Implantation Failures and Miscarriages in Frozen Embryo Transfers Timed in Hormone Replacement Cycles (HRT): A Narrative Review

The recent advent of embryo vitrification and its remarkable efficacy has focused interest on the quality of hormone administration for priming frozen embryo transfers (FETs). Products available for progesterone administration have only been tested in fresh assisted reproduction technologies (ARTs) and not in FET. Recently, there have been numerous concordant reports pointing at the inefficacy of vaginal preparations at delivering sufficient progesterone levels in a sizable fraction of FET patients. The options available for coping with these shortcomings of vaginal progesterone include (i) rescue options with the addition of injectable subcutaneous (SC) progesterone at the dose of 25 mg/day administered either solely to women whose circulating progesterone is <10 ng/mL or to all in a combo option and (ii) the exclusive administration of SC progesterone at the dose of 25 mg BID. The wider use of segmented ART accompanied with FET forces hormone replacement regimens used for priming endometrial receptivity to be adjusted in order to optimize ART outcomes.

ART Innovations: Fostering Women’s Psychophysical Health between Bioethics Precepts and Human Rights

Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, however, goes beyond the mere inability to procreate, but brings about profound psychological, social, and ethical implications of enormous magnitude. In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have gradually become widespread therapeutic options. After all, the implementation of medically assisted reproductive procedures in order to overcome infertility is in keeping with the tenets of the reproductive rights agenda laid out at the International Conference on Population and Development (ICPD) in Cairo in 1994. Nonetheless, concerns still linger about how to implement and regulate such interventions in an ethically tenable fashion. The unremitting pace at which such techniques develop have upset the very notion of sexuality relating to reproduction as well as the concept of family itself. That rift risks causing a crisis in terms of bioethics sustainability and enforcement, which is bound to happen when science and innovation outpace the bioethical precepts on which we rely for essential guidance in medical practice. The authors argue in favor of an approach to regulation and policy-making that puts on the forefront a thorough assessment as to potential risks that such interventions might entail for foundational bioethics principles and inalienable human rights.

cAMP Modulators before In Vitro Maturation Decrease DNA Damage and Boost Developmental Potential of Sheep Oocytes

To date, the underlying mechanisms by which cAMP modulators act during in vitro maturation to improve oocyte developmental competence are poorly understood. Here, we sought to fill this knowledge gap by evaluating the use of phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (IBMX) and adenylyl cyclase activator forskolin during a culture period of 2 h before in vitro maturation (pre-IVM) on the nuclear and cytoplasmic maturation features in essential organelles, cumulus cells activity, and in vitro developmental potential of sheep oocytes. Results showed that pre-IVM treatment significantly decreased (p < 0.05) the DNA damage of mature oocytes (pre-IVM = 2.08% ± 3.51% vs. control = 20.58% ± 3.51%) and increased (p ≤ 0.05) expanded blastocyst rates compared to the control (from the total of oocytes: pre-IVM = 23.89% ± 1.47% vs. control = 18.22% ± 1.47%, and from the cleaved embryos: pre-IVM = 45.16% ± 1.73% vs. control = 32.88% ± 1.73%). Considering that oocytes are highly vulnerable to the accumulation of DNA damage because of exposure to in vitro culture conditions, our results suggest that the modulation of intra-oocyte cAMP levels with forskolin and IBMX before IVM might afford oocytes a more effective DNA repair mechanism to overcome damage obstacles and ultimately improve developmental competence. This previously unappreciated action of cAMP modulators could help to develop improved methods for assisted reproduction technologies in animal and clinical research.

Contextualizing Autophagy during Gametogenesis and Preimplantation Embryonic Development

Mammals face environmental stressors throughout their lifespan, which may jeopardize cellular homeostasis. Hence, these organisms have acquired mechanisms to cope with stressors by sensing, repairing the damage, and reallocating resources to increase the odds of long-term survival. Autophagy is a pro-survival lysosome-mediated cytoplasm degradation pathway for organelle and macromolecule recycling. Furthermore, autophagy efflux increases, and this pathway becomes idiosyncratic depending upon developmental and environmental contexts. Mammalian germ cells and preimplantation embryos are attractive models for dissecting autophagy due to their metastable phenotypes during differentiation and exposure to varying environmental cues. The aim of this review is to explore autophagy during mammalian gametogenesis, fertilization and preimplantation embryonic development by contemplating its physiological role during development, under key stressors, and within the scope of assisted reproduction technologies.

Assisted reproductive technologies: correlation between public law and private law principles

The object of this research is the correlation between public law and private law principles in the context regulation of the use of assisted reproductive technologies in the Russian Federation and the Republic of Tajikistan. The subject of this research is the norms of the Russian and Tajik legislation that regulates the procedure of using assisted reproduction technologies, as well as public law and private law principles of their regulation. The scientific novelty of this work lies in carrying out a comprehensive analysis of the relevant problematic on correlation between public law and private law principles in the context of regulation of the use of assisted reproductive technologies in the Russian Federation and the Republic of Tajikistan (taking into account the contradiction and conflicts of law of these legal relations). The author&rsquo;s special contribution lies formulation of the original proposals for the progressive solution to the problem of correlation between public law and private law principles in regulation of the use of assisted reproductive technologies in the territory of the Russian Federation and the Republic of Tajikistan.

In the quest of a novel BTI (bio-technical identity) Beyond the ontology of the human person

The intuitions and imagination of human visionaries about the infinite possibilities of scientific research and technology are creatively haunting the quest of our species to expand knowledge in the micro-cosmos and the vast space. Since 19th century French writer Jules Verne (1828-1905) and English writer Mary Shelley (1797-1851) had already traced the path to our days and beyond.They were followed by an infinite series of great intuitionists, who were not mere futurists like H.G. Wells, Ray Bradbury, Aldous Huxley, George Orwell, Isaac Asimov, Arthur Clarke, John Brunner and many more. Scientific endeavors and achievements transform the qualities of life and foster social institutions in various ways. The paper deals with a prevailing technological phenomenon, the scientific capacity of gene-editing, promoting thus the emergence of a virtual novel identity. The new achievements in sciences encourage the expression of human free-will allowing for physical and other enhancements or alterations, in reference to biological and technological features that may lead to a new bio-techno-identity (let us call it BTI). The paper reflects on the issue of “enhancing” the established concepts for defining a human being and a human person; it also puts forward the possibility of conducting a theoretical and field researchexamining -and evaluating- the issue and the mechanisms of BTI formation,reassessing all traditional qualities and novel characteristics attributed to humans by the applications of Biotechnology.The issue is eventually approached under the standpoints of Ethical Philosophy, Sociology, Biology, Orthodox Theology and Law. The analysis discusses intuitions in sci-fi literature and cinematography in comparison to reality i.e. the multitude of assisted reproduction technologies, embryonic and genetic labs, implants and even cloning in Western Societies.