Consequences Of Assisted Reproductive Technology Research Articles

Consequences of assisted reproductive technologies for offspring function in cattle.

Abnormal fetuses, neonates and adult offspring derived by assisted reproductive technologies (ART) have been reported in humans, rodents and domestic animals. The use of ART has also been associated with an increased likelihood of certain adult diseases. These abnormalities may arise as a result of an excess of or missing maternally derived molecules during invitro culture, because the invitro environment is artificial and suboptimal for embryo development. Nonetheless, the success of ART in overcoming infertility or improving livestock genetics is undeniable. Limitations of invitro embryo production (IVEP) in cattle include lower rates of the establishment and maintenance of pregnancy and an increased incidence of neonatal morbidity and mortality. Moreover, recent studies demonstrated long-term effects of IVEP in cattle, including increased postnatal mortality, altered growth and a slight reduction in the performance of adult dairy cows. This review addresses the effects of an altered preimplantation environment on embryo and fetal programming and offspring development. We discuss cellular and molecular responses of the embryo to the maternal environment, how ART may disturb programming, the possible role of epigenetic effects as a mechanism for altered phenotypes and long-term effects of ART that manifest in postnatal life.

Postnatal consequences of assisted reproductive technologies in cattle

Postnatal consequences of assisted reproductive technologies in cattle

Cerebral Sinus Vein Thrombosis Following Ovarian Hyperstimulation: A Case Report

Article type: Case Report Thromboembolic phenomena are the serious consequences of assisted reproductive technology. We present a case of cerebral sinus vein thrombosis (CVST) following ovarian hyper stimulation syndrome (OHSS). Ten days after recovering from OHSS, the patient presented in the emergency department with thunderclap headache. Her Magnetic Resonance Venography (MRV) showed occluded left transverse sinus and left sigmoid sinus. The patient was treated with low molecular weight heparin. She made a good recovery and was independent in activities of daily living in follow up after six months. Disturbances of the coagulation system may occur in moderate OHSS and also persist even after the clinical symptoms of OHSS have resolved.

Twin reversed arterial perfusion sequence is more common than generally accepted.

Approximately 75% of monozygotic twin pregnancies share one monochorionic placenta where placental anastomoses are virtually always present to connect the two fetoplacental circulations. These anastomoses cause several serious complications such as acardiac twinning. Acardiac twins lack a functional heart but nevertheless show fetal growth because the normal pump twin perfuses the acardiac body through arterioarterial (AA) and venovenous (VV) anastomoses. The widely accepted 1% monochorionic acardiac incidence dates back to 1944 and the associated 1:35,000 pregnancies to 1953. Our aim was to update this analysis. We accepted the 1% (actually 1.1%) monochorionic acardiac incidence due to lack of more precise data, included the recently observed 58% early cessation of acardiac development as well as consequences of assisted reproductive technology, and assessed the incidence of acardiac twinning under conditions of AA-VV anastomoses. Early acardiac monochorionic twinning increased from 1.1% to 1.1/(1-0.58) = 2.6%, from 1:35,000 to 1:9,500 to 11,000 pregnancies, depending on number and method of assisted reproductive technology, and occurs in approximately 1:8 AA-VV anastomoses-containing monochorionic placentas. Early acardiac twinning is not a rare event. The 1944-based 1% acardiac monochorionic incidence has a weak basis and could therefore be (much) larger. Knowing this incidence more precisely may contribute to our knowledge of embryonic splitting in unequal cell masses.

‘Emotional rights’, moral reasoning, and Jewish–Arab alliances in the regulation of in-vitro-fertilization in Israel: Theorizing the unexpected consequences of assisted reproductive technologies

Consumption rates of assisted reproductive technologies (ARTs) in Israel is internationally unprecedented, a phenomenon that has been the subject of growing anthropological and sociological attention. Explanations for the singular extent of ARTs use in Israel tend to pre-assume and conceptually prioritize the symbolic and political power of pro-natalist discourses, Jewish religious values, and the demographic interests of the Jewish state. This article attempts to understand the exceptional usage of IVF in Israel in terms of its emergent meanings and unexpected effects in a particular local setup. The question that this article tries to answer is: How is the ‘Israeli character’ of IVF emerges within and through the interactive practice of moral justifications, and how might this medical technology affect the networks within which it is enmeshed? The article is based on a case-study analysis of a public dispute that took place in 2003–2004 over the extent of public funding for fertility treatments. Ethnographic analysis of parliament discussions, media coverage, and an online forum of IVF consumers recorded three frames of justification for the uniquely generous public funding scheme of IVF in Israel: ‘rational-economic’, ‘nationalist’, and ‘liberal’. The latter assumes shared ‘emotional vulnerability’ of all ‘childless’ Israelis, Jews and Arabs alike and advocates a universal language of ‘emotional rights’ and ‘human rights’. This liberal framing of IVF, which is the most persuasive justification in the dispute, blurs dichotomous rivalries between Jews and Arabs and generates a potential for alliances between traditionally rival sectors. These are some of the unexpected and non-intuitive consequences of ARTs in Israel.

The costs and consequences of assisted reproductive technology: an economic perspective

Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding of the economics of ART to inform policy about effective, safe and equitable financing of ART treatment. A review was undertaken of key studies regarding the costs and consequences of ART treatment, specifically examining the direct and indirect costs of treatment, economic drivers of utilization and clinical practice and broader economic consequences of ART-conceived children. The direct costs of ART treatment vary substantially between countries, with the USA standing out as the most expensive. The direct costs generally reflect the costliness of the underlying healthcare system. If unsubsidized, direct costs represent a significant economic burden to patients. The level of affordability of ART treatment is an important driver of utilization, treatment choices, embryo transfer practices and ultimately multiple birth rates. The costs associated with caring for multiple-birth ART infants and their mothers are substantial, reflecting the underlying morbidity associated with such pregnancies. Investment analysis of ART treatment and ART-conceived children indicates that appropriate funding of ART services appears to represent sound fiscal policy. The complex interaction between the cost of ART treatment and how treatments are subsidized in different healthcare settings and for different patient groups has far-reaching consequences for ART utilization, clinical practice and infant outcomes. A greater understanding of the economics of ART is needed to inform policy decisions and to ensure the best possible outcomes from ART treatment.

Progenitor Cells for Regenerative Medicine and Consequences of ART and Cloning-Associated Epimutations

The "holy grail" of regenerative medicine is the identification of an undifferentiated progenitor cell that is pluripotent, patient specific, and ethically unambiguous. Such a progenitor cell must also be able to differentiate into functional, transplantable tissue, while avoiding the risks of immune rejection. With reports detailing aberrant genomic imprinting associated with assisted reproductive technologies (ART) and reproductive cloning, the idea that human embryonic stem cells (hESCs) derived from surplus in vitro fertilized embryos or nuclear transfer ESCs (ntESCs) harvested from cloned embryos may harbor dangerous epigenetic errors has gained attention. Various progenitor cell sources have been proposed for human therapy, from hESCs to ntESCs, and from adult stem cells to induced pluripotent stem cells (iPS and piPS cells). This review highlights the advantages and disadvantages of each of these technologies, with particular emphasis on epigenetic stability.

Epigenetic consequences of assisted reproduction and infertility on the human preimplantation embryo

Epigenetic information, which is essential for normal mammalian development, is acquired during gametogenesis and further regulated during preimplantation development. The epigenetic consequences of assisted reproductive technologies (ARTs) and infertility on the health and quality of the human preimplantation embryo are considered in this review.In the zygote, the epigenetic information that is inherited from the sperm and the oocyte intersects and must be appropriately recognized, regulated and then propagated during preimplantation development so as to regulate gene expression in an appropriate manner. A growing body of evidence suggests that ARTs and/or infertility itself may affect these complex processes leading to epigenetic diseases that include disorders of genomic imprinting. The epigenetic safety of human gametes and embryos is of paramount importance. Unfortunately, morphological methods of assessing embryo quality are incapable of detecting epigenetic errors. Further research is therefore critical to resolve these issues.

Panel Reviews Health Effects Data for Assisted Reproductive Technologies

TORONTO—Twenty-five years after the first baby was conceived through in vitro fertilization (IVF) and nearing the birth of the 2 millionth IVF baby, the longterm health consequences of assisted reproductive technologies have yet to be determined. “There’s been a host of often incomplete and, frankly, very confusing data published on the health of these children,” said Kathy Hudson, PhD, director of the Genetics and Public Policy Center at the Johns Hopkins University, in Washington, DC. Hudson helped enlist a panel of experts to review all of the available data on the health of children conceived through assisted reproductive technologies “to get a better idea of what we know and what we don’t know and to make recommendations for where we need to go next,” she said. The effort was undertaken by Johns Hopkins University in collaboration with the American Academy of Pediatrics and the American Society for Reproductive Medicine. Most of the panel’s findings, presented by Hudson at the annual meeting of the American Society of Human Genetics (ASHG), provide reassurance that these procedures are safe, although there were some areas of concern.