May I have your uterus? The contribution of considering complexities preceding live uterus transplantation

In Vitro Fertilisation ◽

Medical Innovation ◽

Uterus Transplantation ◽

Ethical Debate ◽

Care And Support ◽

Different Dimensions

Uterus transplantation combined with in vitro fertilisation (IVF) (henceforth called UTx-IVF) as a treatment for infertility caused by an absence or malfunction of the uterus is advancing. About 50 transplantations have been conducted worldwide and at least 14 children have been born—9 of them by women taking part in a Swedish research project on UTx-IVF. The Swedish research protocol initially stated that the potential recipient must ‘have her own donor’ who is preferably related to the recipient. But what does it mean to ask someone for a uterus? What challenges does this question instigate? And what norms may it enact? In this article, I explore how 10 women—who have considered, and sometimes pursued, UTx-IVF—describe their experiences of searching for a donor. I aim to show how an analysis of such accounts can help us unpack some of the specific relational and gendered dimensions of UTx-IVF and by doing so enrich discussions of risks, benefits, care and support in UTx-IVF. Drawing on research in social sciences and medical humanities that has demonstrated how assisted reproductive technologies and organ donation can provoke social and familial conundrums, with respect to such topics as embodiment and identity, I present three patterns that describe different dimensions of the interviewees’ quest for a uterus donor. I discuss the negotiations that took place, how expectations unfolded and how entanglements were managed as the interviewees considered asking someone for a donation. Such an examination, I suggest, contributes to make care and support more attuned to the experiences and entanglements that UTx-IVF entails for those pursuing it. This will become increasingly important if (or when) UTx-IVF becomes part of general healthcare. To conclude, I problematise responsibilities and relational challenges in medical innovation, and in this way provide insights into how the ethical debate over UTx-IVF can broaden its scope.

Rare occurrence of Tetralogy of Fallot in dizygotic twins conceived via in vitro fertilisation

Cardiology in the Young ◽

10.1017/s1047951119002439 ◽

2019 ◽

Vol 29 (12) ◽

pp. 1541-1542

Author(s):

Jason W. Greenberg ◽

Chetana Reddy ◽

Charles B. Huddleston

Keyword(s):

Tetralogy Of Fallot ◽

In Vitro Fertilisation ◽

Rare Occurrence ◽

Dizygotic Twins

AbstractAn increased incidence of CHD has been noted in twin gestations and in infants conceived using assisted reproductive technologies. However, CHD in these populations remains understudied and the mechanisms underlying these phenomena remain unclear. We present the case of twins conceived via in vitro fertilisation both with Tetralogy of Fallot and additional cardiac and extracardiac malformations.

Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it?

Journal of Medical Ethics ◽

10.1136/medethics-2018-104983 ◽

2019 ◽

Vol 45 (5) ◽

pp. 346-350 ◽

Cited By ~ 4

Author(s):

Mila Stefanova Zemyarska

Keyword(s):

Cost Effective ◽

Conclusive Evidence ◽

Diagnostic Tools ◽

In Vitro Fertilisation ◽

Unborn Child ◽

Effective Adjunct ◽

Psychological Benefit

In vitro fertilisation (IVF) ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child.

Foreword: A perspective on the role of emerging technologies for the propagation of companion animals, non-domestic and endangered species

Reproduction Fertility and Development ◽

10.1071/rd07091 ◽

2007 ◽

Vol 19 (6) ◽

pp. iii ◽

Cited By ~ 1

Author(s):

Monique C. J. Paris ◽

Gabriela F. Mastromonaco ◽

Damien B. B. P. Paris ◽

Rebecca L. Krisher

Keyword(s):

Endangered Species ◽

Emerging Technologies ◽

Companion Animals ◽

Reproductive Physiology ◽

In Vitro Fertilisation ◽

Genetic Management ◽

The Status

Assisted reproductive technologies (ART) have been used successfully in humans, domestic and laboratory species for many years. In contrast, our limited knowledge of basic reproductive physiology has restricted the application of ART in companion animal, non-domestic and endangered species (CANDES). Although there are numerous benefits, and in some cases a necessity, for applying ART for the reproductive and genetic management of CANDES, the challenges encountered with even the most basic procedures have limited the rate of progress. In this foreword we discuss the status of conventional ART, such as artificial insemination and in vitro fertilisation, as well as their benefits and inherent difficulties when applied to CANDES. It is upon these techniques, and ultimately our knowledge of basic reproductive physiology, that the success of emerging technologies, such as those described in this special issue, are dependent for success.

Infertility and the excruciating pursuit of motherhood

Indian Journal of Medical Ethics ◽

10.20529/ijme.2021.057 ◽

2021 ◽

pp. 01-02

Author(s):

Urmila G

Keyword(s):

Intracytoplasmic Sperm Injection ◽

Intrauterine Insemination ◽

Infertility Treatment ◽

In Vitro Fertilisation ◽

Natural Conception ◽

Graphic Description

What’s a Lemon Squeezer Doing in My Vagina? is a memoir of Rohini S Rajagopal’s excruciating five-year long fight with infertility and her journey to motherhood. After several failed attempts at natural conception and many negative home pregnancy tests, the author and her husband Ranjith visit a fertility centre in Bangalore. Rajagopal delivers a graphic description of the physical and emotional unpleasantness of her infertility treatment and also gives a vivid account of her experiences with the assisted reproductive technologies (ARTs) such as the intrauterine insemination (IUIs), in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI). Intrauterine Insemination (IUI) is facilitated by directly injecting a man’s sperm into the woman’s uterus around the time the eggs emerge from the ovaries.

Twin pregnancy, fetal reduction and the 'all or nothing problem’

Journal of Medical Ethics ◽

10.1136/medethics-2020-106938 ◽

2020 ◽

pp. medethics-2020-106938

Author(s):

Joona Räsänen

Keyword(s):

Moral Theory ◽

Twin Pregnancy ◽

Multiple Pregnancy ◽

In Vitro Fertilisation ◽

Singleton Pregnancy ◽

Fetal Reduction ◽

Health Related

Fetal reduction is the practice of reducing the number of fetuses in a multiple pregnancy, such as quadruplets, to a twin or singleton pregnancy. Use of assisted reproductive technologies increases the likelihood of multiple pregnancies, and many fetal reductions are done after in vitro fertilisation and embryo transfer, either because of social or health-related reasons. In this paper, I apply Joe Horton’s all or nothing problem to the ethics of fetal reduction in the case of a twin pregnancy. I argue that in the case of a twin pregnancy, there are two intuitively plausible claims: (1) abortion is morally permissible, and (2) it is morally wrong to abort just one of the fetuses. But since we should choose morally permissible acts rather than impermissible ones, the two claims lead to another highly implausible claim: the woman ought to abort both fetuses rather than only one. Yet, this does not seem right. A plausible moral theory cannot advocate such a pro-death view. Or can it? I suggest ways to solve this problem and draw implications for each solution.

Procreative Liberty and Harm to Offspring in Assisted Reproduction

American Journal of Law & Medicine ◽

10.1177/009885880403000101 ◽

2004 ◽

Vol 30 (1) ◽

pp. 7-40 ◽

Cited By ~ 49

Author(s):

John A. Robertson

Keyword(s):

Child Rearing ◽

Healthy Children ◽

The Novel ◽

Vitro Fertilization ◽

Procreative Liberty ◽

Ethical Debate ◽

The Status

Assisted reproductive technologies (“ARTs”) have enabled many infertile couples to have children but have long been controversial. Opposition initially focused on the “unnaturalness” of laboratory conception and the doubts that healthy children would result. Once children were born, ethical debate shifted to the status and ownership of embryos and the novel forms of family that could result.The new century has brought forth both new and old ethical concerns. The growing capacity to screen the genomes of embryos has sparked fears of eugenic selection and alteration. In addition, concerns about safety have reasserted themselves. Several studies suggest that in vitro fertilization (“IVF”) may be associated with lower birth weights and major malformations. Ethical attention has also focused on whether all persons seeking ARTs should be granted access to them, regardless of their child-rearing ability, age, disability, health status, marital status, or sexual orientation.

Outcomes Of Assisted Reproductive Technologies At The Nairobi In Vitro Fertilisation Centre

East African Medical Journal ◽

10.4314/eamj.v86i4.46944 ◽

2009 ◽

Vol 86 (4) ◽

Cited By ~ 4

Author(s):

LJ Noreh ◽

O Tucs ◽

CB Sekadde-Kigondu ◽

JA Noreh

Keyword(s):

In Vitro Fertilisation

Live birth after in vitro maturation versus standard in vitro fertilisation for women with polycystic ovary syndrome: protocol for a non-inferiority randomised clinical trial

BMJ Open ◽

10.1136/bmjopen-2019-035334 ◽

2020 ◽

Vol 10 (4) ◽

pp. e035334

Author(s):

Xiaoying Zheng ◽

Wei Guo ◽

Lin Zeng ◽

Danni Zheng ◽

Shuo Yang ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Live Birth ◽

In Vitro Maturation ◽

Polycystic Ovary ◽

In Vitro Fertilisation ◽

Ovary Syndrome ◽

Infertile Women

IntroductionPolycystic ovary syndrome (PCOS) is the first common cause of anovulatory infertility. Currently, in vitro fertilisation (IVF) is recommended when conventional attempts have failed. In vitro maturation (IVM) of human oocytes is an emerging treatment option in infertile women with PCOS. It is a patient-friendly intervention, avoiding the risk of ovarian hyperstimulation syndrome, which is a serious complication of controlled ovarian stimulation in the standard IVF procedure. We plan a randomised controlled trial (RCT) to evaluate whether IVM is non-inferior to the standard IVF for live birth in women with PCOS.Methods and analysisThis is a single-centre, open-label, non-inferiority RCT performed in a large reproductive medicine centre in China. Infertile women with PCOS will be randomised to receive either IVM or standard IVF in a 1:1 treatment ratio after informed consent. IVF procedures used in our study are all standard treatments and other standard-assisted reproductive technologies will be similar between the two groups. The primary outcome is ongoing pregnancy leading to live birth within 6 months of the first oocyte retrieval cycle after randomisation. Pregnancy outcome, maternal safety and obstetric and perinatal complications will be secondary outcomes. The planned sample size is 350 (175 per group).Ethics and disseminationEthical permission was acquired from the Ethics Committee of Peking University Third Hospital. The results will be issued to publications through scientific journals and conference reports.Trial registration numberNCT03463772.

Emergency prevention of extinction of a transgenic allele in a less-fertile transgenic mouse line by crossing with an inbred or outbred mouse strain coupled with assisted reproductive technologies

Reproduction Fertility and Development ◽

10.1071/rd06161 ◽

2007 ◽

Vol 19 (8) ◽

pp. 984 ◽

Cited By ~ 1

Author(s):

Anna Mayer ◽

Diana Bulian ◽

Hagen Scherb ◽

Martin Hrabé de Angelis ◽

Jörg Schmidt ◽

...

Keyword(s):

Transgenic Mouse ◽

Fluorescent Protein ◽

Low Fertility ◽

In Vitro Fertilisation ◽

Mouse Line ◽

Transgenic Mouse Line ◽

Green Fluorescent

Certain transgenic mouse lines are difficult to breed or archive and, consequently, their transgenes become lost. We examined a C57BL/6 mouse line (B6-tg), transgenic for green fluorescent protein (GFP) with low fertility, and its crosses with the more prolific inbred C3HeB/FeJ (C3) and outbred Swiss (SW) strains in order to assess the possibility of emergency prevention of extinction of a transgenic allele by using assisted reproductive technologies (ART). Out-crossing was performed by natural mating or in vitro fertilisation (IVF) with heterozygous mice. Most of the crossing combinations resulted in improved archiving and rederivation efficiencies of the transgenic allele. Natural crossing increased both mean litter size by two to three pups and the superovulatory rate from 69% for B6-tg to 70–90% for females from the out-crosses. Each plug-positive B6-tg female yielded an average of 4.6 two-cell embryos, whereas females from the out-crosses produced three- to fivefold that amount. After thawing, 13% of B6-tg embryos and 6–12% of out-crossed embryos developed into transgenic pups after transfer into recipients. After IVF with cryopreserved spermatozoa, cleavage rates were 4% for B6-tg, 22–37% for B6-tg oocytes out-crossed with C3 and SW spermatozoa, 9–49% for gametes from out-crossed mice and 28–44% for back-crosses with B6 oocytes. Transgenic pups were not derived from IVF with B6-tg gametes when either fresh or cryopreserved spermatozoa were used. Rederivation efficiencies were 7% and 4% from out-crosses of B6-tg oocytes with C3 and SW spermatozoa, respectively, 6–22% for gametes from out-crossed mice and 4–10% for the back-crosses. Although out-crossing changes the original genetic background, the strategy of crossing coupled with ART prevents the extinction of an allele of interest, especially where archiving and rederivation of the transgenic line fail.

ANALYSIS OF THE MARKET OF MEDICAL SERVICES IN THE FIELD OF VRT AND MARKETING STRATEGY OF MEDICAL INSTITUTIONS IN KAZAKHSTAN ON THE EXAMPLE OF THE WORK OF MCC PERSONA

Reproductive Medicine ◽

10.37800/rm2020-1-39 ◽

2020 ◽

pp. 38-47

Author(s):

A.V. Lokshina

Keyword(s):

Marketing Strategy ◽

Birth Rate ◽

Statistical Data ◽

In Vitro Fertilisation ◽

Real Situation ◽

Medical Institutions ◽

The Republic

The article discusses the formation of the market for assisted reproductive technologies in the Republic of Kazakhstan, in particular, studies the reasons for its emergence and formation, provides statistical data on the birth rate, registered, infertile marriages in the country as a whole and in the context of regions. Analysis of the existing statistics of patients with infertility shows the need for In Vitro Fertilisation (IVF). The author of the article aims to show the real situation in Kazakhstan in the field of assisted reproductive technologies: he draws attention to the specificity of this market, the working conditions of clinics specializing in this area and the need for a marketing strategy for these clinics. This, according to the author, is a very important area of activity, through which specialists help to find the happiness of motherhood and fatherhood.