Reproductive justice and inequalities

Towards the global coverage of a unified registry of IVF outcomes.

Ovarian stimulation and intrauterine insemination at the quarter centennial: implications for the multiple births epidemic

Neurodevelopmental or behavioral disorders in children conceived after assisted reproductive technologies: a nationwide cohort study

After completing this article, readers should be able to: 1. Describe the outcomes of assisted reproductive technologies (ART) for singleton, twin, and other multiple births. 2. Describe the role of fertility in adverse outcomes seen with ART births. 3. Review the association of birth defects with ART. 4. Delineate the association of disease of genomic imprinting with ART. 5. Describe the relationship between ART and the subsequent incidence of neurodevelopmental sequelae. In the 1977 ruling “Carey v. Population Services International,” the United States Supreme Court ruled that the decision to bear children is constitutionally protected. (1) Significant interest already had been shown in the development and improvements of in vitro fertilization (IVF) for infertile couples. The first human pregnancy and human birth using IVF were reported by Steptoe and Edwards in the United Kingdom. (2) Their work resulted in the first baby born via reproductive technologies, Louise Brown, born on July 25, 1978, at Oldham General Hospital in Oldham, United Kingdom. (3) She was born via a planned cesarean section, and her birthweight was 2.61 kg. The first successful viable IVF in the United States was performed by Jones and Seager-Jones in 1981 in Norfolk, Virginia. (4) Assisted reproductive technologies (ART) have seen a recent surge in popularity. The Centers for Disease Control and Prevention (CDC) reported that 122,872 cycles of ART were initiated in 2003, resulting in the delivery of 48,756 neonates, (5) accounting for approximately 1% of all neonates delivered in the United States. The percentage is higher in many countries, including Denmark, where it is estimated that 5% of all deliveries are with the assistance of ART. (6) Couples pursue ART for myriad reasons, including tubal transport factors, ovulatory dysfunction, uterine factors, endometriosis, male- and female-specific factors, and when a cause of infertility is unknown. (5) It would be very …

The effect of infertility and assisted reproduction on first-trimester placental and fetal development

BackgroundAdvancements in assisted reproductive technologies (ART) and policy development have enabled more people to have biologically related children in Canada. However, as ART continues to focus on infertility and low fertility of heterosexual couples, ART access and research has been uneven towards meeting the reproductive needs of lesbian, gay, bisexual, transgender, queer, two-spirit, intersex, and asexual (LGBTQ2SIA +) people. Furthermore, experiences of reproduction are impacted by intersectional lived realities of race, gender, sexuality, and class. This commentary utilizes a reproductive justice (RJ) framework to consider reproductive access for LGBTQ2SIA + Black, Indigenous, and people of colour (BIPOC), while simultaneously engaging through a critical lens RJ has on ART. An RJ framework considers the constitutive elements of reproductive capacity and decision making that are not often at the forefront of reproductive health discussions. Additionally, this commentary discusses reproductive rights violations and reproductive violence such as coerced and forced sterilizations that have and are currently occurring in Canada. This article considers systems of access and structures of regulation that seek to control the reproductive capacities of marginalized communities, while empowering accessibility and upholding white supremacy and heteronormativity. In thinking through research and access in ART, who are ART users and whose reproduction is centered in research and access in Canada?ConclusionA reproductive justice framework is urgently needed to address inequities of sexual and reproductive health access in Canada.

Aim: to study immunogenetic patterns of couples who have appealed to assisted reproductive technologies (ARTs). Patients and Methods: HLA class II typing was performed in 345 couples with different outcomes of ARTs, i.e., ineffective in vitro fertilization (IVF) or intrauterine insemination (IUI), and missed miscarriage after IVF. Inclusion criteria were primary or secondary ART implantation failures. HLA class II typing was performed by real-time PCR. In addition, HLA genotypes were investigated in women examined for female infertility (ICD-10 cone N97) and men examined for urogenital infections plus spermogram, MAR test, and assessment of AZF deletions. All participants were divided into five groups of pairs based on obstetric and gynecologic history, i.e., one failed IVF attempt (n=100), two failed IVF attempts (n=64), three or more failed IVF attempts (n=87), ineffective IUI (n=48), and missed miscarriage after IVF (n=10). The comparision group included 36 couples with one or more childbirths after ARTs. Results: ART efficacy depends on the HLA genotypes of couples. In women, DQA1*01:02 is associated with IVF failure. In men, DQA1*01:01 is associated with failed ART, and DQA1*05:01 is associated with childbirth after ARTs. In men, DRB1*11 favors effective IUI. DQB1*03:03 in women and DRB1*01, DQA1*01:01, and DQB1*05:01 in men predispose to missed miscarriages after IVF and IUI. In men, DQB1*02:01 contributes to childbirths after ARTs. The outcomes of IVF and IUI are not related to husband-wife matching for HLA class II alleles. Conclusion: HLA class II typing is crucial for diagnosing infertility when using assisted reproductive technologies. KEYWORDS: infertility, in vitro fertilization, alleles, genes, HLA. FOR CITATION: Zagarskikh A.N., Butina E.V., Zaytseva G.A. HLA class II alleles in couples with failed ART attempts. Russian Journal of Woman and Child Health. 2022;5(1):5–10 (in Russ.). DOI: 10.32364/2618-8430-2022-5-1-5-10.

Severity of prematurity risk in spontaneous and in vitro fertilization twins: does conception mode serve as a risk factor?

LANGUAGE NOTE | Document text in Chinese; abstract also in English.儒家倫理從“天道”的角度賦予人之生命以神聖性和超越性，而輔助生殖技術則通過技術使人之“生命”從神聖性、超越性的形上境遇被拋入到世俗境遇中，生命的“袪魅”成為這一趨勢的集中表現。並由此，引發了“生命”的形上界定和由技術展現世俗化的生命界定之間的矛盾和衝突。儒家倫理為技術干預下的“生命”進行道德辯護的關鍵在於：儒家倫理應以一種辯證、開放的態度為輔助生殖技術展現的世俗化的生命倫理提供形而上學的精神本源基礎。By profoundly intervening in human life, human assisted reproductive technology is challenging the convictions of all well-established ethics, Confucian ethics included. Through such technology, human life is thrown from the divine, transcendent metaphysical situation it has traditionally held into this-worldly circumstances. In particular, human assisted reproductive technology brings with it a series of ethical problems. First, the sanctity of life is put in jeopardy. From this perspective, every human life is unique and independent. However, human assisted reproductive technology has the potential to destroy such uniqueness and independence. Second, human subjectivity is lost. An essential attribute of human life is that humans exist as active subjects to be respected, rather than as passive objects to be manipulated. When human assisted reproductive technology is used to control human life, human subjectivity is thrown into crisis. Finally, the existence of human life is fragmented. Human beings are “group” animals, and they live in families built on the basis of blood and marriage. This basis is usually taken as the origin or foundation of Confucian ethics. However, human assisted reproductive technology (especially AIH and reproductive cloning technology) has broken the traditional family structure. It has caused a crisis in the notion of family as an ethical entity and life becomes nothing but “debris.”In the face of such moral crises, it is time to explore Confucian ethics to help people out of their plight. Traditionally, Confucian ethics has a profound and rich content. It takes human life as valuable, sacred, transcendent and eternal. From the Confucian perspective, human life means not only existence as a natural object, but also existence of value and significance in the universe. In developing a proper Confucian ethics to direct the application of human assisted reproductive technology and guide its technical intervention in human life, this essay argues that we must recognize the following crucial point: a dialectical exploration and an open attitude are needed to enable Confucian ethics to provide the Confucian spirit of metaphysical origins and concerns to a new bioethics of assisted reproductive technology. That is, on the one hand, a bridge must be built to connect the metaphysical condition of real life in Confucian ethics with the technical interference of human assisted reproductive technology. On the other hand, it must be noted that human assisted reproductive technology reveals that the problem domain is not merely a simple technology ethics, but also involves deep philosophical or ethical change. Such exploration provides formal support for considering the ethical problems of human assisted reproductive technology from a comic philosophical view that the Confucian bioethical discourse of life must undertake.DOWNLOAD HISTORY | This article has been downloaded 60 times in Digital Commons before migrating into this platform.

Aging and infertility in women: a committee opinion

ABSTRACTOBJECTIVE:To assess the prevalence of successful assisted reproductive technology and to identify the associated factors.METHODS:This population-based birth cohort study was carried out with 4,333 pregnant women expected to deliver in 2015 in the urban area of Pelotas, Southern Brazil. Use of an assisted reproductive technology procedure, type of assisted reproductive technology [in vitro fertilization or intracytoplasmic sperm injection or artificial insemination], number of embryos transferred, success of embryo transfer, number of attempts, and reported reasons for seeking assisted reproductive technology were the main outcomes measured. Use of an assisted reproductive technology procedure was analyzed according to sociodemographic, nutritional, reproductive history, and behavioral characteristics. Unadjusted and adjusted analyses were performed by logistic regression.RESULTS:Among the 4,275 newborns enrolled in the Pelotas 2015 Birth Cohort Study, 18 births (0.4%) were conceived by assisted reproductive technology. Most cases of assisted reproductive technology were by in vitro fertilization (70.6%). All cycles were performed in private clinics under direct out-of-pocket payment. Even after controlling for confounders, maternal age > 35 years, nulliparity and high family monthly income were strongly associated with assisted reproductive technology.CONCLUSIONS:The use of assisted reproductive technology services was reported by only a few women in the Pelotas 2015 Birth Cohort Study. Our study highlights sociodemographic factors associated to assisted reproductive technology procedures. To better understand the patterns and barriers in overall use of assisted reproductive technology services over time, national-level trend studies in assisted reproductive technology treatments and outcomes, as well as studies exploring the characteristics of women who have sought this kind of treatment are needed in low-middle income countries.

Human assisted reproductive technology (ART) laboratory is the core department of ART implementation. In vitro fertilization-embryo transfer (IVF-ET) is a complex operation process, including the implementation of multiple technologies. The quality of its work is directly related to the success or failure of assisted reproductive treatment. Therefore, it is very important to establish a good quality control system to ensure the quality of ART laboratory work. The quality of ART laboratory is affected by various factors, including environment, equipment, consumables, staffing, in vitro operation, and so on. The establishment of a good quality control system for ATR laboratory and the control, monitoring and improvement of the factors affecting the quality of laboratory work is conducive to ensuring the consistency and stability of the quality of laboratory work, helping the timely discovery and continuous improvement of problems, so as to further optimize clinical treatment outcomes. Key words: Assisted reproductive technology (ART); Laboratory; Quality control system

IVF and increased risk for preeclampsia revisited: a meta-analysis

The slippery slopes of advanced reproductive technologies: Presidential address

Effectiveness and safety of intrauterine insemination vs. assisted reproductive technology: emulating a target trial using an observational database of administrative claims