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Comparative reproductive function in cervids: implications for management of farm and zoo populations.

The cervids represent a complex assemblage of taxa characterized by extreme diversity in morphology, physiology, ecology and geographical distribution. Farmed species (for example red deer and fallow deer) are usually the common larger-bodied, gregarious and monotocous species that express marked reproductive seasonality in their temperate environment. Their commercial importance has facilitated considerable research into reproductive physiology and the development of assisted reproductive technologies (ART). In contrast, the remaining species, including many of tropical origin, show wide diversity in reproductive patterns, have generally received little scientific scrutiny, and include a number of endangered taxa that are reliant on ex situ conservation efforts (such as captive breeding) to ensure their survival. Domestication and ex situ management programmes have been associated with widespread translocation of various cervid species around the world, often placing the animals in environments that are not compatible with their evolved reproductive patterns. For example, the summer calving/lactation pattern of red deer, attuned to northern continental climatic patterns, is frequently misaligned with seasonal changes in feed availability in the Australasian pastoral environment. Similarly, seasonal or aseasonal calving patterns of tropical species translocated to temperate regions are usually associated with increased perinatal mortality of calves born in cool seasons. Conversely, temperate species in tropical zones may exhibit aberrant reproductive patterns in the absence of biologically significant photoperiod fluctuations. ARTs, which presently include artificial insemination, embryo transfer and in vitro embryo production, have potential application to the genetic management and population growth of various cervid species. Although application to some farmed cervid species is widespread, these technologies are rarely directly transferable from farmed to endangered species. Even within species, ART protocols developed successfully for one genotype (i.e. subspecies) may be ineffective in another (for example superovulation of red deer and wapiti). Therefore, application to genetic management of endangered species necessitates prior research into their reproductive patterns. This is often difficult because of the rarity of the animals, a lack of suitable handling facilities for the particular species, and the timid nature of the deer. More recently, however, non-invasive reproductive profiling, based on remote collection and monitoring of excreted steroid metabolites, has facilitated such research.

Animals↗

Flow cytometric sorting of non-human primate sperm nuclei.

Pre-determination of the sex of offspring has implications for management and conservation of captive wildlife species, particularly those with single sex-dominated social structures. Our goal is to adapt flow cytometry technology to sort spermatozoa of non-human primate species for use with assisted reproductive technologies. The objectives of this study were to: (i) determine the difference in DNA content between X- and Y-bearing spermatozoa (ii) sort sperm nuclei into X- and Y-enriched samples; and (iii) assess the accuracy of sorting. Spermatozoa were collected from two common marmosets (Callithrix jacchus), seven hamadryas baboons (Papio hamadryas) and two common chimpanzees (Pan troglodytes). Human spermatozoa from one male were used as a control. Sperm nuclei were stained (Hoechst 33342), incubated and analyzed using a high-speed cell sorter. Flow cytometric reanalysis of sorted samples (sort reanalysis, 10,000 events/sample) and fluorescence in situ hybridization (FISH; 500 sperm nuclei/sample) were used to evaluate accuracy of sorting. Based on fluorescence intensity of X- and Y-bearing sperm nuclei, the difference in DNA content between X and Y populations was 4.09 +/- 0.03, 4.20 +/- 0.03, 3.30 +/- 0.01, and 2.97 +/- 0.05%, for marmoset, baboon, chimpanzee and human, respectively. Sort reanalysis and FISH results were similar; combined data revealed high levels of purity for X- and Y-enriched samples (94 +/- 0.9 and 93 +/- 0.8%, 94 +/- 0.7 and 94 +/- 0.5%, 91 +/- 0.9 and 97 +/- 0.6%, 94 +/- 0.6 and 94 +/- 0.9%, for marmoset, baboon, chimpanzee and human, respectively). These data indicate the potential for high-purity sorting of spermatozoa from non-human primates.

Animals↗

Ethical issues in gestational surrogacy.

The introduction of contraceptive technologies has resulted in the separation of sex and procreation. The introduction of new reproductive technologies (mainly IVF and embryo transfer) has led not only to the separation of procreation and sex, but also to the redefinition of the terms mother and family. For the purpose of this essay, I will distinguish between: 1. the genetic mother--the donor of the egg; 2. the gestational mother--she who bears and gives birth to the baby; 3. the social mother--the woman who raises the child. This essay will deal only with the form of gestational surrogacy in which the genetic parents intend to be the social parents, and the surrogate mother has no genetic relationship to the child she bears and delivers. I will raise questions regarding medical ethical aspects of surrogacy and the obligation(s) of the physician(s) to the parties involved. I will argue that the gestational surrogate is "a womb to rent," that there is great similarity between gestational commercial surrogacy and organ transplant marketing. Furthermore, despite claims to freedom of choice and free marketing, I will claim that gestational surrogacy is a form of prostitution and slavery, exploitation of the poor and needy by those who are better off. The right to be a parent, although not constitutional, is intuitive and deeply rooted. However, the issue remains whether this right overrules all other rights, and at what price to the parties involved. I will finally raise the following provocative question to society: In the interim period between today's limited technology and tomorrow's extra-corporeal gestation technology (ectogenesis), should utilizing females in PVS (persistent vehetative state) for gestational surrogacy be socially acceptable/permissible--provided they have left permission in writing?

Depersonalization↗

Access to reproductive genetic services for low-income women and women of color.

This article examines access to reproductive genetics services for low-income women and women of color. It explores implications of the use of reproductive technologies; access and barriers to general prenatal care and its impact on accessing reproductive-genetic services; the implications of obtaining reproductive genetic services through public programs and funding, especially as they relate to equal provision of services. The traditional barriers to reproductive-genetics services; the decision-making process involved in genetic counseling when Caucasians dominate the process of counseling people of color; financial/insurance barriers to care for low- and moderate-income clients are also addressed. Recommendations are made to address the problems and inequities.

Abortion, Eugenic↗

Gestational surrogacy for a human immunodeficiency virus seropositive sperm donor: what are the ethics?

Clinics that provide assisted reproductive technology (ART) are guided by general guidelines set forth by the American Society for Reproductive Medicine and its Ethics Committee and are free to set their own policies within those guidelines. This article presents a case in which a university clinic was presented with a novel request. A same-sex male couple, both positive for the human immunodeficiency virus (HIV), asked to use one of the couple's sperm to establish a pregnancy in an unrelated gestational surrogate through in vitro fertilization, intracytoplasmic sperm injection, and embryo transfer. The couple's argument in favor of such a plan was that no documented case of HIV seroconversion had so far occurred in recipients of gametes from HIV-positive donors. Since gestational surrogates routinely accept the risks inherent in pregnancy and childbearing, an informed surrogate should be allowed to accept the risks of such an arrangement. They further argued that if no clinic were willing to provide such services, data regarding seroconversion would never be obtained. The university ethics committee examined the fertility clinic's policies and found the clinic's refusal to provide such services to be completely consistent with its policy that allows providing services to HIV-discordant couples, same-sex couples, and gestational surrogates, but that always acts to protect the surrogate from exposure to infectious risk.

Ethics, Medical↗

Nontraditional family romance.

Family stories lie at the heart of psychoanalytic developmental theory and psychoanalytic clinical technique, but whose family? Increasingly, lesbian and gay families, multiparent families, and single-parent families are relying on modern reproductive technologies to form families. The contemplation of these nontraditional families and the vicissitudes of contemporary reproduction lead to an unknowing of what families are, including the ways in which psychoanalysts configure the family within developmental theory. This article focuses on the stories that families tell in order to account for their formation--stories that include narratives about parental union, parental sexuality, and conception. The author addresses three constructs that inform family stories and that require rethinking in light of the category crises posed by and for the nontraditional family: (1) normative logic, (2) family reverie and the construction of a family romance, and (3) the primal scene. These constructs are examined in tandem with detailed clinical material taken from the psychotherapy of a seven-year-old boy and his two mothers.

Child↗

Individual implantation rate: proposal for a new index for evaluation of assisted reproduction results.

OBJECTIVE: To assess whether implantation in assisted reproductive technology (ART) cycles is a random event. DESIGN: Retrospective analysis of results. SETTING: Division for Reproductive Endocrinology and ART, Department of Obstetrics and Gynecology, Haemek Medical Center, Afula, Israel. PATIENT(S): A cohort of all cycles reaching ET from July 1, 1995, through June 30, 1996, and a cohort of all pregnancies recorded from January 1, 1995, through October 31, 1996. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Rate of multifetal pregnancy in relation to overall pregnancy rate. The number of gestational sacs observed by sonography, out of transferred embryos in conception cycles, was defined as the individual implantation rate. RESULT(S): Of 367 ETs, 75 (20.4%) yielded pregnancies, of which 31 (41%) were multifetal. Considering the mean number of embryos transferred (3.67), if implantation would have been random, multifetal gestation rate should have been only 14.8%, significantly less than the observed rate. In 110 pregnancies recorded between January 1995 and October 1996, individual implantation rate was 49.4% +/- 27.1% in intracytoplasmic sperm injection cycles compared with 40.5% +/- 20.4% in IVF cycles. CONCLUSION(S): Embryo implantation is not a random event. The index of individual implantation rate may help shed light on mechanisms underlying implantation.

Cohort Studies↗

Management of endometriosis in women older than 40 years of age.

Endometriosis in women older than 40 years of age presents unique therapeutic challenges to the practicing physician. Management requires the evaluation of reproductive goals and a determination of the objectives of therapy, including symptomatic relief and avoidance or delay of recurrence of disease. Important considerations in this age group include diminished fertility and impending menopause. The diagnosis and treatment for endometriosis-associated infertility must be undertaken in an expedient manner. Assisted reproductive technologies may be effective therapies for these patients. Conservative surgery may be necessary to preserve reproductive potential, but definitive surgery may be indicated in women with long-standing pelvic pain. Estrogen replacement therapy may be used in menopausal women with a history of endometriosis.

Adult↗

Families and future children: the role of rights and interests in determining ethical policy for regulating families.

"Rights" and "interests" are key ethical concepts in the debate on the regulation of Assisted Reproductive Technology. This article examines some of the ways in which these terms have been used in the debate, concentrating on their application to the situation of the potential children resulting from the technology. The article argues that, while there have been many misuses of these terms by the parties to the often acrimonious debate, nevertheless ethical regulation depends on maintaining the concepts as of central importance, but at the same time clarifying their use.

Australia↗

Folliculogenesis in the domestic cat (Felis catus).

The dynamic regulation of mammalian folliculogenesis is a key component of the reproductive process. Traditionally, the rodent had been used as a model to study ovarian function and reproductive physiology due to the availability of animals, their relatively short cycle length, high rate of fecundity and short generation interval. We maintain that much basic information can be determined using domestic cat ovaries retrieved from local veterinary clinics following routine spaying, without having the expense of maintaining a colony of laboratory cats. Studies of normal feline reproductive physiology and advances in reproductive technology may be extrapolated for use in endangered non-domestic felids. Increased understanding of feline reproduction will be beneficial to veterinary medicine, and to groups working to control feral cat populations. It is important to examine reproductive mechanisms in alternative animal models as there are a vast number of threatened and endangered species in which we lack the critical reproductive information needed to assist in preserving their long-term survival.

Animals↗

Fertility estimation: a review of past experience and future prospects.

Fertility has many components and stages which require that males and females be functionally capable of carrying out all critical stages if each generational reproductive cycle is to be completed. To accomplish this, the male must produce and ejaculate normal fertile sperm. The female must produce, store and ovulate normal fertilizable oocytes. Furthermore, the female must provide a reproductive system compatible with sperm transport, capacitation, and fertilization of the oocytes, embryo and fetal development, and finally birth of healthy young. Reproductive success or failure at several of these points can be estimated quantitatively on a population basis, and in a few situations on an individual basis. It is important that fertility estimates be determined accurately and with precision to be most useful to researchers and managers of animal enterprises. Many studies have underestimated the biological relationship of fertility to other traits because the estimates lacked precision. Many in vitro manipulations of sperm in artificial insemination, of gametes in various assisted reproductive technologies, and of embryos in embryo transfer are utilized in animal breeding programs. Accurate estimation of reproductive efficiency of these in vitro procedures also is important. Conditions surrounding different sets of fertility estimates almost certainly will be different. These conditions should be described as precisely as possible, and appropriate controls included in all experiments. When possible, experiments should be replicated over time and place to determine the repeatability of the various criteria used to estimate fertility and reproductive efficiency. Advances in genomic information and molecular biology should facilitate characterizing more fully inherent potential fertility of animals at birth. In vitro tests will improve, and automated techniques will facilitate making multiple determinations possible on a large scale. Reliability of fertility estimates will increase, with the potential for enhanced animal reproductive performance through more accurate selection, genetic engineering, and enlightened animal care. Simultaneously, it is important to recognize that prediction of future fertility is more hazardous than estimating fertility, as a completely new set of circumstances may occur which are not predictable. Because fertility estimation may be applied under a myriad of conditions, principles and factors affecting fertility will be emphasized in this review as being more useful than a compilation of numerical examples.

Animals↗

Wisdom, casuistry, and the goal of reproductive counseling.

Reproductive counseling includes counseling of prospective parents by obstetricians, clinical geneticists, and genetic counselors regarding, for example, the use of assisted reproductive technologies, prenatal testing, and preimplantation genetic diagnosis. Two different views on wisdom and the goal of reproductive counseling are analyzed. According to the first view, the goal of reproductive counseling is to help prospective parents reach a wise decision. A specific course of action is recommended by the counselor in contrast to other possible alternatives. According to the second view, the goal of reproductive counseling is not to help prospective parents reach a wise decision but to help them reach their own decision wisely. It is the prospective parents who should make the decision, and it is their value commitments that should be decisive. It is argued that the second approach is to be preferred to the first. It combines respect for autonomy with a recognition of the need for assistance in decision-making. Both the first and second views relate the goal of reproductive counseling to wisdom. A problem is, however, what wisdom more precisely means - there are many different views. A casuistic view of wisdom is investigated. This view roughly defines wisdom as practical prudence in dealing with particular cases. What characterizes a casuistic decision-making method is elaborated in more detail. Applied to the second view, a casuistic view of wisdom implies that the counselor should encourage prospective parents to take into consideration the nature of the particular problem at hand, the context of the problem, their own individual identities, their personal value commitments, and various alternative perspectives, values and arguments.

Counseling↗

[Female sterility].

Recent progress in female sterility of Japanese women is reported in this study. The causes of sterility in the female side, the most popular sterile factor is a tubal factor due to the increase of the endometriosis and pelvic inflammatory disease. The main treatment of the tubal factor is an IVF-ET technique. The ovulatory disturbances occupy the second position of the female sterile factor. The precise endocrinological examinations must be done for the diagnosis of the ovulatory disturbances. In case of the hypergonadotropic hypogonadism, the ovulation induction is almost impossible. Generally, clomiphene citrate is used for moderate hypothalamic anovulations, and bromocriptine or terguride is for prolactin related diseases (hyperprolactinemia, occult hyperprolactinemia, galactorrhea) and endocrinological PCO (LH/FSH > 1) in the beginning. If these treatments are not effective, hMG-hCG therapy will be performed. During hMG-hCG therapy, we must take care for the occurrence of the ovarian hyperstimulation syndrome. For the treatment toward the cervical factor, the artificial insemination with husband semen will be done, however, if it is not effective, IVF-ET must be performed. For the uterine factor (such as after hysterectomy state, adhesion of uterine cavity, etc.) surrogate mothers are hired in some foreign countries, however, it is prohibited in Japan. If patients have anti-phospholipid antibodies, low dose aspirin and/or heparin administration will be done for the treatment of infertility. Recently, the assisted reproductive technology (ART) have made much progress. IVF-ET is performed widely in Japan. Cryopreservation of the fertilized ovum and intracytoplasmic sperm injection (ICSI) are also performed. However, the legal and ethical problems are occurring, and much discussion must be done for the acceptance of such new technologies.

Anovulation↗

The European study of assisted reproduction families: a comparison of family functioning and child development between Eastern and Western Europe.

Developments in reproductive technology over the past 20 years have given infertile couples new opportunities to have children. Although assisted reproduction does not appear to lead to negative consequences with respect to parent-child relationships or the socioemotional development of the child, the outcome for children and their parents may well differ according to the social and cultural environment. The aim of the present study was to compare family functioning and the social and emotional development of children in families created as a result of assisted reproductive techniques in Western Europe with assisted reproduction families in an Eastern European country (Bulgaria) where there is a history of specific pronatalist interventions. The findings indicate greater difficulties in parental adjustment and child behavior in assisted conception families in Eastern Europe. In addition, Eastern European parents were more uncertain than Western European parents about whether they would tell the child, and Eastern European parents were much more secretive with respect to telling others. Thus the outcomes of assisted reproduction for family functioning and child development appear to be independent, to some extent at least, on the social context in which these techniques are carried out.

Adaptation, Psychological↗

Future directions in reproductive medicine.

Major advances in assisted reproductive technology and fertility enhancement in the last decade are discussed in this article. Sustained research efforts have led to refinement in in vitro fertilization and related technologies. Other therapeutic innovations such as the use of newer pharmacologic agents and surgical procedures to preserve reproduction function are highlighted. Future directions and anticipated developments are briefly reviewed.

Fertilization in Vitro↗

Infertility and the desire for multiple births.

Increased physician and patient awareness of the risks of multiple births may be an important strategy to reduce the incidence of multiple gestation associated with assisted reproductive technologies.

Female↗

Antisperm antibodies: origin, regulation, and sperm reactivity in human infertility.

OBJECTIVE: To follow-up and expand discussion on the action mechanisms of antisperm antibodies in human infertility, the etiology and control of antisperm antibody induction, sperm antigens involved in immunoinfertility, and strategies for therapy. DESIGN: A review of the recent literature with an emphasis on female immunoinfertility. RESULTS: The role of antisperm antibodies in clinical infertility continues to be defined. Through assisted reproductive technologies, antisperm antibodies were shown to exert detrimental effects on different prefertilization and possibly postfertilization events. The female reproductive tract is part of the common mucosal immune system and is able to mount effective immune responses against infectious agents, foreign antigens, and, occasionally, sperm cells. Sperm membranes and constituents contain numerous antigenic components foreign to the human body, and yet antisperm antibodies become problematic in few women exposed to semen. Semen and sperm cells contain immunosuppressive factors capable of inhibiting different immune cells. Fertile women apparently produce antisperm antibodies but also possess neutralizing serum anti-idiotypic antibodies that are lacking in virgin and immunoinfertile women. CONCLUSIONS: Antisperm antibodies can affect adversely human fertility but normally may be controlled by anti-idiotypic antibodies, which along with immunosuppressor factors in semen prevent their induction to a significant degree. This balance between detrimental and "beneficial" immune response to sperm may be shifted toward an antisperm antibody response by stimulatory factors such as infection. Therapies may be devised to stimulate the anti-idiotypic antibody system, to induce immune tolerance to sperm antigens, and to use antigens to adsorb antisperm antibodies from spermatozoa.

Antibodies↗

Ambient air and its potential effects on conception in vitro.

Incidences of chemical air contamination (CAC) are common in assisted reproductive technology, but not reported in peer review format. Justified fear of car and industrial emissions clearly exists among reproductive specialists, but standards for air contents and gaseous emission limits have not been reported. Here, we describe air sampling methods and assay systems which can be applied to any laboratory or laboratory item. It was found that unfiltered outside air may be cleaner than high efficiency particulate air filtration (HEPA) filtered laboratory air or air obtained from incubators, due to accumulation of volatile organic compounds derived from adjacent spaces or specific laboratory products such as compressed CO2, sterile Petri dishes and other materials or devices known to release gaseous emissions. Specific groups of products such as anaesthetic gases, refrigerants, cleaning agents, hydrocarbons and aromatic compounds such as benzene and toluene are described. The latter were shown to accumulate specifically in incubators. Isopropyl alcohol was the most dominant product found, though it was not used by the laboratory staff. Concentrations of this agent were low in incubator air, indicating that it was probably absorbed by the water in the pan or by culture medium. Measures to counter CAC are proposed, including the use of activated carbon filters and oxidizing material placed in the central air handling systems, in separate free-standing units or even inside the incubators.

Air Pollution, Indoor↗