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Ethical considerations in Syria regarding reproduction techniques.

Ethical Islamic considerations concerning current medical infertility treatment are outlined, that allow application of all techniques as far as they are compatible with legal marriage: Homogenic insemination is allowed. Heterogenic insemination is not, although it bears slightly better outcome, because of the imperative Islamic rule not to mingle genealogical lines. Neither is surrogate motherhood because of the legal position of the mother in Islamic shari'a and consequent inheritance rights on the one hand and sociological significance of motherhood on the other. The question arises, which is the mother, the biological or the social. In all cases, special attention should be paid to the professionals involved in the procedures. The danger of embryonic sex selection following preimplantation diagnostics is hinted at, precautions should be taken. These ethical considerations are substantial in Arab countries, including Syria.

Ethics, Medical↗

Assisted human reproductive techniques--emerging ethical and legal implications.

The unprecedented and rapid advances in medical sciences have revolutionized modern medicine and surgery in a number of ways. These advances such as human embryo cloning, trans-genetic manipulation, in-vitro fertilization and surrogate motherhood have been able to cure infertility to a large extent by offering 'made to measure or super babies' and can cure a number of conventional diseases and improve the quality of life. Scientists and sociologists are concerned about moral and ethical issues, which have arisen due to these advances in medicine. The new biotechnology and the achievements in bio-engineering offered hope to those couples in fulfilling their yearning for children. What we witness today is just the beginning and not the end of the adventurous march of science in unravelling the mysteries of nature. The moot point now is how can nature be engineered to yield positive results without offending values of human morality, ethics and decency. It is high time that governments and society take stock of the current dilemma, as these advances in biosciences pose a threat to the moral and ethical fabric of modern society.

Ethics, Medical↗

Kinetics of SRY gene appearance in maternal serum: detection by real time PCR in early pregnancy after assisted reproductive technique.

BACKGROUND: Fetal DNA circulating in maternal serum offers a possibility for non-invasive prenatal diagnosis but its kinetics during very early pregnancy is still unclear. In order to clarify this point, the studies on the kinetics of fetal DNA appearance in maternal serum were conducted on patients undergoing assisted reproduction. METHODS: Using a quantitative real time PCR assay, the presence of SRY gene sequences was evaluated in the serum of patients at the onset of pregnancy. RESULTS: Twenty-seven patients were originally studied but first trimester abortion occurred in five cases. Among the 22 ongoing pregnancies, ten were found to bear at least one male fetus and all sera from these women gave positive results for SRY gene detection. The SRY gene was found to be detectable as soon as day 18 after embryo transfer in one case and it had been found in the other nine patients by day 37. CONCLUSIONS: Fetal DNA is found in maternal serum even before the fetal circulation is established, which is highly suggestive that it is released, at least in part, from the trophoblast. Detection of fetal DNA in maternal serum very early in pregnancy may have clinical implications such as with the management of pregnant women carrying a fetus at risk for congenital adrenal hyperplasia.

DNA↗

[Infertility treatment before assisted reproductive techniques].

The prevalence of infertility has increased in recent years, but the medical services to treat these problems are not available for most of the affected couples. The prognosis for fertility is important in order to determine the therapeutic capacity of each service, and to select the couples that could be treated at a primary level, or to send them to more advanced levels of reproductive technology. In practice, the infertility is treated in primary medical levels and the assisted reproductive technology is available only to a limited sector of the poblation. In general, the managed-care plans do not compensate directly for infertility treatments, but they are indirectly paying some therapeutic procedures for fertility.

Adolescent↗

Assisted reproductive techniques and male infertility.

For couples in whom improvement in spermatogenesis is not possible or is unsuccessful in producing conception, ARTs offer much promise. For mild to moderate male factor couples, IUI combined with superovulation is often the initial procedure employed. If unsuccessful, IVF or one of its variations should be considered. With severe male factor cases, couples should proceed directly to IVF or one of its variations in which specific techniques may be used to improve the chances of fertilization. Currently both specialized semen-processing techniques and micromanipulation are used either singly or in combination. More experience is needed to determine which couples will benefit from which techniques. Although the urologist may not actively participate in all the actual ART procedures, it is important that the urologist have a thorough understanding of the procedures and their indications. This allows for accurate counseling of the male factor couple.

Humans↗

Fertility and the use of assisted reproductive techniques in the adult male exstrophy/epispadias patient.

These three cases exemplify, in increasing order of complexity, how the common sense application of already successful techniques might be applied to augment the chance of pregnancy in this group of patients. We believe this to be the first report specifically outlining measures that may assist this group in their goal of pregnancy achievement. To our knowledge, vasal sperm aspiration has never been used for this indication.

Adult↗

[Echography in assisted reproduction techniques].

The Authors describe the A.R.T. echoguided techniques, that can be routinely used in IVF/ET programs. All these techniques are simple and have replaced the previous ones. The echoguided oocyte recovery is now widely accepted instead of the laparoscopic way: the gamete intrafalloppian transfer can be easily performed under local anesthesia; the selective fetal reduction in cases of multiple pregnancies can be easily carried out on an outpatient basis.

Female↗

[Results, evolution of assisted reproduction techniques].

During the last decade IVF and other assisted conception treatment (ACT) methods have become an internationally accepted form of treatment of infertile couple. The final definition of success following ACT is the couple who having received treatment have a live child. As IVF treatment gradually becomes more successful and as the number of babies born as a result of this treatment increases more attention is being focused on the outcome of ACT pregnancies. Recent and futur development of ACT are related.

Female↗

[Reproduction techniques and infectious risks: study of practices in French centers in 1997].

In the absence of specific legislation or consensual recommendations in France regarding the routine screening of infectious transmissibility risk before intra-couple medically assisted procreation (MAP), an inquiry about the practice of screening management in France has been performed. 500 questionnaires were sent, and 104 answers were received. The results of such inquiry coming from 62 private and 42 public centers are the subject of this paper.

Female↗

[1995 evaluation of the CECOS Federation. Use of different methods of assisted reproductive techniques].

Intracervical insemination IC is still the most common method of ART with frozen donor semen. During the year 1995 in France IC was used in 63% of all cycles, with a pregnancy rate per cycle (PR) of 9.3%. Intrauterine insemination IU was used in 24% of all cycles with a PR of 13% (p < 0.01) and in vitro fertilization IVF in 12% of all cycles with a PR of 22% (p < 0.01). The benefit of the different methods, in relation with the number of unsuccessful cycles, and in relation with the quality of frozen semen is analysed.

Female↗

Genetically determined male infertility and assisted reproduction techniques.

This is a review of the common chromosome and genetic disorders associated with male infertility that need to be considered by the clinician and the couple in the context of treatment. Until recently the most relevant disorders have been those inherited from parents, however, with the advent of technologies enabling recovery of sperm from the testicle in men with severely damaged spermatogenesis there is increased interest in those genetic abnormalities that may occur in mitosis and meioses. It is likely that over the next ten years there will be increasing focus on this aspect of male fertility genetic disorders. This article needs to be read in conjunction with the specific in depth reviews in this journal edition.

Aging↗

[Application of sequential culture in assisted reproductive technique].

OBJECTIVE: To investigate the effects of sequential culture technique on the outcomes of in vitro fertilization-embryo transfer(IVF-ET). METHODS: Sequential culture media were used in 47 IVF-ET cycles, and conventional medium in 114 cycles. The fertilization rate, cleavage rate and speed, good embryo rate and pregnancy rate were compared between these 2 groups. RESULTS: There were significantly higher embryo cleavage and quality score rate, pregnancy rate (97.9%, 64.4%, 46.7%) in sequential media group as compared those in conventional medium group (89.7%, 40.2%, 28.2%). CONCLUSION: Sequential culture system is more suitable for the development of cultured human oocytes and embryos.

Blastomeres↗