Development Of Reproductive Technologies Research Articles

The mutuality account of parenthood: a subjective approach to parent-child relationships

Stimulated by development of reproductive technologies, many current bioethical accounts of parenthood focus on defining parenthood at or around birth. They tend to exclude from their scope some parent-child relationships that develop later in a child’s life. In reality, a parent-child relationship can emerge or dissolve over time: the parents of person A as an adolescent or adult may be different to her parents when she is a young child. To address this aspect of parenthood, we propose a new ‘mutuality account’ of parenthood, grounded in the concept of ontological security. We argue that in most cases a parent-child relationship exists if there is mutual ontological security between the parent and child. We suggest that this mutual ontological security is constituted and sustained by shared frameworks of reality and cohesive personal narratives. Our intention is to broaden the conceptual understanding of parenthood, to include parent-child relationships that do not fall neatly into current bioethical accounts, and to argue against the notion that objective physiological, causal, or social ties are necessary to ‘make’ a parent.

Deconstructing Preimplantation Genetic Diagnosis

In recent years, infertility rates have been on the rise, with 19% of women aged 15-49 having difficulties getting pregnant and 26% of women having difficulties carrying such fetuses to term (Centers for Disease Control and Prevention, 2019). This statistic also comes in concert with recent research suggesting a rise in congenital defects and abnormalities in neonates (Silesh et al., 2021). In association with these troubling trends, however, are developments in reproductive technologies and assessments. One such of these technologies is preimplantation genetic testing, otherwise abbreviated PGD. This technique uniquely allows for the detection of chromosomal abnormalities and congenital defects and, used in conjunction with IVF treatments, has seen implementation in around 5 percent of all U.S. IVF cycles (“A Microdeletion, They Called It.,” 2015). Despite the hope that the testing method allows for families around the world, PGD is not without its limitations. This paper first explores PGD, determining the testing process and pinpointing its applications' current extent. It then transitions to analyzing the current methods of sampling and analysis housed in PGD, determining their benefits as well as their detriments. It finally contrasts present methods with the many proposed advances, analyzes the feasibility of such advances, and compares the benefits and limitations of these new treatment plans to conclude the best combination of developments is Blastocyst biopsy and Next Generation Sequencing for the advancement of PGD as a diagnostic procedure.

A Sense of Connectedness in Reproductive Donation. Contrasting Policy With Donor and Donor Kin Lived Experience

This article asks how well new developments in family life are reflected in law and policy, with a particular focus on donor conception. There has been an unprecedented ‘opening up’ of family life in recent decades; this increased diversity is, at least in part, linked to developments in reproductive technologies, including gamete donation. In family lives touched by donation, genetic relations with ‘donor connections’ take genetic connectedness beyond traditional notions of kinship. There is not yet an established social script for how to understand what constitutes meaningful connectedness in reproductive donation. Focussing on the UK context specifically, where assisted conception is highly regulated, this article examines on the one hand, how UK law and policy portray meaningful connectedness in the context of donation, and, on the other hand, how well this fits with connectedness as experienced within egg and sperm donor communities. Drawing on original data from UK law and policy analysis, and empirical interview data with egg and sperm donors and their kin, our analysis shows important disparities between law and policy, and the empirical evidence, suggesting a need for an overhaul of UK donor conception law and policy.

In vivo rabbit embryo production and cryopreservation review. Application to ex situ conservation and rederivation

The development of reproductive technologies in this species is contributing decisively to the development of rabbit farming and the preservation of genetic resources. Obtaining embryos is an essential step to both genetic diffusion and the preservation of genetic resources from genetic erosion or natural disasters. In rabbits, it is common for embryos to be recovered post-mortem after ovarian hyperstimulation with gonadotrophins, although the quality and number of embryos are variable, affecting the embryo viability and offspring rate by the donor. In vivo embryo production within a conservation programme aims not only to obtain a large number of embryos, but also that they come from a greater number of male and female origins, in order to ensure an adequate representation of the original population. This is why both the quality and quantity of embryos obtained per donor rabbit and the rate of donors with offspring after embryo cryopreservation must be considered, as well as the response of the embryos to the chemical, physical and physiological stress to which they are subjected in the rederivation process and its postnatal repercussions on those that survive. Rederived rabbits from cryopreserved and transferred embryos showed phenotypic growth changes, which calls into question the neutrality of the technique and its usefulness in those cases in which a control population is required.

IVF Children Acquiring Emirati Citizenship by the Nationality of a Parent (Jus Sanguinis)

Objective. The technology of in vitro fertilization (IVF) opened a new era in the treatment of infertility but at the same time it created new challenges for civil and international private law. This concerns the issues of determining and/or acquiring child citizenship and legal conflicts associated with this.
 Materials and methods. This study examines the aspects of obtaining UAE citizenship through the study of the UAE Citizenship Law and the principle of jus sanguinis (right of blood) when citizenship is acquired by a parent’s nationality. The research aims to identify whether the current legislative regulation of the UAE meets the current challenges in the field of family relations against the backdrop of new medical advances in IVF. The paper considers the aspects of the UAE legal regulation in the scope of family law relationships. The above issues were considered from the critical evaluation prospects taking into account the potential ways for their improvement.
 Results and Discussion. The problems associated with determining the citizenship for those born as a result of IVF are the subject of discussion, while, as practice shows, the law often does not keep pace with the development of reproductive technologies. Based on the analysis of legal regulation and practice, the study summarizes the grounds for obtaining UAE citizenship by children conceived through IVF and refusals to obtain it.
 Conclusion. The paper recommends mitigating the requirement of proof of paternity as a condition to grant the nationality to an IVF child, especially in the case of purely medical errors in which father has no responsibility.
 Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 676-686

Virtualization of pregnancy: game and reality

Technology is changing human life in every possible way. However, bearing a child came under their influence only in the 20th century, which, together with the changing role of women in society, led to a rethinking of the phenomenon of pregnancy. The article considers how the development of reproductive technologies and their promotion paved the way for the separation of motherhood from bearing children, which began to be understood as a technical process. An analysis of the representation of pregnancy in computer games was also carried out, an emphasis was placed on the desire to ignore or reduce the process of bearing a child, both on the part of the creators of the game and the players. Despite the fact that raising a baby outside the body of a future mother becomes possible due to progress in the field of biomedical technologies justification for this phenomenon is largely due to the increasing virtuality of existence. Introduced in 2022, the EctoLife project integrates the latest reproductive and digital technologies, preparing society to accept virtual play pregnancy, where the baby is raised in an artificial capsule. In a digital society, it is natural to ask for a controlled pregnancy, which occupies a strictly defined place in life, like a capsule in the corner of a room, or in smartphone application, which you can turn to when there is a desire to remember the future baby. As a result, the technical finally replaces the natural: childbearing is built into the technocratic process with unpredictable consequences.

Female fertility preservation in cancer patients.

Fertility preservation in cancer patients or oncofertility is a relatively new trend in modern medicine. In patients with unfulfilled reproductive plans, the possibility of starting a family is one of the key parameters of quality of life after overcoming a cancer. Guidelines have existed since 2013 and in 2020 the European Society of Human Reproduction and Embryology has also published a guideline, but the main problem of their application in clinical practice is the lack of information for both patients and, unfortunately, professionals, as well as the high cost of treatment. From 2022, health insurance companies in the Czech Republic partially cover the expenses for fertility preservation treatment for cancer patients. The possibilities of oncofertility are based, on the one hand, on improving the results of oncological treatment, on the other hand, on the development of reproductive technologies. Thanks to progress in treatment, up to 80% of pediatric oncology patients survive into adulthood, but chemotherapy, especially highly effective alkylating agents, is associated with a high risk of impaired fertility. This article overviewed9 modern global trends of fertility preservation in women undergoing cancer treatment based on an analysis of the English-language literature over the past 5 years.

ЄВГЕНІКА ЯК ВОНА БУДЕ

The potential social effect of technologies for correcting ontogenetic programs in order to improve human qualities (eugenics) is considered. The expected trend in the development of reproductive technologies is to achieve a level at which the duration of intellectually productive longevity will increase critically, which inevitably actualizes eugenic logic. Under liberal values, genome editing technologies themselves do not carry any significant shifts and significant problems regarding the regulation of what is permissible in this edit. However, it is the lengthening of life expectancy, which can be partially facilitated by such editing with an investment in the future of descendants, that is the most reliable aspect of the developers’ efforts. As a result, this will lead to a radical transformation of a number of social institutions associated with the reproduction of people, during which acute ethical conflicts arise.

Patriarhāta beigas: sociālās kustības, ģimene un seksualitāte informācijas laikmetā M.Kastella skatījumā

During the information age, the patriarchalism is undergoing a crisis, which mainly affects the ba-sic cell of the society – the family. The crisis is rooted in transformation of the labour market and the growth of women’s self-esteem, which is caused by globalization, the development of reproductive te-chnologies, as well as feminism and gay and lesbian movements. The identity of a strong, empowered woman has been formed. Women are aware of their rights, values, sexuality, and they define themselves outside the patriarchal matrix. The society strongly opposes manifestations of compulsive sexuality. There is uncertainty about the future in the society. Patriarchal values have lost their legitimacy, therefore a re-turn to the previous values is unlikely to happen. In order for a family to function during post-patriarchate era, it is necessary to create a new, strong, unifying identity appealing for a sufficient number of individu-als, which can influence the formation of new social and family relations.

The Right of Persons Who Have Undergone Sex Reassignment (Correction) Procedure for Cryopreserved Sperm, Oocytes, Embryons, Biological Material Disposal

Nowadays, the reproductive sphere and the institute of family are at the stage of rapid development and transformation. Despite rather wide and solid scientific base of studies of assisted reproductive technologies, it should be stated that scientific interest is low in issues of access to the reproductive rights for particular categories of individuals, as well as there is lack of legal support for the application of assisted reproductive technologies in Ukraine. The issue of access to their own biological material for individuals who have undergone the sex reassignment (correction) procedure has been considered by describing two practical examples. It has been proposed to amend the list of information required from applicants, provided by the Order of the Ministry of Health of Ukraine № 771 dated 23.12.2008, eliminating the requirement to indicate sex, as the sex of an individual is not decisive for exercising the right to dispose of their own biological material. Also, the person is suggested to apply to the court in non-litigious (separate) proceedings to ascertain the fact that the person who has applied to a health care institution for cryopreservation of sperm, oocytes, embryos or biological material, and the person who is currently applying for transportation or use of the same cryopreserved sperm, oocytes, embryos or biological material, is the same person. Such proceedings should be held in the same manner as a change of name, surname or patronymic, because the reassignment (correction) of sex does not have legal consequences different from the change of name, surname or patronymic. It has been concluded that there is the need for a research regarding the protection of the right to reproduction for various categories of subjects. Reproductive rights should remain protected and accessible to every person without redundant restrictions that are contrary to human rights.

Recalled Parental Gender Preference in Chinese Culture: A Taiwan Birth Cohort Study

Chinese culture has long favored sons over daughters. With the development of reproductive technology, the methods can be used not only in facilitation of conception, but also in sex-selective termination of pregnancies. Therefore, this study aimed to investigate: (1) the rate of pregnant expectancy/planning of children; (2) whether the Chinese cultural influence of son preference still exists, and factors effecting sex preference; and (3) whether artificial reproductive technology plays a role in parents giving birth to a child of their preferred sex. We used the Taiwan Birth Cohort Study dataset at six-months, which included 21,248 babies born in 2005. More mothers than fathers reported this pregnancy as unexpected (29.0% vs. 20.5%). Over half of the parents showed no preference for the sex of their child (mothers: 52.6%, fathers: 55.8%). However, among those who showed a preference, significantly more preferred sons than daughters (son preference, mothers: 24.8%, fathers: 24.3%; daughter preference, mothers: 22.5%, fathers: 19.9%). Additionally, structural equation modeling found that parents who had planned their pregnancy were more likely to prefer sons and less likely to prefer daughters. Parents who used artificial reproductive technology for conception were more likely to prefer and conceive sons. A preference for male children still exists in Taiwan, contributing to the high sex ratio at birth of 110 in our 2005 birth cohort. However, over half of the parents reported being neutral in the preference of the gender of their offspring. This suggests that Taiwan is moving toward a more gender-equitable society.

Genetic identity concerns in the regulation of novel reproductive technologies

Confusion concerning a child’s genetic identity is a common objection to the application of novel technologies to human embryos. Unsurprisingly then, concern for genetic identity has been used to justify successive waves of regulatory activity and is again appearing in debates about regulatory responses to emerging reproductive technologies. By examining the history of Australian law’s understanding and responses to so-called genetic identity in the context of past and current scientific developments in reproductive technology, this paper investigates regulatory reform needed for still emerging reproductive technologies. While this paper presents and analyzes in some detail Australian regulation and the policy deliberations and scientific developments that led to them, the identified inconsistencies in the regulatory responses, and recommended reforms to address emerging reproductive technologies offered, address issues relevant to many countries responding to the same technologies.

Taking Human Reproductive Rights Seriously: The Russian Perspective

The very idea of human reproductive rights seems challenging. For much of human history, they were not discussed seriously as being a part of the right to privacy, liberty, security, equality, health, and non-discrimination. The situation changed drastically in the 1990s with the development of reproductive technologies. These technologies do not only help infertile couples to conceive, they allow single men and women, no matter their status and sexual preferences, to have offspring of the same genetic origin. We can affirm that in the 21st century assisted reproductive technology (ART) has completely changed what it means to have a baby and to be a parent. Despite their benefits, reproductive technologies leave space for ethical and medical concerns. A few of the many issues raised by reproductive technologies include: the reproductive right to abortion, legal status of the human fetus, ethical aspects regarding the use and storage of embryos, sex selection, surrogacy and gamete donation, and the right and accessibility to medical sterilization. This article sets forth the existing ethical and human rights standards on these issues and illustrates the need for further development and clarity on balancing these rights and interests in the Russian Federation.

EFFICIENCY OF SERENOA REPENS EXTRACT IN TREATMENT OF EXCTRETRIC-TOXIC INFERTILITY, ASSOCIATED WITH CHRONIC PROSTATITIS

Relevance. The development of reproductive technologies and techniques, the establishment of biological and immunological aspects of the reproductive process and the expansion of the use of biochemical research in routine practice, has led to the increasing attention to androurological disorders.The aim of the study is a comparative analysis of the effectiveness of the therapeutic model using a combination of Serenoa repens extract (in the composition of the drug “Prostamol Uno”), selective antibiotic therapy and physiotherapy in the treatment of excretory-toxic infertility associated with chronic prostatitis.Materials and methods. The study was conducted in a prospective study on parallel groups. The contingent of the study comprised 100 patients of the Clinic “Men’s Health” (Kiev), suff ering from chronic prostatitis and undergoing outpatient treatment for fertility disorders.Results of the study. A comparison of the eff ectiveness of the therapeutic model using a combination of Serenoa repens extract (as part of the Prostamol Uno preparation), selective antibiotic therapy and physiotherapy, and a similar model without prescribing Prostamol Uno for the treatment of excretory-toxic infertility associated with chronic prostatitis.Comparison criteria were the data of the expanded spermogram, the clinical questionnaire I-PSS and the level of interleukin-18 in the seminal plasma (established by the method of enzyme immunoassay).Conclusions. The data confi rming the greater eff ectiveness of the model with respect to the spermiogram indices, namely: the volume and time of liquefaction of the seminal fluid; the number of spermatozoa in 1 ml of seminal fluid; presence of spermatozoa (group A + B); the number of leukocytes in the fi eld of vision; amount of mucus in the semen.Also, when analyzing the clinical eff ects of the model in question, there are more pronounced changes in the symptoms of prostatitis, namely: rapid urination; weakening of the urine stream; reducing the quality of life; of the overall I-PSS score. The reliable effi cacy of the study model of treatment in normalizing the level of interleukin-18 in plasma of seminal fluid was also established.

Mitochondria and reproduction: possibilities for testing and treatment.

Mitochondria, known as the energy factories in all cells, are key regulators of multiple vital cellular processes and affect all aspects of mammalian reproduction, being essential for oocyte maturation, fertilization and embryonic development. Mitochondrial dysfunction is consequently implicated in disease as well as age-related infertility. Since mitochondria are inherited exclusively from the mother, the female gamete is central to reproductive outcome and therapeutic interventions, such as mitochondrial replacement therapy (MRT), and development of new diagnostic tools. The primary purpose of MRT is to improve oocyte quality, embryogenesis and fetal development by correcting the imbalance between mutant and wild-type mitochondrial DNA (mtDNA) in the oocyte or zygote, either by replacing mutant mtDNA or supplementing with wild-type counterparts from heterologous or autologous sources. However, the efficacy and safety of these new technologies have not yet been tested in clinical trials, and various concerns exist. Nonetheless, the perspectives for such procedures are intriguing and include two distinct patient populations that could potentially benefit from the clinical implementation of MRT; 1) patients with mtDNA-disease transmission risk; 2) patients undergoing IVF with recurrent poor embryo outcomes due to advanced maternal age. In this review, we outline the intrinsic roles of mitochondria during oogenesis and early embryogenesis in relation to disease and infertility, and discuss the progress in MRT with the developments in reproductive technologies and the related concerns. In addition, we assess the use of mtDNA as a potential biomarker for embryo viability in assisted reproduction.

Current management of gynecologic cancer in pregnancy

Cancer during pregnancy is a particularly challenging complication. The incidence has increased in recent years due to childbearing at advanced maternal ages due to career choices and/or the development of reproductive technology. Approximately two thirds of cancer cases during pregnancy comprise invasive cervical cancers and breast cancer. Cancer during gestation is characterized by a need for specialized treatment due to major changes in the hormonal profile (estrogen-progesterone), metabolism (enhancement of anabolism), hemodynamic changes (hyperdynamic circulation), immunologic changes (cell-mediated and humoral immunity), and increased angiogenesis (increased blood flow towards the uterus). Moreover, the management of such patients is based on the trimester of pregnancy, type and stage of cancer, and informed consent of the mother based on her wishes. The optimal treatment of cancer during pregnancy remains elusive because there are limited data from retrospective studies with small samples. As a result, it is crucial that data regarding survival of the women and long-term follow-up of the children from different cancer centers and registries are shared. This need is dictated by the fact that the incidence of cancer during pregnancy will continue to rise as child-bearing age continues to increase.

Перинатальні висліди багатоплідної вагітності після запліднення in vitro та при спонтанних вагітностях

Objective - to evaluate perinatal outcomes in multiple gestations after in vitro fertilization compared with spontaneous pregnancies. Material and methods. A retrospective analysis of 375 labour and delivery medical records that were provided in the Medical centre Isida — IVF LLC (Kyiv, 2010-2017), and resulted in 279 twin deliveries after in vitro fertilization and 96 twin deliveries after spontaneous pregnancy (the group of comparison). Results. The risk of miscarriage during pregnancies induced by assisted reproductive technologies is significantly high. The proportion of premature infants (<37 weeks) in the in vitro fertilization group was 227 (41.1%), in the group of spontaneous twins - 63 (32.8%). Analysing the anthropometric indicators of newborns of the in vitro fertilization group, it was found that they were lower than in children of the comparison group. The perinatal pathology incidence in infants from mothers after in vitro fertilization procedure was 1.8 times higher than in the comparison group. The mothers who underwent in vitro fertilization procedure had 1.2 times more often lactation disorders. Early neonatal mortality in twins did not depend on the fertilization type and made up 4.0% for the in vitro fertilization group and 3.1% for the comparison group. Conclusions. The perinatal pathology incidence in multiple gestations associated with in vitro fertilization increases, which can be illustrative of usefullness of further development of reproductive technologies that allow implantation of one embryo.

Molecular and cellular events during blastocyst implantation in the receptive uterus: clues from mouse models.

The success of implantation is an interactive process between the blastocyst and the uterus. Synchronized development of embryos with uterine differentiation to a receptive state is necessary to complete pregnancy. The period of uterine receptivity for implantation is limited and referred to as the “implantation window”, which is regulated by ovarian steroid hormones. Implantation process is complicated due to the many signaling molecules in the hierarchical mechanisms with the embryo-uterine dialogue. The mouse is widely used in animal research, and is uniquely suited for reproductive studies, i.e., having a large litter size and brief estrous cycles. This review first describes why the mouse is the preferred model for implantation studies, focusing on uterine morphology and physiological traits, and then highlights the knowledge on uterine receptivity and the hormonal regulation of blastocyst implantation in mice. Our recent study revealed that selective proteolysis in the activated blastocyst is associated with the completion of blastocyst implantation after embryo transfer. Furthermore, in the context of blastocyst implantation in the mouse, this review discusses the window of uterine receptivity, hormonal regulation, uterine vascular permeability and angiogenesis, the delayed-implantation mouse model, morphogens, adhesion molecules, crosslinker proteins, extracellular matrix, and matricellular proteins. A better understanding of uterine and blastocyst biology during the peri-implantation period should facilitate further development of reproductive technology.

Risk of metabolic disorders in individuals born with assisted reproductive technology and its possible mechanism

With the development and wide use of assisted reproductive technology(ART), the number of children with ART is rapidly increasing worldwide. Consequently, the long-term safety issue of ART procedure has been a research hotspot in the related field. Several clinical and animal studies showed that ART individuals exhibited metabolic abnormalities including changes in glucose and lipid metabolism. The underlying mechanism of this phenomenon remains unclear, although some researchers believe that epigenetic and imprinting alterations caused by ART procedures and subsequent changes in the expression of metabolism-associated genes seems to be the most important reasons. This review will summarize the existing evidences of relationship between ART and metabolic abnormalities as well as its possible mechanisms. (Chin J Endocrinol Metab, 2016, 32: 791-794) Key words: Assisted reproductive technology; Metabolic disorder; Epigenetics

Angiogenesis and Hormonal Regulation on Uterine Receptivity for Blastocyst Implantation

Abstract: Synchronization of embryonic development and differentiation of specific uterine cell types to a receptive state is essential for a successful pregnancy. The period of uterine receptivity for implantation is limited. Increased vascular permeability and angiogenesis are hallmarks of the implantation process. Although implantation involves the interaction of numerous signaling molecules, the hierarchical mechanisms that coordinate the embryo—uterine dialog remain poorly understood. This review highlights our knowledge about angiogenesis, uterine receptivity, and hormonal regulation for blastocyst implantation in the mouse. A better understanding of uterine biology during the peri-implantation period would facilitate the further development of reproductive technology.