Designing Babies

Author(s):  
Robert Klitzman

Since the first “test tube baby” was born over 40 years ago, in vitro fertilization and other assisted reproductive technologies (ARTs) have advanced in extraordinary ways, producing millions of babies. About 20% of Americans use infertility services, and that number is growing. ARTs enable gay and lesbian couples, single parents, and now others to have offspring. Prospective parents can also use preimplantation genetic diagnosis to avoid passing on certain mutations to their children and to avoid abortions of fetuses with these mutations. Other future parents routinely choose the sex of their child and whether to give birth to twins. In the United States, these procedures are largely unregulated, and a large commercial market has rapidly grown, using “egg donors,” buying and selling human eggs and sperm, and using gestational surrogates. Potential parents; policymakers; doctors, including reproductive endocrinologists; and others thus face critical complex questions about the use—or possible misuse—of ARTs. This book examines ethical, social, and policy questions about these crucial technologies. Based on in-depth interviews, Robert Klitzman explores how doctors and patients struggle with quandaries of whether, when, and how to use ARTs. He articulates the full range of these crucial issues, from economic pressures to moral and social challenges of making decisions that will profoundly shape these offspring. The book explores, too, broader social and moral questions regarding gene editing, CRISPR, and eugenics. Klitzman argues for closer regulation of these technologies, which are altering future generations and the human species as a whole.

Author(s):  
N.A. Altinnik , S.S. Zenin , V.V. Komarova et all

The article discusses the factors that determine the content of the legal limitations of pre-implantation genetic diagnosis in the framework of the in vitro fertilization procedure, taking into account international experience and modern domestic regulatory legal regulation of the field of assisted reproductive technologies. The authors substantiates the conclusion that it is necessary to legislate a list of medical indications for preimplantation genetic diagnosis, as well as the categories of hereditary or other genetic diseases diagnosed in the framework of this procedure.


Author(s):  
Harsimrat Kaur ◽  
Ram Dayal ◽  
Kamla Singh

What exactly does an embryologist do? is one of the most common question asked by patients and the possible answer could be that embryologist is the child’s first watchperson. The ability to grow embryos in laboratory environment was a huge scientific achievement. Scientists and Embryologists are involved in reproductive research and fertility treatment. The embryologist has a huge role to play in IVF/ICSI process and the contribution of embryologist is no less than infertility consultant. They might not be doctors, but they are highly trained medical professionals, holding a master’s degree or Ph.D. due to specialized nature of work. They are responsible for management and maintenance of laboratory used in creating embryos as well as monitoring those embryos. The important activities that embryologist does are maintaining the embryology lab (temperature, humidity, CO2 cylinder, diffusion gas and pH), oocyte screening during ovum pickup (OPU), incubation and checking of fertilization, embryo transfer, vitrification and embryo biopsy for pre-implantation genetic screening (PGS) or pre-implantation genetic diagnosis (PGD).


2002 ◽  
Vol 11 (4) ◽  
pp. 401-410
Author(s):  
D. MICAH HESTER

Since the decade of the 1970s, and particularly since the first successful test-tube baby in 1978, the development and use of assisted reproductive technologies (ARTs) have grown exponentially. Would-be parents—including those in so-called traditional male-female marriages, unmarried adults, postmenopausal women, and same-sex partnerships—who just over 20 years ago had no recourse for their (in)fertility issues can now pursue their desires to have children with at least a partial, if not, total, genetic and/or biological relationship. Ovulation-stimulating medications, artificial insemination using the sperm of a husband or unrelated donor (AIH or AID, respectively), in vitro fertilization with embryo transfer (IVF-ET), intracytoplasmic sperm injection (ICS), and gamete and zygote intrafallopian transfers (GIFT and ZIFT) are but a few of a host of treatment options ranging in complexity, invasiveness, and expense. And on the horizon are genetic techniques such as cloning—which was once considered “pure” science fiction but in 1997 became what some call an inevitability, with the development of mammalian cloning in the form of the now-famous (if not infamous) Dolly the sheep.


2018 ◽  
Vol 12 (3) ◽  
pp. 56-63
Author(s):  
E. G. Pitskhelauri ◽  
A. N. Strizhakov ◽  
E. B. Timokhina ◽  
V. S. Belousova ◽  
I. M. Bogomazova ◽  
...  

Most of the negative consequences for the health and development of children born through assisted reproductive technologies are related to health status of their mothers, i.e. infertility, age and the related metabolic, genetic and epigenetic changes affecting the quality of gametes and pregnancy. Improvement of the current techniques of in vitro fertilization, preimplantation genetic diagnosis and other preventive measures will have a favorable effect on the health status of such children.


Author(s):  
Amber Mathiesen ◽  
Kali Roy

For those with an increased risk of having a child with a genetic condition, reproductive options include avoiding pregnancy altogether, undertaking prenatal diagnosis in a current pregnancy, and preventing the transmission of the genetic changes responsible for the condition to a child. This chapter on assisted reproductive technology and reproductive options for the at-risk couple describes the basic techniques of assisted reproductive technologies as well as reproductive testing options prior to in vitro fertilization, including preimplantation genetic screening (PGS) and preimplantation genetic diagnosis (PGD). It includes a brief overview of ovarian stimulation, intrauterine insemination (IUI), and in vitro fertilization. This chapter discusses the details of PGS including the process and its limitations. It also includes a discussion of PGD, including the process, such as linkage analysis, and limitations, such as allele dropout.


2016 ◽  
pp. 166-170
Author(s):  
Y.V. Masliy ◽  
◽  
I.O. Sudoma ◽  
P.S. Mazur ◽  
D.A. Mykytenko ◽  
...  

The objective: to study the possibility of using frozen blastocysts for biopsy and genetic testing and performance measurement transfer euploeded 5–7-day-old embryos after thawing, biopsies, refreezing and thawing in patients with unsuccessful implantation. Patients and methods. The object of the study was the group of patients with repeated failure of implantation (4) in programs of auxiliary reproductive technologies (ART), subject to transfer to the uterus in total (i.e. in all the programs) for at least 6 good quality embryos based on morphological characteristics). All women had sufficient ovarian reserve. The patient was treated for infertility within the ART programs of the clinic of reproductive medicine "Nadiya" in the period from 2006 to 2016. The sample included couples who were not carriers of chromosomal rearrangements, without anomalies of the uterus (congenital and acquired: a doubling of the uterus, one-horned uterus, intrauterine membrane, synechia, submucous myoma of the uterus). All women had a positive ovarian response to controlled stimulation with gonadotropins (at least 7 oocytes) and a sufficient number of cryopreserved embryos. The first group (G1) included 64 women who trophectodermal a biopsy was performed on fresh blastocysts (in a loop controlled ovarian hyperstimulation). The second group (G2) were included 31 women who underwent thawing previously cryopreserved blastocysts trophectodermal re-biopsy and vitrification of blastocysts. Results. It was found that the performance of transfers euploid embryos that were vitrified, bioptrone and revitriphted, a little lower than those that were bioptrone fresh and vitrified only once. At the same time computationa genetic diagnosis previously vitrified blastocysts using comparative genome hybridization in patients with recurrent failed implantation allows to obtain a reasonable pregnancy rate (58%), implantation rate (33.3 %) and the birth of living children (45.1 %). Conclusion. Reprising biopropane embryos does not cause significant destructive impact and allows you to achieve pregnancy and birth of the alive child. Key words: in vitro fertilization, reusable unsuccessful implantation, a method of comparative genome hybridization, refreezing.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 113-116
Author(s):  
L A Bagdasaryan ◽  
I E Korneyeva

The aim of the study is to systematically analyze the data available in the modern literature on the relationship between endometrial thickness and the frequency of pregnancy in the program of assisted reproductive technologies (ART). Materials and methods. The review includes data from foreign and domestic articles found in PubMed on this topic. Results. The article presents data on the relationship between the thickness of the endometrium and the frequency of pregnancy in ART programs. The greatest number of studies is devoted to the evaluation of the relationship between the thickness of the endometrium and the frequency of pregnancy on the day of the ovulation trigger. Data are presented on the existence of a correlation between the thickness of the endometrium measured on the day of the ovulation trigger and the frequency of clinical pregnancy, as well as data on the need to evaluate the structure of the endometrium and the state of subendometric blood flow. The importance of multilayered (three-layered) endometrium as a prognostic marker of success in in vitro fertilization/intracytoplasmic sperm injection programs in the ovum is emphasized. The conclusion. The thickness of the endometrium can not be used as an argument for canceling the cycle or abolishing embryo transfer to the uterine cavity. Further studies in this direction are needed with a study of the morphological and molecular genetic characteristics of the endometrium, which in the future will allow us to evaluate the relationship between the thickness of the endometrium and the probability of pregnancy.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Monfort ◽  
Carmen Orellana ◽  
Silvestre Oltra ◽  
Mónica Rosello ◽  
Alfonso Caro-Llopis ◽  
...  

AbstractDevelopment of assisted reproductive technologies to address infertility has favored the birth of many children in the last years. The majority of children born with these treatments are healthy, but some concerns remain on the safety of these medical procedures. We have retrospectively analyzed both the fertilization method and the microarray results in all those children born between 2010 and 2019 with multiple congenital anomalies, developmental delay and/or autistic spectrum disorder (n = 486) referred for array study in our center. This analysis showed a significant excess of pathogenic copy number variants among those patients conceived after in vitro fertilization with donor oocyte with respect to those patients conceived by natural fertilization (p = 0.0001). On the other hand, no significant excess of pathogenic copy number variants was observed among patients born by autologous oocyte in vitro fertilization. Further studies are necessary to confirm these results and in order to identify the factors that may contribute to an increased risk of genomic rearrangements, as well as consider the screening for genomic alterations after oocyte donation in prenatal diagnosis.


2021 ◽  
Vol 10 (12) ◽  
pp. 2687
Author(s):  
Kaan Aydos ◽  
Oya Sena Aydos

Retrieving spermatozoa from the testicles has been a great hope for patients with non-obstructive azoospermia (NOA), but relevant methods have not yet been developed to the level necessary to provide resolutions for all cases of NOA. Although performing testicular sperm extraction under microscopic magnification has increased sperm retrieval rates, in vitro selection and processing of quality sperm plays an essential role in the success of in vitro fertilization. Moreover, sperm cryopreservation is widely used in assisted reproductive technologies, whether for therapeutic purposes or for future fertility preservation. In recent years, there have been new developments using advanced technologies to freeze and preserve even very small numbers of sperm for which conventional techniques are inadequate. The present review provides an up-to-date summary of current strategies for maximizing sperm recovery from surgically obtained testicular samples and, as an extension, optimization of in vitro sperm processing techniques in the management of NOA.


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