Advanced Reproductive Technologies Research Articles

Crocodilian perivitelline membrane-bound sperm detection.

Advanced reproductive technologies (ART's) are often employed with various taxa to enhance captive breeding programs and maintain genetic diversity. Perivitelline membrane-bound (PVM-bound) sperm detection has previously been demonstrated in avian and chelonian species as a useful technique for breeding management. In the absence of embryotic development within an egg, this technique can detect the presence of sperm trapped on the oocyte membrane confirming breeding, male reproductive status, and pair compatibility. PVM-bound sperm were successfully detected in three clutches of Cuban crocodile (Crocodylus rhombifer) eggs at the Smithsonian's National Zoological Park (NZP) for the first time in any crocodilian species. PVM-bound sperm were detected in fresh and incubated C. rhombifer eggs, as well as eggs that were developing (banded) and those that were not (not banded). The results of this study showed significant differences in average sperm densities per egg between clutches (p = 0.001). Additionally, there was not a significant difference within clutches between eggs that banded and those that did not band (Clutch A, p = 0.505; Clutch B, p = 0.665; Clutch C, p = 0.266). The results of this study demonstrate the necessity to microscopically examine eggs that do not develop (do not band), to determine if sperm is present, which can help animal managers problem solve reproductive shortcomings. PVM-bound sperm detection could be a useful technique in assessing crocodilian breeding programs, as well as have potential uses in studies assessing sperm storage, artificial insemination, and artificial incubation.

Identification of potential biomarkers in donor cows for in vitro embryo production by granulosa cell transcriptomics.

The Ovum Pick Up-In vitro Production (OPU-IVP) of embryos is an advanced reproductive technology used in cattle production but the complex biological mechanisms behind IVP outcomes are not fully understood. In this study we sequenced RNA of granulosa cells collected from Holstein cows at oocyte aspiration prior to IVP, to identify candidate genes and biological mechanisms for favourable IVP-related traits in donor cows where IVP was performed separately for each animal. We identified 56 genes significantly associated with IVP scores (BL rate, kinetic and morphology). Among these, BEX2, HEY2, RGN, TNFAIP6 and TXNDC11 were negatively associated while Mx1 and STC1 were positively associated with all IVP scores. Functional analysis highlighted a wide range of biological mechanisms including apoptosis, cell development and proliferation and four key upstream regulators (COX2, IL1, PRL, TRIM24) involved in these mechanisms. We found a range of evidence that good IVP outcome is positively correlated with early follicular atresia. Furthermore we showed that high genetic index bulls can be used in breeding without reducing the IVP performances. These findings can contribute to the development of biomarkers from follicular fluid content and to improving Genomic Selection (GS) methods that utilize functional information in cattle breeding, allowing a widespread large scale application of GS-IVP.

41 THE EFFECT OF ULTRARAPID VITRIFICATION FOR SHEEP OOCYTE VIABILITY

Advances in reproduction technologies, such as in vitro maturation, IVF, and in vitro culture, have stimulated research for efficient cryopreservation techniques for mammalian oocytes. It is well known that the oocyte is the largest cell of an animal’s body and as such, is full of water and, in many species, fat, making it difficult to cryopreserve. The objective of this work was to study the effect of vitrification for cryopreservation of the metaphase II plate (MPII) of sheep oocytes. In our experiment, we used the Vit-Master™ (MTG, Bruckberg, Germany). Ovaries from 19 ewes of Kazakh Arkharo-Merino breed were acquired after slaughter and maintained at 37°C in TCM-199. The maturation medium was TCM-199, containing 1 mM of glutamine, 10% fetal bovine serum, 5 μg mL−1 FSH, 5 μg mL−1 LH, 1 μg mL−1 oestradiol, 0.3 mM sodium pyruvate, and 100 mM cysteamine. The oocytes were incubated in 400 μL of medium in 4-well dishes covered with mineral oil. The IVM conditions were 5% CO2 in humidified air at 39°C for 24 h. Then, oocytes were placed for 10 min in medium with Hoechst 33342 (3 μg mL−1) and cytochalasin B (7 μg mL−1) to facilitate enucleation of the MPII with a minimum volume of ooplasm. The MPII plates were divided into 2 groups: the vitrification group was exposed to vitrification media containing 1.12 M ethylene glycol (ET) + 0.87 M ME2SO for 5 min and was exposed in vitrification media containing 2.24 M ET + 1.75 M ME2SO for 5 min, and then in vitrification solution containing 4.48 M ET + 40% ME2SO + 0.25 M sucrose for 30 s. Oocytes were loaded into a cryoloop and using negative pressure of liquid nitrogen in the chamber for freezing with the VIT-Master. Oocytes were thawed in a 25°C water bath and then placed in TCM-199 at 20% fetal bovine serum. After 15 min of incubation, the oocytes were activated for extrusion of the second polar body in 1 mg mL−1 Ca ionophore for 5 min and washed for 5 min followed by 4 h in 6-DMAP (0.12 mM) + cycloheximide (0.6 μg mL−1). After activation, the MPII were washed and cultured for 20 h. The control group received the same treatment but were not vitrified. Differences between the experimental groups were tested using Chi-squared test. Our research showed that expulsion of the second polar body after activation was observed in more than 59.7% of the MPII that were not vitrified (control group), whereas 37.7% of vitrified plates had expulsion of polar bodies (P < 0.05). These preliminary studies showed that it is possible to vitrify MPII plates. On the other hand, the drastic reduction of the volume of the sheep oocytes might make cryopreservation possible with greater efficiency.

Ovulation, fertilization and preimplantation embryonic development in raccoon dogs (Nyctereutes procyonoides)

A study involving 32 sexual mature females was conducted to characterize ovulation, fertilization and early embryonic development in vivo in raccoon dogs. Oocytes and embryos were collected from the oviducts and uteri, evaluated by stereomicroscopy. Ovulation occurred 25–32h after a female first accepted mounting, regardless of copulation, when the females were paired with a male in the same cage. Ovulated oocytes were at the primary stage. The number of ovulated eggs in females with or without mating was 9.96±2.65 and 9.00±1.92, respectively. Embryos at 2–4 cell, 8–16 cell, morula, blastocyst, and hatched blastocyst stage were observed at 29–73, 48–100, 98–126, 169–198 and 217–268h after first mating, respectively. Embryos were located in the oviduct prior to 4-cell stage and moved into the uterus after 16-cell stage. Embryos at different stages were often obtained from the same female. During the zygote underwent a series of cleavage divisions, the diameter of the embryo cell mass continuously increased through the 2-cell and 4-cell stage, then started to decrease and was the minimum size at the morula stage. At the blastocyst stage, embryos increased in volume, and finally developed into a hatching blastocyst with a thinner zona pellucida. This is the first full report of preimplantation embryonic development in the raccoon dog, which will facilitate the application of advanced assisted reproductive technology in canine species.

Compassionate Corps: creating access to IVF medications for injured veterans

Implement program to assist wounded Veterans with IVF medications for family building where no coverage or assistance existed. More than 2,000 people who have served in the military have been diagnosed with infertility after suffering from major injuries. However, when active members of the U.S. military and U.S. veterans injured during service are faced with infertility, they become an underserved population. According to law, the Department of Veterans Affairs is prohibited from covering in vitro fertilization treatments for injured veterans, therefore creating a gap in coverage for their fertility benefits and significant cost barriers. In July of 2014 Compassionate Corps launched to raise awareness of fertility coverage gaps and to help alleviate these cost barriers by developing a program tailored for injured U.S. veterans. Compassionate Corps provides IVF stimulation medications at no charge for up to 2 cycles for qualifying applicants. Compassionate Corps is the first patient assistance program to completely eliminate the cost [AD1] of[AD2] fertility medications (Gonal-f, Cetrotide, & Ovidrel) for eligible U.S. Veterans who are infertile due to a service-related injury. • Patient Attested • Patient confirms that he/she/spouse is a medically retired member of the military • Patient submits his/her/spouse's DD-214 and any medical information and records proving the service-related injury • Patient confirms that he/she/spouse has no insurance coverage for the infertility treatments or related medications needed • Physician Attested • Physician confirms that the patient has service-related injuries that have caused infertility • Physician confirms that IUI/OI would be suboptimal or impossible • Physician submits a valid prescription for an eligible drug • Medications Provided • Program is valid for a maximum of 2 cycles per calendar year • Medications are shipped to IVF clinic. To date, more than 80 U.S. veterans have attained access to medications for in vitro fertilization and advanced reproductive technology through the Compassionate Corps program. The Compassionate Corps program was designed and implemented to create access for injured U.S. Veterans who required IVF due to injuries sustained while actively serving in the military. The coverage gap that currently exists creates tremendous financial burdens and barriers to treatment for this very deserving population. The 80 approved applicants were given a chance to build a family because of Compassionate Corps when no other program existed and no legislation had been mandated to protect our heroes who bravely served their country.

The Use of Advanced Reproductive Technologies while Breastfeeding: A Role for in Vitro Maturation

The Use of Advanced Reproductive Technologies while Breastfeeding: A Role for in Vitro Maturation

Applications of Technology for Livestock for Small Holders to Meet Global Food Production

While the Green Revolution greatly changed production of crops worldwide and helped feed over a billion people, improved production of livestock has been more limited across the globe. Modern advances in livestock production have in general only benefitted two groups: large scale livestock producers and consumers in the developed world. In some parts of the world many of the animal production practices have not changed for the last 1000 years and in other regions small holders have benefited only marginally by the scientific advances that now are an integral part of large scale commercial production. However, increased food insecurity and a worldwide food production crisis loom in the future as the most significant scientific challenge facing us in the next 30 years. Expectations are that human population growth will soon go from 7.3 billion to 9.6 billion by 2050, and food production must increase rapidly to meet the demand. These increases must come despite evidence of climate change and limited land and water resources. Whilst there is a perception of over consumption of animal products in the developed world, there are still significant numbers that are undernourished. Animal protein plays a very important role in achieving a balanced diet in the developing world, especially for the adequate nutrition of children. Furthermore, it is expected that significant increased demand for animal source foods will occur especially in the poorer countries of the developing world where most livestock are produced by small holders, but also in countries like China and Brazil which are transforming quickly. Many researchers have touted that modern feeding systems, and the use of advanced reproductive technologies and advanced genetics and genomics will provide solutions to increasing food in the developing world. These opportunities certainly exist, but direction and focus of research, funding issues, human capacity training and training of small holders will all be required for increasing livestock production to satisfy these demands. These activities will need to be embedded within sustainable programs that address implementation from the outset, and benefiting small holder production will be crucial to meeting this challenge.

The Current and Future Uses of Biotechnology in Animal Agriculture

Biotechnologies have been an integral part of improvements in animal genetics, nutrition and health over the past century. Many biotechnologies have become fundamental components of efficient livestock production systems. The genetic improvements that have been enabled by biotechnologies have dramatically decreased the environmental footprint of animal protein production in many parts of the world, and continued innovation is required to address the projected increase in demand for animal products in the future. Breeding programs increasingly utilize a combination of advanced reproductive technologies and genomic tools to accelerate the rate of genetic gain by manipulating components of the breeder’s equation. The use of these biotechnologies and breeding methods has met with little public opposition. In contrast, the use of modern biotechnologies, defined as those that employ the use of in vitro nucleic acid techniques, have been highly controversial, especially those involving the use of genetic engineering. This modern biotechnology distinction is somewhat arbitrary as there are a number of biotechnologies that involve the use of in vitro processes, and many result in genetic modifications that are indistinguishable from the naturally-occurring variation that is the driver of both traditional breeding programs and evolution. A number of useful traits including disease resistance and animal welfare traits have been successfully introduced into various livestock species using both genetic engineering and gene editing techniques. Ultimately these techniques complement the genetic improvement that can be accomplished using traditional selection techniques and, if judged acceptable, offer an opportunity to synergistically accelerate genetic improvement in food animal species.

Synergies between assisted reproduction technologies and functional genomics.

This review, is a synopsis of advanced reproductive technologies in farm animals, including the discussion of their limiting factors as revealed by the study of offspring derived from embryos produced in vitro and through cloning. These studies show that the problems of epigenetic mis-programming, which were reported in the initial stages of assisted reproduction, still persist. The importance of whole-genome analyses, including the methylome and transcriptome, in improving embryo biotechnologies in farm animals, are discussed. Genome editing approaches for the improvement of economically-relevant traits in farm animals are also described. Efficient farm animal embryo biotechnologies, including cloning and the most recent technologies such as genome editing, will effectively complement the latest strategies to accelerate genetic improvement of farm animals.

Menopausal women requesting egg/embryo donation: examining health screening guidelines for assisted reproductive technology.

As more postreproductive women opt to pursue pregnancy with advanced assisted reproductive technologies (ART), the menopausal practitioner will become more involved in counseling, screening, and referral of premenopausal, perimenopausal, and postmenopausal women for these services. This review was conducted with the aim of (1) evaluating ART screening practices as they pertain to postreproductive women, and (2) reviewing the outcomes of ART using oocyte donation in postreproductive women. A total of 950 unique records were found on PubMed, Clinical Key, and Google Scholar. Of these, 252 records were screened for relevance based on their titles and abstracts. With further review of these 252 records, 93 full-text articles were assessed for eligibility, and 63 were excluded based on relevance to our study. Finally, 30 studies were included in our qualitative synthesis. Despite the increasing use of ART in postreproductive women, there are limited guidelines for determining candidacy with regard to maternal health, the most comprehensive of which are the guidelines from the American Society for Reproductive Medicine (ASRM). Although the American Society for Reproductive Medicine guidelines state that healthy women over 50 who are prepared for parenthood are candidates for ART through oocyte donation, they note that older women should be counseled as to the increased obstetric risk associated with advanced maternal age. With aging, particularly for those women who are menopausal and postmenopausal, the woman and her fetus, however, are at risk of increased morbidity and mortality as compared with younger, healthy pregnant women. Because national trends suggest that women are delaying childbearing, the cohort of postreproductive women looking toward ART using donor oocytes as a fertility option will expand and menopausal practitioners will often participate in the ART counseling of these women. Because maternal and fetal morbidity and mortality increase in postmenopausal women who become pregnant through ART, practitioners caring for this cohort should provide input into developing standardized, comprehensive guidelines for this population so that screening is consistent for all older women seeking this intervention and risks are objectively outlined and considered.

Microtubule assembly crucial to bovine embryonic development in assisted reproductive technologies.

Centrosome integrity and microtubule network are crucial to the events around fertilization, including pronuclear development, migration and fusion, and the first mitotic division. The present review highlights the importance of bull spermatozoal centrosomes to function as a microtubule‐organizing center for successful fertilization and the subsequent embryonic development. Spermatozoal centrosomes need to be blended with ooplasmic pericentriolar materials accurately to nucleate and organize the sperm aster. Dysfunction of the spermatozoal centrosomes is associated with fertilization failure, which has been overcome with supplemental stimuli for oocyte activation following intracytoplasmic sperm injection in humans. Even though the spermatozoal centrosomes are functionally intact, abnormal sperm aster formation was frequently observed in vitrified‐warmed bovine oocytes, with delayed pronuclear development and migration. Treatment of the post‐warm oocytes with Rho‐associated coiled‐coil kinase inhibitor or α‐tocopherol inhibited the incidence of the abnormal aster formation, resulting in higher blastocyst yields following in vitro fertilization and culture. Thus, understanding of centrosomal function made it possible to improve the performance of advanced reproductive technologies.

Fertility after two doses of PGF2α concurrently or at 6-hour interval on the day of CIDR removal in 5-day CO-Synch progesterone-based synchronization protocols in beef heifers

Timed artificial insemination protocols in beef cattle are designed to synchronize ovulation in a greater proportion of females while simultaneously achieving acceptable pregnancy rates and a concise calving season. Protocols achieving such goals reduce time and labor associated with estrus detection and make advanced reproductive technologies implementable for beef producers. The objective of the study was to determine the effect of three different PGF2α (PGF) dosage schemes on artificial insemination (AI) pregnancy rates in beef heifers. We hypothesized that two doses of PGF administered concurrently at the time of controlled internal drug release (CIDR) removal would attain similar pregnancy rates compared with two doses given 6-hours apart—one at CIDR removal and the next 6 hours later in the 5-day CO-Synch progesterone-based synchronization protocol. Angus heifers (n = 875) at six locations in Washington, Idaho, and Oregon states were included in this study. Heifers within locations were assigned a body condition score (BCS). All heifers received a CIDR (1.38 g of progesterone) and 100 μg IM of GnRH on Day 0. The CIDRs were removed on Day 5, heifers were randomly allocated to one of three protocol groups: 1PGF (n = 291), received 25 mg IM of dinoprost (PGF); 2CO-PGF (n = 291), received 50 mg IM of dinoprost at CIDR removal, 2PGF (n = 293), received 25 mg IM of dinoprost at CIDR removal, and an additional 25 mg IM of dinoprost 6 hours later. Each heifer was given GnRH (100 μg, IM) and artificially inseminated at 56 hours after CIDR removal. Heifers were examined for pregnancy status between 50 and 70 days after AI to determine time of conception. A mixed-model procedure (PROC GLIMMIX of SAS) was used to evaluate the effect of treatments (1PGF, 2CO-PGF, and 2PGF) on AI pregnancy rates. Models included were treatments, BCS categories (≤5 and >5), and treatment by BCS category interaction. Location (state), handling facilities, handlers, inseminators, and AI sires were included as a random effect in the model. The 2PGF group had greater AI pregnancy rate of 63.6% (185/291), compared with the 2CO-PGF group at 51.9% (151/291) and 1PGF group at 54.9% (161/293; P < 0.001). An AI pregnancy rate of 50% (104/208) was observed for heifers with BCS less than or equal to 5 versus 58.9% (393/667) for heifers with BCS greater than 5 (P < 0.05). Location did not influence the AI pregnancy rate (P > 0.1). In conclusion, beef heifers received two 25-mg doses of PGF at 6-hour interval on Day 5 at CIDR insert removal in a 5-day CO-Synch + CIDR synchronization protocols achieved greater pregnancy compared with heifers received 50 mg of PGF concurrently at CIDR removal.

Consumers’ attitudes about milk quality and fertilization methods in dairy cows in Germany

Major advances in assisted reproductive technologies have improved reproductive efficiency in dairy cattle. However, these developments occurred regardless of the perception of consumers, who often distrust biotechnology in food production. Therefore, the objective of this study was to investigate consumers’ attitudes toward reproductive management practices in dairy cattle. In November 2012, 1,646 participants were interviewed by a commercial market research institute. Participants were selected from all regions and demographic categories to represent the general public in Germany. Seven questions regarding milk-drinking preferences and reproductive technologies were asked in face-to-face interviews. Descriptive statistics and multivariable logistic regression models were used. The majority of people drank milk at least weekly (63%) and found the taste of milk important (60%). Most people perceived advanced reproductive technologies negatively [e.g., the use of sexed semen (53%), embryo transfer (58%), cloning (81%), and hormone treatments to increase fertility (65%)]. Many people lacked basic knowledge about milk production (22% did not know that cows only give milk after calving; 51% did not know that milk naturally contains hormones); however, participants with a high school education, older participants, and those who had concerned themselves with dairy farming were more knowledgeable. Education and providing information might help to inform the public about reproductive management practices in dairy cows.

The Mothership Strikes Back

The Mothership Strikes Back Andrew Parker's The Theorist's Mother, Durham, NC: Duke University Press, 2012I am your mother, Luke, said no Star Wars character ever. While Luke Skywalker negotiates relationships with a succession of father figures (Uncle Owen, Obi-Wan Kenobi, and Yoda) before Darth Vader declares himself to be Luke's true father and hacks off his son's hand with a castrating blow from his phallic lightsaber, Luke's remains obscured in his incestuous romance with Princess Leia, who is ultimately revealed to be his twin sister. Just as it would have been unthinkable for Darth Vader- much less any Jedi Knight-to have been Luke's in the Star Wars universe, when Jacques Derrida was asked, What philosopher would you have liked to be your mother? he responded, It's impossible for me to have any philosopher as a . . . my couldn't be a philosopher. [Switches to French] A philosopher couldn't be my mother (Derrida 2007). Derrida's horrified reaction is used by Andrew Parker as a launching point for his own proposal in The Theorist's Mother, which suggests what unifies the otherwise disparate traditions of critical theory and philosophy from Karl Marx to Jacques Derrida is their troubled relation to (1).With fifty-six pages devoted to notes and a bibliography, the dense but elegant in the other one hundred fourteen pages of this accidental provide both a challenging and pleasurable reading of Jacques Lacan and Gyorgy Lukacs in their roles as legitimate heirs to the traditions fathered by Freud and Marx. Preceding the three main chapters and a coda, the introduction in which Parker lays out his theoretical groundwork is the most compelling portion of the book. While claims to paternity have always been doubtful, those of maternity were assumed to be unambigu- ous until advances in reproductive technology made it possible for motherhood to be split along genetic, biological, and social axes. Because the identity of the has been revealed to be a social construction instead of a biological cornerstone, Parker concludes that such indeterminacy reveals three problems with employing the as a signifier: the distinction of the literal (procreating body) from the figurative (creativity), the relationship of the singular (my mother) to the general (the Mother), and the border between a theorist's life and writing (22-25).More or less corresponding to the three kinds of trouble identified in the introduction, the main chapters of The Theorist's Mother deconstruct the relationship between texts and their supplements-becoming supplements themselves, located both inside and outside of the original texts. If the work of Freud and Marx were to be compared to the Star Wars original trilogy, and the work of Lacan and Lukacs to the Star Wars sequel trilogy, then Parker's book could be viewed as a highly sophisticated form of fan fiction that exposes the assumptions of canonical readings by rereading them from the perspective of a minor character. In the Star Wars sequel, the drama is driven by Chancellor Palpatine's tug-of-war with ObiWan Kenobi over Anakin's loyalty as a disciple; yet the death of Anakin's and his brief romance with Luke's function as fulcrums in the transformations of both Darth Vader's pathology and the political economy of the Star Wars universe. Returning to the universe of The Theorist's Mother, Parker's work tries to locate the role of the Queen as a unif ying agent-both biological and social-in the reproduction of modern theory.In the first main chapter, Parker attempts to ground this project in his own experience by describing his original exploration of the boundary between the mind and the body in a 1985 essay he wrote about his mother's hypochondria. Parker then segues into a discussion of Lacan reading his critics' responses to his earlier work while he was giving his famous seminar on female sexuality. …

The Surrogacy (Regulation) Bill 2016: Pitfalls and challenges ahead

The reproductive environment across the globe has been revolutionized with the advances in assisted reproductive techniques, resulting in ‘Surrogacy’ as one of the most desirable option for infertile couples longing to have a child of their own. In the past, surrogacy arrangements were mostly altruistic deeds confined to close relatives and friends. But, with the introduction of financial arrangements and the official recognition accorded to this type of commercial surrogacy in 2002 it moved beyond the ambit of friends and family and encompassed wider possibilities. The commercialization of surrogacy has raised several ethical, philosophical and legal issues. ‘Fears of black market’, ‘Commoditization of woman and child’, and ‘Exploitation’ are major areas of concern pertaining to commercializing of surrogacy. India consequently emerged as a popular destination for surrogacy arrangements for many foreigners for reasons such as cheap medical facilities advanced reproductive technologies coupled with poor socio-economic conditions and lack of regulatory laws in this regard. A special reference to the ‘baby making’ factory of Gujarat, India in this context is made in the paper. Till now, there were no legal provisions directly dealing with surrogacy except guidelines given by Indian Council for Medical Research, 2006. In 2016, The Surrogacy (Regulation) Bill 2016 was proposed. The implications of outlawing commercial surrogacy via this Bill are being vehemently debated. The paper makes an attempt for the purposes of an academic discussion, to put forth critical issues around surrogacy in light of the provisions of the 2016 Bill and analyzing them vis-a-vis the various parties involved.

Yes, It is Possible.

Human immunodeficiency virus-serodiscordant couples are actively seeking reproductive assistance and often consider or practice unsafe measures to achieve pregnancy. Reproductive issues and concerns unique to these couples need to be addressed before treatment. Assisted reproduction techniques can minimize the risk of infection and complete families associated with serodiscordant couples. Since 1987, more than 4000 published attempts have been reported in which processed spermatozoa from HIV-seropositive men were used to establish pregnancy in HIV-seronegative women. When the female partner is HIV positive, intrauterine insemination (IUI) will suffice in order to prevent horizontal infection. However, when the male partner is HIV positive, a technique developed in Milan over 15years ago, involving sperm washing, is used in order to minimize infection of the healthy partner. Some couples need further treatment, due to inherent infertility, with advanced reproductive technology (ART) procedures, such as IVF or ICSI. Recent innovative approaches such as pre-exposure prophylaxis (PrEP) with antiretroviral drugs may reduce further the susceptibility of the uninfected female partner. Numerous ART centers worldwide treat these couples. Most centers are equipped with separate laboratory space for collecting specimens from infected patients and provide separate storage tanks for freezing infected gametes and embryos in order to protect other patients using the facility. There are no reports of HIV infection of laboratory personnel resulting from processing the gametes/embryos for serodiscordant couples using current laboratory protocols. Cross-contamination of the gametes or embryos of other couples in the same laboratory has also not been reported. The risk is theoretical only, particularly when standard universal precautions are used.

Taming Our Brave New World.

Advances in reproductive technology have already revolutionized our culture in various ways, and future potential developments, particularly in genetics, promise more of the same. The practice of surrogacy threatens to upend the way we understand the family. Germline engineering of human embryos could, among other things, lead to the treatment of genetic diseases hitherto incurable; but the widespread use of such engineering could have broader ramifications for our culture, for better and for worse. Parents may eventually be able to select for desirable traits in their offspring, whether by genetic modification at conception or by choosing to implant one of several genetically profiled embryos. Authors in this issue of The Journal of Medicine and Philosophy address some of the ethical implications of these technological and cultural changes.

Higher-order Multiples

Higher-order multiple gestations have increased since the advent of advanced reproductive technologies. These pregnancies present unique risks to both mothers and fetuses. It is imperative that early diagnosis of chronicity be determined and that proper counseling is performed, so patients understand the risks, evaluation, and management needed.

Sperm Encapsulation from 1985 to Date: Technology Evolution and New Challenges in Swine Reproduction.

In the last 30 years, encapsulation technology has been applied to different species to minimize the loss of spermatozoa after artificial insemination. In particular, the vehiculation of boar sperm cells in barium alginate membrane has proved a valid strategy to reduce the risk of polyspermy and optimize in vivo fertilizing yields. Controlled release of male gametes into the female genital tract has reduced the minimum fertilizing dose of spermatozoa. Notwithstanding these results, encapsulation has not yet reached commercial application, largely due to the additional costs of production. However, encapsulation could be useful in advanced reproductive technology, such as sex sorting, to store sorted boar semen. The controlled release of flow cytometrically sorted spermatozoa could be a promising strategy to reduce the number of cells necessary for each insemination and hence allow the widescale use of sex sorting in this species.

The stillbirth ‘scandal’

The scope of stillbirth has been overlooked by many, few would estimate that in high income countries that, late stillbirths (pregnancies 28 weeks or later) occurs twice as often as death due to HIV/ AIDS; ten times more common than deaths due to Hepatitis B; twice a common as deaths due to congenital anomalies; twice as common as deaths due to preterm complications, and ten times more common that Sudden Infant Deaths (SIDS) [1]. Perinatal audit is the key to identifying potentially modifiable factors that contribute to stillbirth: higher than expected intrapartum deaths should trigger a review of labor and delivery procedures; higher than expected number of losses of multiples should trigger a review of advanced reproductive technologies services [2]. Stillbirth prevention strategies in developed countries do share some similarities to those in developing countries, for example ensuring that poor and less educated women have access to contraception, timely access to good prenatal care. The most demonstrable effect of early prenatal care is the accurate dating of the pregnancy, screening for infection and the prenatal screening for chromosomal and congenital anomalies. In a setting where there is the availability of abortion for affected pregnancies, the number of stillbirths related to anomalies can be reduced significantly [3]. Suboptimal care has been shown to occur in 10 to 60% of stillbirths in developed countries [2]. The most common errors are failure to identify emerging clinical disorders, (such as fetal growth restriction), failure to use up-dated “best practice protocols”, poor communication or non-compliance of the members of the team (including those responsible to follow up with patients when appointments are missed). By focusing some light on the problem of stillbirth there has evolved a number of new and potentially helpful observations. The appreciation that advanced maternal age, racial minority (specifically within the United States non-Hispanic black status), and severe obesity all are associated with an increased risk of stillbirth after 39 weeks of gestation, providers have the opportunity to either increase fetal surveillance or offer induction, thus treating these women as post-dates sooner than their low risk peers. A program of increasing awareness of the importance of fetal movement as well as the optimal management of decreased fetal movement has been shown to reduce the overall stillbirth rate by 30%. [4]. Other interesting recent observations that may modify stillbirth risk are that that the habit of left-lying during sleep may reduce the risk of late pregnancy [5]; that significant maternal stress has been associated with and increased risk of stillbirth [6], and that the evolution of genetic testing to include the evaluation of microarrays (which detects a single-nucleotide polymorphism or duplications or deletions of 500kb or greater) is more sensitive than standard karyotype to a detect potential cause of stillbirth [7]. Hopefully with on-going research we will develop a greater understanding of the elephant in the room and fewer parents will end up in the “stillbirth club”.