Surrogate Embryo Research Articles

Possibilities of reproductive function realization in patients with premature ovarian insufficiency

Premature ovarian insufficiency (POI) directly affects the reproductive health of women all over the world. Currently, the study of this pathology is becoming an increasingly important issue due to the widespread prevalence of premature menopause in the female population. In addition to genetic predisposition, an important role in the development of premature menopause is played by the increasing number of ovarian surgeries due to the development of surgery, as well as radiation and chemotherapy for cancer, leading to premature depletion of the follicular reserve in the ovaries. An important component of treatment for women with POI is not only the management of undesirable symptoms of menopause, prevention of cardiovascular complications and fractures due to decreased bone mineral density, but also the possibility of realizing their reproductive function in the future. Therefore, other treatment options may be offered to women with POI in the absence of spontaneous pregnancy in the natural cycle. Oocyte donation may be recommended for such women, but this treatment option may not be suitable if the patient wishes to have genetically related children. In such a case, oogonal stem cell transplantation, ovarian cortex fragmentation or PRP therapy are possible. In women who will undergo chemotherapy and radiation therapy for cancer, reimplantation of ovarian cortical tissue is recommended to preserve fertility. If there is a risk of malignant cell transfer with this treatment modality, primordial follicles can be isolated from ovarian tissue, cultured and activated in vitro, fertilized, and transferred into the uterine cavity. IVF with surrogate embryo transfer may be an alternative choice for a woman with NPT, which allows her to realize her reproductive plans.

Co-Culture of Mouse Blastocysts on A Human Recellularized Endometrial Scaffold: An In Vitro Model for Future Implantation Studies.

This study evaluates the interaction of mouse blastocysts as a surrogate embryo on a recellularized endometrial scaffold by seeding human endometrial mesenchymal cells (hEMCs). In this experimental study, prepared decellularized human endometrial tissues were characterized by morphological staining, DNA content analysis, and scanning electron microscopic (SEM) analysis. The scaffolds were subsequently recellularized by hEMCs. After seven days of cultivation, the mouse blastocysts were co-cultured on the recellularized scaffolds for 48 hours. Embryo attachment and implantation within these scaffolds were evaluated at the morphological, ultrastructural, molecular, and hormonal levels. There was no morphological evidence of cells and nuclei in the decellularized scaffold. DNA content significantly decreased by 89.92% compared to the control group (P<0.05). Both decellularized and native tissues had similar patterns of collagen bundles and elastin fibers, and glycosaminoglycan (GAGs) distribution in the stroma. After recellularization, the hEMCs attached to the scaffold surface and penetrated different parts of these scaffolds. In the co-cultured group, the embryo attached to the surface of the scaffold after 24 hours and penetrated the recellularized endometrial tissue after 48 hours. We observed multi-layered organoid-like structures formed by hEMC proliferation. The relative expressions of epithelial-related genes, ZO-1 and COL4A1, and SSP1, MMP2, and PRL, as decidualizationrelated genes, were significantly higher in the recellularized group on day 9 in the presence of the embryo compared to the other groups (P<0.05). Beta human chorionic gonadotropin (β-hCG) and prolactin were statistically increased in the recellularized group on day 9 group (P<0.05). hEMCs and mouse embryo co-cultured on a decellularized endometrial scaffold provides an alternative model to study embryo implantation and the earlier stage of embryo development.

Luteal phase ovarian oestrogen is not essential for implantation and maintenance of pregnancy from surrogate embryo transfer in the rhesus monkey

The aim of this study was to investigate whether luteal phase ovarian oestrogen is required for blastocyst implantation and pregnancy maintenance in the rhesus monkey. Preimplantation embryos were retrieved from naturally ovulated, mated embryo donor monkeys. In group I, developmentally normal, age- and stage-matched embryos were transferred to recipient monkeys showing naturally synchronized ovulatory cycles. Immediately prior to embryo transfer, recipients were subjected to bilateral ovariectomy, and following transfer they were treated with i.m. injections of either progesterone (group Ia, n = 4), or oestradiol + progesterone (group Ib, n = 2). Recipient monkeys of group Ic (n = 4) were subjected to sham ovariectomy and vehicle injection. In group Ia, progesterone supplementation alone led to three pregnancies and live births. In group Ib, there was one live birth. In the control group Ic, four transfers resulted in two live births and one abortion on cycle day 58. Analysis of serum progesterone and oestradiol profiles showed that oestradiol had declined to undetectable levels within 3-5 days after ovariectomy in group Ia recipients, and the area under the curve of serum oestrogen concentrations during the peri-implantation period (days 10-20 after ovulation) were less (P < 0.001) in group Ia compared with group Ic. There were no changes in the area under the curve among serum progesterone concentrations in all the subgroups. In group II, long-term ovariectomized embryo recipients (n = 4) were primed with oestradiol till cycle day 11 of simulated transfer cycle, and received progesterone treatment from cycle day 10 till the end of the experiment.(ABSTRACT TRUNCATED AT 250 WORDS)

Artificial Means of Reproduction and Our Understanding of the Family

The new reproductive technologies force us to rethink concepts `mother,' `father,' `family.' As draw analogies to traditional patterns, must distinguish between ethical and conceptual questions. Ruth Macklin is professor of bioethics, Albert Einstein College of Medicine, Bronx, N.Y. It is an obvious truth that scientific and technologic innovations produce changes in traditional way of perceiving world around us. We have only to think of telescope, microscope, and space travel to recall that heretofore unimagined perceptions of macrocosm and microcosm have become commonplace. Yet it is not only perceptions, but also conceptions of familiar that become altered by advances in science and technology. As a beginning student of philosophy, first encountered problems in epistemology generated by scientific knowledge: If physical objects are really composed of molecules in motion, how is it that perceive them as solid? Why is it that objects placed on a table don't slip through empty spaces between molecules? If mind is nothing but electrical processes occurring in brain, how can explain Einstein's ability to create special theory of relativity or Bach's ability to compose Brandenburg Concertos? Now questions are being raised about how a variety of modes of artificial means of reproduction might alter conception of family. George Annas has observed: Dependable birth control made sex without reproduction possible .... Now medicine is closing circle ... by offering methods of reproduction without sex; including artificial insemination by donor (AID), in vitro fertilization (IVF), and surrogate embryo transfer (SET). As with birth control, artificial reproduction is defended as life-affirming and loving by its proponents, and denounced as unnatural by its detractors.[1] Opponents of artificial reproduction have expressed concerns about its effects on family. This concern has centered largely but not entirely on surrogacy arrangements. Among objections to surrogacy made by Roman Catholic Church is charge that the practice of surrogate motherhood is a threat to stability of family.[2] But before consequences for family of surrogacy arrangements or new reproductive practices can be assessed, need to inquire into understanding of family. there a single, incontrovertible conception of family? And who are presupposed in phrase, our understanding? To begin, offer three brief anecdotes. The first is a remark made by a long-married, middle-aged man at a wedding. The wedding couple were both about forty. The bride had been married and divorced once, groom twice. During a light-hearted discussion about marriage and divorce, middle-aged man remarked: I could never divorce my wife. She's family! The second is a remark made by a four-year-old boy. had just moved to neighborhood and was getting to know children. The four-year-old, named Mikey, was being tormented by a five-year-old named Timmy. asked Mikey, Is Timmy your brother? Mikey replied: any more. Not way he acts! The third story appears in a case study presented as part of a bioethics project on everyday dilemmas in nursing home life. A resident, Mrs. Finch, is a constant complainer who seeks more choices and independence than nursing home allows. A social worker at home talked to Mrs. Finch about her adaptation, suggesting that she think of residents and staff group as a large family where we all make allowances for each other and we all pull weight. Mrs. Finch responded that she is in nursing home because she needs health care. She already has a family and does not want another one. In my commentary on case of Mrs. Finch, gave an analysis that suggests some of complexities in understanding concept of family. …

Social policy considerations in noncoital reproduction

NOW THAT 1984 has come and gone, Huxley's vision of our future in<i>Brave New World</i>looms larger than Orwell's. Huxley envisioned the abolition of parenthood and the family, which would take place with the full cooperation of society as it attempted to improve on natural reproduction. We are on our way toward Huxley's vision, and 1984 saw significant scientific and societal developments in noncoital human reproduction and corresponding steps to redefine parenthood and family relationships. On the scientific side, the year saw the first birth from surrogate embryo transfer (SET)¹and the first birth from a frozen embryo (<i>New York Times</i>, April 11, 1984, p A16). On the societal side, the year saw major reports by government-appointed panels on noncoital reproduction in the United Kingdom (the Warnock Report)²and Australia (the Waller Report)³and Congressional hearings on the subject in the United States.⁴ Techniques for

Social Policy Considerations in Noncoital Reproduction

A review is provided of social issues posed by the reproductive technologies of artificial insemination by donor, in vitro fertilization and embryo transfer, surrogate motherhood, surrogate embryo transfer, and the implantation of previously frozen embryos. These issues include possible use unrelated to infertility, status of the embryo, identification of parents, donor screening and anonymity, and commercialization. The policy recommendations of Great Britain's Warnock Committee and Australia's Waller Committee are briefly discussed, as is the current absence of a comparable commission in the United States. Prompt state legislative action is proposed to establish the gestational mother as legal mother and to forbid the sale of human embryos. Action by professional organizations and a national advisory commission are recommended to formulate social policy protecting the interests of children resulting from reproductive technologies.

Making babies without sex: the law and the profits.

The author reviews scientific and societal developments in artificial reproductive technologies during the past year in the U.S., the United Kingdom, and Australia. Successful births resulted from surrogate embryo transfer and from transfer of an embryo following in vivo fertilization. Recommendations on social policy were made by Australia's Waller Committee, Britain's Warnock Committee, and U.S. congressional hearings. Annas stresses the need to define parenthood and restrict commercialization of childbearing through the enactment of legislation, the promulgation of guidelines for sound clinical practice, and the establishment of an interdisciplinary body to monitor developments and the need for further regulation.

Law and the Life Sciences: Surrogate Embryo Transfer: The Perils of Patenting

Surrogate embryo transfer (SET) is a new procedure, developed by a research team led by Dr. John Buster of the Harbor-UCLA Medical Center, that involves recovery by uterine lavage of an embryo from a donor woman for transfer to the sperm donor's wife. With the concurrence of Dr. Buster, Fertility and Genetics Research, Inc., the company that funded the research, has applied for patents on both the instruments used and the SET process itself. Annas discusses the ethical and legal issues raised by applying the concept of process patenting to a reproductive technology, and contends that such patents should be rejected unless the medical profession and the public can be assured that effective quality controls will be utilized and that reproductive privacy will not be compromised.

Embryo Transfer and Ectopic Pregnancy

To the Editor.— The important article of Dr Gary D. Hodgen 1 describing surrogate embryo transfer in monkeys mentions the unexpected demise of one of the donors from tuboovarian ectopic pregnancy. Much to his credit, the author did not dismiss this observation, obviously unrelated to the field of his primary interest, but discussed in some detail and aptly concluded that most likely it was a result of the procedure that involved lavage of the reproductive tract during the process of collecting ova. He attributed, therefore, the ectopic displacement and implantation of the ovum to retrograde flow. In the light of this interesting observation, deserves mention that the first successful attempt by Steptoe and Edwards 2 of reimplanting an ovum fertilized in vitro resulted in tubal implantation under circumstances similar to those described by Dr Hodgen. The mechanism itself that he held responsible for the accidental ectopic implantation

Surrogate Embryo Transfer Combined with Estrogen-Progesterone Therapy in Monkeys Implantation, Gestation, and Delivery Without Ovaries

Pregnancy Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.

Surrogate Embryo Transfer Combined With Estrogen-Progesterone Therapy in Monkeys

The collection of in vivo fertilized embryos by lavage of the normal donor's uterotubal lumens and transfer of these surrogate embryos to the uterotubal environs of long-term castrate female monkeys is described. Sequential estrogen-progesterone replacement therapy that mimics the natural ovarian-menstrual cycle was administered to the recipients, causing the development of proliferative and secretory endometrium to accommodate the perinidatory events leading to successful placentation and embryogenesis. Retrograde irrigation of the uterotubal lumens of 23 normal intact donors was performed three to four days after the estimated time of ovulation, coitus, and fertilization. Of the 17 embryos or eggs collected, some were apparently healthy, as assessed by microscopic inspection, whereas others were obviously degenerating. Eleven surrogate embryos were transferred to steroid-treated, long-term castrate female recipients; four viable pregnancies were detected by measurement of chorionic gonadotropin, all concluding with uneventful deliveries of normal live neonates at term. These findings demonstrate the feasibility of establishing and maintaining normal pregnancy by combining surrogate embryo transfer with an exogenous steroid hormone regimen, even in the complete absence of ovarian function. The clinical implications of these primate studies may be far-reaching because they indicate new potential for childbearing by otherwise infertile or sterile women who have a competent uterus but lack the hormonal milieu provided by ovarian follicular maturation and corpus luteum function in the normal menstrual cycle.

Ethical aspects of surrogate embryo transfer

Ethical aspects of surrogate embryo transfer

Surrogate embryo transfer combined with estrogen-progesterone therapy in monkeys. Implantation, gestation, and delivery without ovaries

Surrogate embryo transfer combined with estrogen-progesterone therapy in monkeys. Implantation, gestation, and delivery without ovaries

Ethical Aspects of Surrogate Embryo Transfer

The article by Hodgen published in this issue ofThe Journal(p 2167) suggests that some infertile women who cannot produce fertilizable ova may one day be able to bear children. Such women may have ovaries that are functionally deficient in a critical respect, or they may lack ovaries entirely. For these women, bearing a child that is genetically "their own" is a physical impossibility. Any new technique that helps to reduce involuntary infertility is to be welcomed, provided that its benefits are not outweighed by safety considerations and social consequences. The present moment, when surrogate embryo transfer (SET) is being tested in primates and initially attempted in humans,^1-3seems the appropriate time to inventory the ethical issues that the clinical use of this new technique may raise. Safety considerations in SET and accompanying techniques concern three biologic individuals—the oocyte or embryo donor, the embryo itself, and the embryo recipient.