Counseling the underserved: when an old reproductive technology becomes a new reproductive technology.
Explore the source record for details and available documents.
Adolescent↗
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.
Public and private regulation of reproductive technologies.
Human reproduction is interrelated with privacy. However, in most countries where new reproductive technologies are used public regulations have been passed to provide a legal framework for such technologies. This interference in private life can be justified by the need to control medical intervention in the human reproductive process. But in order to find a balance between public regulations and other social regulations, this article analyses the impact private regulation may have on issues raised by reproductive technologies. It also addresses the issue of the influence of private bodies on the drafting of public regulations.
Bioethics↗
Assisted reproductive technology in the United States and Canada: 1991 results from the Society for Assisted Reproductive Technology generated from the American Fertility Society Registry.
OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive technology (ART) initiated in the United States in 1991. DESIGN: Data were collected on an annual summary form and submitted to the Society for Assisted Reproductive Technology generated from The American Fertility Society central registry. PARTICIPANTS: Two hundred fifteen programs submitted data on procedures performed in 1991. Data were collected in October of 1992 so that outcome of all pregnancies established would be known. MAIN OUTCOME MEASURES: The outcomes measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth, delivery, and congenital abnormality. RESULTS: In 1991, programs reported initiation of 33,001 cycles of ART treatment, excluding frozen embryo and donor oocyte cycles. Of these, 24,671 cycles initiated were IVF with 15.2% deliveries per retrieval, 5,452 were cycles of GIFT with 26.6% deliveries per retrieval, and 2,104 were cycles of zygote intrafallopian transfer with 19.7% deliveries per retrieval, and 714 were combination cycles, combining IVF and one of the tubal transfer techniques, resulting in 19.3% deliveries per retrieval. In addition to these cycles initiated in 1991, 4,838 frozen embryo procedures were reported, either as separate procedures or in combination with another ART procedure with 11.1% deliveries per procedure, and 1,107 donor oocyte or surrogacy cycles were initiated with an overall success of 25.6% deliveries per retrieval. From all of these procedures, a total of 5,699 deliveries were reported. CONCLUSIONS: In 1991, there were more programs offering more treatment cycles of ART. Average success rates for most ART procedures exhibited a small increase compared with previously reported summaries.
Adult↗
Assisted reproductive technology in the United States and Canada: 1993 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry.
OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive technology (ART) initiated in the United States in 1993. DESIGN: Data were collected on an annual summary form and submitted to the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. PARTICIPANTS: Two hundred sixty-seven programs submitted data on procedures performed in 1993. Data were collected in October 1994 so that outcome of all pregnancies established would be known. MAIN OUTCOME MEASURES: The outcomes measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth, delivery, and congenital abnormality. RESULTS: Programs reported initiations of 41,209 cycles of ART treatment, excluding frozen embryo and donor oocyte cycles. Of these, 33,543 cycles initiated were IVF (standard, with micromanipulation, and for host uterus transfer) with 18.3% deliveries per retrieval; 4,992 were cycles of GIFT with 28.1% deliveries per retrieval; 1,792 were cycles of ZIFT with 24.4% deliveries per retrieval; and 882 were combination cycles, combining IVF and one of the tubal transfer techniques, resulting in 27.8% deliveries per retrieval. In addition to these cycles initiated in 1993, 6,869 frozen ET procedures were reported, either as separate procedures or in combination with another ART procedure with 13.3% deliveries per procedure, and 2,766 donor oocyte cycles were initiated with an overall success of 30.2% deliveries per retrieval. As a result of all procedures, a total of 8,741 deliveries were reported. CONCLUSIONS: In 1993, there were more programs offering more treatment cycles of ART. Overall average success rates (deliveries per procedures) exhibited only a small increase compared with previously reported summaries.
Adult↗
Assisted reproductive technology in the United States and Canada: 1992 results generated from the American Fertility Society/Society for Assisted Reproductive Technology Registry.
OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive technology (ART) initiated in the United States in 1992. DESIGN: Data were collected on an annual summary form and submitted to The American Fertility Society/Society for Assisted Reproductive Technology Registry. PARTICIPANTS: Two hundred forty-nine programs submitted data on procedures performed in 1992. Data were collected in October 1993 so that outcome of all pregnancies established would be known. MAIN OUTCOME MEASURES: The outcomes measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth, delivery, and congenital abnormality. RESULTS: Programs reported initiations of 37,955 cycles of ART treatment, excluding frozen embryo and donor oocyte cycles. Of these, 29,404 cycles initiated were IVF with 16.8% deliveries per retrieval, 5,767 were cycles of GIFT with 26.3% deliveries per retrieval, 1,993 cycles of zygote intrafallopian transfer with 22.8% deliveries per retrieval, and 791 were combination cycles, combining IVF and one of the tubal transfer techniques, resulting in 27.9% deliveries per retrieval. In addition to these cycles initiated in 1992, 5,814 frozen ET procedures were reported, either as separate procedures or in combination with another ART procedure, with 13.9% deliveries per procedure, and 2,032 donor oocyte or surrogacy cycles were initiated with an overall success of 31.3% deliveries per retrieval. As a result of all procedures, a total of 7,355 deliveries were reported. CONCLUSIONS: In 1992, there were more programs offering more treatment cycles of ART. Average success rates exhibited only a small increase compared with previously reported summaries.
Adult↗
Current trends in human IVF and other assisted reproductive technologies.
The new reproductive technologies such as IVF, GIFT, ZIFT, and micromanipulation have had a profound influence on the therapeutic and diagnostic management of infertility, and in turn have resulted in better understanding of human fertilization and embryo development. While the clinical pregnancy rates in GIFT and ZIFT procedures are comparable to the natural fecundity in the population at large, pregnancy rates in IVF have been generally lower. Further investigations should be directed to improve the implantation rates, and to develop better controlled methods of multiple follicle development. Although more studies are needed, a recent report of potential utilization of nonstimulated oocytes for donor programs as well as IVF-cryopreservation was a promising new development (Cha et al. 1989). Other exciting prospects on the horizon are the possibilities of gene transfer for the treatment of certain genetic diseases and diagnostic applications of embryonal biopsy. These new technologies have also generated serious ethical and legal issues. Any ethical or legal guidelines affecting new reproductive technologies should be developed to protect all participants only when the need for regulation is clear. Ethical guidelines and appropriate legislations with contributions from the medical and scientific community are gradually being established worldwide.
Cryopreservation↗
Creating brave new families with advanced reproductive technologies.
The advanced reproductive technologies such as in vitro fertilization, gamete intrafallopian transfer, and donor gametes have created "brave new families," which can no longer be described by traditional definitions based on genetics and gestation. Understanding the particular stresses and issues that these families face can be particularly helpful to the clinician working with these couples and their children. The potential long-term effects also are explored.
Adoption↗
Application of reproductive technology to the Australian livestock industries.
Current use of reproductive technology in the Australian livestock industries is limited, though it increased in line with higher prices for beef and wool through the 1980s. The required techniques, many of which were developed in Australia, are available and the level of expertise is comparable to the best in the world. However, the extensive pastoral industries do not readily lend themselves to these procedures. Only in the dairy industry is artificial insemination used to a significant degree. On the other hand, application of the technology in the pastoral industries is confined largely to studs and breeding cooperatives which provide breeding animals for producer flocks and herds. Hence the impact of applied technology may be more widespread than first appears. Until recently, little regard was paid to application of the technology along sound breeding principles. Artificial insemination and multiple ovulation and embryo transfer (MOET) have not been used so much in planned breeding programmes aimed at local improvement of stock, but more to proliferate genes of reputedly superior stock, imported either from overseas or elsewhere in Australia. This is particularly true of MOET, where the incentive to use it is commonly a short term cash gain made from proliferating breeding stock of a particularly valuable and usually novel strain or breed. Recent technological improvements which render the use of reproductive technology cheaper and more effective will lead to its more widespread use in commercial practice. Techniques for embryo freezing and splitting have been greatly simplified and quickly put into practice. The novel livestock technologies of in vitro oocyte maturation and fertilization have already found commercial application overseas. Fecundity-enhancing products have also been adopted by the livestock industries. There is potential value for greater use of reproductive technology in the livestock industries provided it is implemented according to sound breeding principles and provided associated management practices are applied simultaneously.
Animals↗
Assisted reproductive technology.
Several aspects of reproductive technology are discussed. In tubal infertility, the choice between surgery or in vitro fertilization and embryo transfer (IVF-ET) is addressed. In cases with bilateral distal occlusion or otherwise bad prognosis, IVF is probably more successful and less expensive. IVF in unstimulated cycles has given promising results, with pregnancy rates comparable to the results from the National IVF-ET Registry. If these results can be confirmed by more studies they will probably have a great impact on the choice of treatment in tubal infertility. The results obtained with various transfer procedures in nontubal infertility have still to prove tubal transfer to be a more effective procedure than IVF. Finally, studies on microinsemination in male infertility or unexplained infertility with previous fertilization failure in IVF show promising results with the subzonal insemination and partial zona dissection procedures.
Embryo Transfer↗
Moral pioneers: women, men and fetuses on a frontier of reproductive technology.
As one of the new reproductive technologies, amniocentesis is rapidly becoming routinized, especially for pregnant women in their mid-thirties and older. Prenatal diagnosis has been evaluated medically, economically, and bioethically. But we know very little about how pregnant women and their families who use, or might use, this new technology respond to its benefits and burdens. This article reports on a two-year field study in New York City. Responses of genetic counselors, a multicultural patient population using and refusing amniocentesis, women who had received "positive" diagnoses, and families with children who have the conditions that can now be diagnosed prenatally were all elicited through participant-observation. My goal in this study is to assess the social impact and cultural meaning of one new reproductive technology.
Adult↗
Moral traditions, ethical language, and reproductive technologies.
The Vatican Instruction on reproductive technologies and the OTA report, Infertility, both use "rights" language to advance quite different views of the same subject matter. The former focuses on the rights and welfare of the embryo, and the protection of the family, while the latter stresses the freedom and rights of couples. This essay uses the work of Alasdair MacIntyre and Jeffrey Stout to consider the different traditions grounding these definitions of rights. It is proposed that a potentially effective mediating language could be that of "human nature", and argued that donor methods raise more serious moral objections than homologous ones.
Catholicism↗
Controlled ovarian hyperstimulation regimens in assisted reproductive technologies.
The goal of assisted reproductive technologies (ART) is to influence the recruitment of multiple, mature ovarian follicles. Several methods, including spontaneous cycle ART, clomiphene-based ART regimens, and gonadotropin regimens with and without adjuncts, are used. The controversies surrounding these techniques and their relative advantages and drawbacks are reviewed.
Female↗
The present status of assisted reproductive technology in Asia-Oceania.
This is a survey on the present status of assisted reproductive technology in the Asia-Oceanic region. The survey formats were sent to the 19-member societies of AOFOG. By the end of August 1991, 11 countries responded: Australia, Egypt, Hong Kong, Israel, Japan, Malaysia, New Zealand, Philippines, Republic of China, Singapore and Thailand. This report is a summary of data from 12 countries including Korea. It comprised of 14 headings: IVF, GIFT, AIH, AID, donor sperm in ART, donor eggs in ART, preembryos from IVF for donation, cryopreservation of eggs, cryopreservation of fertilized eggs and preembryos, research of preembryos, surrogate mothers, additional procedures, quality assurance in reproductive technology and formation of policy for emerging reproductive technology. Each heading is composed of status of regulations, cost and coverage and the results and management of program.
Asia, Southeastern↗
Reproductive technologies and the bottom line.
Reproductive technologies have turned out to be creatures of the marketplace, a fact we did not foresee. Because of this commercialization, women must be as careful in selecting a clinic as in buying a used car. Where initially it appeared that government would impose test-tube babies and genetic engineering on society, the great irony is that we now look to government to protect us from the Brave New World.
Commerce↗
Integration of clinical genetics into assisted reproductive technologies: implications for nursing practice.
Assisted reproductive technologies (ART) have moved from the experimental periphery of clinical treatment to the center of routine practice in the field of reproductive endocrinology. With advances in technology, reduced operative risks, increasing third party reimbursement and increased accessibility to ART programs, a more heterogeneous group of couples is seeking these services. The traditional ART couple has been joined by a growing number of couples who are at risk for or affected by a genetic disorder. These individuals seek alternative methods of conception to minimize the risk of conceiving a child with a significant birth defect. Programs offering donor gamete, donor embryo, gestational carrier, and in the future, preimplantation genetic testing must be prepared for the unique needs of the "traditional" infertile and "nontraditional" fertile couple.
Chromosome Aberrations↗
A case of conflicting paradigms: nursing and reproductive technology.
This article addresses the paradigm conflict between nursing and reproductive technology. This technology is discussed as a conceptual system emphasizing fragmentation and distance, in contrast to the philosophical foundation of nursing, which aspires to holism and connection. The sensory modalities of sight, the paradigmatic sense of distance, and touch, the paradigmatic sense of connection, are considered as they highlight the conflict between nursing and reproductive technology. Particular attention is given to the techniques of ultrasonography and amniocentesis.
Amniocentesis↗
Ethical considerations of the new reproductive technologies. Ethics Committee of The American Fertility Society.
In September 1986, The American Fertility Society issued a report, Ethical Considerations of the New Reproductive Technologies, setting forth the then-held ethical position of the Society on the various new reproductive technologies. In 1987, the Congregation for the Doctrine of the Faith issued the Instruction on the Respect for Human Life and Its Origin and on the Dignity of Procreation. While both documents state that very similar moral criteria were used to derive ethical positions with respect to various reproductive procedures, the conclusions as to the ethical acceptability of the various procedures differ sharply in the two documents. The question can be raised about the procedure used by the Congregation of the Faith to derive its conclusions from the stated premises. Thus, while stating that "the individual integrally and adequately considered" is to be the basis of the moral judgment, the fact is that most conclusions are based on and referenced to past Catholic statements. While the difference in conclusion from similar premises may be troubling to society, it can be especially paralyzing to four groups: (1) those who face problems that might be solved by one or another of the new reproductive technologies; (2) those who are involved in applying them; (3) those who are responsible for institutional policies where such techniques may be applied; and (4) those who are in a position to influence public policy in a legislative or regulatory way. Because of the conflicting conclusions of the two documents, the present Ethics Committee (1986-87) of The American Fertility Society was convened and considered these guidelines in the light of the Instruction. For reasons set forth previously, the Committee reaffirmed the finding of the 1985-86 Committee that basic in vitro fertilization with homologous gametes is ethically acceptable. The Committee reaffirmed the finding that the use of heterologous gametes is also ethically acceptable, provided that various precautions and guidelines are observed, as outlined in its previous report. The Committee recognized and re-evaluated the long-debated and very complex issue of the moral status of the gamete, zygote, pre-embryo, embryo, and fetus. The reasons for believing that progressive degrees of respect are due with progressive development were set forth here and in the previous document. The Committee reaffirmed the position that experimentation on the pre-embryo in conformity with the policies and guidelines, as previously expressed, can be ethically justifiable and, indeed, necessary, if the human condition is to be improved.(ABSTRACT TRUNCATED AT 400 WORDS)
Endocrinology↗
Reproductive technologies and court-ordered obstetrical interventions: the need for a feminist voice in nursing.
As the developments in and increasing use of reproductive technologies continue and as court-ordered obstetrical interventions occur, questions regarding nurses' roles in these developments become increasingly important. In this article, I identify a number of issues surrounding these developments in reproductive health care and examine how nurses have dealt with these issues. I also attempt to encourage nurses to examine and discuss these developments from a critical, woman-centered perspective. A review of articles from the nursing literature (1985-1990) grouped together on the basis of the concerns identified, approach used, or subjects studied is presented. The majority of researchers view reproductive technologies as either acceptable or as requiring legislation and control. Few researchers in nursing have identified concerns about reproductive technologies or court-ordered obstetrical interventions from a feminist perspective. It is crucial that questions be raised about the underlying assumptions of these measures and about their implications for women as patients and for nurses as practitioners, women, and promoters of health. Otherwise, nurses may be supporting technologies and other measures that harm women and nursing itself.
Female↗