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Being Disabled and Contemplating Disabled Children
Published in Joel Michael Reynolds, Christine Wieseler, The Disability Bioethics Reader, 2022
There is now an array of means through which potential parents can not only identify, but often choose, the characteristics of their future child, at least in the sense of choosing between different options. Technologies of prenatal diagnosis (PND) range from ultrasound, through biochemical or genetic analysis of fetal tissue obtained via amniocentesis or chorionic villus sampling (CVS), to non-invasive prenatal testing (NIPT), which tests fetal tissue from a sample of the mother’s blood. Coupled with in vitro fertilization, preimplantation genetic diagnosis (PGD) makes it possible to genetically profile in vitro-produced embryos before deciding which one(s) to transfer for pregnancy. Most recently, attention has turned to the future and more speculative possibilities of genome editing: a different mode of genetic reproductive selection that I discuss later on.
Preimplantation Genetic Testing and Reproductive Genetics from a Physician's Perspective
Published in Darren K. Griffin, Gary L. Harton, Preimplantation Genetic Testing, 2020
Reproductive genetics is now inseparably linked to reproductive medicine procedures and is becoming an integral part thereof. It has been applied in the diagnosis of factors of infertility and genetic disorder carrier status. This is specifically used for screening assessments before admitting a couple to an in vitro fertilization (IVF) program for targeted diagnosis of hereditary diseases or defects, or as part of preimplantation genetic testing (PGT) procedures. In many cases it is becoming an integral part of controlling therapeutic results in the form of noninvasive or invasive prenatal diagnosis.
Regulation of Reproduction by Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
In vitro fertilization (IVF) is the process of fertilizing an egg by sperm outside the body. In 1978, Louise Brown was the first child born after her mother received a natural cycle IVF treatment. In recognition of this accomplishment, Dr. Robert Edwards, the developer of this technique, was awarded the Nobel Prize in Physiology and Medicine in 2010. Since the 1980s, IVF has been practiced worldwide. In 2018 alone, over 8 million children were born using IVF and other assisted reproduction techniques. Patients as old as 65 have benefited from IVF.
Intrasaccular methotrexate treatment of cervical pregnancies maintains fertility: a case series
Published in Journal of Obstetrics and Gynaecology, 2023
Otto Hugo Valdés-Martínez, Luis Humberto Sordia-Hernández, María Ofelia Sordia-Piñeyro, Jesús Dante Guerra-Leal, Selene M. García-Luna, Felipe Arturo Morales-Martínez
A 35-year-old nulliparous patient with a history of primary infertility. In vitro fertilization was performed with antagonist protocol. Two fresh day-3 embryos were transferred. The patient reported mild transvaginal bleeding for one week without additional symptoms. The ultrasound revealed an intrauterine gestational embryo corresponding to 6.2 weeks gestational age with a normal fetal heart rate. A second gestational sac of 11 mm in diameter was found in the cervix with a 4-mm crown-rump length embryo inside with a normal heart rate. Three days later, under epidural anaesthesia, the cervical gestational sac was punctured with ultrasound guidance, a millilitre of amniotic fluid was aspirated, and 100 mg of MTX were injected. No complications were observed. At 38.4 weeks of gestation, a c-section was performed, with no complications.
Ten things you learned in your residency about retinoblastoma that have changed the 2023 Victor T. Curtin Lecture
Published in Ophthalmic Genetics, 2023
Fortunately, there is PGD. PGD (Pre implantation Genetic Diagnosis) is an accepted assisted reproductive technique that we first employed for retinoblastoma (in 2003). It starts by first identifying the mutation in the affected parent and creating nested PCR probes. Then in vitro fertilization is performed by inserting one sperm into one harvested egg (usually about 20 eggs are fertilized). Instead of implanting that into the uterus you wait three days in vitro. At three days, the embryo is typically eight cells, you then micropipette out one of the eight cells (a seven cell embryo develops without difficulty) and using the PCR probes can identify which of the fertilized eggs has the retinoblastoma genetic abnormality. The fertilized egg without the defect is then implanted into the uterus (23) the number of fertilized eggs inserted depends on the age of the mother and the wishes of the family. The child will have all the genes from both parents - no gene has been added, removed, or altered - you have just pre-selected the fertilized egg without the Rb genetic defect. Since publishing this in 2003 it is now widely available worldwide (23). (Figure 3)
Exploring Cisgender Women’s Experiences of Reproductive Loss After In Vitro Fertilization
Published in Women's Reproductive Health, 2023
Meghan Forgie, Amanda Vandyk, Wendy Peterson, Danielle Dubois
Infertility is the inability to conceive despite frequent, unprotected sex over the span of one year (Zegers-Hochschild et al., 2009). Globally, approximately 48 million couples live with infertility (Mascarenhas et al., 2012; World Health Organization, 2021). In some countries, such as Canada, infertility has doubled in the last four decades (Public Health Agency of Canada, 2019). In vitro fertilization—the process of external fertilization of the egg with sperm and the subsequent embryo transfer into the uterus (Zegers-Hochschild et al., 2009)—is a treatment option for infertility. Unfortunately, nearly 70% of people who undergo in vitro fertilization experience an unsuccessful attempt or treatment failure, and approximately 20% of pregnancies achieved through in vitro fertilization, using one’s own oocytes, result in miscarriage (Canadian Fertility & Andrology Society, 2019). Reproductive losses, such as treatment failure and miscarriage following the use of assisted reproductive technologies, can lead to stress disorders and increased levels of anxiety (Farren et al., 2016), problems within the partner relationship (Gold et al., 2010; Luk & Loke, 2019; Shreffler et al., 2012), as well as sadness and mourning (Brier, 2008; Fenstermacher & Hupcey 2013; Gameiro & Finnigan, 2017). Research has also shown that the use of in vitro fertilization itself has physical, psychological, emotional, and financial consequences (Boivin et al., 2012).