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Patient autonomy and criminal law
Published in Paweł Daniluk, Patient Autonomy and Criminal Law, 2023
Elisabeth Symeonidou–Kastanidou
ΙΙΙ. Finally, participation in a process of having a child through surrogacy without having complied with the terms of the law (Art. 26 (8) Law 3305/2005) is also a criminal offence. Under Greek law, in order for medically assisted reproduction to take place legally through a surrogate mother, a court approval is required, which is provided before the transfer. It presupposes a written and unpaid agreement between the persons seeking to have a child and the woman who will conceive and carry it. Her husband's agreement is also needed, if she is married (Art. 1458 of the Civil Code, as amended by Art. 1 of Law 3089/2002). If the transfer takes place without the consent of the pregnant woman or persons wishing to have a child, imprisonment of two to five years and a fine of at least 1,500 euros shall be imposed.
Genetic Counseling in Assisted Reproductive Technology
Published in Carlos Simón, Carmen Rubio, Handbook of Genetic Diagnostic Technologies in Reproductive Medicine, 2022
Carrier screening is a genetic test typically performed on both members of a reproductive couple. Carrier screening aims to identify recessive and X-linked variants in a healthy population of patients. If both members of the reproductive couple are carriers of variants in the same recessive gene, or if a female is a carrier of an X-linked variant, there is a risk of passing on a genetic condition to offspring. Identifying such risk enables a couple to consider various reproductive options, including spontaneous conception followed by prenatal diagnosis or an ART approach utilizing preimplantation genetic testing for monogenic disorders (PGT-M) to select embryos identified to be at reduced risk of developing the condition prior to pregnancy. Some genetic conditions and specific variants are more common in certain ethnic populations, and so ethnicity-based carrier screening panels were historically offered to reproductive couples. Because of advancing technology and the opportunity to perform PGT-M on embryos obtained through in vitro fertilization (IVF), many infertility clinics now utilize pan-ethnic expanded carrier screening as part of their standard work-up.
Accounting for the money-made parenthood of transnational surrogacy
Published in Zeynep B. Gürtin, Charlotte Faircloth, Conceiving Contemporary Parenthood, 2020
While Zelizer's idea of relational work mainly captures how such accounting is done at an interactional level, her work could also be seen as pointing towards an institutional order as people are ‘working through institutions (and sometimes against them)’ (Fourcade 2012, 1060) to maintain meaningful relations. Within the surrogacy and ART literature, attention has been devoted to the institutional arrangements that enable the marketization of egg, sperm and pregnancy (e.g. Almeling 2011; Rudrappa 2015).
Reproductive health in adults with congenital heart disease: a review on fertility, sexual health, assisted reproductive technology and contraception
Published in Expert Review of Cardiovascular Therapy, 2023
J.A. van der Zande, G. Wander, K.P. Ramlakhan, J.W. Roos-Hesselink, M.R. Johnson
The diagnostic procedures to investigate the cause of infertility, such as a hysterosalpingogram, are not without risks. Cardiovascular monitoring is required and appropriate pain relief is recommended to minimize the risk of a vagal reaction. Women with CHD undergoing ART should be closely monitored, especially those with moderate or complex CHD, in an expert center. The most common complications of ART are OHSS and multiple pregnancy. In women with CHD, the key principle is to use the ART with the least likelihood of these complications. OHSS is a feared complication, and even the mild form of OHSS can be life-threatening in women with CHD. Careful follicle monitoring is essential and, in the case of excessive response to follicle stimulation, cycle cancellation or freezing the embryos is recommended. Single embryo transfer is recommended to minimize the risk of multiple pregnancies. Antibiotic prophylaxis is not recommended during insertion of an intra-uterine device or during oocyte or sperm retrieval as stated by the ESC guidelines for infective endocarditis. However, in high-risk patients (e.g. with a prosthetic valve or earlier endocarditis) it can be considered, given the incidence of endocarditis since the introduction of these new guideline has been increased, and the incidence of serious side-effects of antibiotic prophylaxis is relatively low [57,83].
The Rate of Spontaneous Preterm Birth and Associated Neonatal Adverse Outcomes in Low-Risk Pregnancies Conceived Spontaneously Versus Intrauterine Insemination or Infertility Medications
Published in Women's Reproductive Health, 2023
Cassie Hobbs, Gabrielle Jude, Han-Yang Chen, Megha Gupta, Michal Fishel Bartal, Suneet P. Chauhan, Stephen Wagner
Pregnancies subsequent to ART have an increased risk of adverse pregnancy and neonatal outcomes, such as multiple births, preterm birth, miscarriage, preeclampsia, and gestational diabetes (American College of Obstetricians & Gynecologists’ Committee on Obstetric Practice et al., 2016; Doty et al., 2021; Sanders et al., 2022). However, there are limited data examining usage of IFM/IUI and preterm birth. Several cohort studies have demonstrated that IVF is an independent risk factor for spontaneous preterm birth in low-risk term singleton pregnancies compared to spontaneous conception (Palomba et al., 2016; Zhu et al., 2016). In contrast, few single-center studies, with mixed results, have examined the effect of IFM/IUI on the risk of spontaneous preterm birth (Malchau et al., 2014; Messerlian et al., 2015; Wang et al., 2002).
Anticipatory Governance of Noninvasive Prenatal Testing for “Non-Medical” Traits: Lessons from Regulation of Medically Assisted Reproduction
Published in The American Journal of Bioethics, 2023
Hui Zhang, Jing Wang, Yan Qin, Chuanfeng Zhang, Bingwei Wang, Yuming Wang
As an integral part of ART procedures, preimplantation genetic testing (PGT) enables the practitioner to select embryos predicted to be free of a specific genetic condition or chromosomal abnormalities prior to transfer. However, in theory, PGT can be used to select any genetically determined characteristics desired by expectant parents, including sex and other non-medical traits. Although the policy and legislative approaches to PGT vary widely between countries (including public ordering, private ordering, or a mixture of the two models), its regulation has followed a linear path across the world during the last decade, with incremental changes driven by scientific advances and greater social uptake. Despite its greater social acceptability, widening of the permissibility criteria for PGT remains controversial (Ginoza and Isasi 2020). Related social, ethical, and policy debates have elicited the need for forward-looking governance for PGT. Similarly, the scope of NIPT is expected to expand to include a detailed analysis of the fetal genome, including non-medical traits (Bowman-Smart et al. 2023), and we believe that there is also an urgent need for anticipatory governance in NIPT for non-medical traits.