Direito à Não Discriminação e à Verdade Biológica dos Nascidos por PMA em Portugal e no Brasil

This study discusses issues related to Medically Assisted Procreation, particularly about heterologous artificial insemination – using genetic material from third parties – and “replacement pregnancy” in Portugal and Brazil. Therefore, it addresses the right to “biological truth” for those born by PMA and non-discrimination in the use of genetic material, focusing on respect for the dignity of the human person. It is questioned how advances in science in this area can lead, in the case of PMA, to the choice of “perfect” embryos, and we start from the hypothesis that this leads to “genetic eugenics.” Methodologically, this is an exploratory bibliographical review. According to the Portuguese standard, the PMA has as beneficiaries the hetero couple, the single woman and women who are married or in a de facto union who can even have a “shared pregnancy”, but the “replacement pregnancy” is only done exceptionally and is not donor secrecy allowed. In Brazil, if it is free and with the help of relatives up to the fourth degree, regardless of the peer’s sexual orientation and maintaining the confidentiality of the donor, the “replacement pregnancy” is guaranteed to everyone.

Vasovasostomie robot assistée : résultats sur le spermogramme post-opératoire à 3 mois & la fécondité secondaire à propos de 4 cas

Objective: Evaluation of the efficacy of robotic vasovasostomy post-vasectomy. Patients and methods: We present a retrospective study of four patients aged from 36 to 51 years, who were operated of a vasovasostomy between September 2007 to July 2009. The same surgeon performed a robotic-assisted vasovasostomy, bilateral for three of them and only left unilateral for the last patient who underwent orchidectomy for right testicular seminoma. These patients had a preoperative semen analysis confirmed the absence of sperm after vasectomy. All patients had an outcome of spermatozoa on testicular deferens side in per-operative. The permeability of the distal vas deferens was systematically checked. The success criterion was the presence of spermatozoa in semen control three months. The paternity post vasovasostomy without medically assisted procreation due to father sterility was a secondary endpoint. Results: Four patients had between 0.6 and 27 million sperm per mL in postoperative semen analysis. Three to seventeenth months after the vasovasostomy, the wives of four patients have started a pregnancy between. Conclusion: The robotic vasovasostomy surgery is a technique that enabled this small group of patients having good results in regard to deferential recanalization and to recovery of secondary spontaneous fertility. A larger cohort needs to be evaluated. The medical and economical aspects of this method should be compared to those of usual technics, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

Surrogacy and “Procreative Tourism”. What Does the Future Hold from the Ethical and Legal Perspectives?

Background and objectives: To explore the ethical and legal complexities arising from the controversial issue of surrogacy, particularly in terms of how they affect fundamental rights of children and parents. Surrogacy is a form of medically-assisted procreation (MAP) in which a woman “lends” her uterus to carry out a pregnancy on behalf of a third party. There are pathological conditions, such as uterine agenesis or hysterectomy outcomes, that may prevent prospective mothers from becoming pregnant or carry a pregnancy to term; such patients may consider finding a surrogate mother. Many issues relating to surrogacy remain unresolved, with significant disagreements and controversy within the scientific community and public opinion. There are several factors called into play and multiple parties and stakeholders whose objectives and interests need to somehow be reconciled. First and foremost, the authors contend, it is essential to prioritize and uphold the rights of children born through surrogacy and heterologous MAP. Materials and methods: To draw a parallel between Italy and the rest of the world, the legislation in force in twelve European countries was analyzed, eleven of which are part of the European Union (France, Germany, Italy, Spain, Greece, Netherlands, Belgium, Denmark, Lithuania, Czech Republic and Portugal) and three non-members of the same (United Kingdom, Ukraine and Russia), as well as that of twelve non-European countries considered exemplary (United States, Canada, Australia, India, China, Thailand, Israel, Nigeria and South Africa); in particular, legislative sources and legal databases were drawn upon, in order to draw a comparison with the Italian legislation currently in force and map out the evolution of the Italian case law on the basis of the judgments issued by Italian courts, including the Constitutional and Supreme Courts and the European Court of Human Rights (ECHR); search engines such as PubMed and Google Scholar were also used, by entering the keywords “surrogacy” and “surrogate motherhood”, to find scientific articles concerning assisted reproduction techniques with a close focus on surrogacy. Results: SM is a prohibited and sanctioned practice in Italy; on the other hand, it is allowed in other countries of the world, which leads Italian couples, or couples from other countries where it is banned, to often contact foreign centers in order to undertake a MAP pathway which includes surrogacy; in addition, challenges may arise from the legal status of children born through surrogacy abroad: to date, in most countries, there is no specific legislation aimed at regulating their legal registration and parental status. Conclusion: With reference to the Italian context, despite the scientific and legal evolution on the subject, a legislative intervention aimed at filling the regulatory gaps in terms of heterologous MAP and surrogacy has not yet come to fruition. Considering the possibility of “fertility tourism”, i.e., traveling to countries where the practice is legal, as indeed already happens in a relatively significant number of cases, the current legislation, although integrated by the legal interpretation, does not appear to be effective in avoiding the phenomenon of procreative tourism. Moreover, to overcome some contradictions currently present between law 40 and law 194, it would be appropriate to outline an organic and exhaustive framework of rules, which should take into account the multiplicity of interests at stake, in keeping with a fair and sustainable balance when regulating such practices.

Mater semper certa (non) est. Dylematy dotyczące rodzicielstwa w dobie dostępności technik medycznie wspomaganej prokreacji w poglądach Henryka Ciocha

The availability of medically assisted procreation techniques for some is a boon, giving the opportunity to have their own offspring, for others a threat to natural parenthood. Ethical and philosophical aspects dominate the discussion on the normative shape of artificially assisted procreation treatments and their impact on the relationship between motherhood and fatherhood. When confronted with a specific value system, some of the solutions proposed in this area cannot be approved. Noticing the paradoxical dangers of the progress of medicine, Henryk Cioch strongly opposed the use of the so-called artificial (unnatural) conception techniques. He considered any method of human interference in the process of conception of a child deviating from the natural associating of spouses and serving the creation of a new life to be immoral and therefore unacceptable.