Tag: ovaries

Bioethics Blogs

“Eggsploitation: Maggie’s Story” Reveals Unknown Risks of Egg Retrieval

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Eggsploitation: Maggie’s Story is the fourth in a series of original documentaries about assisted reproduction directed by Jennifer Lahl, president and founder of the Center for Bioethics and Culture (CBC). The 22-minute short film functions as a sort of sequel to Eggsploitation, released in 2010 and re-released in an expanded version in 2013. Lahl has also directed two other films about donor-conceived people: Breeders: A Subclass of Women? (2014) and Anonymous Father’s Day (2011).  While some of CBC’s staff hold conservative views, its film series focuses squarely on concerns about the fertility industry that many reproductive rights and justice advocates share.

Maggie was diagnosed with Stage IV Invasive Ductal Carcinoma, a breast cancer, at the age of 32. Her risk factors were minimal: she was young, healthy, had never had children, and had no family history of cancer. But Maggie had undergone egg retrieval ten times in as many years because, she said, she wanted “to help people.” She now believes that these procedures caused her cancer. 

At the time, Maggie was excited to have her eggs “chosen” by an infertile couple. But over the course of the decade, she gradually became “uncomfortable” with the fertility industry. One turning point came when a nurse urged Maggie to demand more money for her eggs, because of “what you’re going through and how many times he [the fertility doctor] has used you and everything he’s gotten from you.” When a second fertility clinic recruited her because of her previous successful egg retrievals, she felt it was a bit odd.

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

Slowing the Biological Clock

Slowing the Biological Clock

June 24, 2015

(MIT Technology Review) – years researchers believed that women were born with all the eggs they would ever have. Thatand the fact that the quality of the eggs diminishes when a woman reaches her 40smeant infertility was inevitable past a certain age. But in 2004, Jonathan Tilly and other researchers at Massachusetts General Hospital showed that ovaries also contain egg precursor cells, which might, in theory, mature into new eggs or boost the health of existing ones. Now OvaScience, which Tilly cofoundeda member of this year’s 50 Smartest Companies listis developing treatments for infertile couples. In its first commercially available approach, energy-producing mitochondria are transferred from egg precursor cells into mature eggs to rejuvenate them. These eggs are then used for in vitro fertilization. In May, the first baby was born to parents who tried this approach.

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

Sperm from ovaries

This one’s a little technical, but may very well have significant implications for scientist’s ability to influence sex determination in mammals.

Japanese researchers have discovered a way to influence the sexual fate of germ cells in medaka (rice fish).

The Scientist reports:

“Somatic cells in the gonads of a developing vertebrate provide germ cells with cues, such as hormones, to develop into sperm or eggs. Studying the ways these cues affect a germ cell’s commitment to become sperm or eggs, Toshiya Nishimura from the laboratory of Minoru Tanaka at the National Institute for Basic Biology in Okazaki, Japan, and colleagues uncovered a single gene that, when missing from female embryos of the Japanese rice fish, or medaka (Oryzias latipes), leads the fish to produce functional sperm soon after hatching.”

According to the researchers, the gene foxl3, is the sole determinant in the sexual fate of the rice fish. Foxl3 appears to allow female germ cells to react to environmental signals while the mutant is shielded from these gonadal somatic cell cues. 

Researchers disrupted the foxl3 gene in some of the female specimens, and in these fish sperm began to generate in the ovaries. 

It’s unclear whether the results in medaka will have any impact on the study of sex determination in mammals, said Allan Spradling, a developmental biologist at the Carnegie Institution for Science in Baltimore, Maryland.

This article is published by Xavier Symons and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines.

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

Hereditary Breast and Ovarian Cancers: Moving Toward More Precise Prevention

Caption: “Homologous Hope” sculpture at University of Pennsylvania depicting the part of the BRCA2 gene involved in DNA repair.
Credit: Dan Burke Photography/Penn Medicine

Inherited mutations in the BRCA1 gene and closely related BRCA2 gene account for about 5 to 10 percent of all breast cancers and 15 percent of ovarian cancers [1]. For any given individual, the likelihood that one of these mutations is responsible goes up significantly in the presence of  a strong family history of developing such cancers at a relatively early age. Recently, actress Angelina Jolie revealed that she’d had her ovaries removed to reduce her risk of ovarian cancer—news that follows her courageous disclosure a couple of years ago that she’d undergone a prophylactic double mastectomy after learning she’d inherited a mutated version of BRCA1.

As life-saving as genetic testing and preventive surgery may be for certain individuals, it remains unclear exactly which women with BRCA1/2 mutations stand to benefit from these drastic measures. For example, it’s been estimated that about 65 percent of women born with a BRCA1 mutation will develop invasive breast cancer over the course of their lives—which means approximately 35 percent will not. How can women in this situation be provided with more precise, individualized guidance on cancer prevention? An international team, led by NIH-funded researchers at the University of Pennsylvania, recently took an important first step towards answering that complex question.

In a study published in the journal JAMA, the researchers analyzed genetic data and health information from more than 31,000 women with mutations in BRCA1/2.

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 Drug that Cried “Feminism”

Branded as “The Little Pink Pill” and “Female Viagra,” flibanserin, Sprout Pharmaceuticals’ only drug, was recently resubmitted to the Food and Drug Administration for approval for hypoactive sexual desire disorder (HSDD), a questionable condition promoted by pharmaceutical companies to sell questionable drugs. Flibanserin, a failed-antidepressant-turned-libido-boosting-drug, has already been rejected twice by the FDA due to a lack of proven efficacy in the face of possible safety concerns.

Rather than putting this drug to sleep, Sprout attacked the FDA for, of all things, sexism. Sprout created a public relations campaign called “Even the Score” that has misled several consumer groups, congresswomen, and many reporters into believing that the FDA is willing to approve male, but not female, treatments for sexual dysfunction. After all, they approved Viagra, the little blue pill, so shouldn’t the little pink pill get approved as well?

Well no, actually. Prescription drug regulation is driven by safety and efficacy, not parity. Promoting a lower standard of efficacy and safety in drugs for women is not feminist. Nor is drawing comparisons to unrelated drugs.

That Viagra comparison, for example. “The little blue pill” does not affect libido. Viagra and similar medications treat physical sexual dysfunction caused by arterial disease, diabetes, or other blood flow disorders. These drugs enable men who are already aroused, but who have a physical limitation, to have sex. Flibanserin isn’t female Viagra. The closest thing to female Viagra is a personal lubricant, which treats a common cause of physical sexual dysfunction, is used before sex, can be used at any age, and eases the way when the spirit is willing but the flesh isn’t cooperating.

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

Ethics of Penile Transplants

by Craig Klugman, Ph.D.

This weekend, doctors in South Africa announced a new first—a successful penis transplant. The 9-hour operation took place in December 2014. After three months of recovery, the recipient is able to urinate, achieve an erection and a sexual response. As of yet, the recipient does not have full sensation in the organ.

The recipient was 18 years old when he underwent a ritual circumcision that went wrong and left him with 1cm of the original penis. Estimates are that dozens to hundreds of men are maimed each year as a result of these rituals.

This was not the first attempted transplant. That honor goes to China in 2006. The patient had the penis removed after he and his wife described psychological distress and strange swelling.

A BBC report said that the South African surgeons spent time asking whether this operation was ethical. After all, the recipient will be on anti-rejection drugs for the rest of his life and a penis may be psychologically and reproductively important, but it is not life supporting in the way that a heart or liver would be. Using needle aspiration and in vitro fertilization, these men could father children. Alternative methods can be fashioned to allow the elimination of urine. Sexual function though, is clearly compromised.

A 2010 article in the Asian Journal of Andrology discussed the ethical issues of penile transplant. These included surgical risks, informed consent, body image, and privacy. For the donor family, the authors identified concerns with assessing the suitability of a donor, privacy, and the consent process.

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

Fertility Clinic Courts Controversy with Treatment That Recharges Eggs

(NPR) – A woman trying to get pregnant goes through a surgical procedure to remove a small piece of her ovary, so that doctors can extract mitochondria from the immature egg cells. In a separate procedure, doctors remove some of the woman’s mature eggs from her ovaries. They then inject the young mitochondria into the eggs in the lab, along with sperm from the woman’s partner; except for adding mitochondria to the mix, the process is the same one that’s followed with standard in vitro fertilization. The resulting embryo can then be transferred into her 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

The Ethics of Uterus Transplantation

In the last couple of years, the media has reported women undergoing uterus transplantations. Just last month, the media reported that the first baby was born from a transplanted uterus. While the woman’s identity remains unknown, she is a 36 year old Swedish woman who was born with ovaries, but not a uterus. She and her partner underwent IVF to produce embryos that could then be transferred into the transplanted uterus. This donor is a friend of hers who is 61 years old and had experienced menopause seven years beforehand. The quality of a woman’s uterus does not diminish over time, so she is able to successfully carry a pregnancy event postmenopausally (it is the quality and quantity of her eggs that leads to infertility and eventually menopause).  Both the woman and the baby are doing fine, according to media reports. However, the baby was born prematurely at 32 weeks because the women developed preeclampsia and the fetal heart rate became abnormal. It is not clear from the media reports whether the development of preeclampsia was related to the uterus transplantation.

Uterus transplantation raises a bunch of ethical issues. One critique of uterus transplantation, as well as other forms of assisted reproductive technologies, is that is not net medically necessary.   Rather, it is an elective procedure, as people can live without biologically reproducing. Yet this critique fails to acknowledge that much of medicine deals with quality-of-life issues and not necessarily life-or-death issues. Infertility is a serious quality-of-life issue, especially for women, who often find a diagnosis of infertility to be psychologically devastating.

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

Cheaper by the Dozen

by Sean Philpott-Jones, Director of the Center for Bioethics and Clinical Leadership

As a bioethicist, I appreciate the fact that the American public has become deeply engaged in a number of important health policy debates.

For example, should local, state and national agencies forcibly quarantine travelers coming from countries affected by the Ebola virus? Should public and private companies be required to provide employees with health insurance plans that include oral contraceptives if doing so runs counter to the religious beliefs of the owners? Should terminally ill cancer patient Brittany Maynard have the right to end her own life (which she did this past Saturday)?

One interesting story that slipped under the radar, however, was the recent announcement that two major corporations, tech giant Apple and social networking service Facebook, will now pay for female employees who want to freeze their eggs. These companies will cover the costs of extracting, freezing and storing eggs, even when this is done for non-medical reasons. This is a pretty substantial benefit, as the extracting the eggs can cost $20,000 or more. Storage fees can run an additional $1,000 a year.

This should be up for public discussion and debate. Although many people may disagree with me, I believe that these two companies (and those that follow their example) are making a big mistake. That is not to say that I don’t think that companies like Apple and Facebook shouldn’t provide coverage for fertility-related treatments like egg freezing as part of a comprehensive health insurance plan. They should, but only for medically justified reasons.

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

Left Out In The Cold: Seven Reasons Not To Freeze Your Eggs

Françoise Baylis criticizes including egg freezing as part of employee benefits packages.

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In 2012, the American Society for Reproductive Medicine (ASRM) lifted the experimental designation on human egg freezing. At this time, it was careful to indicate that freezing technology should not to be used for elective purposes, particularly as this might give young women false hope. A 2014 fact sheet prepared by the ASRM confirms that “Even in younger women (i.e., > 38 years old), the chance that one frozen egg will yield a baby in the future is around 2-12%.”

These professional cautions are of no consequence to Facebook or Apple, however. Both of these companies have decided to include egg freezing in their employee benefit package. As an alternative, they could have decided to improve the health benefits offered to all employees. Or, to stay focused on the issue of reproduction, they could have included a full year of family leave in the benefit package. Instead, they chose to pay up to $20,000 for egg freezing. Now call me crazy, but I think this choice just might have to do with their corporate priorities – which include keeping talented workers in their 20s to early 30s in the workplace, not at home caring for babies.

Sadly, from my perspective, some describe this corporate decision in positive terms. They congratulate the companies for “taking the lead”. In this way, they both endorse the decision and encourage others to follow this lead. Already, Virtus Health in Australia has announced that it too will pay for egg freezing for its female employees. According

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.