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PubMed1992

Requirements or incentives by government for the use of long-acting contraceptives. Board of Trustees, American Medical Association.

Following the approval of the long-acting contraceptive levonorgestrel (the Norplant Contraceptive System) for use by women, government officials have required or proposed uses of levonorgestrel that are problematic. One court ordered a woman convicted of child abuse to use levonorgestrel as a condition of her probation; legislators have proposed that women on welfare be paid to use levonorgestrel. Court-ordered use of long-acting contraceptives because of child abuse raises serious questions about a person's fundamental rights to refuse medical treatment, to be free of cruel and unusual punishment, and to procreate. The state's compelling interest in protecting children from abuse may be served by less intrusive means than imposing contraception on parents who have committed child abuse. If government benefits were based on the use of long-acting contraceptives, individuals would have to assume a potentially serious health risk before receiving their benefits. Government benefits should not be made contingent on the acceptance of a health risk.

Adult↗

PubMed1996

Partner consent for sperm donation.

The current practice of demanding the consent of the spouse for sperm donation is analysed. Three aspects of marriage may be involved: (i) sexual exclusivity and adultery, (ii) family composition and (iii) procreational exclusivity. The different justifications for giving the partner the right to participate in the decision-making process are critically scrutinized. The perspective taken in this article is that the transfer of gametes must be understood and situated within the moral framework of the relationship between donor and partner. Depending on the kind of relationship the donor has with his partner, he may be morally obliged to consult his procreational partner. In a close relationship, all decisions concerning the use of one's reproductive faculties should be joint decisions. However, it is not the task of the clinic or the physician to see that donors honour their agreements and commitments. The clinic should not seek the partner's consent, although in the counselling sessions it should be pointed out to the donor that he may have a responsibility to inform his partner and to confer with her on his donation.

Community Participation↗

PubMed1983

[History of contraception and a look to the future].

The desire to limit procreation is as old as mankind. The means to reduce the number of children has been abortion and infanticide rather than contraception. But contraceptive methods have been used already in prehistoric times. They were partly logical, partly illogical and ineffective. Definite improvements were made in 19th century and a more scientific approach began in the 20th century. In order to master the problems of population explosion in developing countries intensive financial and organizational efforts have to be made.

Christianity↗

PubMed2002

Progression of atheroma: a struggle between death and procreation.

Traditional thinking accorded a major role to deranged cell proliferation as a determinant of the abnormal cellularity of atheroma. However, studies conducted in several laboratories have documented the occurrence of disordered apoptosis during atherogenesis, leading to the death of lipid-rich foam cells (promoting lipid-core formation) and depletion of vascular smooth muscle cells (fostering fragility of the fibrous cap). A complex interplay of environmental factors and endogenous proteins regulates apoptosis and contributes to the struggle between cell death and procreation in atherosclerosis. In addition to a variety of growth factors, chemically modified lipids, reactive oxygen species, proinflammatory cytokines, and Fas ligand produced by activated immune cells may influence cell viability through a diversity of pathways, including the caspase cascade, the Bcl-2 protein family, and the oncogene/antioncogene system. A clarification of the molecular mechanisms responsible for vascular cell death may aid in the development of novel therapeutic strategies to treat atherosclerosis and its complications, including the acute coronary syndromes.

Animals↗

PubMed1990

Fake abortion clinics: the threat to reproductive self-determination.

The establishment of "fake abortion clinics" poses a great threat to women's ability to make free and informed procreative decisions. Such clinics intentionally deceive pregnant women into believing that they provide a full range of women's health services when, in reality, they provide only a pregnancy test, accompanied by intense anti-abortion propaganda. Because fake abortion clinics threaten women's interests in "privacy" and decisional autonomy, state attorneys general should challenge them under deceptive business practice statutes. Successful challenges can be brought without violating anti-abortion groups' First Amendment rights.

Abortion, Legal↗

PubMed1990

Freud, Fliess, and the parenthood of psychoanalysis.

This paper focuses upon the roles of procreation, fatherhood, and identification with the fertile mother in Freud's creation of psychoanalysis. Fatherhood and motherhood, pregnancy and birth, children and siblings, figure prominently in Freud's self-analysis and in his relationship with his prototransference object, Wilhelm Fliess. Although Freud attributed his self-analytic interest and revived oedipal conflict to the death of his father, becoming a parent himself was also a significant determinant. Birth as well as death reactivated his childhood and stimulated his creative ferment.

Europe↗

PubMed1998

Eurocord position on ethical and legal issues involved in cord blood transplantation.

The Eurocord group held a round table discussion on the topic of ethical and legal issues involved in cord blood transplantation at the group's 2nd annual meeting at Annecy in May 1997. As chairman of the session the author was commissioned to put in writing the group's consensus on the subject. This covers the topics of: cord blood collections for autologous and intra-familiar usage; procreation for the purpose of haematopoietic progenitor cell donation for transplantation of a family member; cord blood banking including safety requirements and quality control regulations; patient priorities for usage of stored units; and patent rights. This paper's text was submitted for review to other participating members of the group. No amendments were made. The author feels confident that the paper faithfully reflects the consensus achieved.

Adult↗

PubMed1993

Embryo reduction in triplet pregnancies after assisted procreation: a comparative study.

OBJECTIVES: To evaluate pregnancy outcome after selective embryo reduction by transcervical aspiration or transvaginal puncture and intrathoracal injection with potassium chloride (KCl) in triplet pregnancies occurring after assisted procreation and to compare this outcome with that for triplets not undergoing embryo reduction. DESIGN: Retrospective case series. SETTING: In vitro fertilization program of the Centre for Reproductive Medicine of the Dutch-speaking Brussels Free University, Belgium, which is a tertiary referral institution. PATIENTS: Seventy-two patients presenting a triplet pregnancy after assisted procreation. INTERVENTION: Transcervical aspiration embryo reduction at 8 to 9 weeks of pregnancy or transvaginal puncture and intrathoracal injection of KCl at 9 to 10 weeks of pregnancy. MAIN OUTCOME MEASURES: Rate of spontaneous embryo reduction, complications relating to the procedure, pregnancy, and neonatal outcome. RESULTS: The rate of spontaneous reduction was 18%. Among the 14 patients undergoing transcervical aspiration, 3 aborted and 4 lost an additional fetus. The transvaginal puncture technique had a lower complication rate (2/19). Neonatal outcome was improved in pregnancies after selective embryo reduction. After transvaginal puncture, the outcome was comparable with that for twin pregnancies after assisted procreation. CONCLUSIONS: Triplet pregnancies after assisted procreation had a poor neonatal outcome. The outcome was improved after spontaneous reduction. Transcervical aspiration should not be used because of its high rate of early and late complications. Transvaginal puncture had less early complications, but the technique might be associated with prematurity and third trimester fetal death. In triplet pregnancies, embryo reduction decreases the number of babies going home per patient, but the quality of life of the remaining babies is improved.

Abortion, Induced↗

PubMed2005

Harming by conceiving: a review of misconceptions and a new analysis.

An objection often is raised against the use of reproductive technology to create "nontraditional families," as in ovum donation for postmenopausal women or postmortem artificial insemination. The objection states that conceiving children in such circumstances is harmful to them because of adverse features of these nontraditional families. A similar objection is raised when parents, through negligence or willful disregard of risks, create children with serious genetic diseases or other developmental handicaps. It is claimed that such reproduction harms the children who are created. In reply to this Harm to the Child Argument, it has been pointed out that the procreative acts that supposedly harm the child are the very acts that create the child. This reply has been developed into an argument that, in most of the types of cases under consideration, creating the child does not harm her. This reply, the No Harm Argument, has been stated in three main ways, and it is one of the most misunderstood arguments in bioethics. This paper examines the main rebuttals that have been made to the No Harm Argument and argues that none of them is successful.

Ethical Theory↗

PubMed1993

[1992 results of sperm donor procreation. French Federation of CECOS and private cooperative centers].

In 1992, the results record the referred activity of French Federation of CECOS and IFREARES-Toulouse. 6,714 patients underwent donor inseminations for one or more cycles, 20,525 cycles were undertaken resulting in 2,234 pregnancies using AID or IVF. 606 volunteers men come forwards as donors. The analysis of 1,777 deliveries resulting of recoveries realised in 1991, showed with IVF a high rate for twins and multiple births. The activity of semen preservation and embryo's storage is always increasing. The wishes about the parentless outcome embryos is performed.

Clinical Protocols↗

PubMed1989

[Male infertility and medically assisted procreation].

Three hundred thirty patients underwent in vitro fertilization in our centre since 1985. Fifty two percent of them presented an abnormal spermogram (sperm count less than or equal to 20 X 10/ml; mobility less than 40%; teratospermia greater than 60%). In those cases, lack of fertilization is statistically increased but pregnancy rate per transfer is similar to this observed with pure female cases. Sperm count, mobility and teratospermia influence the success rate but are not sufficient criteria of ability to fertilize. On the other hand, hamster test is without predictive interest.

Adult↗

PubMed1993

Between rationality and metaphysics: the legal regulation of assisted reproduction in Germany, Austria and Switzerland--a comparative analysis.

The article discusses various legal aspects of assisted procreation. Emphasis is put on the law in Germany, Austria and Switzerland, where several acts have already been passed by parliament or are in preparation. Even among these countries there is no common approach towards the regulation of reproductive medicine. Whereas Germany criminalizes many of the new reproductive techniques, Austria has laid down an excessive number of administrative requirements that the gynaecologist has to meet. In Switzerland the legal situation is difficult to survey because each canton can decide its own regulation.

Austria↗

PubMed1993

The efficacy and efficiency of an in-vitro fertilization programme including embryo cryopreservation: a cohort study.

A cohort of 485 couples starting their first in-vitro fertilization (IVF) attempt between January, 1989 and February, 1991 inclusive, were followed until June 1, 1992. A total of 1086 treatment cycles were initiated (mean 2.2, range 1-6). Of these, 235 (21.8%) cycles were cancelled, giving a total of 851 embryo replacements (mean 1.7, range 1-5). After IVF treatment, 189 women have either delivered or have an ongoing pregnancy in the second or third trimester. This gives a baby take-home rate of 17.4% per started cycle and 22.2% per embryo replacement. For 91 (18.6%) of the couples, the treatment was abandoned prior to completion of the three scheduled IVF attempts and 57 (11.7%) of these had no completed IVF cycles. In the group of couples with reduced sperm quality, the delivery rate was significantly lower than that of the other groups. A total of 193 women had embryos cryopreserved in at least one IVF cycle; 124 of these women started a frozen embryo replacement cycle and 88 had at least one cycle with replacement of frozen/thawed embryos, resulting in 25 deliveries/ongoing pregnancies. Due to the Norwegian law on assisted procreation 65 (33.7%) of the women have had their frozen embryos thawed and discarded after 12 months of storage. The cryopreservation programme, with the limitations of the Norwegian law, gives a 5.2% increase in the baby take-home rate for women entering the IVF programme, an increase of 13.2% in the number of ongoing pregnancies/deliveries and an 11.6% increase in number of children/viable fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)

Cryopreservation↗

PubMed2005

Innate and adaptive immunity in female genital tract: cellular responses and interactions.

The mucosal immune system in the female reproductive tract (FRT) has evolved to meet the unique requirements of dealing with sexually transmitted bacterial and viral pathogens, allogeneic spermatozoa, and the immunologically distinct fetus. Analysis of the FRT indicates that the key cells of the innate and adaptive immune systems are present and functionally responsive to antigens. Acting through Toll-like receptors in the Fallopian tubes, uterus, cervix, and in the vagina, epithelial cells, macrophages, natural killer cells, and neutrophils confer protection through the production of chemokines and cytokines, which recruit and activate immune cells, as well as bactericidal and virucidal agents, which confer protection at times when adaptive immunity is downregulated by sex hormones to meet the constraints of procreation. The overall goal of this paper is to define the innate immune system in the FRT and, where possible, to define the regulatory influences that occur during the menstrual cycle that contribute to protection from and susceptibility to potential pathogens. By understanding the nature of this protection and the ways in which innate and adaptive immunity interact, these studies provide the opportunity to contribute to the foundation of information essential for ensuring reproductive health.

Animals↗

PubMed1988

Ministerial Directive No. 1072, June 1985.

This Directive contains nonmandatory guidelines and recommendations for in vitro fertilization and embryo transfer in Chile. The Guidelines are based on the assumption that the constitutional guarantee of the right of the child to be born includes the right to procreate. They set forth the medical reasons for the use of these assisted reproduction techniques, procedures to be followed by institutions applying these techniques, technical facilities, qualifications of medical staff, and the manner in which records are kept. They recommend the mandatory appointment of an Ethics Committee and the obligation to advise couples using these techniques. They also recommend the requirement that all normal and fertilized ovules be returned to the mother and not stored or used for research.

Americas↗

PubMed2006

Jekyll and hyde: two faces of cannabinoid signaling in male and female fertility.

Mammalian reproduction is a complicated process designed to diversify and strengthen the genetic complement of the offspring and to safeguard regulatory systems at various steps for propagating procreation. An emerging concept in mammalian reproduction is the role of endocannabinoids, a group of endogenously produced lipid mediators, that bind to and activate cannabinoid receptors. Although adverse effects of cannabinoids on fertility have been implicated for years, the mechanisms by which they exert these effects were not clearly understood. With the identification of cannabinoid receptors, endocannabinoid ligands, their key synthetic and hydrolytic pathways, and the generation of mouse models missing cannabinoid receptors, a wealth of information on the significance of cannabinoid/endocannabinoid signaling in spermatogenesis, fertilization, preimplantation embryo development, implantation, and postimplantation embryonic growth has been generated. This review focuses on various aspects of the endocannabinoid system in male and female fertility. It is hoped that a deeper insight would lead to potential clinical applications of the endocannabinoid signaling as a target for correcting infertility and improving reproductive health in humans.

Cannabinoid Receptor Modulators↗

PubMed1980

Analysis of a follow-up study of genetic counseling.

A follow-up study of 212 families for whom genetic counseling had been provided was performed to assess the effectiveness of the non-directive genetic counseling service at the Mount Sinai Medical Center in New York City. The preliminary result have been reported previously (Godmilow & Hirschhorn 1977). Of those families surveyed, 72% responded. Adequate recall of the genetic information was demonstrated by 74% of those responding, and 80% described their counseling experience as favorable. A direct relationship was noted between the degree of satisfaction and whether or not the counselees received the mode of counseling they preferred, i.e., individual versus team. Sixty-two percent of those counselees reaching a procreative decision indicated that genetic counseling had influenced their decision making. A significant correlation was noted between the magnitude of the occurrence or recurrence risk and the procreative decisions reached. However, some decisions were modified by the counselees' subjective interpretation of the burden associated with the disorder in question. It is concluded that follow-up of genetic counseling by questionnaire, together with statistical analysis of the data received, can provide the genetic center with valuable information regarding strengths and weaknesses of the counseling program and can suggest ways to improve the counseling process and thereby enhance its effectiveness.

Congenital Abnormalities↗

PubMedDate not supplied

Procreative liberty: the case for preconception sex selection.

Preconception sex selection for non-medical reasons raises serious moral, legal and social issues. The main concerns include the threat of a sex ratio distortion due to a common preference for boys over girls, the charge of sexism, the danger of reinforcing gender stereotypical behaviour in sex selected children, and the fear of a slippery slope towards creating designer babies. This paper endeavours to show that none of the objections to preconception sex selection is conclusive and that there is no justification for denying parents the right to choose the sex of their prospective children.

Abortion, Induced↗