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The commodification of the body and its parts.

The human body--and its parts--has long been a target for commodification within myriad cultural settings. A discussion of commodification requires that one consider, first, the significance of the body within anthropology and, second, what defines a body "part." After exploring these initial questions, this article outlines dominant theoretical approaches to commodification within anthropology, with Mauss and Marx figuring prominently. The discussion then turns to historically well-documented forms of body commodification: These include slavery and other oppressive labor practices; female reproduction; and the realms of sorcery and endocannibalism. An analysis here uncovers dominant established approaches that continue to drive current studies. The remainder of this article concerns emergent biotechnologies, whose application in clinical and other related scientific arenas marks a paradigmatic shift in anthropological understandings of the commodified, fragmented body. The following contexts are explored with care: reproductive technologies; organ transplantation; cosmetic and transsexual surgeries; genetics and immunology; and, finally, the category of the cyborg. The article concludes with suggestions for an integrated theoretical vision, advocating greater cross-fertilization of analytical approaches and the inclusion of an ethics of body commodification within anthropology.

Anthropology, Cultural↗

A clinical study comparing PureSperm and SpermFilter for density gradient separation of human spermatozoa in assisted reproduction.

OBJECTIVE: To compare a new density gradient medium, SpermFilter, for purifying spermatozoa in assisted reproduction with the more established medium, PureSperm. DESIGN: Part 1, a multicenter study on 225 semen samples purified using either PureSperm (115 semen samples) or SpermFilter (110 semen samples). Part 2, a retrospective, single center study on a total of 898 assisted reproductive cycles (245 insemination cycles using husband semen, 58 insemination cycles using donor semen and 595 in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. SETTING: Part 1, three fertility clinics in Denmark (two university-affiliated fertility clinics and one private clinic). Part 2, one university-affiliated fertility clinic in Denmark. MAIN OUTCOME PARAMETERS: Part 1, purity of purified spermatozoa (% motile), motility index and recovery of motile spermatozoa. Part 2, malformation and baby take-home rates (insemination cycles), fertilization, cleavage, implantation, malformation and baby take-home rates (IVF/ICSI cycles). RESULTS: No statistical differences were observed in any of the parameters investigated. CONCLUSION: SpermFilter is a valid alternative to PureSperm in assisted reproduction technology (ART).

Adult↗

Comparative aspects of conceptus growth: a historical perspective.

This review provides a historical background for a series of articles arising from a symposium on Early Regulation of Mammalian Development. It begins by tracing connections between the work of J. Cossar Ewart and the first cloning of mammals by somatic cell nuclear transfer. Historical scientific landmarks over the last century that have affected our attitudes to 'fetal autonomy' and conceptus development are reviewed briefly, as are salient studies that have established the importance of nutrition to pre- and postnatal life. Finally, attention is drawn to some differences in conceptus development among various mammals, and the argument made that understanding these differences might be of benefit to the development of reproductive technology.

Animals↗

Nonsurgical treatment of male infertility. An update.

As has been shown, when well-defined pathophysiology such as hypogonadotropic hypogonadism exists in subfertile men, reasonably successful treatment options are available. When subfertility is unexplained or idiopathic, treatment is less successful. At present, numerous conditions of varying pathophysiology are lumped together as "idiopathic subfertility" and treated with the same nonspecific therapeutic modalities with minimal success. As further research elucidates the biochemical abnormalities causing these conditions, rational and specific therapies may be developed. In addition, advances in assisted reproductive technologies will allow treatment for many patients for whom no therapy currently exists.

Fertility Agents, Male↗

Women and the family of the future.

The complexities of current societal trends impose a daunting challenge to providers of maternal child health services. Demographers, anthropologists, sociologists, policy makers, and health care providers struggle to grasp the multiple issues in an effort to create useful strategies for the 21st century. The 1990s have been labeled the decade of women's health. Legislative and policy efforts have focused new and much-needed attention on women as recipients and providers of health care. The realities of mothers in the work force, the epidemic of adolescent pregnancy, the swelling ranks of women and children in poverty, the increasing number of women with acquired immune deficiency syndrome, the new advances in reproductive technology, and the effect of population and immigration trends greatly influence the childbearing client of the future and create enormous pressures for critical problem solving.

Child↗

Influence of global sperm DNA methylation on IVF results.

BACKGROUND: In cases of male infertility, routine analysis for sperm characteristics is a poor predictive factor for the segmentation rate and embryo development in assisted reproductive technologies. It is assumed that epigenetic factors could have an influence on the embryo's quality. The aim of this work was to determine the relationship between sperm DNA methylation level and fertilization and pregnancy rates according to the assisted reproduction technique performed. METHODS: A prospective study was undertaken. Ejaculates were obtained from men (n = 63) undergoing an assisted reproduction procedure. 5-Methylcytosine was immunostained with a polyclonal antibody and revealed by fluorescein isothiocyanate. The DNA methylation level was then quantified by flow cytometry. RESULTS: Sixty-three conventional IVF cycles were performed, 760 oocytes were retrieved, an average of 8.1 +/- 4.8 embryos was obtained, and 2.4 embryos were transferred. Neither the fertilization rate nor the rate of good quality embryos was correlated with the DNA methylation level (r = -0.1 and r = -0.08 respectively; not significant). When sperm DNA methylation was >555 arbitrary units, the pregnancy rate was 33.3% compared with 8.3% in the lower (<555) group (P<0.05). CONCLUSION: DNA methylation level in human sperm could represent a new approach to study the ability of sperm to lead to pregnancy in an assisted reproduction procedure, especially when sperm samples with normal characteristics are used.

5-Methylcytosine↗

Avoiding the slippery slope in ethics and bioethics: 'ought' entails 'can' and vice versa.

This article addresses the slippery slope argument in ethics and bioethics, and demonstrates that a lack of consensus about human nature and what constitutes a person contributes to its frequent use in such areas. Rationality and autonomy are contrasted with sentence, and a utilitarian quality of life approach with a deontological sanctity of life approach as defining criteria of personhood. It is argued that the concept 'quality of life' is itself a slippery slope. Genetic engineering is discussed as a paradigm of the slippery slope argument in use, as well as IVF, and the distinction between experimental and therapeutic research-both issues of concern to feminists. Australia has been a leader of scientific research in the new reproductive technologies, with regulative thinking following the technological breakthroughs. The question is posed whether biotechnology will repeat a similar pattern.

Bioethics↗

An idiopathic infertility with oocytes metaphase I maturation block: case report.

BACKGROUND: A case of idiopathic primary infertility was attributed to a block in oocyte meiosis affecting the transition between metaphase I and metaphase II. METHODS AND RESULTS: A couple suffering unexplained primary infertility was unsuccessfully treated by various means of assisted reproductive technology. After four unsuccessful pregnancy attempts using intrauterine inseminations (IUI), IVF was attempted (all oocytes remained unfertilized), followed by an ICSI cycle. None of the retrieved oocytes expelled the polar body, and therefore were not injected. The failure of these assisted reproduction cycles was, in both cases, due to the immaturity of the oocytes recovered. Cytogenetic analysis of the oocytes retrieved for ICSI provided evidence of meiotic arrest. Using cytogenetic staging criteria we were able to show that this arrest occurred between metaphase I and anaphase I. CONCLUSIONS: Meiotic blocks affecting oocytes have already been described for various mammals. We discuss here mechanisms that might be involved in this possibly inherited disorder in humans, and ways in which our knowledge of them could be increased.

Adult↗

ICSI for treatment of human immunodeficiency virus and hepatitis C virus-serodiscordant couples with infected male partner.

BACKGROUND: Assisted reproductive technology with semen washing can offer a significant reduction in risk of sexual and vertical transmission of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) in serodiscordant couples with infected male partner. METHODS: Among couples coming to our centre for reproductive problems from January 2001 to December 2003, we selected 43 couples with seropositive male and seronegative female: 25 couples with HIV-seropositive males, 10 couples with HIV/hepatitis C virus (HCV)-seropositive males and eight couples with HCV-seropositive males. Sperm samples were washed and used for ICSI. RESULTS: Seventy-eight cycles of ICSI were performed. The mean fertilization rate was 70.34 +/- 20.14% (mean +/- SD). A mean number of 3.55 +/- 1.11 (range: 1-5) embryos of good quality was transferred for each patient. We obtained 22 pregnancies (21 singletons and one twin), with a pregnancy rate per transfer of 28.2% and an implantation rate per transfer of 15.2%. The cumulative pregnancy rate was 51.2%. At follow-up, no seroconversion was detected in any patient. CONCLUSIONS: Our data suggest that sperm wash and ICSI could be useful for reducing the risk of HIV and/or HCV transmission in serodiscordant couples with infected male wishing to have a child, irrespective of their fertility status.

Adult↗

Increasing the efficiency of suckled calf production using embryo transfer technology.

The data reviewed in this paper illustrate the benefits of increased output that can be obtained from suckler herds using embryo transfer technology. The technology can be used within breeding schemes to increase the rate of genetic progress for selected traits or to transfer embryos of superior genetic merit and, in the future, embryos of predetermined sex to beef cows. The success of the technology is dependent on the achievement of good pregnancy rates. Experience gained on commercial farms suggests that the main reason for poor success rates in some herds lies with the general level of management of such herds rather than with the reproductive technology itself. Much experience has been gained on the management of embryo transfer recipients and twin-bearing cows. In particular, the nutritional requirements of such animals during the early post partum period and during mid and late pregnancy, and the management of twin-bearing cows during the perinatal period, are discussed.

Animals↗

Attitudes to prenatal and preimplantation diagnosis in Saudi parents at genetic risk.

BACKGROUND: Prenatal diagnosis (PND) is only available for severe abnormality in Saudi Arabia, and preimplantation genetic diagnosis (PGD) has been proposed as a valuable alternative. The acceptability of PGD is unexplored, and may ultimately determine the value of this technology in Saudi Arabia. This study reports attitudes towards PND and PGD of Saudi couples offered genetic counselling following the birth of a child with a single gene or chromosomal condition. METHODS: Thirty couples attending the King Faisal Specialist Hospital and Research Centre in Riyadh were interviewed using a semi-structured questionnaire. One couple had previous experience of PND and none had experience of PGD or IVF. RESULTS: Eight of the 30 couples (27%) would only accept PGD; four (13%) only PND; three (10%) either technology; the remainder would accept neither test, or were unsure. The main concerns of those who would accept neither technology were related to personal religious views. Specific concerns about PGD related to the IVF procedure, the risk of multiple pregnancies, the chance of mistakes and the chance of not getting pregnant. A high proportion of couples (six out of seven; 86%) who had a child with thalassaemia expressed interest in PGD, and all would be prepared to use technology to avoid having an affected child. Views were more mixed for the other conditions. CONCLUSION: PGD is acceptable to many couples and for some, it represents a valuable alternative to PND. However, parents' concerns are complex, and the acceptability of different reproductive technologies must be established on an individual basis.

Abortion, Eugenic↗

Second-Look Microlaparoscopy

Second-look laparoscopy performed a short time after corrective surgery to determine reproductive function has always been controversial. The need for general anesthesia and additional abdominal wall trauma make it unpopular. However, postponing pelvic evaluation after the original surgery results in a large proportion of women attempting pregnancy with deformed anatomy as the result of reformation of pelvic adhesions. Since November 1995 we performed microlaparoscopy for a second look in 20 patients. Original procedures were performed for endometriosis, salpingo-oophorolysis, tubal repair, and complicated ectopic pregnancy. Six of the women had adhesions that interfered with fertility and were referred to an assisted reproduction technology (ART) program. Procedures lasted 14 minutes (range 10-17 min). We encountered no complications. Patients were discharged after 2 hours of recovery and resumed normal activity. Second-look microlaparoscopy can be an important tool in assessing the efficacy of reconstructive reproductive surgery, and in accelerating referral to ART programs in women with poor results.

Journal Article↗

Non-reproductive heritable disorders in infertile couples and their first degree relatives.

The genetic safety of intracytoplasmic sperm injection (ICSI) remains a matter of continuing debate. One source of concern is the limited knowledge about the general genetic constitution and background of patients who need sophisticated reproductive technology to procreate. It has been postulated that such individuals could be carriers of genetic lesions that might result in an increased prevalence of heritable disorders among their offspring. To investigate this issue, we determined the frequency of potentially heritable non-reproductive diseases in 621 infertile couples and their first degree relatives. A total of 1302 fertile couples who underwent genetic counselling prior to prenatal diagnosis served as controls. The infertile patients had a slightly higher prevalence of potentially heritable non-reproductive disorders ('significant genetic risk factors') than the controls (1. 9 versus 0.9%; P = 0.015). In contrast, such diseases were less prevalent in their families than in the fertile couples' families. Our data do not support the hypothesis that their familial genetic background predisposes children born after ICSI to malformations or other non-reproductive genetic diseases.

Adult↗

[The effect of ecoestrogens on the development of the mammalian reproductive system].

Recently, it has been shown that the environment contains a large variety of chemical substances possessing estrogenic activity (ecoestrogens/environmental estrogens). In this connection, the problem of estrogenic effects exerted by the environment on animal ontogenesis is very important. Here, we review that available data concerning the effects of ecoestrogens on the development of the reproductive system in mammals. We discuss issues of reproductive toxicology related to the effects of these substances during prenatal and postnatal development, with special attention to the effect of ecoestrogens and modern reproductive technologies on preimplantation embryonic development.

Animals↗

Assisted hatching.

Assisted hatching entails the opening or thinning of the zona pellucida before embryo transfer in order to improve the results of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). The technique can be performed mechanically, chemically or with a laser beam. A piezoelectric method has also been described. Meta-analyses of randomised trials have shown that assisted hatching increases the clinical pregnancy, implantation and on-going pregnancy rates in patients with poor prognosis for IVF and ICSI, particularly those with repeated implantation failure. The technique is not without risks, and has been associated with an increased incidence of monozygotic twinning. Nevertheless, it remains an invaluable tool in assisted reproductive technology.

Embryo Transfer↗

What price parenthood?

Current reproductive technology challenges us to think seriously about social values surrounding childbearing. Thoughtful discussion must combine careful attention to the experience of pursuing parenthood by technological means with principled reflection on the morality of this pursuit.

Dehumanization↗

A relationship between traditionally motivated patterns and gamete donation and surrogacy in urban areas of Greece.

BACKGROUND: Although gamete receipt or donation has become an integral part of infertility management, previous research in the field of social attitudes and intention to use medical technologies is limited. The aim of this paper was to investigate people's intentions to receive or donate sperm, oocyte or uterus (surrogacy) and to identify possible motivational patterns explaining this intention. METHODS: Personal interviews were conducted with 365 men and women of reproductive age (18-45 years). Stratified random sampling was performed to select the men and women for interview. The content of the instrument used was derived from in-depth qualitative interviews with physicians experienced in assisted reproductive technologies, as well as from people who had recourse to gamete donation and surrogacy. RESULTS: The results obtained highlighted the following major aspects: (i) approximately 50% of the survey's participants would be prepared to receive/donate sperm and oocyte; (ii) the results from multiple regression analysis suggest that the 'traditional gender roles' pattern is positively associated with 'intention to use gamete donation and surrogacy'. On the contrary, 'confidence in emotional relationship' is negatively associated with 'intention to use gamete donation and surrogacy, and (iii) men are more likely than women to report 'intention to use gamete donation and surrogacy'. CONCLUSION: These data suggest that specific motivational patterns of the population need to be thoroughly analysed and taken into consideration, in order that appropriate counselling be addressed to individuals and couples.

Adult↗

Economical and ecological importance of indigenous livestock and the application of assisted reroduction to their preservation.

Among the many mammalian species that are threatened as the result of habitat destruction are numerous species of rare or little-known native livestock that possess features that render them ideally adapted to their environment. Because of the vital and valuable role many of these species play both to the ecology and economy of their native countries, attention is being directed towards initiating breeding programs that might insure their continued survival. This review introduces and highlights the importance of some of these indigenous species and outlines efforts currently underway to apply assisted reproductive technologies to their conservation.

Animals↗