Search PubMed⌕ Search

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.

At least 1,423 records · Page 79Linked to original sources
PubMed2005

Ethical considerations in prenatal sex selection.

Developments in assisted reproductive technologies have made it possible for couples to select the sex of a child prenatally. This article used the NASW Code of Ethics and information from the Ethics Committee of the American Society of Reproductive Medicine to consider ethical dilemmas related to social justice (for example, reinforcement of gender bias, the potential for gender discrimination and oppression, a move toward eugenics, restricted access based on social or economic status, and the discarding of human embryos), the importance of human relationships (for example, threats to the well-being of sex-selected children, parent-child relationships, and couple relationships), and self-determination and the dignity and worth of the individual (for example, the right of individuals or couples to choice and personal desires). Implications are discussed for social work practice, policy articulation and advocacy, research, and education.

Adoption↗
PubMed2006

[Ovarian response to COH and oocyte quality].

Defining markers that could reliably predict good oocyte quality could improve the management of infertile patients. Although a few potentially important predictors of oocyte quality have been identified, their application in assisted reproductive technologies (ART) is discussed.

Biomarkers↗
PubMed1993

Survey results on the current practice of ovum donation. Ovum Donor Task Force of the Psychological Special Interests Group of the American Fertility Society.

OBJECTIVE: To investigate how many programs currently have an ovum donor program and to examine the current state of the art in ovum donor programs regarding management, screening, and implementation. DESIGN: Surveys were sent to members of the Society for Assisted Reproductive Technology (SART) and the Psychological Special Interest Group of the American Fertility Society. RESULTS: Of 160 SART members, 82 surveys were returned. Psychological Special Interest Group surveys were excluded. A trend toward more third party reproduction was seen. There was little uniformity among programs regarding medical or psychological screening. Differences were seen between the screening and administration of ovum and sperm donation. CONCLUSIONS: Unlike sperm donation, ovum donation has begun in the known donor realm. Medical and psychological screening is currently limited in many ovum donor programs and highly variable with both known and anonymous donors. Most programs do use a mental health person as part of the screening process. More guidelines are needed to provide uniformity for the current practice of ovum donation.

Age Factors↗
PubMed2006

Endometriosis, recurrent miscarriage and implantation failure: is there an immunological link?

Endometriosis is more frequently diagnosed in patients with infertility than in a normal population. The goal of this paper is to give an overview of the clinical and fundamental evidence for a possible link between endometriosis and (recurrent) miscarriage or implantation failure after treatment with assisted reproductive technology. According to the literature, there is insufficient evidence for an association between endometriosis and (recurrent) miscarriage, but there is, however, epidemiological evidence to support the link between endometriosis and recurrent implantation failure after assisted reproduction. This can possibly be explained by alterations in humoral and cell-mediated immunity in women with endometriosis. Humoral immunological changes include increased formation of antibodies against endometrial antigens, anti-laminin-1 auto-antibodies and other auto-immune antibodies (e.g. antiphospholipid). Cell-mediated immunological changes include alterations in peritoneal and follicular fluid immune cells and cytokines. The possible negative effect of these immunological changes on folliculogenesis, ovulation, oocyte quality, early embryonic development and implantation in women with endometriosis suggests that infertility in endometriosis patients may be related to alterations within the follicle or oocyte, resulting in embryos with decreased ability to implant.

Abortion, Habitual↗
PubMed1990

Ethics and technological advances: contributions of social work practice.

Rapid technological advances in biomedicine have created ethical dilemmas for social workers and other health professionals. This article reviews three areas in which advances have been most dramatic; life support for terminally ill and elderly persons, reproductive technologies and services to severely impaired newborns. It presents principles and processes that can help structure decision making when choices are many and difficult to make. Finally, it suggests ways that social work can use its own technology to help humanize and demystify sophisticated medical technology.

Ethics, Medical↗
PubMed1998

Obstetric and gynecologic devices; reclassification and classification of medical devices used for in vitro fertilization and related assisted reproduction procedures--FDA. Final rule.

The Food and Drug Administration (FDA) is announcing that it is reclassifying instrumentation intended for use in in vitro fertilization (IVF) and related assisted reproduction technology (ART) procedures, including but not limited to gamete intrafallopian transfer (GIFT), embryo transfer (ET), and intracytoplasmic sperm injection (ICSI), from class III (premarket approval) to class II (special controls). FDA is also reclassifying assisted reproduction microscopes and microscope accessories from class III to class I. This reclassification is on the Secretary of the Department of Health and Human Services' (the Secretary's) own initiative based on new information. Accordingly, the order is being codified in the Code of Federal Regulations. Upon the effective date, this Federal Register document may be cited in the absence of an existing predicate device which would be used to support substantial equivalence. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a draft guidance entitled "Devices Used for In Vitro Fertilization and Related Assisted Reproduction Procedures: Submission Guidance for a 510(k)."

Device Approval↗
PubMed2001

Results of assisted reproduction techniques in Latin America.

The fact that today it is possible to write a comprehensive report on assisted reproduction technologies in Latin America is the result of a serious and systematic effort, accomplished by more than 80 centres, from Mexico to Chile. Over the past 10 years, these centres representing the vast majority of assisted reproductive treatment cycles performed in Latin America, have agreed voluntarily to report their work to our regional registry using a pre-established format. Furthermore, during 1999 and part of 2000, all centres were visited by a team of biologists and clinicians, who evaluated for consistencies in the data reported. This activity also included an evaluation of personnel, facilities, etc. It can be proudly said that the data reported are a true reflection of the actual situation in our region.

Journal Article↗
PubMed2005

Ensuring access to education and services on infertility for the underserved.

Race, culture, ethnicity, and socioeconomic status (SES) all influence how men and women cope with cancer-related infertility and whether they use infertility services. Unfortunately, these variables have not yet been studied in samples of cancer survivors. This article provides an overview of Medline-cited studies from 1980 to the present that examine the influence of ethnicity and socioeconomic status on the use of infertility services. Although underserved groups are disproportionately at risk for infertility in the United States, they are also less likely than middle- to high-SES Caucasians to seek medical treatment for this problem. Barriers to their use of infertility treatment include lack of knowledge, lack of financial resources, and cultural norms. It is very important for oncology care providers to take ethnicity and SES into account when counseling patients about infertility and to be aware of cultural and religious values with regard to assisted reproductive technology.

Adaptation, Psychological↗
PubMed1992

Ethical issues in assisted reproduction.

Since the birth of Louise Brown in 1978, no other area in clinical practice and medical research has held the public interest to the same extent as the assisted reproductive technologies. This has led to the formation of committees of enquiry, guidelines from professional bodies, the passage of legislation, and the formation of legislative bodies. The ethical issues which arise in the clinical practice of assisted reproduction, the donation of gametes and embryos, and their cryopreservation, surrogacy, and human embryo research are reviewed.

Ethics↗
PubMed2004

Comparison of hydrosonography and diagnostic hysteroscopy in the evaluation of infertile patients.

OBJECTIVE: In the present study we evaluated the value of hydrosonography in the screening for intracavitary structural pathologies in patients with a history of infertility before the implementation of assisted-reproductive technology. Hysterescopy was regarded as the gold standard procedure. STUDY DESIGN: A retrospective study. MATERIAL AND METHODS: A total number of 115 infertile women aged between 19 and 47 (33.4 +/- 5.3), who were candidates for assisted reproductive techniques, were enrolled in this retrospective analysis. The study comprised data obtained from patients undergoing infertility investigation between 2001 and 2003 at Ozel Ege IVF Center and the Department of Obstetrics and Gynecology of Ege University Faculty of Medicine. The results obtained by hydrosonography were later compared with those of hysteroscopy. Sensitivity, specificity, positive predictive value and negative predictive value for hydrosonography were calculated. RESULTS: In a total of 115 women, 53 (46%), 24 (20%), 30 (26%) and 8 (7%) were found to have normal endometrial cavities, submucous myoma, endometrial polyps and uterine septum, respectively, on hydrosonography. Forty-five (85%) of 53 women, who were supposed to have normal findings on hydrosonography, were confirmed by hysteroscopy. In the remaining eight women (15%), two had endometrial polyps, three had uterine septum, one had submucous myoma and two had intrauterine synechia on hysteroscopic examinations. The sensitivity, specificity, positive and negative predictive values of hydrosonography in the detection of structural endometrial cavity lesions were 85%, 75%, 75% and 84%, respectively. Two intrauterine adhesions were not recognized by hydrosonography. CONCLUSION: Hydrosonography may be a useful tool in the evaluation of intrauterine cavity structural pathologies in infertile patients with the exception of intrauterine adhesions. In addition, hydrosonography was found to be sensitive in the detection of intrauterine septum.

Adult↗
PubMed2001

Recombinant human follicle-stimulating hormone: a scientific step to clinical improvement.

Urinary-derived follicle-stimulating hormone (FSH) preparations have been used clinically for many years. Although effective, these have a number of disadvantages, not least of which is their variable composition. The availability of recombinant human FSH (r-hFSH), produced from CHO cells, with its constant composition and exceptionally high purity, has, therefore, aroused great interest. This review focuses on the use of r-hFSH for ovarian stimulation in assisted reproduction technology protocols and the treatment of World Health Organization Group I and II anovulation. The use of r-hFSH has been shown to lead to improvements in efficacy over urinary-derived preparations, particularly in assisted reproductive treatment, and a recent meta-analysis has shown higher ongoing pregnancy rates with the recombinant product. Although the two available recombinant products from CHO cells (follitropin alpha [Gonal-F((R))] and beta [Puregon((R))]) are similar from a physicochemical perspective, some minor advantages have been reported for follitropin alpha in relation to pregnancy rates and better local tolerance to injections. The apparent higher bioactivity of r-hFSH has led to reduced total FSH consumption over shorter treatment periods compared with conventional preparations, thus reducing overall exposure for patients. This is likely to confer not only safety benefits, but also cost-effectiveness as demonstrated through pharmaco-economic modelling.

Journal Article↗
PubMed2002

The claim from adoption.

In this article several justifications of what I call 'the claim from adoption' are examined. The claim from adoption is that, instead of expending resources on bringing new children into the world using reproductive technology and then caring for these children, we ought to devote these resources to the adoption and care of existing destitute children. Arguments trading on the idea that resources should be directed to adoption instead of assisted reproduction because already existing people can benefit from such a use of resources whereas we cannot benefit individuals by bringing them into existence are rejected. It is then argued that a utilitarian argument proposed by Christian Munthe that supports the claim from adoption in some situations should be rejected because the support it offers does not extend to certain situations in which it seems morally obvious that resources should be expended on adoption rather than assisted reproduction. A version of the Priority View improves upon Munthe's utilitarianism by supporting the claim from adoption in the cases in which Munthe's argument failed. Some allegedly counterintuitive implications of the Priority View are then discussed, and it is concluded that the Priority View is more plausible than utilitarianism. In a concluding section on policy issues it is argued that, even though the claim from adoption can be justified in a variety of situations, it does not follow that, in these situations, governments should direct resources away from assisted reproduction and towards adoption.

Adoption↗
PubMed2004

Assisted reproduction: managing an unruly technology.

Technology is "unruly" because it operates in a social context where it is shaped by institutions, organisations and individuals in ways not envisaged when it was first developed. In the UK assisted reproductive technology has developed from strictly circumscribed beginnings as a treatment for infertility within the NHS, to a service which is more often offered by commercial clinics and purchased by clients who are not necessarily infertile. The article considers the process by which assisted reproductive technology has been created and developed, a process which is ideological rather than technical, and the social implications of its ever expanding use. In a society where the discourse around reproduction and family life, is one of choice and acceptance of diversity of life styles, the conditions are set for further "uruliness" supported by clinicians and commercial interests. The HFEA, public consultations and media coverage tend to subscribe to the way ethical issues are framed by those interested parties, an approach that favours increased liberalisation.

Female↗
PubMed2003

Selective reduction.

Multifetal pregnancy reduction continues to be controversial. Attitudes about MFPR have not, in our experience, followed a simple "pro-choice/pro-life" dichotomy. As far back as the mid to late 1980s, opinions about the subject were varied. Even then, when much less was known about the subject, opinions did not always parallel the usual pro-choice/theological boundaries. We believe that the real debate over the next 5 to 10 years will not be whether or not MFPR should be performed with triplets or more. The fact is that MFPR does improve those outcomes. A serious debate will emerge over whether or not it is appropriate to offer MFPR routinely for twins, even natural ones, for whom the outcome is commonly considered "good enough." Our data suggest that reduction of twins to a singleton improves the outcome of the remaining fetus. No consensus on appropriateness of routine 2-1 reductions is ever likely to emerge. The ethical issues surrounding MFPR will always be controversial. Over the years, much has been written on the subject. Opinions will always vary from outraged condemnation to complete acceptance. No short paragraph could do justice to the subject other than to state that most proponents do not believe this is a frivolous procedure but do believe in the principle of proportionality ie, therapy to achieve the most good for the least harm). Over the past 15 years, MFPR has become a well-established and integral part of infertility therapy and attempts to deal with the sequelae of aggressive infertility management. In the mid 1980s, the risks and benefits of the procedure could only be guessed. We now have clear and precise data on the risks and benefits of the procedure and an understanding that the risks increase substantially with the starting and finishing number of fetuses in multifetal pregnancies. The collaborative loss rate numbers (ie, 4.5% for triplets, 8% for quadruplets. 11% for quintuplets, and 15% for sextuplets or more) seem reasonable to present to patients for the procedure performed by an experienced operator. Our experiences and anecdotal experiences from other groups suggest that less experienced operators have worse outcomes. Pregnancy loss is not the only poor outcome. The other main issue with which to be concerned is very early premature delivery, where there is an increasing rate of poor outcomes correlated with the starting number. The finishing numbers are also critical, with twins having the best outcomes for cases starting with three or more. Triplets and singletons do not do as well. We hope that MFPR will become obsolete as better control of ovulation agents and assisted reproductive technologies make multifetal pregnancies uncommon.

Female↗
PubMed2005

The role of early embryonic environment on epigenotype and phenotype.

The influence of epigenetic modifications to the genome on the phenotype of the adult organism is now a tractable problem in biology. This has come about through the development of methods that enable us to study the methylation state of the DNA and the packaging of the chromatin at specific gene loci. It is becoming clear that early embryogenesis is a critical period for the establishment of the epigenotype. Furthermore, it appears that this process is sensitive to environmental conditions. This is a concern in light of the increasing use of artificial reproductive technologies throughout the world.

Animals↗
PubMed2006

[Male infertility update].

Exact etiological factors cannot be found in more than 70% of male infertility. Although the causes of some male infertility are known, the pathogenesis is not yet clear. Therefore, the diagnosis and treatment of male infertility are particularly complicated. Some breakthroughs have been made in the treatment of refractory male infertility since the development of ICSI in 1992. However, traditional treatment should also be taken into account for individual male infertility. The standardization of diagnosis and treatment and the improvement of the success rate and safety of assistant reproductive technology will be the dominant factors in the development of male infertility researches.

Humans↗
PubMed1999

A survey of oncologists regarding sperm cryopreservation and assisted reproductive techniques for male cancer patients.

BACKGROUND: The authors surveyed the current knowledge, opinions, and clinical practices of oncologists regarding pretherapy cryopreservation of semen from male cancer patients since the introduction of intracytoplasmic sperm injection (ICSI). METHODS: A survey was sent to all members of the American Society of Clinical Oncology in Minnesota. RESULTS: Forty-six of 165 oncologists (28%) responded. Factors considered important in how strongly to recommend cryopreservation were patient age at the time of diagnosis (94%), type of treatment (83%), type of cancer (65%), urgency to initiate treatment (63%), and preexisting infertility (57%). Oncologists perceived patients to be significantly more concerned about cryopreservation than they were themselves during pretherapy counseling (P = 0.0005). Oncologists estimated that 27% of their patients chose to cryopreserve sperm. However, only 26% of the oncologists knew about ICSI. The cancers perceived to warrant cryopreservation the most were lymphomas, leukemias, and testicular carcinomas. The treatment modalities perceived to warrant cryopreservation the most were distributed among various chemotherapy and radiation regimens. A majority of respondents to the survey knew where patients could go to cryopreserve sperm (89%), but less than half of the respondents gave accurate information about the cost. CONCLUSIONS: Most of the oncologists surveyed were unaware of recent advances in reproductive technology in which only a few sperm are needed for successful in vitro fertilization with ICSI. This lack of awareness may be contributing to underutilization of sperm cryopreservation by male cancer patients. Currently, all male cancer patients of reproductive age who will have treatment that may affect testicular function and who may desire children in the future should cryopreserve sperm before the initiation of therapy.

Cryopreservation↗
PubMed2002

Cryopreservation, screening and storage of sperm the challenges for the twenty-first century.

The advent of HIV and the serious nature of the sequelae resulted in a major reassessment of artificial insemination practices in the UK. The development of human semen cryopreservation had enormous impact on reproductive medicine and the availability of cryopreserved quarantined donor semen became a mainstay for the treatment of male infertility in the UK. The regulation and accreditation of assisted reproductive technologies and the introduction of peer-reviewed guidelines have largely standardized clinical and laboratory practice. The introduction of assisted fertilization techniques such as intracytoplasmic sperm injection, testicular sperm retrieval and improved oncology treatments have placed pressure on reproductive biologists and cryobiologists to design and use cryopreservation protocols for the optimum survival of sperm.

Cryopreservation↗