scholarly journals Dilemmatic tensions around parenthood: the ambiguous third-party role in Assisted Reproductive Technologies and Surrogacy in France and Portugal

2019 ◽  
Vol 56 (2) ◽  
pp. 381-404 ◽  
Author(s):  
Catarina Delaunay
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Potential ◽  
The United States ◽  
Reproductive Technologies ◽  
Third Party ◽  
Special Focus ◽  
Human Beings ◽  
Reproductive Process ◽  
Gay Couples ◽  
Pregnancy And Childbirth

This article analyzes couples’ attitudes towards the third-party role in Assisted Reproductive Technologies with gamete donation, and problematizes parenthood and kinship. I base my analysis on 66 in-depth interviews with different ART actors (from beneficiaries to professionals) in France and Portugal, conducted as part of a research project already completed. Special focus is given to 19 interviews with heterosexual and homosexual couples who used third-party reproduction in Europe and the United States. I found a physical and moral detachment operation among heterosexual and lesbian couples vis-a-vis the donor of reproductive potential, who is depersonalized and reduced to a functionality. The objective is to preserve the intimacy of the couple and the autonomy of the parental project. This contrasts with innovative and enlarged family dynamics developed by gay couples, who integrate both female figures (surrogate and oocyte donor) in their children’s family history, through bonding efforts in a logic of reciprocity (gift and counter-gift). The purpose is to reject the negative image of a woman’s body being commodified while preserving the natural appearance of procreation. I conclude that a naturalist conception of kinship persists —one based on shared biogenetic substances that bind together one parent and the donor-conceived child— along with the centrality of biological processes such as pregnancy and childbirth. There are different ways of easing tensions inherent to the contractual intervention of third parties in the reproductive process. ART re-elaborates the line of demarcation between commodities and gifts and between living things and human beings, while reconfiguring family concepts.

A comparison of response in the presence or absence of a delay in induction therapy with bortezomib, lenalidomide, and dexamethasone

2018 ◽  
Vol 25 (7) ◽  
pp. 1692-1698 ◽  
Author(s):  
Allison J Schepers ◽  
Alexis R Jones ◽  
Brandi N Reeves ◽  
Sascha A Tuchman ◽  
Jill S Bates
Keyword(s):  
Induction Therapy ◽  
Response Rate ◽  
Medical Center ◽  
Reproductive Potential ◽  
The United States ◽  
Delay Group ◽  
Primary Objective ◽  
Third Party ◽  
Mean Delay ◽  
Risk Patients

Purpose Lenalidomide, bortezomib, and dexamethasone (RVd) has emerged as a preferred induction therapy in multiple myeloma (MM) in the United States. Due to lenalidomide's teratogenic risk, patients and prescribers must comply with a risk evaluation and mitigation strategy (REMS) program. The REMS program limits dispensing to certain third-party specialty pharmacies, whose average prescription fill times are longer than in-house specialty pharmacies. In practice, a delay in procurement of lenalidomide may mean that patients start therapy with only bortezomib and dexamethasone, delaying the start of more effective triplet therapy. The primary objective of this study is to determine if a delay from start of bortezomib and dexamethasone to start of triplet therapy with lenalidomide impacts rate of achievement of very good partial response (VGPR) after four cycles of RVd. Methods This was a single-center retrospective review of adults with newly diagnosed MM who received RVd induction therapy at University of North Carolina Medical Center between April 2014 and June 2017. Patients who started lenalidomide ≥10 days after bortezomib comprised the “Delay” group, while those who started lenalidomide concurrently with bortezomib or within 1–9 days after bortezomib comprised the “No Delay” group. The primary outcome was VGPR or better response rate after four cycles of RVd. Results Thirty-eight patients met inclusion criteria. Nine patients (23.7%) experienced any delay in initiation of lenalidomide, with a mean delay of 7.8 days (range 1–18). Four patients (10.5%) experienced a delay ≥10 days. No patients in the Delay group were of reproductive potential, compared to 8.8% in the No Delay group ( p = 0.54). VGPR or better response rate did not differ between the Delay and No Delay groups (66.7% vs. 58.8%, p = 0.79). The mean number of lenalidomide prescriptions generated per RVd cycle was 1.35 (range 1–5, SD 0.74). Conclusions This study did not demonstrate an effect on clinical response after delays ≥10 days between bortezomib and lenalidomide initiation. No patients in the delay group were females of reproductive potential, which is the primary target for increased safety behind the REMS program.

REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY

2021 ◽  
pp. 41-48
Author(s):  
Spiridenko G.Yu. ◽  
Petrov Yu.A. ◽  
Palieva N.V.
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Assisted Reproductive Technologies ◽  
Hormone Replacement ◽  
Reproductive Potential ◽  
Reproductive Technologies ◽  
Pathological Process ◽  
Reproductive Age ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.

154 A method of oviductal semen deposition for use in the goat

2020 ◽  
Vol 32 (2) ◽  
pp. 203
Author(s):  
N. Buzzell ◽  
S. Blash ◽  
K. Miner ◽  
M. Schofield ◽  
J. Pollock ◽  
...  
Keyword(s):  
Assisted Reproductive Technologies ◽  
Sperm Quality ◽  
Sperm Concentration ◽  
The United States ◽  
Reproductive Technologies ◽  
Poor Quality ◽  
Implant Removal ◽  
Suitable Alternative ◽  
Midline Laparotomy ◽  
Post Surgery

The objective of this study was to investigate a method of oviducal semen deposition as a strategy for producing offspring from poor-quality cryopreserved goat sperm. Invitro fertilisation (IVF) and AI are common assisted reproductive technologies used in small ruminants, but they have varied results in the goat. The use of poor-quality cryopreserved-thawed sperm (<50% live/dead ratio at post-thaw) can decrease the rate of success. These procedures were performed in the month of November in Central Massachusetts in the United States (42° N). Seven 10-year-old dairy goats (Saanen, Toggenburg, and Alpine breeds) were synchronised and superovulated using a progesterone implant on Day 0, a prostaglandin injection at Day 7, two daily injections of 36mg of FSH ~12h apart on Days 12-15, and progesterone implant removal on Day 14 followed by an injection of 50µg of gonadotrophin-releasing hormone. Sperm deposition was performed on Day 17 (72 h after implant removal). The animals were anaesthetised using a standardised protocol, intubated, and maintained using isoflurane, and sterile prep was performed before a midline laparotomy procedure. Straws from a single ejaculate from a transgenic founder that was cryopreserved using a commercial two-step glycerol-egg yolk-based extender were used. A straw from this collection was post-thawed 30 days after collection and, using a commercial live/dead stain, 67% live sperm was determined. The optimal type of sperm prep and sperm concentration is unknown and may be dependent on sperm quality. Therefore, different gradient preps using Vitrolife SpermGrad at three volumes (1.5 (used on two animals), 1.0, and 0.5mL) as well as two volumes of IVF Bioscience Bovine BO-SemenPrep (4.0mL (used on two animals) and 2.0mL) were used. All five pellets were diluted in 1.0mL of IVF Bioscience Bovine BO-IVF media. Sperm concentrations ranging from 75×106 to 27×106 spermmL−1 were deposited into one oviduct; then, a 10:1 dilution was performed and 7.5×106 to 2.7×10 spermmL−1 were deposited into the contralateral oviduct. The depositions were performed just proximal to the uterotubal junction in a volume of 0.1mL of diluent via a tuberculin syringe attached to a 20-gauge needle. Two days following the procedure, oviducts were flushed postmortem from three of the seven randomly selected goats. All three had fertilised embryos, and nineteen 8-cell embryos were retrieved. Three of these embryos were surgically transferred to the distal uterine horn of a suitable recipient. The recipient became pregnant and produced a single offspring. The remaining four of seven goats were killed 41 days post-surgery. Two of the four goats were pregnant, with one carrying one fetus and the other carrying five fetuses. Further studies are needed to optimise this method, but these initial results indicate that oviducal semen deposition directly into the oviduct proximal to the uterotubal junction may be a suitable alternative for producing offspring from suboptimal cryopreserved-thawed goat sperm.

scholarly journals Is Information Power? Comparing Anonymous and Open Egg Donation

2017 ◽  
Vol 22 (2) ◽  
pp. 130-141 ◽  
Author(s):  
Amy Speier
Keyword(s):  
United States ◽  
Czech Republic ◽  
Assisted Reproductive Technologies ◽  
The United States ◽  
Reproductive Technologies ◽  
Fertility Treatment ◽  
Egg Donation ◽  
Gamete Donation ◽  
The Czech Republic ◽  
Egg Donor

Both the Czech Republic and the United States are destinations for cross-border reproductive travellers. For North Americans, including Canadians, who opt to travel to the Czech Republic for IVF using an egg donor, they are entering a fertility industry that is anonymous. This makes the Czech Republic different from other European countries that necessitate open gamete donation, as in Austria, Germany and the United Kingdom. For reproductive travellers coming to the United States for fertility treatment, there is a wider menu of choices regarding egg donation given the vastly unregulated nature of the industry. More recently, professionals in the industry are pushing for ‘open’ egg donation. For intended parents traveling to either location seeking in vitro fertilization using an egg donor, they must choose whether or not to pursue open or closed donation. As pre-conception parents, they navigate competing discourses of healthy parenting of donor-conceived offspring. They must be reflexive about their choices, and protective when weighing their options, always keeping their future child's mental, physical and genetic health in mind. Drawing from ethnographic data collected over the course of six years in the United States and the Czech Republic, this paper will explore both programs, paying special attention to the question of how gamete donation and global assisted reproductive technologies intersect with different notions about healthy pre-conception parenting.

The Affordable Care Act and assisted reproductive technology use

2015 ◽  
Vol 34 (2) ◽  
pp. 71-90 ◽  
Author(s):  
Patricia Stapleton ◽  
Daniel Skinner
Keyword(s):  
Affordable Care Act ◽  
Technology Use ◽  
Assisted Reproductive Technologies ◽  
Insurance Coverage ◽  
The United States ◽  
Reproductive Technologies ◽  
Gender And Sexuality ◽  
Insurance Markets ◽  
The Affordable Care Act ◽  
American Society

The Affordable Care Act (ACA) has prompted numerous gender and sexuality controversies. We describe and analyze those involving assisted reproductive technologies (ART). ART in the United States has been regulated in piecemeal fashion, with oversight primarily by individual states. While leaving state authority largely intact, the ACA federalized key practices by establishing essential health benefits (EHBs) that regulate insurance markets and prohibit insurance-coverage denials based on pre-existing conditions. Whatever their intentions, the ACA’s drafters thus put infertility in a subtly provocative new light clinically, financially, normatively, politically, and culturally. With particular attention to normative and political dynamics embedded in plausible regulatory trajectories, we review—and attempt topreview—the ACA’s effects on infertility-related delivery of health services, on ART utilization, and on reproductive medicine as a factor in American society.

scholarly journals Assisted reproductive technologies: psychoneurological, moral-ethical, and socio-cultural aspects

2020 ◽  
Vol 12 (5) ◽  
pp. 104-110
Author(s):  
N. A. Tyuvina ◽  
A. O. Nikolaevskaya
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Surrogate Mother ◽  
Reproductive Process ◽  
Vitro Fertilization ◽  
Cultural Traditions ◽  
Cultural Aspects ◽  
The One ◽  
The Impact

The paper provides a definition of sexual and reproductive health and infertility and also reflects modern ideas about ways to overcome infertility using assisted reproductive technologies, such as in vitro fertilization (IVF) and surrogacy. It shows the specificity of the impact of an IVF procedure on the mental health of a potential mother. The features of the neonatal health status, as well as neuropsychiatric disorders in babies born using the IVF procedure are described. The authors present two types of surrogacy (traditional and gestational ones) and the features of their use in different countries according to governmental legislative regulation, socioeconomic and religious factors, and cultural traditions in society. They unveil the features of a psychological relationship between the mother (surrogate and presumed one) and the fetus. The consequences of surrogacy for a surrogate mother, genetic parents, and a child himself/herself are noted to be little studied. It is shown that the development of assisted reproductive technologies (IVF and surrogacy), on the one hand, helps fight infertility and, on the other hand, entails a number of problems (moral and ethical, legal, cultural and religious, socioeconomic, and neuropsychiatric ones) that need to be solved in order to prevent psychological, neurological, and mental abnormalities in all the participants (a surrogate mother, an unborn child, and potential parents) in the assisted reproductive process:

scholarly journals Legal Responsibility for Abuses and Crimes in the Field of Artificial Human Reproduction

Lex Russica ◽  
2019 ◽  
pp. 48-52
Author(s):  
N. V. Kruchinina
Keyword(s):  
Human Rights ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Human Reproduction ◽  
Legal Responsibility ◽  
Human Beings ◽  
Artificial Reproduction ◽  
Forensic Research ◽  
Human Reproductive ◽  
Common Understanding

The article analyzes different points of view concerning reproductive human rights. Every year the number of cases when assisted reproductive technologies are used is increasing in Russia. The author draws attention to the lack of a common understanding of reproductive human rights, their protection and regulation in different countries of the world, to different perceptions of legal responsibility for abuses in the field of artificial reproduction of human beings, and to the existence of different definitions of crime in the field of human reproduction.The article presents an overview of foreign legislation on criminal law protection of human reproductive functions. The study of criminal and civil cases and examination of scientific developments in this area compels the author to admit the existence of abuses and crimes in the field of artificial reproduction of human beings. The article attempts to determine the list of crimes against reproductive human rights and considers them as an object of forensic research.

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