Artificial Insemination, Egg Donation, and Adoption
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Reproductive Technology in Germany and the United States: an Essay in Comparative Law and Bioethics
ROBERTSON - REVISED FINAL PRINT VERSION.DOC 12/02/04 6:55 PM Reproductive Technology in Germany and the United States: An Essay in Comparative Law and Bioethics * JOHN A. ROBERTSON The development of assisted reproductive and genetic screening technologies has produced intense ethical, legal, and policy conflicts in many countries. This Article surveys the German and U.S. experience with abortion, assisted reproduction, embryonic stem cell research, therapeutic cloning, and preimplantation genetic diagnosis. This exercise in comparative bioethics shows that although there is a wide degree of overlap in many areas, important policy differences, especially over embryo and fetal status, directly affect infertile and at-risk couples. This Article analyzes those differences and their likely impact on future reception of biotechnological innovation in each country. INTRODUCTION ..................................................................................190 I. THE IMPORTANCE OF CONTEXT.............................................193 II. GERMAN PROTECTION OF FETUSES AND EMBRYOS ...............195 III. ABORTION .............................................................................196 IV. ASSISTED REPRODUCTION .....................................................202 A. Embryo Protection and IVF Success Rates................204 B. Reducing Multiple Gestations ....................................207 C. Gamete Donors and Surrogates .................................209 V. EMBRYONIC STEM CELL RESEARCH......................................211 -
Egg Freezing and Disposition of Frozen Eggs Consent
Lucile Salter Packard Children’s Hospital Medical Record Number Patient Name CONSENT • CRYOPRESERVATION & Addressograph or Label - Patient Name, Medical Record Number DISPOSITION OF OOCYTES Page 1 of 3 INFORMED CONSENT TO EGG FREEZING AND DISPOSITION OF FROZEN EGGS Lucile Salter Packard Children’s Hospital at Stanford (Stanford) desires to provide you with relevant and appropriate information so that you may make an informed and voluntary choice regarding the disposition of your eggs following the IVF process. Because of the possibility of your death or permanent incapacitation after eggs have been produced and frozen, it is important to decide on the disposition of any eggs that remain in the laboratory in these situations. Since this is a rapidly evolved field, both medically and legally, Stanford cannot guarantee what the available or acceptable avenues for disposition will be at any future date. Currently, the disposition alternatives upon death or permanent incapacitation are: 1. Discarding the cryopreserved egg(s) 2. Donating the cryopreserved egg(s) for quality improvement 3. Donating the cryopreserved egg(s) to another individual in order to attempt pregnancy. Note: • Egg donation to achieve a pregnancy is regulated by the FDA (U.S. Food and Drug Administration), as well as state laws, as donated tissue. Certain screening and testing of the persons providing the sperm and eggs are required before donation can occur. • You are free to revise the choices you indicate here at any time by completing another form and having it notarized. • Your will should also include your wishes on disposition of the eggs and be consistent with this consent form. -
KEMRI Bioethics Review 4
JulyOctober- - September December 20152015 KEMRI Bioethics Review Volume V -Issue 4 2015 Google Image Reproductive Health Ethics October- December 2015 Editor in Chief: Contents Prof Elizabeth Bukusi Editors 1. Letter from the Chief Editor pg 3 Dr Serah Gitome Ms Everlyne Ombati Production and Design 2. A Word from the Director KEMRI pg 4 Timothy Kipkosgei 3 Background and considerations for ethical For questions and use of assisted reproduction technologies in queries write Kenyan social environment pg 5 to: The KEMRI Bioethics Review 4. Reproductive Health and HIV-Ethical Dilemmas In Discordant Couples Interven- KEMRI-SERU P.O. Box 54840-00200 tions pg 9 Nairobi, Kenya Email: [email protected] 5. The Childless couple: At what cost should childlessness be remedied? pg 12 6. Multipurpose Prevention Technologies As Seen From a Bowl of Salad Combo pg 15 7. Case challenge pg 17 KEMRI Bioethics Review Newsletter is an iniative of the ADILI Task Force with full support of KEMRI. The newsletter is published every 3 months and hosted on the KEMRI website. We publish articles written by KEMRI researchers and other contributors from all over Kenya. The scope of articles ranges from ethical issues on: BIOMEDICAL SCIENCE, HEALTHCARE, TECHNOLOGY, LAW , RELIGION AND POLICY. The chief editor encourages submisssion of articles as a way of creating awareness and discussions on bioethics please write to [email protected] 2 Volume V Issue 4 October- December 2015 Letter from the Chief Editor Prof Elizabeth Anne Bukusi, MBChB, M.Med (ObGyn), MPH, PhD , PGD(Research Ethics). MBE (Bioethics) , CIP (Certified IRB Professional). Chief Research Officer and Deputy Director (Research and Train- ing) KEMRI Welcome to this issue of KEMRI Bioethics Review focusing on Reproductive Health Ethics. -
Regulating Egg Donation: a Comparative Analysis of Reproductive Technologies in the United States and United Kingdom
FOUR REGULATING EGG DONATION: A COMPARATIVE ANALYSIS OF REPRODUCTIVE TECHNOLOGIES IN THE UNITED STATES AND UNITED KINGDOM Michelle Sargent While rapid scientific development of egg donation technology has made it possible to elude infertility and to expand options for means of procreation, it has also thrust policy makers advanced societies in the midst of a raging debate that involves several ethical concerns. This paper describes and contrasts the respective regulatory approaches of the United States and the United Kingdom towards egg donation, and explores their potential implications for policy making in both countries. Michelle Sargent is currently pursuing her masters at the Gerald R. Ford School of Public Policy at the University of Michigan, with a concentration in energy, climate change, and environmental policy. Prior to returning to school to pursue her masters, Ms. Sargent worked at an environmental consulting firm on several different projects, including a new business model to reduce chemical usage and hazardous waste in chemical manufacturing firms, and a philanthropic collaborative to promote sustainable food systems in California. She also coordinated grant administration to small Latino nonprofits with a foundation affinity group. Ms. Sargent was named a Morris K. Udall scholar in environment in 2000 and received her Bachelor of Arts from Vassar College. Michigan Journal of Public Affairs – Volume 4, Spring 2007 The Gerald R. Ford School of Public Policy – The University of Michigan, Ann Arbor www.mjpa.umich.edu Regulating Egg Donation: A Comparative Analysis 2 INTRODUCTION Procreation is a fundamental human drive. The image of happy parents holding a healthy baby pervades our society, from Gerber commercials to TV sitcoms. -
Receiving Donated Eggs
DONORS Receiving donated eggs Donor egg treatment splits a traditional IVF cycle in to two parts. The first part involves your egg donor and the stimulation of her ovaries, followed by the egg collection. The second part involves you as the recipient of the donated eggs, adding sperm to eggs, embryo transfer and the subsequent pregnancy test. Finding a donor Success with donated eggs If you don’t have a personal donor we recommend The two factors that contribute most to the advertising. The clinic advises where to place an chance of success belong to your donor ad, what to say, and follows up the women who – her age and the number of eggs collected. reply. You have the first option on potential donors The graph on page 73 for IVF also applies recruited from your advertisement. for donor egg, but we do have some specific results for egg donation that includes donors younger than 30 as shown in Figure 12. Because we do far fewer donor egg treatments than ‘normal’ IVF, there are fewer women in each age group, so the margin Egg donor wanted of error is larger. For those of you who are We are a couple, both in our early 40s, statistically minded, the vertical bars in who sadly haven’t become pregnant after 3 cycles of IVF. Figure 12 show 95% confidence intervals. If you are a healthy, non smoking woman, We have found that birth rates have 20–37, who has preferably completed your own family and would like to help been a bit lower for recipients aged 34 and us achieve our dream of having a family, we will be forever grateful. -
Religious Aspects of Assisted Reproduction
FACTS VIEWS VIS OBGYN, 2016, 8 (1): 33-48 Review Religious aspects of assisted reproduction H.N. SALLAM1,2, N.H. SALLAM2 Department of 1Obstetrics and Gynaecology and Alexandria Fertility and 2IVF Center, Alexandria, Egypt. Correspondence at: [email protected] or [email protected] Abstract Human response to new developments regarding birth, death, marriage and divorce is largely shaped by religious beliefs. When assisted reproduction was introduced into medical practice in the last quarter of the twentieth century, it was fiercely attacked by some religious groups and highly welcomed by others. Today, assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation. Orthodox Christians are less strict than Catholic Christians but still refuse third party involvement. Interestingly, in contrast to Sunni Islam, Shi’a Islam accepts gamete donation and has made provisions to institutionalize it. Chinese culture is strongly influenced by Confucianism, which accepts all forms of assisted reproduction that do not involve third parties. Other communities follow the law of the land, which is usually dictated by the religious group(s) that make(s) the majority of that specific community. The debate will certainly continue as long as new developments arise in the ever-evolving field of assisted reproduction. Key words: Assisted reproduction, Buddhism, Christianity, Hinduism, Islam, ICSI, IVF, Judaism, religion, religious aspects. Introduction birth, death, marriage or divorce. -
Outcome of Assisted Reproductive Technology in Men with Treated and Untreated Varicocele: Systematic Male Fertility Review and Meta‑Analysis
Asian Journal of Andrology (2016) 18, 254–258 © 2016 AJA, SIMM & SJTU. All rights reserved 1008-682X www.asiaandro.com; www.ajandrology.com Open Access INVITED REVIEW Outcome of assisted reproductive technology in men with treated and untreated varicocele: systematic Male Fertility review and meta‑analysis Sandro C Esteves1, Matheus Roque2, Ashok Agarwal3 Varicocele affects approximately 35%–40% of men presenting for an infertility evaluation. There is fair evidence indicating that surgical repair of clinical varicocele improves semen parameters, decreases seminal oxidative stress and sperm DNA fragmentation, and increases the chances of natural conception. However, it is unclear whether performing varicocelectomy in men with clinical varicocele prior to assisted reproductive technology (ART) improve treatment outcomes. The objective of this study was to evaluate the role of varicocelectomy on ART pregnancy outcomes in nonazoospermic infertile men with clinical varicocele. An electronic search was performed to collect all evidence that fitted our eligibility criteria using the MEDLINE and EMBASE databases until April 2015. Four retrospective studies were included, all of which involved intracytoplasmic sperm injection (ICSI), and accounted for 870 cycles (438 subjected to ICSI with prior varicocelectomy, and 432 without prior varicocelectomy). There was a significant increase in the clinical pregnancy rates (OR = 1.59, 95% CI: 1.19–2.12, I 2 = 25%) and live birth rates (OR = 2.17, 95% CI: 1.55–3.06, I 2 = 0%) in the varicocelectomy group compared to the group subjected to ICSI without previous varicocelectomy. Our results indicate that performing varicocelectomy in patients with clinical varicocele prior to ICSI is associated with improved pregnancy outcomes. -
Recipient Handbook
RECIPIENT HANDBOOK Boston IVF 130 Second Avenue Waltham, MA 02451 The Egg Donation Process: Step by Step 1. If you have not yet discussed egg donation with your Boston IVF physician or you have not seen your Boston IVF physician within the year, set up an appointment. Your spouse or partner must come with you to this appointment. 2. Contact the Egg Donation Team (781)434-6500. They will be responsible for working with you to ensure that you, your partner, have been properly screened, and for synchronizing and coordinating your cycle with the donor’s cycle. 3. Attend an Egg Recipient Seminar with the Egg Donation Program Coordinator for comprehensive information about egg donation. Please contact the Donor Egg Team to make an appointment for the next seminar. 4. Meet with the Financial Coordinator. Learn about what your insurance policy may cover. Discover what testing may be required by your insurance company. Discover what your out of pocket costs will be. 5. Begin your egg recipient evaluation. Please mail or hand-deliver your medical records from tests performed outside of Boston IVF. 6. With the completion of all your testing the Egg Donation Program Coordinator will contact you by phone to let you know the screening process is complete. 7. Go to the Boston IVF website www.bostonivf.com. Click on Patient Resources on the top right hand side. Log in with the username “bostonivf” and password “patient” and download 3 consent forms: ¾ Recipients of Egg Donation ¾ Embryo Freezing ¾ Thaw consent. Please read these forms and bring them with you to the seminar or your next appointment with your Boston IVF physician, to sign and be witnessed. -
Egg Donor IVF (Recipient) Egg Donation Is a Variation of IVF Treatment for Women Who Have Difficulty Achieving a Healthy Pregnancy with Their Own Eggs
Egg Donor IVF (Recipient) Egg Donation is a variation of IVF treatment for women who have difficulty achieving a healthy pregnancy with their own eggs. Following ovarian stimulation, eggs are obtained from a healthy young donor and fertilized with sperm from the recipient’s partner. One or two good quality embryos are then transferred to the recipient’s uterus. Candidates Women whose ovaries are absent Women who have gone through an early menopause Women with reduced ovarian reserve (low antral follicle count, abnormal clomiphene challenge test or day-3 FSH > 12 IU/L) Women whose ovaries have not responded well to ovarian stimulation during IVF Women who have had poor egg/embryo quality during their IVF cycles Women with a chromosomal or genetic disorder that can transmitted through the eggs Women less than 51 years old Advantages of donor eggs, as compared to adoption: You can have control over the prenatal environment You can experience pregnancy and delivery Your partner can be the biological father of the child You can have a genetic link with the child if the donor is a family member Your risk of miscarriage or chromosomal abnormalities will be related to the donor’s age and medical history, not to your age or reproductive history Donor Selection At this time, we do not have access to anonymous donors. In fact, Canadian law (Bill C-6) prohibits payment of donors, aside from reimbursement for expenses. Therefore, we can only accept altruistic donors who are friends or family members, who are not being paid for their participation, who are well known to you and with whom you are comfortable sharing this experience. -
Donor Eggs for the Treatment of Infertility
CLINICAL Caitlin Dunne, MD, FRCSC Donor eggs for the treatment of infertility Using donated eggs can be a remarkably successful fertility treatment in the right circumstances. Though donor egg pregnancies may carry some increased obstetrical risks, the risks are manageable and can offer women a chance at pregnancy when there is no other option. ABSTRACT: Egg donation is a common treatment the right time to recover the resulting embryo, Columbia has the highest age of first birth in for infertility. It is most often used for women with which was transferred into the intended moth- Canada at 30.5 years versus 30.3 years in On- premature menopause, advanced reproductive er’s uterus.2,3 tario.10 According to Statistics Canada, 2010 age, or a history of unsuccessful in vitro fertilization In the early 1980s, assisted reproductive marked the first time that more women in their attempts. Because egg donors are generally in their technology was developing rapidly in Canada 30s were having children compared to women 20s, pregnancy success rates are high. In many cas- and around the world.4 Fertility pioneers used in their 20s.11 es, donor eggs give women a chance at pregnancy laparoscopy to retrieve donor eggs for fertiliza- The possible consequences of delaying child- when there would be no other option. Donor egg tion in vitro.3,5,6 These early “third-party repro- bearing are infertility, embryo aneuploidy, and pregnancies may carry some increased obstetrical duction” techniques were groundbreaking at miscarriage. These are largely attributed to aging risks related to preeclampsia and advanced mater- the time, given that the world’s first IVF baby, oocytes with failing meiotic spindles and other nal age. -
Influence of Placental Abnormalities and Pregnancy-Induced Hypertension in Prematurity Associated with Various Assisted Reproduc
Journal of Clinical Medicine Article Influence of Placental Abnormalities and Pregnancy-Induced Hypertension in Prematurity Associated with Various Assisted Reproductive Technology Techniques Judy E. Stern 1,* , Chia-ling Liu 2 , Sunah S. Hwang 3, Dmitry Dukhovny 4 , Leslie V. Farland 5, Hafsatou Diop 6, Charles C. Coddington 7 and Howard Cabral 8 1 Department of Obstetrics & Gynecology, Dartmouth-Hitchcock, Lebanon, NH 03756, USA 2 Bureau of Family Health and Nutrition, Massachusetts Department of Public Health, Boston, MA 02108, USA; [email protected] 3 Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA; [email protected] 4 Division of Neonatology, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA; [email protected] 5 Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; [email protected] 6 Division of Maternal and Child Health Research and Analysis, Bureau of Family Health and Nutrition Massachusetts Department of Public Health, Boston, MA 02108, USA; [email protected] 7 Department of Obstetrics and Gynecology, University of North Carolina, Charlotte, NC 28204, USA; [email protected] 8 Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA; Citation: Stern, J.E.; Liu, C.-l.; [email protected] Hwang, S.S.; Dukhovny, D.; Farland, * Correspondence: [email protected]; Tel.: +1-603-252-0696 L.V.; Diop, H.; Coddington, C.C.; Cabral, H. Influence of Placental Abstract: Objective. Assisted reproductive technology (ART)-treated women exhibit increased risk Abnormalities and Pregnancy- of premature delivery compared to fertile women. -
Applications of CRISPR/Cas9 in Reproductive Biology
Applications of CRISPR/Cas9 in Reproductive Biology Faheem Ahmed Khan, Nuruliarizki Shinta Pandupuspitasari, Huang ChunJie, Hafz Ishfaq Ahmad, Kai Wang, Muhammad Jamil Ahmad and ShuJun Zhang* Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of the Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, Te People’s Republic of China. *Correspondence: [email protected] htps://doi.org/10.21775/cimb.026.093 Abstract into genes that interact with environment to develop Genome editing is unravelling its benefts in wide a specifc phenotype. Although extensive studies areas of scientifc development and understanding. have been carried out but still the understanding Te advances of genome editing from ZFNs and of genes and its function is far from understanding TALLENs to CRISPRs defnes its wide applicabil- because genes are diferentially expressed. Te pre- ity. Reproduction is the fundamental process by sent advances in genome editing technologies takes which all organisms maintain their generations. a leap towards endogenous genome modifcation, CRISPR/Cas9, a new versatile genome editing which gives rise to several opportunities to deal tool has been recently tamed to correct several with diseases and undesired phenotypes (Khan et disease causing genetic mutations, spreading its al., 2016). arms to improve reproductive health. It not only Te continuous update to knowledge reservoir edits harmful genetic mutations but is also applied owes to molecular studies unfolding several impor- to control the spread of parasitic diseases such as tant aspects of genes and their interactions with malaria by introducing selfsh genetic elements, the environment enabling scientists to do forward propagated through generations and population via and reverse genetics model cells and organisms reproduction.