Tag: infertility

Bioethics News

3D artificial ovary constructed with excellent results. New hope for women infertility

A team of researchers from the McCormick School of Engineering at Northwestern University in the United States has reported that it has managed to construct the structure of an artificial ovary 3D  (see HERE) a hydrogel that, once transplanted in an animal, can interact with its tissues and create a functioning ovary. This artificial scaffold was implanted in sterilized female mice, with cell division to ovulation taking place in two months. After mating, these females became pregnant and gave birth to healthy mice that survived, after being nursed by their mothers. This is undoubtedly a great technological breakthrough with visions of being used in humans to resolve infertility issues (see HERE).

La entrada 3D artificial ovary constructed with excellent results. New hope for women infertility aparece primero en Bioethics Observatory.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Will CRISPR fears fade with familiarity?

With all these ‘test tube’ babies grown up, how have our reactions to the technology evolved? AP Photo/Alastair Grant

The first “test-tube baby” made headlines around the world in 1978, setting off intense debate on the ethics of researching human embryos and reproductive technologies. Every breakthrough since then has raised the same questions about “designer babies” and “playing God” – but public response has grown more subdued rather than more engaged as assisted reproductive technologies have become increasingly sophisticated and powerful.

As the science has advanced, doctors are able to perform more complex procedures with better-than-ever success rates. This progress has made in vitro fertilization and associated assisted reproductive technologies relatively commonplace. Over one million babies have been born in the U.S. using IVF since 1985.

And Americans’ acceptance of these technologies has evolved alongside their increased usage, as we’ve gotten used to the idea of physicians manipulating embryos.

But the ethical challenges posed by these procedures remain – and in fact are increasing along with our capabilities. While still a long way from clinical use, the recent news that scientists in Oregon had successfully edited genes in a human embryo brings us one step closer to changing the DNA that we pass along to our descendants. As the state of the science continues to advance, ethical issues need to be addressed before the next big breakthrough.

Birth of the test-tube baby era

Louise Brown was born in the U.K. on July 25, 1978. Known as the first “test-tube baby,” she was a product of IVF, a process where an egg is fertilized by sperm outside of the body before being implanted into the womb.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Web Round Up: Time to Chill? Egg Freezing and Beyond by Moira Kyweluk

A focus on age-related fertility decline, and exploration of ways to expand the timeline and options for biological parenthood have been consistent cultural and web-wide fixations. The $3 billion United States fertility industry was in the headlines once again this month including coverage of the launch of Future Family, a service offering  a “fertility age test” to women and negotiated-rate infertility medical care, alongside newly published research on ovarian tissue preservation, an alternative to oocyte cryopreservation or “egg freezing”, both procedures aimed at potentially extending a woman’s fertility window.

In the wake of findings presented in July 2017 at the European Society of Human Reproduction and Embryology conference in Geneva, Switzerland by Marcia Inhorn, Professor of Anthropology and International Affairs at Yale University, popular media headlines blared:  “Why are women freezing their eggs? Because of the lack of eligible men”  and “Women who freeze their eggs aren’t doing it for career reasons.” The study analyzed interviews from 150 women in their late 30s and early 40s who opted for egg freezing in Israel and the United States. Results “show that women were not intentionally postponing childbearing for educational or career reasons, as is often assumed in media coverage of this phenomenon, but rather preserving their remaining fertility because they did not have partners to create a family with. The researchers conclude that women see egg freezing as ‘a technological concession to the man deficit’, using it to ‘buy time’ while continuing their search for a suitable partner to father their children.”

The American Society of Reproductive Medicine, the regulatory board that governs the safe and ethical use of fertility technologies, reclassified egg-freezing technology from “experimental” to standard-of-care in 2012.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

First case of deceased donor uterine transplantation. It is a relevant medical and social issue

Being able to resolve the reproductive problems suffered by women who have no uterus – whether due to an organic cause or functional abnormality of the uterus – is unquestionably a major medical and social issue.

The two possible solutions to this problem are uterus transplantation or surrogacy, the latter solution presenting objective ethical difficulties.

Uterus transplants to date have been performed using living donors, with unpredictable outcomes. Now, the first case of deceased donor uterine transplantation performed in the United States has been published. The recipient of the uterus was a woman with Mayer-Rokitansky-Kuster-Hauser syndrome, that is, she had no uterus.

The journal Fertility and Sterility has disseminated a video describing the essential steps in this transplantation process, particularly as regards selection of a suitable donor with no history of infertility or uterine malformations. The death of the donor should be determined by presentation of brain death but not cardiac death. The authors concluded that: “Uterine transplantation, although currently experimental, has gained the potential to become the first true treatment for uterine factor infertility. This procedure can become a promising option for the approximately 1.5 million women worldwide for whom pregnancy is not possible because of the absence of the uterus or presence of a nonfunctional uterus. Deceased donor uterine transplantation will further serve to broaden accessibility for this treatment.”

Ethical approach

For our part, as the organ donor is a deceased person with brain death (see true definition of this death HERE), we see no ethical issue for this practice; on the contrary, it seems an encouraging medical prospect to resolve the reproductive problem of women who have no uterus or whose uterus is not functionally useful, although the risk-benefit balance must always be taken into account, especially as regards the surgical act.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Genetically Engineering Nature Will Be Way More Complicated Than We Thought

July 20, 2017

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For more than half a century, scientists have dreamed of harnessing an odd quirk of nature— “selfish genes,” which bypass the normal 50/50 laws of inheritance and force their way into offspring—to engineer entire species. A few years ago, the advent of the CRISPR-Cas9 gene editing technology turned this science fictional concept into a dazzling potential reality, called a gene drive. But after all the hype, and fear of the technology’s misuse, scientists are now questioning whether gene drives will work at all.

Gene drive is a molecular technology that forces an edited gene to be passed along into all of an organism’s offspring, overriding nature’s 50/50 inheritance mix. The first human-engineered gene drive was only demonstrated in fruit flies in 2015, but scientists were soon talking about using gene drives to exterminate invasive pests or kill off throngs of malarial mosquitoes.

But soon after, other researchers demonstrated that as an infertility mutation in female mosquitoes was successfully passed on to offspring over many generations, resistance emerged, allowing some mosquitoes to avoid inheriting the mutation. Just as bacteria can develop resistance to antibiotics, wild populations can develop resistance to modifications aimed at destroying them. Gene drive, dead.

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Image: By DBCLS 統合TV, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=55175302

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Pope Francis’ Appointments to Bioethics Board Suggest Progressive Turn

Four notable American ethicists have been appointed by Pope Francis to his bioethics advisory board, and are projected to potentially “temper the group’s conservative views on sexual morality and life issues,” according to the National Catholic Reporter. The group is among 45 international members of the Pontifical Academy for Life, composed of both renewed and newly added experts that will counsel the pontiff on bioethical challenges.

Pope Francis has thus far maintained the Church’s opposition to abortion, contraception, abortion and euthanasia. In 2016, he defined human life as encompassing “conception to natural death.”

The group of American ethicists includes John Haas (President of the National Catholic Bioethics Center, Philadelphia), Ignatius John Keown (Professor of Christian Ethics, Georgetown University, Washington), Kathleen Foley (Neurologist at Memorial Sloan Kettering Cancer Center, New York, and Professor of Neurology, Cornell University, Ithaca), and Carl Anderson (CEO and Chairman of the Knights of Columbus, Connecticut [a Catholic-based fraternal service organization]).

Though reappointed member Anderson resolutely opposes abortion, the stances of other new board members “reflect a desire for a less combative tone on the issue,” noted the Reporter. Additionally, some members who had vocalized opposition to a Vatican conference on infertility at which certain ethicists had not endorsed Church positions were not invited to rejoin the board.

The post Pope Francis’ Appointments to Bioethics Board Suggest Progressive Turn appeared first on Global Bioethics Initiative (GBI).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Reflections on the Federal Budget & LGBT Families

Sophia Fantus argues that the expansion of a tax credit to LGBT individuals who use assisted reproduction helps to legitimize and include the perspectives, needs, and experiences of LGBT families.

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Assisted reproduction is associated with high out-of-pocket expenditures as services often cost tens of thousands of dollars. For the past ten years in Canada, heterosexual couples diagnosed with medical infertility have been able to claim the cost of assisted reproduction as part of their medical expense tax credit. Recently, the Canadian Government approved a new federal budget that allows LGBT (lesbian, gay, bisexual and transgender) and single persons to also receive a tax credit for assisted reproduction. That tax credit is retroactive for up to ten years.

The World Health Organization defines infertility as a disease in which there is a failure to achieve a pregnancy after at least 12 months of regular unprotected sexual intercourse. Accordingly, assisted reproduction has been conceptualized as a biomedical intervention to resolve a diagnosed medical condition. The new retroactive tax credit signifies the adoption of broader definitions of infertility that include LGBT experiences.

The Rainbow by Robert Delaunay, 1913

The use of assisted reproduction by LGBT families separates heterosexuality and heterosexual sex from procreation, and yields novel routes to parenthood for LGBT individuals. In contrast to the typical heterosexual experience, the use of assisted reproduction by LGBT individuals is often the primary (and desired) choice for pursuing parenthood. By including the experiences of LGBT families in the federal budget, the Government is indirectly supporting a broader understanding of infertility from a medical model to a social and structural model that recognizes  single women and men, as well as LGBT couples, who require a third-party to procreate.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Participants’ Testimonials: GBI Summer School a Smashing Success, (June 19-30), 2017

The GBI Summer School proved to be even better than anticipated or described. As a newcomer to the discipline, I had expected the course to provide a broad overview of topics and speakers. Indeed, while broad, the degree of expertise and timely subject material provided an excellent and comprehensive survey of the discipline in global and local settings. Moreover, the students provided another dimension of diversity, both in nationalities and areas of expertise. The speakers made their presentation materials readily available, answered questions, and were willing to address topics of interest offline. I would strongly recommend the course to both novices and subject matter experts alike. The course especially demonstrated the need, relevance, and desirability for global bioethics to be better incorporated into public policy formulation.

Geoffrey Pack, Prevention and Protection Officer, Office of Homeland and Security, City of San Diego, M.A.L.D., Fletcher School of Law and Diplomacy, Tufts University in Cooperation with Harvard University

The GBI Summer School, in the heart of NYC’s Pace University Campus, is a fantastic opportunity! International scholars and professionals from all over the world attended the program, contributing their experiences and engaging with bioethics experts. The City of New York – with the nearby Pace University Campus, Brooklyn Bridge, City Hall, and 9/11 Memorial – provided the perfect setting to discuss the global ethical challenges in technology and medicine. Discussions ranged from law and politics to culture and psychology, encompassing the ethical dilemmas that define the 21st century. I have immensely enjoyed not just the internationally known faculty but also hearing from the learners who come from all over the world representing diverse fields.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The need for Christians to make distinctively biblical moral decisions

I am continuing to reflect on the recent CBHD conference. One of the paper presentations I attended was related to the role of Christian faith and the church in decisions about fertility treatments. Heather Prior and an associate are doing research on how Christian couples in their community make decisions about treatments for infertility including such things as IVF. In the preliminary results she was reporting they found that many of the churches that the couples in their study attended had statements about the use of reproductive technology, but that none of the couples dealing with infertility were aware of those statements. Few had sought any counsel on their decisions from their pastors or others in their church.

I find that concerning. In my interaction with Christian students I have become very concerned that even those with strong Christian faith tend to think about ethical issues using thought patterns they have absorbed from the surrounding culture rather than using distinctively biblical ways of thinking. I don’t think this is limited to students, and this study suggests that it is not. The culture that we live in believes that people should make their own decisions about how they live based on how they feel about any decisions they need to make. It also says that those around them should affirm whatever they decide. I fear that Christians are taking on that same attitude. If we think like the world around us, we will make decisions on things such as reproductive technology based on what we desire and how we feel and expect the church to affirm whatever decision we make.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

IVF and respect for the dignity of human life

This past Thursday through Saturday I was at the CBHD summer conference which was focused on genetic and reproductive technologies. One of the sessions that I found most interesting was the final session on Saturday in which representatives of the Roman Catholic, Orthodox, and Protestant traditions of the Christian church discussed how their traditions view reproductive technology with a focus on in vitro fertilization. The Roman Catholic representative expressed some of the reasons why the Roman Catholic Church takes the position that all use of IVF is impermissible because it violates things that they see as essential in how God designed human beings to come into existence within a marriage relationship. The Orthodox representative said that while some Orthodox churches such as the Roman Orthodox Church have taken a specific position on IVF, most Orthodox churches see the decision about whether to use IVF in the treatment of infertility as a decision that should be made on a case-by-case basis with the infertile couple seeking the guidance of their bishop or spiritual mentor. The Protestant representative made it clear that there is not one Protestant position and identified himself as coming from an evangelical Protestant viewpoint. He said that most who have that point of view are primarily concerned about the moral problems of such things as the use of third-party gametes, surrogacy, and the destruction of excess embryos. He stated that IVF would generally be considered permissible as a treatment for infertility as long as those more problematic things were avoided.

During the question-and-answer time the Protestant representative was given a question about whether the fact that the destruction of human embryos was a necessary part of the development of the technique for IVF made the use of IVF today morally problematic.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.