Filiation, or a person's parentage, is one of the major components of someone's identity, often with important implications for that person's welfare in social and personal terms. Fertility specialists are enjoined to consider the welfare of the child, and this is a legal requirement in assisted reproduction techniques in the UK. This paper is in three parts, discussing some of the potential problems regarding filiation of the prospective child born of assisted reproduction techniques, in relation to the use of gametes and embryos. The first two parts concentrate on the status of children born as a result of treatment given posthumously, and on filiation problems associated with donation of gametes or embryos, and surrogacy. The third part compares British and French legislation with special regard to the welfare of the child, as well as underlining the common trends and principles enunciated in both legislations. This is particularly appropriate at a time when the European Society for Human Reproduction and Embryology is about to issue ethical guidelines in assisted reproduction, and when both the Council of Europe and the European Commission have commissioned studies on the implications of the assisted techniques, including those concerning status of the potential children.

Child Welfare↗

PubMed1993

Effects of age, gravidity and male infertility status on cumulative conception rates following artificial insemination with cryopreserved donor semen: analysis of 2998 cycles of treatment in one centre over 10 years.

The effects of age, gravidity and male infertility status on cumulative conception rates after donor insemination were investigated in an analysis of 2998 treatment cycles undertaken on 443 patients. It was found that the cumulative conception rates after 3, 6 and 12 cycles of treatment were 21, 40 and 62% respectively for patients < 30 years of age compared with 17, 26 and 44% for those aged > or = 30 years (P = 0.008). There was also a significant difference (P < 0.001) in results depending on course of treatment and the cumulative conception rates were 19% after 3 cycles, 33% after 6 cycles and 54% after 12 cycles of treatment in the first course of treatment compared with 40, 67 and 79% respectively in those who returned for subsequent courses of treatment after having achieved a donor insemination pregnancy in the first treatment course. Gravidity and male infertility status (azoospermia or oligozoospermia/asthenozoospermia) did not significantly affect the cumulative conception rates.

Adult↗

PubMed1991

Semen and cervical mucus parameters and success in artificial insemination.

Over the last 2 years, data on cervical mucus, thawed semen and their interaction in vitro have been collected at the time of insemination in all patients referred to our clinic for artificial insemination by donor (AID). A total of 37 patients have become pregnant, including one who became pregnant twice, and 27 patients have completed a course of 6-12 inseminations or withdrawn without becoming pregnant after a minimum of four cycles of treatment. A comparison of data from these two groups reveals significant differences in cellularity, penetrability and ferning of the cervical mucus and in the motility of spermatozoa in the thawed semen. In a comparison of sperm parameters in the same semen sample prior to freezing and after thawing, those samples which were fertile showed a lower reduction in motility due to freezing and thawing. Studies on the in vitro interaction between mucus and spermatozoa show that, in certain combinations, the mucus appears to induce abnormalities in the midpiece region or the tail, which impair sperm progression. Collection and analysis of data from up to three inseminations per cycle demonstrates that there is considerable variation between patients in the stability of their periovulatory mucus and has also allowed a number of patients with 'problem mucus' to be identified.

Cervix Mucus↗

PubMed1989

The value of sperm swimming speed measurements in assessing the fertility of human frozen semen.

The purpose of this study was to evaluate relationships between measured sperm velocity and in-vivo fertility, using donor semen samples from an artificial insemination (AID) programme. Seventy-one frozen semen samples were examined; measurements of sperm velocity were made immediately after thawing, upon a motile 'swim-up' fraction, and finally after 3.5 h incubation at 37 degrees C in the freezing mixture. Zona-free hamster egg penetration assays were performed upon all samples. Two groups of samples were identified; seven donors (11 samples) had failed to produce any pregnancies through AID from a range of 3 to 14 cycles tested, whilst the remaining samples (from 25 donors) had achieved at least one pregnancy each. The mean sperm velocity (+/- SEM) for the latter 'fertile' group was significantly higher than the corresponding value for the 'infertile' group; (i) after thawing, 65.9 +/- 1.8 versus 50.4 +/- 3.2 microns/s (P less than 0.001) and (ii) after 3.5 h incubation, 42.1 +/- 2.1 versus 24.7 +/- 5.7 microns/s (P less than 0.002). Using the maintenance of sperm velocity during incubation as an indicator of survival, life-table analyses were used to calculate monthly conception rates on various sub-groups of the semen samples. Poor survival (greater than 40% decline in velocity over 3.5 h) was associated with a monthly pregnancy rate of only 11.58% (362 cycles), whilst better survival (less than 40% decline) was associated with the significantly higher (P = 0.024) pregnancy rate of 16.87% (480 cycles).

Evaluation Studies as Topic↗