Tag: procreation

Bioethics News

Incidence of ectopic embryos doubles in assisted reproduction

Ectopic embryos doubles is an added risk for assisted reproduction. Remains to know if the clinics inform it to their clients

Ectopic pregnancies are a serious obstetric complication, also occurring after assisted reproduction. Several articles report that the incidence of ectopic pregnancies (ectopic embryos) after using assisted reproduction techniques is higher (double) than that of natural pregnancies (4.5% versus 2.2%). Several of these have described the possible causes of ectopic pregnancies in assisted reproduction. Now, an article has been published in Fertility and Sterility (see HERE) in which some of these causes are analysed, after assessing 18,432 pregnancies resulting from assisted procreation techniques. It seems that one of the causes is ovarian stimulation and also the type of sperm used in the case of artificial insemination.

Click here about the risks and possible treatment

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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 Blogs

“3-Parent Babies” Sally Forth

The journal Nature reports that scientists advising the U.K.’s Human Fertilization and Embryology Authority (HEFA) have judged that attempts to bring so-called “3-parent babies” to birth is “ready for limited clinical testing.”   Presumably this means that the underlying technology, mitochondrial replacement, has been tested enough in the laboratory that it’s ready to try for human procreation.  Also presumably, HEFA will promulgate rules or guidelines to address safety and other ethical issues.

I posted on mitochondrial replacement technology, or MRT, most recently this past February 25.  Follow the link for further background.  Other contributors to this blog have also written about it over the last couple of years.

As described in the report in Nature, the most salient worry seems to involve the effectiveness of the technology.  In a favored approach, a woman affected with a potentially serious genetic disease involving genes in her mitochondria has the nucleus of one of her eggs, which has most of her genes which in turn are normal, transferred into a fully healthy egg from another woman donor.  The resulting egg is then fertilized in the lab (i.e., fairly standard IVF), and would then be implanted into the mom for pregnancy, and so on it goes.   The worry?  That some of the abnormal mitochondria come along for the ride, so that the transfer is not “pure,” as it were.  In that case, the disease could still be handed down to the offspring if enough abnormal mitochondria stowed away.

This has been tested in the lab by doing the egg nuclear transfer and fertilization, creating human embryos (i.e.,

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

Prohibition of experimentation with human embryos ratified by the Italian Constitutional Court

“Banning of all clinical and experimental human embryos experimentation that is not to its benefit”

The ban on experimenting on human embryos remains in force in Italy. This was established in the Constitutional Court with a ruling in which the Court rejected the alleged unconstitutional nature of article 13 of Law 40, which bans clinical and experimental research on human embryos. The same ruling denies the possibility of withdrawing consent to assisted procreation after fertilisation of the egg. The Constitutional Court examined two questions of unconstitutionality raised by judges in Florence. The first referred to the banning of all clinical and experimental research on the embryo that is not to its benefit (art. 13 of Law 40), and the second to the ban on revocation of consent to assisted procreation once the egg has been fertilised (art. 6). “The first issue”, says the official statement, “has been declared inadmissible due to the high level of discretion, complexity of the ethical and scientific profiles that characterise it, the balance established by the legislator between the dignity of the embryo and the demands of scientific research: the balance that, wrongfully, the Florence Court asked the Constitutional court to change, being possible a number of options, necessarily reserved for the legislator. The second matter was declared, for its part, inadmissible due to lack of relevance in the test procedure, as the person who presented the appeal did in fact decide to see the assisted reproduction procedure through to the end” (ACEPRENSA, 30-III-2016).

Photo: Shutterstock

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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

The Climate Crisis Call For Fewer Children

Bioethicist: The climate crisis calls for fewer children

 

Travis N. Rieder, Johns Hopkins Berman Institute of Bioethics

 

Earlier this summer, I found myself in the middle of a lively debate because of my work on climate change and the ethics of having children.

 

NPR correspondent Jennifer Ludden profiled some of my work in procreative ethics with an article entitled, “Should we be having kids in the age of climate change?,” which summarized my published views that we ought to consider adopting a “small family ethic” and even pursuing fertility reduction efforts in response to the threat from climate change. Although environmentalists for decades have worried about overpopulation for many good reasons, I suggest the fast-upcoming thresholds in climate change provide uniquely powerful reasons to consider taking real action to slow population growth.

 

Clearly, this idea struck a nerve: I was overwhelmed by the response in my personal email inbox as well as op-eds in other media outlets and over 70,000 shares on Facebook. I am gratified that so many people took the time to read and reflect on the piece.

 

Having read and digested that discussion, I want to continue it by responding to some of the most vocal criticisms of my own work, which includes research on “population engineering” – the intentional manipulation of human population size and structure – I’ve done with my colleagues, Jake Earl and Colin Hickey.

 

In short, the varied arguments against my views – that I’m overreacting, that the economy will tank and others – haven’t changed my conviction that we need to discuss the ethics of having children in this era of climate change.

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

Mother to child transmission of HIV? Now affected couples could conceive a healthy child naturally

Mother to child transmission of HIV is almost resolved. When the existence of people infected with human immunodeficiency virus (HIV) was described in 1980, it was thought that this could directly affect their chances of conceiving a child. However, with the therapeutic advances that have been emerging, the panorama has been changing drastically. The first consequence is that there is already very little likelihood that a HIV-positive pregnant women can infect her child, i.e. so-called vertical transmission of HIV from mother to child has been practically resolved. Undoubtedly however, the most important thing is that it can now be practically assured that HIV-positive individuals, properly treated, will not transmit the infection to their children, whether they use assisted procreation or natural conception (Human Reproduction  31; 18-925, 2016). We believe this last possibility is very important, as it circumvents the ethical difficulties that accompany assisted reproduction techniques, especially in vitro fertilisation.

La entrada Mother to child transmission of HIV? Now affected couples could conceive a healthy child naturally aparece primero en Observatorio de Bioética, UCV.

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

Assisted reproduction: Do pregnancies achieved following assisted reproduction techniques have more risks?

One medical and ethical aspect of assisted reproduction that should be considered is to what extent singleton pregnancies achieved following these procedures have (or ave not) more risks than those conceived naturally. In an extensive meta-analysis that included 161,370 births following assisted procreation and 2,280,241 conceived naturally, the authors concluded that assisted reproduction risksART [assisted reproduction technology] singleton pregnancies are associated with higher risks of pregnancy-related complications and adverse pregnancy outcomes, compared with those conceived naturally”(Fertility and Sterility 105; 73-85,2016).

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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 Blogs

A Private Right of Procreation in the U.S. Supreme Court

By Dov Fox The landmark abortion decision in Whole Woman’s Health v. Hellerstedt eclipsed quieter reproductive rights news out of the Supreme Court at the end of its term. It involves a couple’s claim that the Tennessee Supreme Court violated their equal protection rights … Continue reading

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

Automation, Robotics, and the Economy

The Joint Economic Committee — a congressional committee with members from both the Senate and the House of Representatives — invited me to testify in a hearing yesterday on “the transformative impact of robots and automation.” The other witnesses were Andrew McAfee, an M.I.T. professor and coauthor of The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies (his testimony is here) and Harry Holzer, a Georgetown economist who has written about the relationship between automation and the minimum wage (his testimony is here).

My written testimony appears below, slightly edited to include a couple things that arose during the hearing. Part of the written testimony is based on an essay I wrote a few years ago with Ari Schulman called “The Problem with ‘Friendly’ Artificial Intelligence.” Video of the entire hearing can be found here.

*   *   *

Mr. Chairman, Ranking Member Maloney, and members of the committee, thank you for the opportunity to participate in this important hearing on robotics and automation. These aspects of technology have already had widespread economic consequences, and in the years ahead they are likely to profoundly reshape our economic and social lives.

Today’s hearing is not the first time Congress has discussed these subjects. In fact, in October 1955, a subcommittee of this very committee held a hearing on automation and technological change.[1] That hearing went on for two weeks, with witnesses mostly drawn from industry and labor. It is remarkable how much of the public discussion about automation today echoes the ideas debated in that hearing.

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

IVF clinic success rates. Live birth rates are much lower than those claimed in their advertising brochures.

An important medical and ethical issue is to determine the efficacy of in-vitro fertilisation (IVF) following one or several fertilisation cycles. In other words, the likelihood of a woman giving birth to a live child after three or more fertilisation cycles in a IVF clinic, i.e. the efficacy as regards having a child for a woman attending an IVF clinic for fertility problems.

Few studies to date have addressed this issue. Only one paper published in the New England Journal of Medicine (366; 2483-2491, 2012) has reported the cumulative birth rate following several IVF cycles.

An extensive study has now been published (JAMA, 314; 2655-2662, 2015) addressing this issue.

The first thing that stands out in the study is the sample size: from an initial sample of 235,000 women who used IVF in the United Kingdom between January 2000 and June 2012, 156,947 were eventually included, following detailed sample selection.

The most notable finding was that the cumulative birth rate was 65.3% after six ovarian stimulation cycles, albeit with wide variations according to age and treatment type. This would therefore be the likelihood of achieving a live birth for an English woman attending an assisted procreation clinic in the United Kingdom, after three or four ovarian stimulation cycles.

However, as mentioned, these percentages depend greatly on the woman’s age. In women under 40 years of age using their own oocytes (eggs), the live birth rate after the first cycle was 32.2%, but in women aged between 40 and 42 years, the live birth rate after the first cycle was only 12.3%,

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.