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[Gamete and embryo donations].

Medical taking part in procreation in gamete and embryo donation is recent in France and has been included in the field of medically assisted procreation as defined by a law since 1994. Theses activities are strictly regulated. If procreation using donor sperm has been broadly carried out for 30 years in the CECOS leading to the birth of approximately 40,000 children, oocyte and embryo donation had a more recent and limited development. The main questions to which are faced the couples procreating through gamete and embryo donation is whether their child should be told about its origin since they have to build a parenthood and a filiation which are not first depending on biological and genetic links.

Embryo, Mammalian↗

'Ascospore O', Oxidant, host assistance: the pathway to carcinogenesis.

Sufficient evidence exists to conclude that a cycle of sequential physiological events is the pathway contributing to the transformation of the mammalian cell to its malignant phase. The cycle of events involves a reticulum or network of cells. These consist either of the reticuloendothelial cells, the squamous, or the epithelial group. A second factor requires the presence, intracellularly, of conidia derived from one of the various groups of the anaerobic micro-organisms known as Ascomycetes. These conidia as a separate entity, totally free of any part of their parental origin, constitute the invasive agent which, however, can or may lie quiescent at the onset. They retain genetically an electronegative viable chemical complex (Oxidant) and also an asexual procreative unit. This Oxidant can alternately accept the negative charged ions (anions) while releasing oxygen. The subsequent ensuing circulation and compatible flow of blood by the host provides the source for the electrolytes as well as the metabolites, enzymes, etc. It is this continued flow of blood that promotes the next stage of the conidia's lifecycle and reactivates their anaerobic respiration, metabolism, and reproduction of new asexual conidia. This is the cycle of physiological events that ultimately contributes to the transformation of an animal (human) cell to its malignant phase. It also accounts for the pathological consequences as clinically present in malignantly ill patients.

Animals↗

The inheritance of Leber's disease. A genealogical follow-up study.

Members of two Leber families previously published in 1944 (Lundsgård) and 1968 (Seedorff), were traced during the years 1968-1980 and questioned in 1981 about their eyesight. Age at onset, manifestation rate, the frequency of onsets of the disease in the families in the course of time, the procreation in the female lines of descent, and the carrier rate are considered. Women born in the female lines of descent were found to be carriers provided that they had a sufficient number of descendants so that the disease had a possibility of manifesting itself.

Adolescent↗

[Sterilization of the male].

Vasoresection has great significance as a method of contraception. Next to surgicial sterilization of the female it is the most reliable method of contraception if surgical technical errors are avoided and postoperative speriograms are carried out. According to a review by Leader (2711 cases), 1 patient in 400 remaining capable of procreation must nevertheless be reckoned with. The failure is due to the fact that the surgeon did not identify a vas deferens or a spermatogranuloma led to a spontaneous recanilization. For this reason ths stumps of the vas should be stitched round. The question of electrocoagulation of the intima with ligature of the adventitia also arises.

Humans↗

The child and/or the embryo. To whom does it belong?

The relationships between embryos and children conceived by assisted procreation and their genetic and uterine parents are discussed. The situations arising in AID, embryo donation, surrogacy, etc. are debated in relation to the status of embryos and children as projects of the parents producing them. The same principle is applied to the use of embryos in research.

Abortion, Spontaneous↗

Response to Orr and Siegler--collective intentionality and procreative desires: the permissible view on consent to posthumous conception.

Orr and Siegler have recently defended a restrictive view concerning posthumous sperm retrieval and conception, which would limit insemination to those cases where the deceased man has provided explicit consent for such a procedure. The restrictive view dominates current law and practice. A permissible view, in contrast, would allow insemination and conception in all but those cases where the posthumous procedure has been explicitly refused, or where there is no reasonable evidence that the deceased person desired children. I describe a phenomenology of procreative desires which supports the permissible view, and which is compatible with requirements concerning the interests of the decedent, concepts of medical infertility, and the welfare of the future child. The account illustrates how our current obsession with individual rights and autonomy can be self-defeating and repressive.

Attitude to Death↗

Acceptance of prenatal diagnosis in families referred for genetic counseling.

Procreative attitudes and acceptance of prenatal diagnosis were analysed in 567 families which received information about prenatal diagnosis. This group was selected from 1914 families referred for genetic counseling. Obstetric data following birth of the index case, results of amniocenteses performed and changes of attitudes in these families are presented.

Female↗

Attitudes toward surrogate motherhood in Canada.

The issue of surrogate motherhood captured worldwide attention with the Baby M case in the United States. Some medical practitioners now claim that the surrogate arrangement may be the answer for certain women who are unable to conceive children naturally. Feminist activists are highly critical about the issue. In her landmark book The Mother Machine, Corea (1985) called surrogates "breeders," women whose bodies are being used by men. Lawyers and ethicists debate whether surrogacy is baby selling or not, and religious fundamentalists have condemned any form of procreation outside the "normal" or "natural" form of sexual relations within a marriage. But what do Canadian women think about commercial surrogacy? Findings pertaining to this issue from the latest national fertility survey of 5,315 women in the reproductive ages of 18-49 are reported.

Adolescent↗

Using Augustine in contemporary sexual ethics. A response to Gilbert Meilaender.

In response to Gilbert Meilaender's innovative interpretation of Augustine and of Roman Catholic teaching, the author suggests (1) that Meilaender attributes to Augustine a more positive view of sexual pleasure than the texts will support, (2) that modern Roman Catholic teaching suggests that love should have priority over procreation as a meaning of sex; and (3) that the moral logic of Meilaender's argument does not require a rejection of all reproductive technologies. Nonetheless, the author agrees that a more critical attitude should be adopted toward the reasons for which technologically assisted reproduction is promoted and undertaken, as well as toward its social impact.

Catholicism↗

Research in reproduction: the Indian scenario in the last decade [I].

The physiology of reproduction attempts to decipher the biological basis of procreation. Fundamental advances in the biology of reproduction are essential to decipher this process. In this article, an attempt has been made to chronicle some recent advances in our understanding of the biology of reproduction during the last decade based on the contributions of scientists working in India.

Animals↗

[Role of the hemobiologist in the detection and prevention of post-transfusional hepatitis].

To prevent post-transfusional hepatitis B and C, two epidemiologic studies were performed. The first, based on the frequencies distribution of hepatitis B virus serological markers versus sex and classes of age, has permitted the assessment of the profile of the infection in a population composed of 573 north vietnamese blood donors. There is no significant difference between men and women frequencies of HBs antigen (11.5%), anti-HBs antibody (70.2%) and anti-HBc antibody alone (3.8%), but a significant difference of no-marker frequencies: 7.8% and 17.9% in men and women respectively (X2 = 9.11; p = 0.010). The percentage of no-marker decreases when the mean age of each class increases. The second, using the increase of the serum alanine aminotransferase (ALAT) activity as an indirect marker of non-A, non-B hepatitis for determining in a population of more than 25,000 parisian blood donors, the percentage of donors eliminated. They are between 0.70 and 0.76 in women and 2.26 and 2.46 in men. These investigations can be applied to prevent the hepatitis B transmission in a population of 102 south vietnamese women in age to procreate or to determine the percentage of blood donors eliminated (3.12%) in a population of 2,950 Parisians composed in majority (50.9%) of new donors. The hemobiologist will have an important role to elaborate strategies for orientation of blood gifts with hepatitis B and C virus markers.

Asia, Southeastern↗

[Management of reproduction disorders in spinal cord injured adolescents].

Adolescence is a period of research of sexual identity. How does a teenager build himself when a paraplegic or quadriplegic? How can the team of nursing staff help him? First we shall study the erection and the sexual relations and secondly we shall study the procreation issue. It is necessary to have early concrete information really suitable for a neurologic definition of a spinal cord injury and to conserve sperm before having complications of urinary infections. We inform 24 paraplegic or tetraplegic teenagers at the CMPA in Neufmoutiers and the CECOS at the Cochin Hospital in Paris.

Adolescent↗

Breast cancer genetics: family history, heterogeneity, molecular genetic diagnosis, and genetic counselling.

Between 5% and 10% of breast cancer cases can be traced to primary genetic factors. Before the discovery of the BRCA1 and BRCA2 genes, if a first-degree relative in direct genetic lineage had hereditary breast cancer or hereditary breast-ovarian cancer syndrome, the best estimate of family members' genetic risk for breast cancer was 50%. Now the lifetime cancer destiny of a patient who carries a BRCA1 or BRCA2 germ line mutation can be determined with an extraordinary degree of precision. However, a major concern facing clinicians is how to use this powerful genetic knowledge without harming the patient. This presentation focuses on the need for (a) compilation of a detailed family history of cancer of all anatomic sites; (b) understanding of the natural history of hereditary breast cancer and its heterogeneous forms and the pathobiology of hereditary breast cancer; and (c) preparation for performance of genetic counseling that is based on the results of DNA sequencing to detect genes related to cancer susceptibility. The discussion addresses the advantages of this molecular genetic movement, which include the abilities (a) to predict who is and who is not at inordinately high risk for cancer; (b) to provide opportunities for highly targeted disease surveillance and management; (c) to give patients the information they need to make appropriate long-term decisions about matters such as procreation; and (d) to give genetic counselors the information they need to appreciate the emotions patients may encounter, such as fear, anxiety, and apprehension, and the ordeal of being subjected to discrimination by insurance companies and employers.

Adult↗

[1995 evaluation of medically-assisted procreation with a donor. French Federation of CECOS].

1995 results of French Federation of CECOS and IFREARES-Toulouse are recorded. In 1995 16% less AID demands were registered. 5156 patients (19% less than in 1994) underwent procreations with sperm donor during 14209 cycles (AID and IVF D), resulting in 1655 pregnancies. 647 volunteers men come forwards as sperm donors. The analysis of the 1606 deliveries resulting of 1994 activity show always the same percentage of multiple births and malformations. The activity of semen preservation is increasing with an higher percentage of cryopreservation, consequence of ICSI using.

Female↗

[Assisted reproduction and hepatitis C virus infection].

Medically assisted procreation poses a difficult problem when one or both partners of couple are infected with HCV. Epidemiologic and fundamental works show a low risk of HCV sexual transmission and no pregnancy complications or fetal abnormalities have been reported. However, the outcome of HCV infected children is unknown. These contrasting findings suggest that medically assisted procreation using sperm of spouse needs to be cautious. Before medically assisted procreation, testing of couples for HCV antibodies must be done and interferon therapy is required for patients with histological chronic active hepatitis and for HCV positive mothers or infected couples. In the absence of specific legislation or consensual recommendations, detailed informations must be given to the couples in order to obtain an informed consent.

Female↗

6. Ethical issues related to multiple pregnancies in medically assisted procreation.

In this sixth statement of the ESHRE Task Force on Ethics and Law, the focus is on the ethical issues raised by multiple pregnancies resulting iatrogenically from the use of medically assisted procreation. The incidence of multiple pregnancies and the consequences for the child are discussed, together with general and specific ethical issues. Four recommendations are made-single embryo transfer, public funding for assisted reproduction, multiple pregnancies reported as complications not successes, and a uniform method of presenting results.

Bioethical Issues↗

[Genetic counselling (results of ten years experience). IV. Attitude of persons seeking counselling and reliability of the counsel (author's transl)].

The authors, from their personal experience arising from 766 consultations, show that the percentages of marriages or procreations in subjects themselves suffering from a disorder, or with affected relatives, are independent of the risk estimated for their offspring. The procreation rate in couples with affected children is lower in high risk cases and depends also on the family composition. It appears that this procreation is voluntary in the great majority of cases because there were very few terminations of pregnancy among the couples seen before procreation. The estimated risks correspond to the risks observed but the authors insist that there is a relatively high proportion (4.4 per cent) of children born with a disorder different from that which motivated the consultation.

Abortion, Eugenic↗

The brain decade in debate: VII. Neurobiology of sleep and dreams.

This article is a transcription of an electronic symposium held on February 5, 2001 by the Brazilian Society of Neuroscience and Behavior (SBNeC) during which eight specialists involved in clinical and experimental research on sleep and dreaming exposed their personal experience and theoretical points of view concerning these highly polemic subjects. Unlike most other bodily functions, sleep and dreaming cannot, so far, be defined in terms of definitive functions that play an ascribable role in maintaining the organism as a whole. Such difficulties appear quite clearly all along the discussions. In this symposium, concepts on sleep function range from a protective behavior to an essential function for maturation of the nervous system. Kleitman's hypothesis [Journal of Nervous and Mental Disease (1974), 159: 293-294] was discussed, according to which the basal state is not the wakeful state but sleep, from which we awake to eat, to protect ourselves, to procreate, etc. Dreams, on the other hand, were widely discussed, being considered either as an important step in consolidation of learning or simply the conscious identification of functional patterns derived from the configuration of released or revoked memorized information.

Animals↗