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Whose Body?
Published in Nicholas Colgrove, Bruce P. Blackshaw, Daniel Rodger, Agency, Pregnancy and Persons, 2023
On such an account, both the mother and the fetus straightforwardly have parts, identifiable as such because, while they are not identical with the organism as a whole, they play some functional role in the biological economy of that organism. At the earliest stages, zygotes and embryos have a cell or cells and a membrane, the zona pellucida, as parts. The embryo is, however, the executor of its own subsequent growth and development, and that development includes the growth of new organs and organ systems; the fully developed human organism is, of course, highly complex with many different organic parts. The mother may rightly say of those parts that they are hers precisely because together they compose the organism that she is. And the fetus may say the same about the parts that compose the organism that he or she is.
Implantation and Embryonic Imaging
Published in Mary C. Peavey, Sarah K. Dotters-Katz, Ultrasound of Mouse Fetal Development and Human Correlates, 2021
Mary C. Peavey, Sarah K. Dotters-Katz
Similarly to human ovulation and fertilization, the mouse embryo after ovulation is transported through the fallopian tube, where fertilization with sperm occurs. The fertilized oocyte is known as the zygote, which will continue to divide into an embryo. As the embryo travels through the fallopian tube, it continues to undergo cell division; by the third day, the embryo is approximately eight cells and begins compaction. On its fifth day of growth, the human embryo has developed into a blastocyst and travels to the uterus where it begins the process of implantation and further growth. At this point, as in humans, the blastocyst consists of a discrete inner cell mass, within a spherical cavity lined by the trophectoderm cell layer. These preimplantation events cannot be ascertained via ultrasonographic methods in either the human or mouse. However, the non pregnant uterus, consisting of the myometrium and endometrium can be easily measured via sonographic methods. See Fig. 1.1.
Paper 3
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
An ectopic pregnancy results from the implantation of the fertilised embryo outside the uterus, mostly in the fallopian tube. The most common presentation is at around 7 weeks’ gestation. The risk is increased with an intrauterine device in situ, smoking, a history of pelvic inflammatory disease, blocked tubes or previous ectopic pregnancy. Levonorgestrel, the progesterone-only emergency contraceptive pill, can impede the intra-tubal migration of the fertilised ovum and may increase the risk of ectopic implantation. PV bleeding does not always occur. Abdominal pain may be vague. Diaphragmatic irritation from internal bleeding causing shoulder tip pain is another symptom. Ectopic pregnancy is the leading cause of maternal mortality in the first trimester. Immediately refer to hospital for specialist management, options for which include: expectant (monitor serum β-HCG, may fail spontaneously and resorb), medical (methotrexate) or surgical (salpingostomy/salpingectomy). Subsequent pregnancies should always be referred for early scanning.
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.
The vitrification system may affect preterm and cesarean delivery rates after single vitrified blastocyst transfer
Published in Systems Biology in Reproductive Medicine, 2022
Yunhong Lin, Lincui Da, Shengrong Du, Qingfen Chen, Suzhu Chen, Beihong Zheng
Endometrial preparation protocols and the determination of clinical and birth outcomes were as follows. For patients who underwent single vitrified-warmed blastocyst transfer, the natural cycle or hormone replacement cycle protocol was used for endometrial preparation. The ovulation day or progesterone injection day of the patient was day 0. D5 single-blastocyst transfer was performed on Day 5 after ovulation or progesterone injection under B-type ultrasound guidance. Twenty-five to fifty days after blastocyst transfer, clinical pregnancy was assessed based on the presence of a gestational sac on B-type ultrasound. Ongoing pregnancy was defined as the presence of a fetal heartbeat on B-type ultrasound at 12 weeks of gestation. A pregnancy in which the embryo was implanted outside the uterine cavity on B-type ultrasound was deemed an ectopic pregnancy. Miscarriage within 12 weeks of clinical pregnancy was deemed an early miscarriage, and miscarriage between 12 weeks and 28 weeks was deemed a late miscarriage. Delivery after 28 weeks of pregnancy but before 37 weeks was deemed a preterm delivery, and delivery between 37 weeks and 42 weeks was deemed a full-term delivery. The gestational age was determined by the number of days from the first day of the patient’s last menstruation to the day of fetal delivery. The normal birth weight range of the newborns was 2.5–4 kg. A low birth weight was defined as less than 2.5 kg, a very low birth weight was defined as less than 1.5 kg, and macrosomia was defined as a birth weight higher than 4 kg.
The effectiveness of micronized progesterone in the complex therapy of ‘thin endometry’ syndrome
Published in Gynecological Endocrinology, 2021
Nagima M. Mamedalieva, Almagul M. Kurmanova, Saltanat B. Baikoshkarova, Saule Issenova, Balzira Bishekova, Gainy Zh. Anartayeva
Thus, the revealed changes in the level of immunocompetent cells indicate that the pathogenesis of miscarriage in thin endometrial syndrome is a pronounced decrease in the level of CD8 + cytotoxic/suppressor endometrial lymphocytes and CD56 + lymphocytes, as well as a sharp decrease in intracellular production of γ-interferon, IL-1 and IL-10 endometrial lymphocytes. As you know, the implantation process can be thought of as an inflammatory reaction that promotes attachment and invasion of the embryo into the endometrium, providing the necessary interaction with the maternal vascular system. Deficiency of signaling molecules and their synthesis of proteins, which occurs in the syndrome of ‘thin’ endometrium, is accompanied by disruption of peri-implantation mechanisms, including the regulatory action of sex steroid hormones.