Friday, July 1, 2016
New York Times (June 13, 2016): China's Call to Young Men: Your Nation Needs Your Sperm, by Javier C. Hernández:
Styling it as an important contribution to society, the Chinese government is doing all it can to encourage young men to donate sperm. The country faces severe shortages, and about half of the current volunteers are screened out.
The enticements to donate run the gamut, including coveted iPhones and cash along with messages of patriotism and exhortations to help China deal with its aging population. Culturally, though, donating sperm and using donated sperm are hard to sell. Men in China associate semen with vitality and are reluctant to give any away. Couples struggling with fertility are many times uncomfortable using an unrelated man's sperm to conceive.
Thursday, June 30, 2016
CTV News (June 9, 2016): New IVF Method Limits Transfer of Bad DNA to Babies: Study:
Nuclear transfer, a reproductive technique wherein the nucleus of an egg cell replaces the nucleus of an egg cell that has healthier cytoplasm, holds promise for older women whose eggs have undergone changes with age that make them unsuitable for reproduction.
Now United States scientists want to use the technique to avert birth defects that have their genesis in the cytoplasm of the mother's egg, affect the muscles, eye, brain or heart of the child, and have no effective treatment. The idea is that by transferring the nucleus of an egg to an egg with healthy cytoplasm, disease-causing mutations of the mitochondria (the energy centers of the egg cells, will not be passed on to the child. The technique has been legal in Britain since last year.
So far, the study has shown that that "small tweaks to the existing procedure can reduce the risk of mutant mitochondrial DNA transferal." Two examples are performing the procedure on the day of the egg's fertilization and freezing the egg of the patient rather than that of the donor.
The technique does not remove the risk of the child's contracting a disease but does reduce it. Ongoing research will focus on refining the technique.
Tuesday, June 28, 2016
New York Times (June 11, 2016): Navigating Fertility Clinics with a Click, by Glenn Rifkin:
A heterosexual couple in San Francisco who planned to have children soon after their wedding ran into the roadblock of infertility. They became a statistic in a common story, spending tens of thousands of dollars on treatments without results, and wound up emotionally damaged by the experience.
But this couple's story ends differently than most. Concerned about what they felt was a lack of accountability on the clinic level, they left behind high-paying jobs and started Fertility IQ, a website that assesses fertility doctors and clinics. The website gathers and reports information from patients about their experiences so that others are not caught in the often frustrating and disappointing cycle of seeking medical care via word-of-mouth referrals.
The website is a work-in-progress that some have compared with Yelp given its subjectivity. But at least one patient found it to be "invaluable and game-changing."
Wednesday, June 8, 2016
The Chronicle (May 30, 2016): Woman Faces Fight to Use Dead Partner's Sperm, by Andrew Backhouse:
A Queensland woman, granted judicial permission to extract sperm from her deceased fiance will likely face a legal challenge to her use of the sperm to have a child with the aid of in vitro fertilization. The partner's family has returned to New Zealand with his body and may well oppose her use of the extracted sperm. The family gave permission for the extraction on an emergency basis because sperm is rendered useless for fertilization within twenty-four hours of a man's death. The couple had been trying to conceive a child before the man's untimely death. Friends of the couple appeared in court to testify about the couple's commitment and desire to have a family. The presiding judged urged "mature reflection . . . whether to proceed with the use of any extracted material."
Monday, June 6, 2016
New York Times (May 30, 2016): Triplet and Higher-Order Births in U.S. Down 41%, by Nicholas Bakalar:
Women 25 and older and in particular women 45 and older are giving birth to fewer higher-order births, 90 percent of which have been triplets in recent years. The sharpest drop occurred among non-Hispanic white women, though the rate in this group is still 57 percent higher than for non-Hispanic black women and twice as high as the rate for Hispanic women. The increase in higher-order births prior to 1998 was attributed to the rising average maternal age. This average has continued to rise; the decline in higher-order births, then, is thought to be the result of the practices of infertility centers, namely, not implanting multiple embryos in women seeking treatment.
Wednesday, June 1, 2016
Human Reproduction (May 21, 2016): Santa Claus in the Fertility Clinic, by Hans Evers:
The editor-in-chief of this premier medical journal criticizes infertility physicians for creating therapeutic illusions with misdiagnoses, useless medications, and unnecessary treatment. Evers is referring specifically to the unnecessary use of intra-cytoplasmic sperm injection (ICSI) in cases where in vitro fertilization (IVF) by itself would be sufficient to create a viable pregnancy. ICSI is indicated in cases of male-factor infertility, but such cases do not comprise the majority of infertility cases. Evers bases his evaluation on data covering 2008 through 2010 and gathered by the International Committee Monitoring Assisted Reproductive Technology (ICMART). The data show that the ICSI-to-IVF ratio varies from 1.4 in Asia to a staggering 60.3 in the Middle East. Studies show that the use of ICSI in non-male-factor infertility cases results in fewer lives births than the use of IVF alone. It does not improve the chances of a successful fertilization in such cases. Evers calls for the end of this costly and ineffective therapeutic illusion.
Tuesday, May 31, 2016
New York Times (May 21, 2016): Is Egg Freezing Only for White Women?, by Reniqua Allen:
When her most recent intimate relationship ended, Reniqua Allen considered freezing her eggs. Though marketed as a technique to help women gain control over their reproductive lives, including having children to raise alone, egg freezing, as Allen discovered, appears to be a procedure that few black women are considering. The reason is in part marketing: infertility care websites and advertisements spill over with images of happy white families. But Allen also wonders whether the negative stereotype of the single black mother in the United States was driving black women away from this form of assisted reproduction.
Poor black women are criticized for having too many babies they “can’t afford” and professional middle-class black women are criticized for being too picky and not finding a man. But when professional white women follow these same patterns, it’s often labeled a trend or brave or empowering.
In her research, Allen discovered that slowly the terms of the conversation around egg freezing are changing, allowing room for black women at the margins. Whether to embrace egg freezing or reject it is not an easy choice. The choice could be driven by what Allen refers to as "respectability politics" or even unresolved issues she has with her father. Her fervent hope is that whatever choice she makes, she can play a part in making "unconventional decisions the norm."
Thursday, May 5, 2016
New York Times (May 3, 2016): Fewer Surrogacy Options as Nepal Joins a Trend, by Rachel Abrams:
Nepal has banned surrogacy after serving as a robust surrogacy destination for hopeful parents from around the world. Nepal became a popular destination especially for gay couples after India decided to bar gays from have children via surrogacy there. Developing countries like Nepal, India and Thailand have one by one restricted or prohibited surrogacy to respond to concerns that surrogacy is akin to human trafficking and that surrogates in those countries are exploited by couples who cannot afford surrogacy in the United States. They may also be exploited by agencies and few protections if an agency refuses to pay or the surrogate becomes ill or is injured. Complicating the debate is the fact that surrogates in these countries can earn much, much more than other employment options afford them.
Sunday, March 13, 2016
New York Times (Mar. 10, 2016): First Uterus Transplant in United States Fails, by Denise Grady:
Performed by physicians at the Cleveland Clinic, the first uterus transplant in the United States has failed. The nature of the complications with the transplant have not been revealed, but pathologists are analyzing the uterus in the hopes of determining what went wrong.
The Clinic's uterine transplant program is an effort to enable women without a uterus to become pregnant and give birth.
Tuesday, March 8, 2016
New York Times (Feb. 25, 2016): First Uterus Transplant in U.S. Bolsters Pregnancy Hopes of Many, by Denise Grady:
Doctors at the Cleveland Clinic have performed the first uterus transplant in the United States. The recipient is already a mother, having adopted three boys.
The surgery is complex and multi-phased. The recipient first undergoes egg extraction. The eggs are then fertilized with the sperm of her partner, and the resulting embryos are frozen. The recipient then begins a regime of immunosuppressants, in preparation for the transplant. She will be monitored for a year to determine whether the transplant was successful. Only then will embryos be introduced into the uterus. After one or two successful pregnancies, the uterus will be removed.
The Cleveland Clinic will attempt ten uterine transplants as part of a clinical trial to determine whether it will offer uterine transplant as a standard procedure.
Monday, March 7, 2016
New York Times (Feb. 29, 2016): Veterans Seek Help for Infertility Inflicted by Wounds of War, by Denise Grady:
Despite a new policy giving troops the opportunity to freeze their eggs or sperm before deployment, the military offers veterans no coverage for in vitro fertilization (IVF), leading to questions about how best to support soldiers who sustain injury to their reproductive systems in combat and are medically retired or discharged from the military. Adding insult to injury is the fact that the military does cover IVF for active-duty service members. A bill to rectify this inequity was headed toward a vote last summer, but its sponsor withdrew it when Republicans threatened to riddle it with exceptions that would prohibit the Veterans Administration from having anything to do with Planned Parenthood.
Sunday, February 28, 2016
CNN (Feb. 26, 2016) Should parents be allowed to choose the sex of their baby?, by Carina Storrs:
Prospective parents may have preferences on whether they have a boy or girl. In vitro fertilization (IVF) opens up new possibilities for parents to choose the sex of their baby as well as controversies about whether sex selection is appropriate. The American Society for Reproductive Medicine initially took the position that use of IVF for sex selection should "not be encouraged" but recently eased its stance.
Determination of the sex of an embryo prior to implantation requires genetic screening, which provides prospective parents with genetic information about the embryo, including its sex. Some clinicians argue that manipulating the embryo to conduct the screening creates an unnecessary risk , but there is no current evidence that it is unsafe. There is also concern that the use of IVF for sex selection could divert resources away from medically necessary IVF.
Perhaps the greatest concern about sex selection is that it could cause or reinforce gender bias. In the United States, there is no evidence that parental choice would lead to a gender imbalance, and it appears more likely that sex selection is used as a form of "family balancing." For instance where parents of boys may decide they would like their next child to be a girl. However, even this "gender neutral" form of sex selection may reinforce bias and attitudes about the link between gender differences and biological sex. Canada and the United Kingdom have banned the use of IVF for sex selection except if it is used to avoid the risk of sex-linked genetic diseases.
Tuesday, February 9, 2016
The Washington Post (Feb. 3, 2016): Ethicists approve ‘3 parent’ embryos to stop diseases, but congressional ban remains, by Joel Achenbach:
An advisory panel called together by the US Food and Drug Administration concluded, this week, that it is ethically permissible to proceed with in-vitro fertilization that combines the DNA of three parents to form an embryo. The panel, made up of scientists and bioethicists, approved a procedure called mitochondrial replacement techniques (MRT), but advises caution in its use.
MRT replaces the nucleus of a donor's egg with the mother's nucleus and then fertilizes the egg with the father's sperm. The procedure guards against certain diseases that can be passed down from mother to child through the egg's mitochondria.
Though the procedure has been approved by the House of Lords in the UK, it is currently on hold in the US due to a congressional ban.
More information can be found at Slate.
Wednesday, January 20, 2016
New York Times (Jan. 19, 2016): Anti-Abortion Groups Join Forces Over Frozen Embryos, by Tamar Lewin:
Disputes by divorcing couples over frozen embryos are nothing new. In the past they have been decided in favor of the party who does not want to procreate or in accordance with any contracts the couple executed to control their disposition. But a new litigation strategy is for the party seeking to have children with the embryos without the consent of the other to hire counsel better known for their anti-choice stance in the abortion wars. The legal theory these lawyers expound is that an embryo has a fundamental interest in being born, ergo, that the party who wishes to procreate should be allowed to do so. The strategy fits nicely within the "personhood" theory which holds that an embryo is a person at the moment of conception. Indeed, counsel in an ongoing appeal in a frozen-embryo dispute in Missouri cite the Missouri law that life begins at conception. Of course a court will probably not find the existence of "human life" to be synonymous with the existence of a "human person," if only to adhere with the Supreme Court's decision in Roe v. Wade, which remains the law of the land.
Wednesday, December 23, 2015
New York Times (Dec. 23, 2015): With In Vitro Fertilization, Persistence Pays Off, Study Suggests, by Catherine Saint Louis:
Doctors have long thought that after three or four failed rounds of in vitro fertilization, the prospect of a patient becoming pregnant are grim. But a study published recently in the Journal of the American Medical Association calls into question the received wisdom. The study finds "that nearly two-thirds of women undergoing I.V.F. will have a child by the sixth attempt, suggesting that persistence can pay off, especially for women under 40." Indeed, there appears to be a modest increase in the cumulative rate for live births up to the ninth IVF cycle. Few patients can afford, however, that many cycles of IVF, which cost $12,400 each on average. And risks such as ovarian hyperstimulation syndrome must be taken into account, as must the shattering emotional toll of failed cycles.
Tuesday, October 20, 2015
New York Times (Oct. 16, 2015): Egg Donors Challenge Pay Rates, by Tamar Lewin:
In a federal lawsuit, a group of women are challenging [infertility] industry guidelines that say it is “inappropriate” to pay a woman more than $10,000 for her eggs. The women say the $10,000 limit amounts to illegal price-fixing, and point out that there is no price restriction on the sale of human sperm. A federal judge has certified the claim as a class action.
The crux of the lawsuit is the allegation that infertility clinics have set the price of egg donor services at a low, non-competitive level, in a move that draws infertile couples to infertility clinics. The industry has responded that the guideline aims to protect egg donors and recipients, an arguably procompetitive motive. But as Kimberly Krawiec has pointed out, the evidence in the case seems to point the other way: egg donors could command higher prices in the open market. A cap on the price they can charge diminishes their power in the marketplace.
The lawsuit will likely go to trial next year.
Thursday, April 30, 2015
The New York Times op-ed: Sofía Vergara’s Ex-Fiancé: Our Frozen Embryos Have a Right to Live, by Nick Loeb:
LAST August, I filed a complaint in Santa Monica, Calif., using pseudonyms, to protect two frozen embryos I created with my former fiancée. I wanted to keep this private, but recently the story broke to the world. It has gotten attention not only because of the people involved — my ex is Sofía Vergara, who stars in the ABC series “Modern Family” — but also because embryonic custody disputes raise important questions about life, religion and parenthood.
When we create embryos for the purpose of life, should we not define them as life, rather than as property? Does one person’s desire to avoid biological parenthood (free of any legal obligations) outweigh another’s religious beliefs in the sanctity of life and desire to be a parent? . . .
The New York Times - Public Editor's Journal: Frozen Embryos Article Was Intended to Spark Debate: Mission Accomplished, by Margaret Sullivan:
An Op-Ed essay titled “Sofía Vergara’s Ex-Fiancé: Our Frozen Embryos Have a Right to Live” started to draw fire almost immediately after its publication Wednesday night.
The vehemence of reader criticism prompted me to ask Andrew Rosenthal, the editorial page editor who supervises the opinion-side sections of The Times, for response. . . .
Tuesday, March 17, 2015
The Washington Post: Elton John is boycotting Dolce and Gabbana for calling children conceived with IVF ‘synthetic’, by Soraya Nadia McDonald:
This year, Italian designers Domenico Dolce and Stefano Gabbana unveiled a celebration of motherhood at Milan Fashion Week, sending models down the catwalk who were visibly pregnant or carrying little chubby-cheeked bundles of joy. . . .
Recent statements Dolce and Gabbana made to Panorama, an Italian magazine, have cast their fall-winter 2016 collection, which they named “Viva la mamma,” in an entirely new light.
In the interview, translated by the Telegraph, the couple stated: “We oppose gay adoptions. The only family is the traditional one. … No chemical offsprings and rented uterus: Life has a natural flow, there are things that should not be changed.”
“You are born to a mother and a father — or at least that’s how it should be,” Dolce said. “I call children of chemistry, synthetic children. Rented uterus, semen chosen from a catalog.” . . .
Saturday, November 29, 2014
Newsweek: Twins: The Fetal Paradox, by Amy Klein:
In 2004, Danielle Decrette went in for in vitro fertilization. It wasn’t her first time—she and her husband had a 3-year-old daughter conceived through IVF—and she knew what she was getting into. Just as he had four years before, Decrette’s doctor stimulated her with hormones, extracted her eggs from her ovaries, fertilized them with sperm in the lab and placed the resulting embryo in her uterus. But this time the process failed. So the doctor decided to transfer two embryos in the next round to increase her odds of getting pregnant.
“You know you could have twins,” the doctor warned her before the procedure. . . .
That was 10 years ago. Today, fertility doctors would almost certainly have pushed her away from the idea of a two-embryo implant . . . .
Monday, October 6, 2014
The Huffington Post -- The Blog: Reproducing Race, by Dov Fox (University of San Diego Law):
More than a million children in the U.S. each year are conceived with donated sperm or eggs. Sperm banks and egg vendors offer online ordering and direct shipping of donor materials that prospective parents can shop for based on SAT scores, personality tests, and celebrity likeness.
"[W]hat we try to do is give [parents] as much choice as possible," explains Dr. Cappy Rothman, co-founder of the world's leading sperm bank, California Cryobank. "If our customers wanted high school dropouts," he adds, "we would give them high-school dropouts."
What many of these (mostly white) parents want is a child who will look like they do. This means picking a donor who is, like them, white. . . .