Assisted Reproductive Technology Practitioners Research Articles

Legal and ethical challenges in assisted reproductive technology practice in Ghana.

Infertility remains a global challenge, with assisted reproductive technology (ART) progressively gaining relevance in developing countries, including Ghana. However, associated ethico-legal challenges have not received the needed policy attention. This study explored the legal and ethical challenges of ART practice in Ghana. The study employed an exploratory phenomenological approach to examine ART in Ghana, focusing on ethics and law governing this practice. Respondents were ART practitioners, managers, facility owners, representatives of surrogacy/gamete donor agencies, and regulatory body representatives. A semi-structured interview guide was used to collect data.The in-depth interviews were audiotaped, and responses transcribed for analysis through coding, followed by generation of themes and sub-themes, supported with direct quotes. It emerged that there are no ethical and legal frameworks for ART practice in Ghana, and this adversely affects ART practice. Ethical challenges identified border on informed consent, clients' privacy and clinical data protection, gamete donation issues, multiple gestations, single parenting, and social and religious issues. The legal challenges identified include the non-existence of a legal regime for regulating ART practice and the absence of a professional body with clear-cut guidelines on ART practice. In the absence of legal and ethical frameworks in Ghana, practitioners intimated they do comply with internationally accepted principles and general ethics in medical practice. There are no regulations on ART in Ghana. Legal and ethical guidelines are essential to the provision of safe and successful ART practices to protect providers and users. Governmental efforts to regulate Ghana need to be prioritized. This study had no external funding support. It was funded privately from researchers' contributions.

O-220 Artificial intelligence for embryo selection: ethical, social and regulatory issues

Abstract Study question What are the key ethical, social and regulatory issues raised by artificial intelligence technologies (AI) for embryo selection, and how might these be best managed? Summary answer Key issues with AI for embryo selection include deskilling, transparency, accountability, and fairness. These require attention to improve psychosocial and clinical outcomes in ART. What is known already Artificial intelligence (AI) technologies play a growing role in the assisted reproductive technology (ART) sector. Machine learning holds enormous promise for improving the selection of human embryos for transfer after IVF. Time-lapse imaging in conjunction with machine learning has the potential to standardise and automate embryo selection, improving clinical outcomes. Promising results have recently been published, and AI tools have reached the market. However, ethical and regulatory analysis has not kept pace with the technology. There has been negligible research on the ethical, social, and regulatory issues raised by the use of machine learning methods for embryo selection. Study design, size, duration A terrain-mapping review of the academic literature was performed to identify the key social, ethical and regulatory issues raised by AI for embryo selection. This is part of a multi-method study, collecting qualitative and quantitative data alongside ethical and regulatory analysis.The study is expected to take 1 year. Participants/materials, setting, methods A systematic review of the extant literature on the ethical, social, and regulatory issues raised by machine learning for embryo selection, combined with a narrative review of the broader literature on the use of AI in healthcare was undertaken. This review of ethical and regulatory issues will ultimately combine with data from semi-structured interviews and an online survey of ART patients and practitioners, including fertility specialists and embryologists, and ART regulators in Australia. Main results and the role of chance This paper reports on ethical and regulatory analysis of key issues that emerge from the use of AI for embryo selection. The use of AI in healthcare generally has raised serious concerns about deskilling and ‘dehumanization’(as roles traditionally performed by humans are displaced by technology), transparency, accountability, and fairness. This paper examines these issues in the ART context, to begin to develop guidance on how to best implement this technology in ways that balances the interests of all stakeholders and is consistent with maintaining public trust in the field of ART. Limitations, reasons for caution It is anticipated that much of the analysis of the social, ethical and regulatory issues will be generalisable internationally. However, the study prioritises one context - that of Australia. Some features of the Australian context may limit generalisability. Wider implications of the findings There is a need to address the ethical, social and regulatory issues that arise with the emergence of innovative technologies within ART to maintain public trust and ensure that psychosocial and clinical outcomes are improved. Further data collection on stakeholder views of machine learning for embryo selection will be required. Trial registration number Not applicable

Attitudes toward posthumous assisted reproduction in China: a multi-dimensional survey

BackgroundProfessional legislation and ethics guidelines for posthumous assisted reproduction (PAR) are lacking in China. This study aims to measure the attitudes of the general public, IVF couples, and assisted reproductive technology (ART) practitioners toward PAR in China.MethodsA multi-dimensional survey was designed, and electronic questionnaires were used. General demographic data, reproductive viewpoints, attitudes toward PAR, interactive ability to predict the partner’s attitude toward PAR, and the legal attributes and rights to the disposal of posthumous embryos were evaluated.ResultsThe study found that the traditional Chinese viewpoints of fertility had changed. The approval rates for PAR were 79.10%, 55.32%, and 58.89%, in the general public, IVF couples, and ART practitioners, respectively. Most participants agreed that the psychological well-being of offspring should be previously considered before making a PAR decision (81.84%, 73.61%, and 76.98%, respectively). Multivariable logistic regression analysis showed that age, marital status, and gender were common influencing factors, while occupation, religion, and pregnancy history showed no influence on support for PAR. Males and females showed similar predictive abilities for their partners’ attitudes toward PAR (57.87% for males, 61.12% for females). Intracouple agreement analysis showed that the consistent rate of consistency in attitudes toward PAR was 65.28%.ConclusionThe findings suggested that the approval rate of PAR was relatively high in China. Legislation and ethics guidelines for PAR may be considered in China. The psychological well-being of offspring should be considered before the implementation of PAR. Due to the very large regional and demographic differences in China, investigation of a larger samples of participants is necessary.

Pregnancy Rate after Embryo Transfer on Day 5 and Day 6 in IVF. A Systematic Review and Meta-Analysis

Study Question: The question: is there any difference in pregnancy rate between embryo transfer day 5 and day 6 in IVF? What Is Known Already? Blastocyst transfer is increasingly popular in assisted reproductive technology (ART) centers today. Very few articles concentrate on comparing Day 5 and Day 6 embryo transfer with conflict results. Objective, Study Design: Systematic review and meta-analysis of published controlled studies. Searches conducted from 2001-2020 on PubMed. Medline, EMBASE, and ISI Web of Science Electronic database is used to collect data, using the following search terms: blastocyst, Day 5, Day 6, embryo transfer (E.T.) and pregnancy rate. Materials, Setting, Methods: A total of 6 full-text articles preselected from 211 references, based on title and abstract. Two independent reviewers performed data selection and extraction according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). This systematic review was conducted according to (PICO) standard. Random-effect meta-analysis performed on all data (overall analysis). Results and the Role of Chance: Data from 6 relevant articles were extracted and integrated into the meta-analysis that reported clinical pregnancy rate (CPR) as an outcome in 5640 cycles, 2274 cycle had embryo transfer at day 6 and the control was 3366 cycle had embryo transfer day 5 showed a significantly higher clinical pregnancy rate following Day 5 embryo transfer compared with Day 6 embryo transfer with odd ratio and 95% confidence limit 0.73 (0.66 - 0.82) p value < 0.000. Sensitivity analysis led to similar results and conclusions. Limitations, Reasons for Caution: The validity of meta-analysis results depends mainly on the quality and the number of published studies available. Indeed, this meta-analysis included no randomized controlled trial (RCT). Wider Implications of the Findings: In regards to the results of this original meta-analysis, ART practitioners should preferably transfer D5 rather than D6 blastocysts. Further RCTs are needed to address the question of whether D6 embryos should be transported.

Well-informed by national registers? A comparison of national ART registers in Germany, France and the United Kingdom

Objectives: National registers which document assisted reproductive technology (ART) treatments are important for a range of stakeholders. Their websites and reports are a source of information for ART practitioners, (future) patients and the public. The aim of our study was to compare national ART registers in the three European countries with the largest populations and evaluate whether ART registers currently meet the information needs of the different groups.Methods: We compared the publications of national registers in three European countries (the United Kingdom, France and Germany) with diverse regulatory approaches. Our analysis focused on two criteria: data quality and patient orientation.Results: Our findings suggest that the German and French registers’ publications fulfil the criteria to a lesser degree than the British register publications, by collecting data that are likely to be less accurate and publishing less information specifically targeted at patients.Conclusions: Differences in the publications and the data collection methods of the three registers impact the opportunities of various stakeholders to access information about ART from their respective national registers.

Regulation of assisted reproductive technologies in the United States

The regulation of any social activity is a complex activity, and perhaps this is no more so than in medicine where the interests of patients, profes sionals, society, and government can be in conflict. A special area of regula tory concern involves assisted reproductive technologies (ART), which are medical procedures involving the laboratory manipulation of gametes (sperm and eggs). In vitro fertilization (IVF) is the most commonly performed ART, whereas other technologies include intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis/screening (PGD/S) and assisted hatching (AH). The use of donor eggs (oocytes) and surrogates (gestational carrier, host uterus) are also considered ART procedures. Donor insemina tion (DI) by itself is generally not considered an ART procedure. Somatic cell nuclear transfer (SCNT) or "cloning" has been classified into thera peutic cloning or the use of SCNT to produce cells and tissues that can be used to treat disease, and is considered appropriate by many people, and reproductive cloning, the use of SCNT to create a genetically "identical" individual, which is considered an inappropriate use of technology by almost everyone. ART technologies are also used to create stem cells for both research and potential therapeutic purposes. Why should these technologies be regulated, what should be regulated, how should it be done, and who should be responsible? These are difficult questions that have been answered differently in many countries and by

Human reproductive cloning and related techniques: an overview of the legal environment and practitioner attitudes.

This study provides an overview of the legal environment and assisted reproductive technology (ART) practitioner attitudes toward human reproductive cloning. A review of the law and a survey of ART practitioners and a comparison group of attorneys were undertaken. Human reproductive cloning has been prohibited in many countries, and may soon be prohibited in others. However, many ART practitioners support its use for limited indications. ART practitioners were surveyed concerning their views on human reproductive cloning and related techniques. A few had considered using or had used embryo splitting or germ cell nuclear transfer. Although they expressed some concerns about the present risk of reproductive cloning, most indicated that it did not violate their religious beliefs. More than three-quarters of ART practitioners responding indicated that they would be willing to provide human reproductive cloning in indicated cases if it were legally permissible to do so. A significant percentage of the group also indicated that they currently have the ability to provide this service.