even "boy-fathers". As soon as flying becomes a routine matter (after the 1000th flying hour) and thus less stressful, jet and helicopter pilots even become "girl-fathers". The pilots of military transport aircraft show no deviation from the control group of the male population of the Federal Republic of Germany with respect to the sex ratio of children procreated by them. The intention of this somewhat curious study was established by considerations that pilots would be entitled to protection and/or compensation for damages incurred in cases where their procreative capacity had been detrimentally affected by activities in the line of duty.
The Bible illustrates some interesting views on the matter of Gynecology and Obstetrics. Beside the Old and New Testaments, some Apocrypha have to be discussed for their content about this subject. This article concerns the following points: impregnation, formation of the human embryo, Eve's creation, indirect fecundation and spermatic pollution, bi-sexuality of the first man, libido, signs of virginity, female infertility, incest, multiparity, post-menopausal conception, the fructifying powers of amulets, plants and seeds, the course of pregnancy and antenatal care, normal and difficult labour, premature birth (was Moses premature?), perineal tears, the first birth without pain, twin pregnancy, procidentias, breech delivery, maternal deaths, midwives and Pharaoh, nursing, swaddling, breast-feeding and weaning of the baby. Uncleanliness and purification of the woman following childbirth or during menstruation according to levitical advice are discussed.
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Heterotopic pregnancy is the combination of intra-uterine pregnancy and ectopic pregnancy in the same patient whatever is the localization of the ectopic pregnancy. The aim of this work was to summarize the epidemics and clinical factors, the diagnostic means and the therapeutic methods for the spontaneous heterotopic pregnancy in Moroccan context. In a period of 6 years (1993-1998), 8 patients were treated for heterotopic pregnancy in Lalla Meryem Maternity of Casablanca, with a rate of 0.2/1000. Patients' ages ranged from 19 to 37. The backgrounds were: abortions (4 cases), secondary sterility (2 cases) and genital infection (2 cases). Five patients consulted for metrorrhagia associated with pelvic pain. Two for pelvic pain and one for metrorrhagia. The diagnosis was confirmed before echography in 5 cases. All patients were operated on, 3 in a condition of haemorrhagic shock. Ectopic pregnancy lay at the level of the fallopian tube in 7 cases and at the level of the ovary in one. The treatment consisted of a salpingectomy in the 7 patients with tubal localisations, the ovary pregnancy benefited from ovariectomy. Evolution has been marked by expulsion of intra-uterine pregnancy in 6 cases. Two women were able to carry out their pregnancy. Heterotopic pregnancy is more and more frequent because of genital infection increase and especially the wide diffusion of the assisted medical procreation.
OBJECTIVE: To examine thoroughly the profile and motivations of a group of women who regretted sterilization so much that they were prepared to undergo reversal microsurgery or in vitro fertilization treatment. MATERIAL: and methods. The study followed one hundred women from their first consultation for a period of 3 years in order to analyze the outcome of their initial decision. RESULTS: Analysis of the circumstances at the time of the sterilization indicate 3 main factors which later caused the women to regret the decision Three years after the initial consultation, 69% of the patients have withdrawn from further investigation and /or treatment for different reasons analyzed in this study. 17 of the patients have undergone reversal microsurgery and 14 have attempted one or more in vitro fertilization treatments. Of these 31 patients, 12 (38.7%) have given birth to at least one child. CONCLUSION: These results sufficiently prove that tubal sterilization is worthy of consideration as much by the patient as by the physician as a method of irreversible contraception despite the developments in tubal microsurgery or in medically assisted procreation.
OBJECTIVES: The aim of the study was to assess procreation in group of patients who were treated by conservative operation for borderline tumors of the ovary. DESIGN: The analysis included 42 patients conservatively operated for ovarian tumor of borderline malignancy in Department of Gynecology Medical University of Gdansk between 1978-2000. The incidence of pregnancy, age of patients, tumor pathology, type of conservative surgery and the course of pregnancy and labour were evaluated in this study. RESULTS: In the analysis group were 36 (85.7%) stage IA, 2 (4.8%) stage IB, 3 (7.1%) stage IC and 1 (2.4%) stage III C patients. Unilateral adnexectomy was performed in 36 (85.7%) patients, 4 (9.5%) unilateral cystectomy, 2 (4.8%) bilateral cystectomy with omentectomy in one case. After conservative operation 10 (23.8%) patients were pregnant and delivered healthy children but 2 patients delivered twice and 1 third. Recurrence was observed in 2 patients in period of 27 and 50 months after operation. 5 years survival was 97.6%. CONCLUSIONS: Percentage of pregnancy after conservative treatment for borderline ovarian tumors was high (23,8%) and number of recurrences was low so conservative surgery allows young women to retain procreational potential without increasing risk of recurrence.
The authors report their own experience as regard to the genetic counseling for consanguineous marriages. They observe that outpatients still marry and procreate despite the medical advices.
Divergent and sometimes conflicting positions with respect to human stem cells and cell therapy do not merely reflect disagreement among scientists and conflicts of interest. They attest the ethical tension resulting from recent progress in understanding the earliest stages of development of the human being that can be observed in vitro. Can the extremely potent notion of the human person starting with conception apply to the very first stage of artificial in vitro fertilisation and disregard the fact that to be a real substitute for natural conception, implantation in the uterus that enables the oocyte to nest and a new human being to develop must also be included? Several arguments are presented that plead in favour of making a clear distinction between the status of in vitro cells obtained by artificial fertilisation and that of the embryo, which becomes a developing human being from the moment it implants in the endometrium of the uterus. This subject could have remained in the sphere of the individual conscience, but it has now become a theme for social debate! The revision of the French 1994 so-called Bioethics Laws, which was recently approved on first reading on 22 January 2002, authorizes research on spare embroys from in vitro fertilisation under certain conditions. However, for the sole reason that there is a risk of opening the door wide to reproductive cloning, which is unanimously rejected and condemned, all research on stem cells deriving from the nuclear transfer of a somatic cell is prohibited, irrespective of the distinction between cloning for therapeutic purposes and reproductive cloning. It is undeniable that if the efficacy of somatic stem cells could be demonstrated, they would offer a far more preferable solution, for several reasons, than those involving stem cells obtained from spare embryos from IVF or nuclear transfer. Nevertheless, how will a comparison of the two methods be possible if one of them is prohibited a priori? At present, many fear that French researchers will be prevented from doing essential research that, even if it has far to go, is indispensable if we wish to attempt to control the failures of natural procreation and open the way towards the new regenerative medicine that so many look forward to.
In 1973 Judge Blackmun, in the celebrated case of Roe v Wade, stated that "we need not resolve the difficult question of when life begins". A quarter of a century later, there is indeed a need to attempt to resolve this question. This article sets out briefly ethical issues arising from medically-assisted procreation and analyses the concepts of life, personhood and the beginning of personhood. It is submitted that the fundamental criterion in resolving the issue is to rethink the value and dignity of human life in a technologically advanced world. Since the ultimate wisdom on the purpose of life emanates from God, the article analyses diverse theological perspectives, in particular that of Christianity and Islam. In valuing human life, the article asserts that human beings must use technology responsibly and to humankind's benefit, rather than submit to exploitation by it.
When the body is ailing the mind is soon impaired. Good health practices contribute to longer and better life. A balanced life of work-rest-play is necessary to human health. Psychosocial stresses at any period of life may impair morale and productivity and increase the likelihood of physical or mental disease. Bereavement, separation, divorce, loss of friendship, retirement, loss of self-esteem and symbolic losses contribute significantly to mental and physical ill health. Social and psychological support systems are vital to mental health maintenance. Mature persons evolve principles, values, moral and ethical tenets, philosophic and religious ideals and special codes of conduct to give meaning to their lives. The basic needs of survival and procreation must be integrated with moral precepts relating to interindividual behavior so as to give a person a feeling of self-worth, which is an indispensable element in mental health.
The "Fetus Protection Law" (Embryonenschutzgesetz ESchG) regulates the abusive use of reproductive techniques, the use of human embryos and the choice of sex. The Bundestag has singled out certain practices as being abusive, prohibited them and put criminal sanctions on them. Individual exemptions from criminal prosecution are made in favour of the surrogate mother who is to be the target of an assisted procreation and the foster-father. The ESchG represents a snapshot of current views on current practices in reproductive medicine. And therefore the ESchG will be rendered obsolete by newly created reproductive technologies if legislation does not adapt the law to these changes.
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