The marketing of the new reproductive technologies: medicine, the media, and the idea of progress.
Explore the source record for details and available documents.
Australia↗
SEARCH · Search PubMed
Results for “Reproductive Technologies”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Gay science: assisted reproductive technologies and the sexual orientation of children.
There are no technologies at the present time that would allow parents to select the sexual orientation of their children. But what if there were? Some commentators believe that parents should be able to use those techniques so long as they are effective and safe. Others believe that these techniques are unethical because of the dangers they pose to homosexual men and women in general. Both sides point to motives and consequences when trying to analyse the ethics of this question. These arguments are reviewed, and it is concluded that opponents of these technologies have not shown good reason why the law or policy should override parental choice in this matter. In general, therefore, if technologies become available to choose the sexual orientation of children, parents should be allowed to use them, provided they are safe and disrupt no interest of the child. This use will, at the very least, protect homosexual children from parents who do not want them, but it will also allow parents who want homosexual children to make that choice as well.
Ethics, Medical↗
Effect of the mode of assisted reproductive technology conception on obstetric outcomes for survivors of the vanishing twin syndrome.
Survivors of the "vanishing" twin syndrome, which occurred in dichorionic twins only, and singletons that began as singletons, had similar mean gestational duration and birth weights, as well as similar frequencies of maternal and neonatal complications. This similarity persisted when conventional IVF and IVF plus ICSI cases were separately evaluated.
Abortion, Spontaneous↗
[Assesment of the woman's age as a main predictive factor of assisted reproductive technology treatment outcome].
Several factors could be used as a predictors of in vitro fertilization treatment outcome: female age, aetiology of sterility, previous ovarian surgery, embryo morphology and cleavage rates and also the technique of embryo transfer. The aim of the present study is to evaluate the role of the age to be used as a prognostic factor for the sterility treatment outcome. The tasks we assigned were to compare the several parameters: duration of the stimulation, number of retrieved oocytes, fertilization rate, implantation rate and clinical pregnancy rate after IVF/ICSI in different age's groups. The study results clearly demonstrate that in spite of decreasing number of retrieved oocytes after the age of 30, the fertilization rate remains elevated till 40 years. Regardless of this fact, the implantation rate and the clinical pregnancy rate were significantly lower after the age of 35. Reduction of the success rate in these cases showed that ART, despite of its renewals, is not the strategy for getting over the age in human reproduction.
Adult↗
The economic impact of the assisted reproductive technologies.
Thousands of cycles of in vitro fertilization (IVF) are performed each year. In the US, multiple births occur after 39% of IVF cycles, whereas in Europe, the figure is 26%. Indeed, multiple births are a major factor in the costs attributable to IVF. Reducing the multiple birth rate may reduce the overall costs of IVF, and providing insurance coverage of IVF may contribute to lowering multiple birth rates. The use of IVF is likely to expand in response to increases in infertility and scientific advances.
Female↗
A case of simultaneous tubal-splenic pregnancy after assisted reproductive technology.
OBJECTIVE: To present a case of simultaneous splenic and tubal pregnancy following in vitro fertilization. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 37-year-old woman who had undergone in vitro fertilization and embryo transfer for unexplained infertility at another clinic. INTERVENTION(S): Laparoscopy and laparotomy. MAIN OUTCOME MEASURE(S): Serum concentration of human chorionic gonadotropin (hCG) after salpingosplenectomy. RESULT(S): After transfer of three embryos following fertilization by intracytoplasmic sperm injection (ICSI) at another clinic, the patient was referred to our hospital with suspicion of ectopic pregnancy. Because tubal pregnancy was suspected, laparoscopic right salpingectomy was performed. Although villi were detected in the resected fallopian tube, the serum hCG concentration did not decrease after the operation and a new intraabdominal hemorrhage was detected. We then suspected abdominal pregnancy in the epigastric region, and performed magnetic resonance imaging, computed tomography, and ultrasound examinations, which revealed implantation at the inferior pole of the spleen. Splenectomy was performed, with the resulting disappearance of intraabdominal hemorrhage and rapid fall of the serum concentration of hCG. CONCLUSION(S): Assisted reproduction sometimes results in heterotopic pregnancy, but an abdominal pregnancy involving the upper abdominal organs is considered extremely rare. Particularly, splenic pregnancy is usually overlooked and may only be discovered after a sudden intraabdominal hemorrhage. If hemorrhaging is present in the abdominal cavity but pregnancy is not detected within the pelvis, it is advisable to examine patients using imaging techniques to detect any upper abdominal pregnancies.
Adult↗
A physiological replacement for polyvinylpyrrolidone (PVP) in assisted reproductive technology.
The technique of intracytoplasmic sperm injection (ICSI) requires mechanical immobilization of the sperm that are to be injected; damage thus caused to the sperm membrane is considered to be necessary to activate the sperm for fertilization. Mechanical immobilization and the injection procedure are facilitated by introducing the sperm into a viscous medium that will hinder motility: a solution of polyvinylpyrrolidone (PVP) has been used successfully for this purpose. PVP is an artificial polymer, which has been regarded as chemically inert, although adverse effects have been reported as a result of its use both in vivo and in vitro. Therefore, the use of hyaluronate, the natural component of the extracellular matrix of the cumulus-oocyte complex, was investigated as a replacement for PVP during ICSI. A solution of hyaluronate was found to be as effective as PVP in facilitating the injection procedure, its effect on sperm motility was readily reversible, and its use did not affect the outcome of the treatment cycles in terms of fertilization, pregnancy and live birth rates. Every attempt should be made to eliminate artificial factors in assisted reproductive procedures. Hyaluronate, a natural and readily degradable glycosaminoglycan can be used as a substitute for the artificial PVP polymer without jeopardising the outcome of the treatment cycle.
Adult↗
Response to 'No country is an island: comment on the House of Commons report Human Reproductive Technologies and the Law'.
Edgar Dahl supports sex selection, e.g. through separation of X and Y sperm or through PGD. It is argued in this commentary that while such sex selection would seem reasonable for balancing a family (wanting a daughter if one already has a son, or vice-versa), it is likely to lead to skewing of female-male ratios, not only in India where it is already as low as 0.8 in certain parts, but possibly also in Great Britain as male chauvinism is not a thing of the past anywhere.
Female↗
Should all infertile males undergo urologic evaluation before assisted reproductive technologies? Two cases of testicular cancer presenting with infertility.
OBJECTIVE: To report two cases of testicular cancer in patients presenting with infertility. DESIGN: Case reports. SETTING: University-affiliated urology practice. PATIENT(S): Two men presenting with infertility. INTERVENTION(S): Complete history and physical, hormonal assays, semen analysis, scrotal ultrasound, radical orchiectomy. MAIN OUTCOME MEASURE(S): Testicular pathology specimens. RESULT(S): Testicular cancer was diagnosed in two men sent to a urology clinic for infertility treatment. CONCLUSION(S): A thorough evaluation should be completed in all males in couples presenting with infertility.
Adult↗
Relationship of timing of agonist administration in the cycle phase to the ovarian response to gonadotropins in the long down-regulation protocols for assisted reproductive technologies.
OBJECTIVE: To assess whether the ovarian response to exogenous gonadotropins and cycle performance is affected by different timing of an agonist administration in long down-regulation protocols. DESIGN: An agonist was administered irrespective of cycle phase, with exogenous gonadotropin beginning 15 days later. PATIENTS: Five hundred fifty-seven normovulatory infertile patients, aged < or = 38 years, were classified into seven study groups, depending on the phase of the cycle in which agonist was started. MAIN OUTCOME MEASURES: Endocrine profile, amount of exogenous stimulation, occurrence of ovarian cysts, mean number of oocytes recovered and embryos transferred, pregnancy rate, implantation rate, and live-birth rate of the seven groups. RESULTS: The ovarian response of the groups did not show any statistically significant differences in relation to the initiation of the agonist. The only effect was a different incidence of ovarian cyst formation, but this phenomenon did not affect cycle performance. The pregnancy, implantation, and live-birth rates showed differences that did not reach statistical significance. CONCLUSION: Agonists initiation can be programmed in advance irrespective of the phase of the cycle. This approach can be of help for the logistics of assisted reproduction programs.
Adult↗
Primate models for assisted reproductive technologies.
Although the deliberate creation of human embryos for scientific research is complicated by ethical and practical issues, a detailed understanding of the cellular and molecular events occurring during human fertilization is essential, particularly for understanding infertility. It is clear from cytoskeletal imaging studies of mouse fertilization that this information cannot be extrapolated to humans because of unique differences in centrosomal inheritance. However, the cytoskeletal rearrangements during non-human primate fertilization are very similar to humans, providing a compelling animal model in which to examine sperm--egg interactions. In order to address this key step in primate fertilization and to avoid the complexities in working with fertilized human zygotes, studies are now exploring the molecular foundations of various assisted fertilization techniques in a monkey model. While intracytoplasmic sperm injection with ejaculated or testicular sperm is quite successful in primate models, there are some specific differences when compared with standard IVF that warrant further investigation, particularly in regards to nuclear remodeling, genomic imprinting, Y-chromosome deletions and developmental outcomes. Similarly, primate models have been useful for examining spermatid function during fertilization but these have met with limited success. One area of primate reproductive research that has yet to be mastered is reproductive cloning. Genetically identical primates would provide the ultimate approach for accelerating stem cell-based therapies for a number of neurodegenerative diseases such as Alzheimer's and Parkinson's disease, as well as targeted gene therapies for various metabolic disorders.
Animals↗
[Tendency of concrete interpretation of the "Anna threefold" fantasy in "late" mothers and in the area of reproduction technology].
Leonardo da Vinci's painting "The Virgin and Child with St. Anne" ("Anna Selbdritt" = Anne Threefold) is used here to explain and illustrate early infantile female fantasies deriving from the narcissistic desire to correspond to the omnipotent mother and infantile ideas about the imaginary child. The painting is analyzed as an image of the central female fantasy in need of development. It is argued, on the basis of observation of the psychodynamic singularities found among a clinical sample of "late mothers" and their "planned" children that among women with a personal history of disturbance of the development of female identity there can be an acting out and concretization of these early fantasies during a narcissistic crisis with the fulfillment of an urgent desire for children. The central female developmental phases are, as it were, subverted. This "bypassing" of a developmentally adequate transformation of early infantile fantasies involves not only a disturbance in the relationship to the mother's own child and to her mother but also an impairment of the sense of female and maternal identity and of the ability to establish heterosexual relationships. There is also discussion of the degree to which reproductive medicine encourages and strengthens female willingness to concretize untransformed infantile fantasies and thus threatens to become a tempting instrument of power over more than just a woman's body.
Adult↗
Screening standards in assisted reproduction technologies: the screening of semen donors--where do we draw the line?
The most recent British Andrology Society guidelines have certainly stirred up much debate about the exclusion of donors that are seropositive for cytomegalovirus (CMV). Arguments will inevitably go back and forth regarding the statistical risk of donors passing on infection and the point at which that risk becomes unacceptable. As with many of these debates, a number of different opinions will be offered but a consensus will be almost impossible. However, the case of CMV highlights difficulties common to the screening of donors for many infectious and genetic disorders.
Antibodies, Viral↗
The proposed model surrogate parenthood act: a legislative response to the challenges of reproductive technology.
In this Article, Manus proposes a Model Surrogate Parenthood Act. He examines the medical and scientific history of surrogacy and reviews the jurisprudence in the area, specifically the constitutional relationship between procreation rights and surrogacy. The author asserts that surrogate motherhood cannot be, and indeed, should not be, eradicated through legislation criminalizing it. The proposed Model Act, presented here in its entirety, attempts to reduce the problems inherent in the concept of surrogate parenthood by putting the process under strict court supervision and by zealously protecting the rights of the surrogate mother and the child to be conceived.
Female↗
Cryobiology in human assisted reproductive technology. Would Hippocrates approve?
Recent advances in human cryobiology have been substantially greater than the first slow step from freezing spermatozoa in animals in Italy, published in 1776 to observing motility in frozen-thawed human sperm in 1938(1). Reports on cryopreservation of rabbit oocytes (1947)(1) and births from fertilised frozen-thawed mice oocytes in 1977(1) were soon followed by the first human pregnancy (1983)(1) and birth (1984)1 following transfer of frozen-thawed embryos after in-vitro fertilisation (IVF). Whereas cryopreservation of human sperm and embryos in tertiary level fertility centres is now commonplace, the full clinical, scientific and sociological consequences of progress in this rapidly moving field are to be determined. These include pregnancy with frozen-thawed human mature, oocytes after conventional IVF (1986)4, intracytoplasmic sperm injection (ICSI)(5) (1996), pregnancies following use of frozen-thawed mature (1995)(5,6) and immature oocytes (1999)(7), ovarian tissue banking (8) and possible autografting (1999)(9) as well as repeated freeze-thawing of male gametes and of embryos (10,11). Cryopreservation of female and male gametes instead of embryos offer solutions of obvious religious, ethical, legal and clinical problems. In addition, there may be benefits in reducing the cost of infertility treatment, improving the safety of fertility treatment with respect to ovarian hyperstimulation syndrome and repeated treatment with controlled ovarian hyperstimulation, prevention of diseases such as sexually transmitted diseases and hereditary disorders and preventing infertility by possible long-term storage of gametes, gonadal tissue and even embryos. The benefits of cryopreservation of sperm, oocytes and embryos in the management of subfertile couples, many being self-evident to some, bear emphasis. Cryopreservation of sperm offers substantial organisational, cost and social advantages in IVF/ICSI treatment, in that it is no longer necessary for both partners to be present at the time of oocyte retrieval, or to have the sperm retrieval done simultaneously, as frozen-thawed sperm (ejaculatory, epididymal or testicular) can be used. This strategy permits men in the latter two categories to be able to support their partners at the time of oocyte retrieval, with the knowledge that their sperm surgically obtained some time previously, is available. It is now clear that, in men with obstructive azoospermia, the use of fresh or frozen-thawed sperm will yield equivalent fertilisation rates following ICSI. In men with non-obstructive azoospermia, with a 60% chance only of obtaining sperm from the testicular aspiration or biopsy, the option could be cryopreservation of the sperm harvested first and later controlled ovarian hyperstimulation of the female partner, to use thawed sperm which will lead to equivalent fertilisation rates using fresh sperm. Thus, one may avoid cost of treatment of the female in those couples who do not wish to use donor sperm as a back-up in the 40% of men from whom sperm is not obtained. Important consequences of cryopreservation of gametes and gonadal tissue are likely to be in the area of prevention of hereditary and familial diseases, as cryopreservation of oocytes, sperm, embryos and blastocysts is exploited fully in pre-implantation genetic diagnosis (PGD) strategies12. Embryo biopsy now permits screening to identify normal embryos from couples who are carriers of known single gene defects and hereditary disorders and the list of these conditions is expanding rapidly. PGD is feasible on frozen-thawed blastomeres even if cells have lysed after thawing, providing information relevant for surviving blastomeres or blastocysts. But what of the gene probes which will soon deluge us on the completion of the Human Genome Project? Can we anticipate benefits and consider proposing that couples with familial disorders, whether degenerative e.g. Type 2 Diabetes, or malignant conditions such as cancer of the ovary, breast and colon? Should we cryopreserve oocytes/sperm/embryos for the purposes of PGD once the markers are available? Cryobiology indeed provides hope now for women and men with neoplastic diseases, who are about to receive oncotherapy for malignancies which inevitably will render them sterile. Men may now freeze epididymal, testicular as well as ejaculatory sperm as ICSI has revolutionalised the treatment of male infertility. It might be likely that testicular tissue from prepubertal boys can be cryopreserved with a reasonable expectation that techniques will soon be developed to effect maturation of spermatogonia in-vivo or in-vitro13. The greatest advance is likely to be for women suffering from reproductive cancer, who may now consider mature and immature oocytes being frozen or vitrified with a reasonable chance of fertilisation by ICSI later, as well as the cryopreservation and storage of ovarian cortex tissue biopsies. Work is proceeding still to refine techniques of in-vitro maturation of frozen-thawed immature oocytes, and the frozen-thawed ovarian cortex tissue slices. The potential benefits will not only be to female fertility for the latter conditions but endocrine disorders as well as by autotransplantation (1999)9. Currently, ovarian tissue banking8 is being considered by women undergoing procedures or treatment which could destroy ovarian function with quite realistic but cautious expectations of preserving ovarian function, but tomorrow women may consider banking ovarian tissue as insurance against childlessness because of the risk of disorders in the reproductive tract (endometriosis, simple recurrent ovarian cysts) and even advancing years. For those who have conceived with surplus oocytes cryopreserved, anonymous oocyte donation is a possibility for the solution of ethical and legal problems. All over Europe, the age of women having their first child is dramatically increasing now being in their late twenties, with likely significant implications in the need to fertility treatment in the Millennium. Society has always been excited but understandably cautious about the prospect of whole body cryopreservation. Hippocrates would have argued that Society could separate medicine and its advances from religious views, dogma and prejudice and, on the present evidence, would probably have looked upon human cryobiology favourably. Human cryobiology is here to stay and society as well as the profession is addressing its relevance. There are clear signs that this technology can and will alleviate suffering by preventing genetic and familial diseases, infections and infertility as well as lowering the cost and social consequences of the treatment. For these reasons, further research in this field should be welcomed and supported.
Cryopreservation↗
Significance of increased endometrial thickness in assisted reproduction technology treatments.
PURPOSE: The purpose of this study was to evaluate the relationship between thick endometrium and both implantation and pregnancy rates in ART treatments. METHODS: The study group was composed of consecutive women undergoing ultrasonographic evaluation on the day of hCG administration in our ART unit. Endometrial thickness was measured at the thickest part of the midsagittal plane. On the basis of the findings, patients were divided into two groups: A--endometrial thickness >14 mm (above the 95th percentile) and B--endometrial thickness 7-14 mm (between the 5th and 95th percentiles). Patients with a thickness of less than 7 mm were excluded from the study. RESULTS: In all, 1218 cycles were included in the study (50 in Group A and 1168 in Group B). There was no significant difference between the groups in mean patient or mean number of embryos transferred. Similar pregnancy and implantation rates were noted in Group A (24 and 11.3%, respectively) and Group B (27.7 and 14.7%, respectively). Endometrial thickness was found to have a significant positive correlation with the duration of follicular stimulation, and an inverse correlation with woman's age. CONCLUSIONS: Increased endometrial thickness (>14 mm) is not associated with decreased implantation or pregnancy rates in assisted reproduction.
Adult↗
Controlled ovarian hyperstimulation: an adjunct to assisted reproductive technology.
Controlled ovarian hyperstimulation was given to a study group consisting of male factor, endometriosis, and unexplained infertility. The aim of the study was to determine whether COH might be of value for such couples in a setting lacking ART facilities. When compared with their own spontaneous cycles or with a control group (untreated but scanned), COH proved significantly better for unexplained infertility. However, COH was not significantly effective for male factor infertility. This study shows that COH should be offered routinely in general hospitals to couples on long-term waiting lists for ART (especially those facing enforced expectant management).
Adult↗
The development and application of the modern reproductive technologies to horse breeding.
Although the horse was probably the first animal to experience and benefit from artificial insemination, it trailed the field somewhat with regard to the application of embryo transfer and other oocyte and embryo-related modern breeding technologies. But with a late run it is now back in mid-field and gaining fast on the other large domestic species in the application of the many technological advances of the past 20 years to sound breeding practice. Improvements in extenders and cryoprotectants have resulted in a veritable upsurge in the transport and insemination of cooled and frozen stallion semen, and parallel improvements in ovulation induction and synchrony, exogenous gonadotrophic stimulation of multiple fertile ovulations and simplified, more efficient methods for non-surgical transfer of embryos to recipient mares, coupled with relaxation of breed society registration restrictions, have together contributed to a similar upsurge in the application of embryo transfer to all breeds and athletic types of horses worldwide, with the continuing and notable exception of the Thoroughbred. Although conventional in vitro fertilization remains something of an unjumped fence in equids, other modern breeding technologies like hysteroscopic low-dose insemination, fluorescence-activated sex sorting of stallion spermatozoa, between-species embryo transfer, embryo freezing and bisection, transvaginal ultrasound-guided oocyte collection, intracytoplasmic sperm injection for fertilization (ICSI), gamete intrafallopian transfer (GIFT) and now nuclear transfer (cloning), have all been applied to equids with encouraging success. Cloning, especially, holds enormous promise for the Sporthorse industry to re-create champion geldings in stallion form for breeding purposes.
Animals↗