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PubMed1996

[Follicle freezing and autografting. A new method of medically assisted procreation?].

Although frozen human follicles were shown to be viable after thawing, more than forty years, the low yield of primordial follicles after cryopreservation has greatly limited research in this area. The aim of freezing follicles is to stock a patient's ovocytes before potentially destructive therapy for cancer then to reimplant the follicular tissue after successful treatment. The patient's ovulatory capacity would then theoretically be restored, allowing natural or possibly in vitro fertilization. As have other teams, we recently renewed work in cryopreservation of follicles in experimental models in search for a better cryopreservation agent and have had encouraging results suggesting that primordial human follicles or ovarian fragments can be grafted successfully after cryopreservation. Questions still under study include the optimal site for implantation, the survival time for grafts and the quantity of follicles needed to achieve pregnancy. Work on large animal models or xenografts of human tissues on immunotolerant animals may provide further insight. The possibilities of grafting primordial follicles, either alone or within ovarian tissue, may raise hope for many women, although new questions such as an age limit for reimplantation and use of allografts requiring preparation with major immunosuppressive therapy require further debate.

Animals↗
PubMed2005

Assisted procreation in cases of hepatitis B, hepatitis C or human immunodeficiency virus infection of the male partner.

Guidelines for assisted procreation impose a special responsibility upon physicians for the health of the expected child because of their active role in inducing pregnancy. Therefore, careful clinical evaluation of both partners has to precede every application of these methods. Risks for the mother's health or the development of the child count as a relative contraindication for a treatment. To balance these relative contraindications, the existing risk factors have to be recognized through screening examination. If a chronic infection occurs in the male partner, prevention for the female partner is theoretically possible by using a condom. As this inhibits a pregnancy, at least in cases of human immunodeficiency virus and hepatitis C virus infections, realization of a pregnancy requires assisted procreation. The main question in these cases is whether infectious particles can be eliminated by sperm processing to ensure the safe treatment of the healthy female partner.

Female↗
PubMed2005

Can artificial techniques supply morally neutral human embryos for research? Part I. Creating novel categories of human embryos.

Manipulations of the molecular composition and formation of human embryos are posing vital new challenges to traditional concepts of human identity and procreation. Current trends in embryology in particular are reshaping the ethical question of how scientific research should treat experimentally derived embryos. Some investigators have argued that embryos created through artificial means are technologically novel entities that should be exempt from ethical restraints placed on research involving human embryos that come into being through natural processes. These include uniparental embryos derived through cloning or parthenogenesis, as well as multiparental, hybrid-parental, and xenohybrid-parental embryos. If confined to natural means many of these genetic unions could not occur, but through the intervention of technology, it is becoming possible to design and grow strange and unusual forms of embryos, in some cases using human gametes. Regardless of the genetic contributors or the processes used to fertilize and stimulate egg activation, in each case the new embryo represents an individual organism that begins a process of development. We conclude that the prospect of creating or redesigning new human life should be held to a stringent ethical standard of precaution, even higher than that of deciding to destroy existing embryonic life. Accordingly, we urge cautious ethical reflection and broad public discussion prior to deciding whether to permit embryologic research into novel forms of procreative means in nonhuman animals, to be further extended to humans.

Animals↗
PubMed2006

Sexual behaviors and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus infection: experience of an urban tertiary center.

PURPOSE: To assess sexual knowledge, behaviors, and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus (PNA HIV) infection. Increasingly, children with PNA HIV infection survive to adolescence and become sexually active. Understanding their procreational intentions could aid in designing reproductive health and secondary prevention programs. METHODS: A cross-sectional survey of adolescents and young adults with PNA HIV infection at an urban tertiary center was conducted. From June 2003 through September 2004, participants completed a questionnaire that inquired about their sexual knowledge and behaviors. Participants aware of their diagnoses also completed items regarding procreational intentions. RESULTS: Seventy-four percent (57/77) of eligible participants completed the survey. Thirty-three percent (19/57) of participants reported having had penile-vaginal intercourse, 89.4% of them after learning of their HIV status. Fifty percent (5/10) of sexually active female participants had been pregnant. Among the 50 participants who were aware of their diagnosis, 70% (n = 35) expressed intent to have children. A majority of those aware of the risk of maternal-to-child transmission (MTCT) (71.1%) expressed intent to procreate. Participants who perceived MTCT as low were more likely to express intent to procreate than those who perceived the risk of MTCT as high. CONCLUSIONS: Adolescents with PNA HIV infection are becoming sexually active and express intent to have children. This has important implications for secondary prevention of HIV infection. These adolescents need innovative intervention programs offering reproductive health education including procreational choices and considerations.

Adolescent↗
PubMed1998

Factors and their origins in mate selection and choice among humans: implications for individual psychotherapy and counseling.

A mechanism of mate selection in humans is proposed and elaborated. It is further proposed that this mechanism constitutes one of the important factors for stability and the necessary longevity of the procreational dyad and therefore the procreational success of humans as a species. The concepts and mechanisms of assortative mating (homogamy) and that of complementarity of temperaments of the mates (heterogamy) which guide such selections are described, the relationships between the two are explored, and finally their possible early developmental origins are proposed. Evidence from a small study of 20 married couples' responses in temperament tests is offered as well as some illustrative case histories all pointing to those mechanisms. The argument is based mainly on principles of evolutionary psychology.

Adult↗
PubMed1995

Children's rights and artificial procreation.

Techniques of artificial human reproduction should be assessed in the light of the interests of the children to be born from them. The problems of the child without a father and of the child with two mothers are discussed. The author concludes that the law should dissuade arrangements that are not in the best interests of the children.

Child Advocacy↗
PubMed1996

Requiem or renaissance for the law reform commission of Canada?

From 1975 to 1992, the protection of life project of the Law Reform Commission of Canada sought to help society answer some of the legal and bioethical riddles posed by the biomedical revolution, particularly as these developments affected the protection of human life, public safety and fundamental values. A focus on the risks, benefits, rights and duties associated with biomedical sciences and technology provided the project both a means of inquiry into pressing health law and bioethics questions, and a methodology of law reform. The inquiry was often applied through a transdisciplinary perspective, to such topics as the redefinition of death, medically assisted procreation, behavioral alteration, human experimentation, organ transplantation, consent, and the criminal law. Amid recent initiatives to resurrect the Commission, the contributions of the protection of life project are likely to be judged by the bioethico-legal decision-making, dispute resolution, legislative or regulatory enactments and court decisions influenced by its corpus of thought.

Advisory Committees↗
PubMed1995

Persons of lesser values--moral argument and the "final solution".

For many persons, 'Holocaust-abomination' is a fixed point on their moral compass: if anything can be evil, it was. Yet at least one of the justifications deployed by its perpetrators (the eugenics argument) involves widely-held values concerning human health and procreation. Hence persons endorsing many current activities based on those values (e.g. genetic counselling) have been charged with being on a morally deplorable slippery slope. This paper sketches the necessary structure of a moral position capable of consistently embracing those values without placing its occupants on that slippery slope.

Ethical Analysis↗
PubMed1976

[Seasonal variations in the birth rate and conception rate within the last 200 years (author's transl)].

The monthly variations and the mean daily conception rates of 136,828 deliveries from 1803 to 1970 within the same population area are reviewed. It was found that the conception rate during the first half of the 19th century showed a rapid increase from its low during the winter to its maximum in May and that this pattern became much less pronounced in the 20th century. During the second half of the 20th century, the highest conception rate shifted for the first time to the summer and the third quarter of the year. In contradistinction to this development, the low of the conception rate during the winter from January to March is much less pronounced during the first half of the 20th Century and remains constant with the lowest conception rate in February into the second half of the 20th century. The importance of the influence of nature during the spring and winter and of the working and living patterns as well as the influence of family planning and recreational activities on the intensity of procreation in the human within the last 200 years is discussed.

Birth Rate↗
PubMed1997

"Goodbye Dolly?" The ethics of human cloning.

The ethical implications of human clones have been much alluded to, but have seldom been examined with any rigour. This paper examines the possible uses and abuses of human cloning and draws out the principal ethical dimensions, both of what might be done and its meaning. The paper examines some of the major public and official responses to cloning by authorities such as President Clinton, the World Health Organisation, the European parliament, UNESCO, and others and reveals their inadequacies as foundations for a coherent public policy on human cloning. The paper ends by defending a conception of reproductive rights of "procreative autonomy" which shows human cloning to be not inconsistent with human rights and dignity.

Animals↗
PubMed2001

Cancer patients, gametes, gonadal tissue, and the UK legal status.

With advances in reproductive technologies, there are new opportunities for preservation of fertility potential for cancer patients receiving damaging treatment regimens. These include cryopreservation of gonadal tissue and maturing germ cells. These developments were not envisaged in the UK Human Fertilisation and Embryology Act 1990. Complex legal interpretations have followed in deciding which techniques come under statutory remit of the Human Fertilisation and Embryology Act 1990, and whether a licence is necessary to conduct such activities. The decisions have depended on the legal definition of the gamete and the fact that substituted consent within the Act 1990 is specifically disallowed. In our analyses we believe several areas require further explanation or improvement: the definition relating to the oocyte, its applicability to ovarian tissue, a pre-Tanner stage 2 patient whose immature spermatozoa may satisfy the definition of gamete, and the legal mechanism of substituting consent which may allow the unregulated use of frozen gonadal tissue or germ cells for procreation in future years. In a recent development it appears that gonadal tissue may come under a 'tissue specific body' and not the Human Fertilisation and Embryology Authority. It makes sense from the standpoint of patient welfare and the limited public and clinical resources, to place under one regulatory body all biological material where the ultimate aim is human procreation.

Journal Article↗
PubMed1988

Ethical considerations of the new reproductive technologies. By the Ethics Committee (1986-87) of The American Fertility Society in light of Instruction on the Respect for Human Life in its Origin and on the Dignity of Procreation issued by the Congregation for the Doctrine of the Faith.

In September 1986, The American Fertility Society issued a report, Ethical Considerations of the New Reproductive Technologies, setting forth the then-held ethical position of the Society on the various new reproductive technologies. In 1987, the Congregation for the Doctrine of the Faith issued the Instruction on the Respect for Human Life and Its Origin and on the Dignity of Procreation. While both documents state that very similar moral criteria were used to derive ethical positions with respect to various reproductive procedures, the conclusions as to the ethical acceptability of the various procedures differ sharply in the two documents. The question can be raised about the procedure used by the Congregation of the Faith to derive its conclusions from the stated premises. Thus, while stating that "the individual integrally and adequately considered" is to be the basis of the moral judgment, the fact is that most conclusions are based on and referenced to past Catholic statements. While the difference in conclusion from similar premises may be troubling to society, it can be especially paralyzing to four groups: (1) those who face problems that might be solved by one or another of the new reproductive technologies; (2) those who are involved in applying them; (3) those who are responsible for institutional policies where such techniques may be applied; and (4) those who are in a position to influence public policy in a legislative or regulatory way. Because of the conflicting conclusions of the two documents, the present Ethics Committee (1986-87) of The American Fertility Society was convened and considered these guidelines in the light of the Instruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Bioethics↗
PubMed2000

[Relationship between human immunodeficiency virus and sperm--implications in medically assisted procreation].

The number of HIV-sero-discordant couples (man HIV+, woman HIV-) asking for assisted reproductive technologies (ART) has been increasing more and more since the efficiency of antiretroviral therapy was clinically proven. Long-term survey and amelioration of life quality in treated HIV-seropositive patients have induced in these couples a strong wish to conceive but they expected the most reduced risk of viral contamination. Epidemiologic data concerning HIV transmission during episodic unprotected sexual acts showed an elevated annual seroconversion rate which justifies that since 1992, European biologists specialized in human reproduction have proposed to carry out ART using intrauterine insemination (IUI) with prepared sperm in the population of couples where the man is HIV-seropositive. In spite of adapted technologies of sperm preparation, presence of HIV nucleic acids was demonstrated in purified spermatozoon (SPZ) fractions, resulting from residual free virus or virus linked to SPZ or residual infected cells, not completely eliminated. However, approximatively 2000 IUI were carried out with an HIV-controlled sperm treatment and no female and newborn seroconversions were reported. Even if the total lack of risk is impossible to obtain, a strict method of infected sperm preparation associated with sensitive virological techniques should permit us to obtain a minimal risk of contamination of women after IUI. In vitro fertilization (IVF) with or without microinjection allowed us to obtain the same results but they should be confirmed by further studies to be more relevant. These European workings, associated to a clear legal regulation in France, permit us to considerate that carrying out ART in HIV-sero-discordant couples in which the man is HIV-seropositive is allowable regarding both the viral problem and eventual sterility.

Adult↗