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Tang, Shiu-wai. "Reproduction has never been natural the social construction of reproduction in the age of new reproductive technologies /." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22331888.
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Wilson, Poe Emma. "Vitrification of day 5/6 human morulas/blastocysts: A 10 year retrospective study in a private assisted reproductive techniques [ART] clinic." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96876.
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Thesis (MMed)--Stellenbosch University, 2015.ENGLISH ABSTRACT: This study was designed to retrospectively evaluate the established embryo vitrification/warming programme currently implemented at Drs Aevitas Institute for Reproductive Medicine and to look at factors that might play a role in optimizing the pregnancy outcomes thereof. Vitrification is the achievement of a “state of suspended animation” wherein molecular translational motions are arrested without structural reorganization of the liquid. In embryo vitrification it involves placement of the embryo in a very small volume of vitrification medium that must be cooled at extremely high cooling rates. The vitrification medium contains cryoprotectants to prevent any cryoinjury from occurring to the embryo. This process was initially proposed to effectively manage supernumerary embryos, but it has also provided a viable method of reducing costs for additional embryo transfers as well as the reduction of the incidence of multiple births. Patients who are at risk of ovarian hyper stimulation syndrome (OHSS) can also have all of their embryos vitrified in advance to reduce the likelihood of adverse clinical symptoms if a pregnancy is established. Throughout the period in which vitrification has been in practice, there have been advances in technology as well as continual research being conducted to establish whether newly suggested techniques do, in fact, optimize the outcomes of vitrification. Focus has subsequently been applied to the carrier device used for vitrification, the day on which the embryos are vitrified and stored, as well as the number of embryos transferred in each respective cycle, all to ensure the most favourable outcome. This retrospective study confirmed the use of the Cryotop® as the most viable carrier device for successful survival and pregnancy outcomes. Transfer of day 5 vitrified embryos resulted in significantly higher pregnancy rates compared to day 6 vitrified embryos. Results also indicated that the number of embryos transferred does indeed have a significant effect on the pregnancy outcome and consequently we can possibly argue against the implementation of single embryo transfer in the vitrification programme. Investigation into the effect of female age, specifically oocyte age, on each of these categories indicated that reduced age can be associated with optimal outcomes; however this could not be proven statistically in this cohort of patients. To further look at optimization of the vitrification/warming programme, a Literature Survey was conducted to ascertain the results after Assisted Hatching in frozen/warmed human embryos. Assisted Hatching has been proposed as a solution to Zona Pellucida hardening, which has been found to occur during vitrification. The need for further studies and a meta-analysis of the literature is confidently proposed, as well as a Prospective Study to evaluate the effect of Laser Assisted Hatching in the human blastocyst vitrification/warming programme at Drs Aevitas Institute for Reproductive Medicine.
AFRIKAANSE OPSOMMING: Hierdie studie is ontwerp om die gevestigde embrio vitrifikasie/ontdooi program by Drs Aevitas Instituut vir Reproduktiewe Medisyne, retrospektief te evalueer en die faktore te optimaliseer wat swangerskap uitkomste kan beïnvloed. Vitrifikasie is die proses waardeur die molekulere aktiwiteit binne die embrio in ‘n staat van arres gehou word sonder om die strukture binne die sitplasma te versteur. Dit behels die plasing van ʼn embrio in 'n klein hoeveelheid vitrifikasie medium wat teen 'n hoë tempo afgekoel word. Die vitrifikasie medium bevat kriobeskermmiddels wat die embrio tydens die vitrifikasie proses teen moontlike skade beskerm. Hierdie proses is aanvanklik voorgestel om oortollige embrio’s doeltreffend te bestuur. Dit bied ʼn koste effektiewe metode vir embrio terugplasing, en verlaag die insidensie van veelvoudige swangerskap. Vitrifikasie bied pasiënte met ʼn hoë risiko vir ovariale hiperstimulasiesindroom (OHSS) ‘n alternatief om nadelige kliniese simptome te vermy indien ʼn swangerskap bereik word. Tegnologiese vordering en voortdurende navorsing ondersoek voortdurend nuwe tegnieke vitrifikasie uitkomste te optimaliseer. Fokus word geplaas op die draertoestel wat gebruik word vir vitrifikasie, die dag waarop die embrio's gevitrifiseer en gestoor word, sowel as die aantal embrio’s wat met elke vitrifikasie siklus teruggeplaas word. Hierdie retrospektiewe studie het bevestig dat die gebruik van die Cryotop® die mees suksesvolle toestel vir oorlewing en swangerskap uitkomste is. Die terugplasing van dag 5 gevitrifiseerde embrios het beduidende hoër swangerskapsyfers as dag 6 embrios tot gevolg gehad. Die resultate het ook aangedui dat die aantal embrio's wat teruggeplaas word 'n beduidende uitwerking op die swangerskapsyfer het. Daar kan dus moontlik teen die implementering van 'n enkel embrio-terugplasing neiging in die vitrifikasie program geargumenteer word. Resultate het ook getoon dat optimale uitkomste verwant is aan ʼn laer oösiet ouderdom, alhoewel dit nie in die groep pasiente statisties bewys kon word nie. 'n Literatuurstudie oor AH (Assisted Hatching) op gevitrifiseerde/ontdooide menslike embrio’s is uitgevoer om die vitrifikasie/ontdooi program verder te optimaliseer. AH bied ‘n oplossing vir Zona pellucida verharding, wat tydens vitrifikasie plaasvind. Verdere studies, 'n meta-analise van die literatuur, sowel as 'n prospektiewe studie om die effek van laser AH in gevitrifiseerde/ontdooide menslike blastosiste by Drs Aevitas Instituut vir reproduktiewe medisyne te evalueer, word voorgestel.
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Batty, Lynne Patricia. "Assisted Reproductive Technology: The Aotearoa/New Zealand Policy Context: A thesis submitted in fulfilment of the requirements for the degree of Master of Arts in Sociology in the University of Canterbury." Thesis, University of Canterbury. Sociology, 2002. http://hdl.handle.net/10092/912.
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The focus of this thesis is the current policy situation in relation to assisted reproductive technologies (ART) in Aotearoa/New Zealand. I explore how government policies (and lack of policy) have shaped access to ART. I also explore the policy initiatives of funding agencies, the National Ethics Committee on Assisted Human Reproduction (NECAHR), managers, healthcare professionals, and interest groups. My investigation into ART policy issues critically examines the various formal mechanisms and policies used to regulate and control ART in Aotearoa/New Zealand. Drawing on my analysis of policy-focused documents and material from in-depth interviews with key actors in the policy debate, I demonstrate how the ad hoc and contingent approach to ART developments, practices, funding, and access has contributed to inconsistent and inequitable access to ART services. I argue that the lack of an ART-specific policy organisation contributes to fragmented, and possibly discriminatory, policy decisions. I examine how the use of restrictive access criteria to manage the increasing demand for publicly funded ART services disadvantages certain groups wishing to use these services. By investigating the influence of rationing strategies on the allocation of resources and regulation of access, I provide some appreciation of the 'messy reality' of policy creation, interpretation, and implementation. I argue that the criteria used to limit access to public ART services obscure the use of social judgements and provider discretion. Likewise, they succeed in limiting publicly funded ART treatments to those who conform most effectively to the normative definition of family. My analysis of the ART policy discourse identifies silences and gaps in relation to specific ART practices, particularly the use of ART by Maori. I highlight the invisibility and marginalisation of Maori within the ART policy debate. After examining the broader issues concerning Maori access to health services, I explore how these may affect Maori using ART services to overcome infertility. I argue that the gathering of information about the utilisation of ART services is crucial for the accurate identification of the needs of Maori. It is also fundamental for effective monitoring of state health policy decisions and outcomes.
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Szoke, Helen. "Social regulation,reproductive technology and the public interest : policy and process in pioneering jurisdictions /." Connect to thesis, 2004. http://eprints.unimelb.edu.au/archive/00002866.
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Ellender, Stacey. "Assisted reproduction defining and evaluating the multiple outcomes of technologically advanced interventions /." online access from Digital Dissertation Consortium, 2005. http://libweb.cityu.edu.hk/cgi-bin/er/db/ddcdiss.pl?3193097.
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A, Muhlhauser Paul. "Imageneing the rhetoric of the human gamete industry /." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Dissertations/Spring2009/p_muhlhauser_041709.pdf.
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Brokensha, Steven. "Psychosocial discourse and the "new" reproductive technologies : a critical analysis." Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/14320.
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Bibliography: leaves 47-53.The "new" reproductive technologies (NRTs) have gathered substantial momentum in recent years. 'Psychological' discourse on these techniques has tended towards uncritical preoccupation with intra-individual, constitutional factors, and has ignored the sociocultural, political and economic contexts of these practices. Within an inter-disciplinary, social-constructionist framework, this study presents a feminist critique of the NRTs in which they are argued to be biopsychosocially noxious to women. Modern biomedicine's appropriation and ownership of infertility as "disease" is argued to be consistent with the agendas of capitalism and patriarchy. Results of fieldwork within a particular medical setting are presented to develop a hermeneutic of the discursive interface between medical gatekeepers and the applicant 'patients' with whom they negotiate treatment. In a concluding section a dominant theme in gatekeepers' talk, "the well-being of the child", is ideologically analyzed; women-centered strategies are briefly discussed; and implications for the interface between psychology and reproductive technology are drawn.
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Mignin, Erin Nicole. "Embryonic Policies: Reproductive Technology and Federal Regulation." Bowling Green State University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1354301736.
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Smith, Heather K. "The impact of framing on policy passage: the case of assisted reproductive technology." Thesis, Georgia Institute of Technology, 2011. http://hdl.handle.net/1853/42774.
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In the last 30 years, in vitro fertilization (IVF) has created a significant amount of controversy around the world. Within the U.S., policy movement has been limited, occurring primarily at the state level, which has created a fragmented system of rules to manage the technology. However, there appear to be indications that how the issue is presented, and which actors are chosen to be represented in legislation, may impact the passage of policy, thereby also providing a reason for why little policy movement has occurred. In this study, pieces of federal, California and Georgia legislation were examined for the occurrence of differing frames, as identified by the actors presented, in order to determine whether different frames occurred in passed legislation than those found in failed legislation. It was determined that, while actors did not differ significantly between passed and failed legislation, there were some slight differences between actors used at the federal level, as well between the different state levels. Even further, the presentation of actors and their interests did appear to differ slightly between passed and failed legislation.
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Wasunna, Angela. "Averting a clash between culture, law and science : an examination of the effects of new reproductive technologies in Kenya." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ64309.pdf.
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Siano, Linda J. "Intracytoplasmic sperm injection overcomes previous fertilization failure with conventional in vitro fertilization /." View abstract, 2000. http://library.ctstateu.edu/ccsu%5Ftheses/1600.html.
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Thesis (M.A.)--Central Connecticut State University, 2000.Thesis advisor: Kathy Martin. " ... in partial fulfillment of the requirements for the degree of Master of Arts in Biological Sciences." Includes bibliographical references (leaves 23-27).
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Wunderlin, Beverly J. "The Regulation of Medically Assisted Procreation in Europe and Related Nations and the Influence of National Identity, Social Cultural, and Demographic Differences." Thesis, University of North Texas, 2002. https://digital.library.unt.edu/ark:/67531/metadc3192/.
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This study details the Medically Assisted Procreation regulations in thirty-five nation-states, and explores the influence of national identity, social cultural and demographic differences on these regulations. Detailed data were gathered from ministries of health, offices of prime ministers, embassy staff, and others on regulations for each nation. These data were used to categorize the nations in regard to MAP legislation status and regulatory policy regarding marital or age restrictions; posthumous conception; sperm, ovum, or embryo donation, surrogacy; and policy on handling donors. Possible associations between national identity, social cultural, and demographic data for each nation and their regulations were explained. The thirty-five nations were treated as a population with common geographical and political ties. PRE methods, and eta coefficients were used to assess the associations. Sixteen nations have adopted MAP legislation, eight nations have either alternative regulatory guidelines or partial structures, four nations have legislation pending and possibly some laws, and seven nations are unregulated. Based upon statistical analysis, language group emerges as an important indicator for differences in MAP regulations. For example knowing a nation's language group enabled percent improved prediction of that nation's regulatory handling of embryo donation. The percent GDP spent on health care was found to have a substantial or moderate association with most regulations. The findings of this study indicate that the cultural roots associated with national identity as well as economic circumstances such as health care budgets impact the policy making process responsible for the regulation of MAP in Europe. Among other mediating circumstances, MAP related family law cases brought to the European Court of Human Rights create an accumulation of judge-made law, which help create a common European standard. This study of the European region provides a baseline for further research and a reference for cross cultural comparisons.
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Ross, Dianne May. "Infertile couples' attitudes towards reproductive alternatives : a survey of the members of the Infertility Awareness Association of Canada, Toronto Chapter." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23446.
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Social workers are increasingly being called upon to work with clients who wish to have a child but are unable to do so without medical intervention. This study, a cross-sectional survey design, examines the attitudes of couples towards donor insemination (DI), in vitro fertilization (IVF), contractual pregnancy, adoption and living child free. A random sample of 200 names was drawn from the membership of the Infertility Awareness Association of Canada, Toronto Chapter. Surveys were completed by 74 participants (37 couples). Participants were generally well educated, affluent and ranged in age from 26 to 63 years. Women were one third more likely to report feeling pressure to have children than were men. The source of this pressure was most often reported to be external/interpersonal relationships (e.g., friends, family, partner). Women were significantly more likely to strongly agree that they would use DI or IVF if they were infertile; whereas, men were more likely to only agree when considering DI, and to be unsure or neutral when considering IVF. The possibility of living child free was an alternative that very few participants had seriously considered, as many were still pursuing one or more reproductive alternative. Although significant differences were found within couples for DI, IVF and living child free in the vignettes, unexpectedly an overall theme of agreement between women and men was found as well. In addition, participants revealed a desire for support in their consideration of, and decision making regarding, the reproductive alternatives they may pursue. Clearly, the findings point to the need participants have to receive counselling, and/or follow-up to help them cope with their infertility and the possibility that they may not be able to have children.
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Kitabayashi, Yukio. "The dignity of man as a creature and the limitation of current reproductive technology." Theological Research Exchange Network (TREN), 1990. http://www.tren.com.
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Bastiaan, Hadley Saville. "The effect of solubilized homologous zona pellucida on the human acrosome reaction, sperm-zona binding and motion characteristics of capacitated human spermatozoa." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53630.
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Thesis (PhD)--Stellenbosch University, 2003.ENGLISH ABSTRACT: CHAPTER 1 provides literature based background information to emphasize the use of a sequential, multistep diagnostic schedule for couples in an assisted reproductive program as well as the clinical importance of sperm morphology as recorded by strict criteria during the diagnostic approach of the infertile couple. Furthermore, the chapter includes evidence underlining the growing need for the implementation of the physiologically induced acrosome reaction as an important contribution to the assisted reproductive program. The zona pellucida-induced acrosome reaction (ZIAR), sperm-zona interaction as well as computer-assisted semen analyses were investigated. CHAPTER 2 provides detailed experimental protocols of the materials and methods used in the study. CHAPTERS 3-6 each represent a separate study that was prepared as a scientific paper and encompass the experimental research undertaken in the reproductive biology research laboratory at Tygerberg Hospital to address important aspects of human acrosome processes. In the first study, we aimed to evaluate the regulatory role of the Gi-like protein during the AR of normal sperm donors and the role of intact acrosomes during sperm-zona binding. It seems that pertussis toxin-sensitive Gi-like protein in human spermatozoa plays an important regulatory role in the ZIAR and this underlines the importance of intact acrosomes during sperm-zona binding. In the second study, we aimed to evaluate the relationship between the ZIAR and the percentage normal spermatozoa as well as the sperm-ZP binding potential among men referred for a routine semen analysis. ZIAR testing should become part of the second level of male fertility investigations, i.e., sperm functional testing, since 15% of the andrology referrals revealed an impaired AR response to solubilized ZP. In the third study, we aimed to evaluate the possible relationships between the sperm morphology, the acrosome responsiveness to solubulized human ZP and the sperm-zona binding potential among consecutive andrology referrals and randomly selected IVF cases. ZIAR results provide further information regarding dysfunctional sperm and can be used as an additional diagnostic test since the results predicted fertilization failure during IVF treatment. In the fourth study, we aimed to evaluate changes in the sperm motion characteristics and the occurrence of hyperactivated motility after exposure to ZP among andrology referrals. Solubilized human ZP induces hyperactivated motility among sperm populations that have been capacitated under laboratory conditions. Capacitated spermatozoa have an elevated percentage hyperactivated cells that correlate with the percentage normal spermatozoa in the ejaculate. CHAPTER 7, the general discussion, is brief and concise to avoid unnecessary repetition, underlines the validity of a sequential, multistep diagnostic approach and concludes with the recommendation that the ZIAR should form part of the diagnostic tools in the assisted reproductive program.
AFRIKAANSE OPSOMMING: HOOFSTUK 1 bestaan uit ’n omvattende agtergrondstudie wat bestaan uit die ontwikkeling van diagnostiese toetse, die hantering van die egpaar in die reproduktiewe ondersteunings-program asook op die kliniese belang van spermmorfologie. Die toenemende behoefte aan die implementering van die fisiologies-geinduseerde akrosoomreaksie, as ’n belangrike bydrae tot die reproduktiewe ondersteuningsprogram, word ook beklemtoon. Die zona pellucida geinduseerde akrosoomreaksie (ZIAR), sperm-zonabinding asook rekenaar-bemiddelde semenanalises is ondersoek. HOOFSTUK 2 dek gedetailleerde eksperimentele protokolle van die materiale en metodes wat in die studie gebruik is. HOOFSTUKKE 3-6 behandel die eksperimentele navorsing wat in die laboratorium van die reproduktiewe biologie-eenheid te Tygerberg hospitaal uitgevoer is en wat as ses afsonderlike wetenskaplike publikasies aangebied word. Die doel van die eerste studie was om die regulerende rol van Gi-proteiene tydens die AR van normale spermdonors asook die rol van intakte akrosome tydens sperm-zonabinding te evalueer. Dit kom voor asof Gj-protei'ene in spermatozoa ’n belangrike regulerende rol in die ZIAR speel. Dit beklemtoon die belangrikheid van intakte akrosome tydens sperm-zonabinding. Die doel van die tweede studie was om die verhouding tussen die ZIAR en die persentasie normale spermatozoa asook die sperm-zonabindingspotensiaal tussen mans wat vir ’n roetine semenanalise verwys is te evalueer. ZIAR-toetsing moet deel uitmaak van die tweede vlak van manlike fertiliteitsondersoeke, d.w.s. funksionele toetsing, aangesien 15% van die andrologie pasiente ’n verswakte AR respons tot opgeloste ZP openbaar. In die derde studie was die doel om die moontlike verhoudinge tussen sperm-morfologie, die ZIAR en die sperm-zonabindingspotensiaal onder opeenvolgende andrologie-pasiente asook lukraak geselekteerde IVB-pasiente te evalueer. Die ZIAR-resultate bied verdere informasie aangaande disfunksionele spermatozoa en kan gebruik word as ’n addisionele diagnostiese toets aangesien hierdie resultate mislukte bevrugting tydens IVB behandeling voorspel. Die vierde studie het ten doel gehad om veranderinge in spermmotiliteitseienskappe asook hiperaktiwiteit na die blootstelling aan opgeloste zona onder andrologiepasiente te evalueer. Daar is afgelei dat opgeloste menslike zona hiperaktiwiteit induseer in spermpopulasies wat onder gunstige laboratoriumkondisies gekapasiteer is. Die gekapasiteerde spermatozoa het ’n verhoogde persentasie gehiperaktiveerde spermatozoa getoon wat met die persentasie normale spermatozoa in die ejakulaat korreleer. In HOOFSTUK 7 word aangetoon dat dit noodsaaklik is om die diagnostiese skedule by die hantering van die onvrugbare egpaar te gebruik asook dat die ontwikkeling van die funksionele toestand belangrik is vir die bepaling van ZIAR.
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Hoogendijk, Christiaan F. (Christiaan Frederik). "Sperm DNA fragmentation : implications in assisted reproductive technologies." Thesis, Stellenbosch : Stellenbosch University, 2007. http://hdl.handle.net/10019.1/21626.
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Dissertation (PhD)--University of Stellenbosch, 2007.ENGLISH ABSTRACT: Male fertility has for many years been defined in vitro as the ability of sperm to fertilize oocytes and to obtain early cleavage-stage embryos. Spermatozoa comprise of an extraordinary high percentage of polyunsaturated fatty acids in their plasma membrane. Due to an extremely low content of cytoplasm, sperm cells have a particularly low potential to scavenge reactive oxygen species (ROS), and are therefore highly sensitive to oxidative processes, which lead to sperm nucleus DNA damage/fragmentation. Normally, DNA fragmentation occurs in every ejaculate and can be induced by an excessive ROS production of active leukocytes or the spermatozoa themselves. Under distressed conditions, DNA fragmentation may also occur in the testis as a result of oxidative processes in the apoptotic cascade. These DNA fragmentations can be regarded as late signs of programmed cell death (apoptosis). Clinically, DNA fragmentation in spermatozoa results in significantly decreased implantation and pregnancy rates especially in patients with oligo- and/or teratozoospermia. The p-pattern normal sperm morphology has been shown to give poorer fertilization rates in vitro than the g- and n-patterns. In this study there is reported on the significant correlation found between the p-pattern normal sperm morphology and sperm DNA fragmentation as measured with the terminal deoxynucleotidyl transferase-mediated dUDP-biotin end labeling (TUNEL) assay. This finding further explains the lower fertility potential of patients presenting with p-pattern normal sperm morphology. In addition, this study explores the intricate relations between ROS in the semen, DNA fragmentation of the spermatozoa, as measured with the TUNEL assay and the sperm chromatin structure assay (SCSA ), spermatozoa apoptotic status and sperm parameters as measured with a standard semen analysis. Positive correlations were found between ROS and the apoptotic status of the sperm, as well as between sperm with non-fragmented DNA and sperm concentration and percentage motility. The results emphasize the importance of sperm selection especially when the treatment of choice is intracytoplasmic sperm injection (ICSI). An early sign of programmed cell death, also known as apoptosis, is the externalization of phosphatidylserine (PS) from the inner membrane leaflet to the outer leaflet. PS shows a high affinity to Annexin V. Apoptotic spermatozoa are able to fertilize oocytes, but embryo senescence may occur at the time when the paternal genes are activated. In this study there is reported on a novel method whereby spermatozoa can be separated on the basis of their apoptotic status through flow cytometry. Results showed that the normal sperm morphology, according to strict criteria, of the resultant nonapoptotic sperm fraction is significantly higher than that of the apoptotic counterpart. With refinement of this technique, it will be possible in future to use these separated non-apoptotic sperm cells during ICSI for fertilization. From the above it is apparent that the spermatozoon has to play a vital role in the development of the embryo from fertilization to implantation and pregnancy. It is, however, important to note that besides the gametes, there are other critical factors which contribute to a successful in vitro fertilization (IVF) cycle, among these are the in vitro culture conditions. In this regard, this study compared two sequential embryo culture systems. It was found that the more complex medium resulted in better day three embryo quality and a better blastocyst formation rate and pregnancy rate. These findings highlight the importance of a holistic perspective towards the complexity of the factors involved in affecting embryo quality and pregnancy outcome.
AFRIKAANSE OPSOMMING: Manlike fertiliteit is vir baie jare gedefinieer as die in vitro vermoë van ‘n spermsel om ‘n eiersel te bevrug om sodoende embrios te verkry. Die spermsel se plasmamembraan bestaan uit ‘n hoë persentasie poli-onversadigde vetsure. As gevolg van die klein hoeveelhede sitoplasma van die spermsel het dit ‘n beperkte weerstand teen reaktiewe suurstof spesies (ROS) en is gevolglik baie sensitief vir oksidasie. Oksidasie lei tot DNS skade/fragmentasie. DNS fragmentasie kom in spermselle van alle ejakulate voor en is gewoonlik die gevolg van ROS produksie deur die leukosiete in die semen of vanaf die spermselle self. Onder sekere omstandighede kan DNS fragmentasie ook voorkom in die testis waar dit deel vorm van apoptose. Hierdie tipe DNS skade word gesien as laat tekens van geprogrammeerde seldood (apoptose). In oligo- en/of teratozoospermiese mans lei DNS fragmentasie tot verlaagde implantasie- en swangerskapssyfers. Die p-patroon normale sperm morfologie groep gee laer in vitro bevrugting en swangerskapsyfers as die g- en n-patrone. In hierdie studie doen ons verslag oor die statisties betekenisvolle korrelasie wat gevind is tussen die p-patroon normale sperm morfologie en DNS fragmentasie soos gemeet met die ‘terminal deoxynucleotidyl transferase-mediated dUDP-biotin end labeling’ of te wel TUNEL toets. Hierdie bevinding is ‘n verdere verklaring vir die laer fertiliteits potensiaal van pasiënte wat voordoen met p-patroon sperm morfologie. ‘n Verdere doel van die studie was om die moontlike verband tussen ROS in die semen, spermatozoa DNS fragmentasie, apoptotiese status van die sperms en die motiliteits parameters van die spermatozoa te bepaal. ‘n Positiewe korrelasie is gevind tussen ROS en sperm apoptotiese status. Sperms met ongeframenteerde DNS is ook positief gekorreleer met sperm konsentrasie en motiliteit. Die resultate beklemtoon die belangrikheid van spermseleksie veral in pasiënte waar die keuse van behandeling intrasitoplasmiese sperm inspuiting (ICSI) is. ‘n Vroeë teken van apoptose is die eksternalisering van ‘phosphatidylserine’ (PS) vanaf die interne oppervlakte van die plasmamembraan na die eksterne oppervlak. PS het ‘n hoë affiniteit vir Annexin V. Apoptotiese sperms het die vermoë om ‘n oösiet te bevrug, maar kan lei tot die staking van embrio deling wanneer die vaderlike gene ‘n rol begin speel in embrio ontwikkeling. In hierdie studie het ons ‘n nuwe metode ontwikkel waarvolgens die spermatozoa in die ejakulaat op grond van hul apoptotiese status geskei kan word in apoptotiese en nie-apoptotiese fraksies. Die normale sperm morfologie van die nie-apoptotiese fraksie is betekenisvol beter as dié van die apoptotiese fraksie. Verdere verfyning van die tegniek kan daartoe lei dat dit in die toekoms toegepas kan word om vir nie-apoptotiese sperms te selekteer veral voor die uitvoering van ICSI. Uit die bogenoemde is dit duidelik dat die spermsel ‘n baie belangrike rol in die ontwikkeling van ‘n embrio, vanaf bevrugting tot implantasie en swangerskap, speel. Dit is egter ook belangrik om in gedagte te hou dat daar ander bydraende faktore tot ‘n suksesvolle in vitro swangerskap is, soos laboratorium toestande en embrio kultuursisteem. Om hierdie rede is daar ook twee kultuurmedia in hierdie studie vergelyk. Daar is bevind dat die meer komplekse medium beter kwaliteit embrios op dag drie lewer, asook meer blastosiste en ‘n hoër swangerskapsyfer. Dit is dus duidelik dat dit uiters belangrik is om ‘n holistiese perspektief te hê op die komplekse faktore wat ‘n invloed mag hê op bevrugting, embrio kwaliteit asook die swangerskapsyfer.
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Wong, Yim-kuk Aileen. "Stress and coping for women from infertility to assisted reproductive treatments /." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22331529.
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Oh, Jay J. "The Imago Dei and its implications for germ-line genetic enhancement technology." Theological Research Exchange Network (TREN), 1997. http://www.tren.com.
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Tang, Shiu-wai, and 鄧紹偉. "Reproduction has never been natural: the social construction of reproduction in the age of new reproductivetechnologies." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31225202.
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NOTARSTEFANO, VALENTINA. "Development of new molecular tools for the characterization of human Granulosa cells: new implications for the research on human infertility." Doctoral thesis, Università Politecnica delle Marche, 2018. http://hdl.handle.net/11566/252927.
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Nella routine della riproduzione assistita, la selezione degli ovociti si basa sulle loro caratteristiche
morfologiche, nonostante la scarsa correlazione tra tali parametri e la competenza dell’ovocita. Pertanto,
la ricerca si sta concentrando sull’identificazione di marker che possano supportare l’attuale metodica di
valutazione, in particolare studiando le cellule della Granulosa (GCs), che svolgono compiti fondamentali
all’interno del microambiente del follicolo: produzione di estradiolo e progesterone, regolazione
dell’avanzamento della meiosi e dell’attività trascrizionale dell’ovocita, produzione di nutrienti essenziali
per l’ovocita, e accumulo di metaboliti secreti. Pertanto, la progressione degli step della follicologenesi
dipende strettamente dalla comunicazione bidirezionale tra ovocita e le cellule somatiche che lo
circondano.
Lo studio delle GCs ha messo in luce molti aspetti circa le funzionalità ovariche, la follicologenesi, e i
meccanismi con cui fattori endogeni ed esogeni possono alterare questi delicati processi.
In questo senso, lo scopo principale del presente PhD è stato quello di caratterizzare le GCs, applicando
per la prima volta la tecnica Fourier Transform Infrared Microspectroscopy (FTIRM), in modo da
sviluppare un nuovo metodo per valutare la qualità degli ovociti umani. Questo potrebbe rappresentare
uno strumento nuovo, affidabile e oggettivo per la valutazione della qualità degli ovociti nella routine
della riproduzione assistita.
Oltre al tema principale, sono state applicate le tecniche FTIRM, Raman Microspectroscopy e qPCR per
studiare i meccanismi di intaccamento del metabolismo, della composizione biochimica e dell’attività
cellulare causati da fattori endogeni ed esogeni, in particolare l’invecchiamento riproduttivo,
l’endometriosi ovarica e inquinanti plastici.
Le informazioni ottenute su queste cellule contribuiscono alla comprensione dei meccanismi di
danneggiamento della follicologenesi, tramite un approccio multidisciplinare che ha visto l’accoppiamento
di analisi spettroscopiche e qPCR. Grazie ai risultati ottenuti, è stato proposto un approccio innovativo
per l’analisi della qualità degli ovociti tramite caratteristiche spettrali delle GCs, suggerendo la possibilità
di un’applicazione dell’FTIRM come strumento diagnostico di facile utilizzo nella routine di riproduzione
assistita.In assisted reproductive routine, oocyte selection is based on its morphological features, which seem not to be related to its intrinsic competence. Hence, several efforts have been made to identify markers to be added to the actual evaluation, in particular focusing on the crucial roles of Granulosa cells (GCs) in the follicular microenvironment: production of estradiol and progesterone, regulation of the meiosis steps and the transcriptional activity in the oocyte, production of essential nutrients for the oocyte, and accumulation of secreted metabolites. Hence, the progression through the steps of folliculogenesis heavily relies upon bi-directional interactions between germ cells and the surrounding somatic cells. The study of GCs has shown to be determining to highlight particular features of ovarian mechanisms and folliculogenesis, and also to identify the endogenous and exogenous factors that can impair these delicate processes. In this sense, the main aim of the PhD project was to characterize GCs, applying for the first time Fourier Transform Infrared Microspectroscopy (FTIRM) to develop a method for evaluating the quality of human oocytes. This could represent a new, reliable and objective tool for oocyte quality assessment in assisted reproduction routine. Besides this main topic, the impairment induced by endogenous and exogenous factors on the biochemical composition, metabolism and cellular activity of GCs was also investigated by FTIRM, Raman Microspectroscopy and qPCR, shedding new light on the mechanisms governing folliculogenesis. In particular, the research was focused on the impairment determined by reproductive aging, ovarian endometriosis, and plastic pollutants. The information obtained on GCs contribute to the understanding of the mechanisms of impairment of folliculogenesis, by a multidisciplinary approach made of spectroscopic analysis and qPCR. Thanks to the results, an innovative approach to evaluate oocyte quality by spectral features of GCs was proposed, suggesting the possibility to apply FTIRM as a clinical feasible diagnostic tool in assisted reproduction routine.
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Williams, Thomas D. "An ethical analysis of the use of fertility drugs." Online full text .pdf document, available to Fuller patrons only, 2000. http://www.tren.com.
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Nel, Marlize. "A comparison of the effect of Polyvinylpyrrolidone (PVP) and SpermSlow on human spermatozoa." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97028.
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Thesis (MMed)--Stellenbosch University, 2105.ENGLISH ABSTRACT: Intracytoplasmic sperm injection (ICSI), as well as other micromanipulation assisted reproductive technology methods, such as physiologic ICSI (PICSI) and intracytoplasmic morphologically selected sperm injection (IMSI), are routinely used in many fertility laboratories around the world. An integral part of these methods is the manipulation of spermatozoa in preparation of the injection into the oocyte. It is common practice to place prepared spermatozoa in a viscous holding medium to facilitate the handling, manipulation and slowdown of spermatozoon movement during the immobilization and injection processes of ICSI. The possible effect of these holding mediums on basic semen parameters, as well as the sperm deoxyribonucleic acid (DNA) and structural integrity of spermatozoa, is of importance. Hamilton Thorne IVOS® developed an automated software solution for live sperm morphology evaluation under high magnification, called IMSI StrictTM. It combines Tygerberg Strict Criteria morphological classification of human spermatozoa with motile sperm organelle morphology examination (MSOME) and provides software-based categorization. The IMSI StrictTM software was developed to aid in the IMSI spermatozoon selection process that enables objective classification of spermatozoa to remove inter-technician variation. For good optics and spermatozoon evaluation in IMSI StrictTM, spermatozoa need to be moving very slowly or be immotile, but still viable. This can be achieved by placing spermatozoa in a viscous holding medium, either polyvinylpyrrolidone (PVP) or SpermSlowTM, sometimes for a substantial time period. Before marketing the clinical use of IMSI StrictTM, the possible toxicity or deleterious effect of PVP and SpermSlowTM on spermatozoa needs to be excluded. The primary objective of this study was to evaluate the effect of PVP and SpermSlowTM on human spermatozoa after different exposure times using a viability stain, CASA motility and kinetic parameters, chromatin packaging analysis (CMA3 staining analysis) and DNA fragmentation analysis (TUNEL analysis). The secondary objective was to evaluate the effect of PVP and SpermSlowTM on human spermatozoa‟s ultrastructure with Transmission Electron Microscopy. This prospective analytical study was conducted at Drs Aevitas Fertility Clinic (Vincent Pallotti Hospital, Cape Town, South Africa) as well as the Fertility Unit at Tygerberg Hospital (Cape Town, South Africa) between July 2013 and October 2014. A total of 90 separate (no duplication) semen samples were analysed for the quantitative analysis (primary objective) and 1 sample for the descriptive analysis (secondary objective). Results showed that although PVP and SpermSlowTM treated sperm outcomes often differed significantly after typical statistical analysis, clinically these two mediums were shown to be equivalent (using a specific statistical test for equivalence) for the tested outcomes. PVP and SpermSlowTM had no detrimental effect clinically on sperm viability, motility parameters, chromatin packaging and DNA fragmentation rate. The secondary investigation indicated that SpermSlowTM might exert a disintegrating effect on various sperm membranes, and as a secondary consequence of the eventual necrotic process, alteration of chromatin and cytoskeletal components. PVP medium on the other hand did not show these disintegrating effects. This finding needs to be further investigated since only one semen sample was evaluated. Based on this study‟s results, either PVP or SpermSlowTM can be used for IMSI StrictTM purposes. However, the study did not include the technical aspects of the usage of PVP and SpermSlowTM.
AFRIKAANSE OPSOMMING: Intrasitoplasmiese sperm inspuiting (ICSI), sowel as ander mikro-manipulasie voortplantings tegnieke, soos fisiologiese ICSI (PICSI) en intrasitoplasmiese morfologies geselekteerde sperm inspuiting (IMSI), word in baie fertiliteitsklinieke regoor die wêreld gebruik. 'n Integrale deel van hierdie metodes is die manipulasie van spermatosoa ter voorbereiding van die inspuitproses. Dit is algemeen om voorbereide spermatosoa in 'n viskose medium te plaas om die hantering, manipulasie en vertraging van spermatosoön beweging tydens die immobilisasie en inspuitproses van ICSI te fasiliteer. Die effek van hierdie mediums op basiese semenparameters, sowel as die sperm deoksiribonukleïensuur (DNS) en strukturele integriteit van spermatosoa, is van belang. Hamilton Thorne IVOS® het 'n sagteware oplossing, IMSI StrictTM, vir lewende sperm morfologie evaluering onder hoë vergroting ontwikkel. Hierdie sagteware bied sagteware-gebaseerde morfologiese klassifikasie deur die Tygerberg streng kriteria morfologiese klassifikasie met beweeglike spermorganel morfologie ondersoek (MSOME) te kombineer. Die IMSI StrictTM sagteware is ontwikkel om die objektiewe klassifikasie van spermatosoa vir IMSI spermatosoön seleksie moontlik te maak. Spermatosoa moet baie stadig beweeg of immotiel, maar steeds lewensvatbaar wees om goeie optika en spermatosoön evaluering vir IMSI StrictTM te verseker. Dit sal bereik kan word deur spermatosoa in 'n viskose medium, hetsy PVP (“polyvinylpyrrolidone”) of SpermSlowTM, vir 'n aansienlike tydperk te inkubeer. Voordat IMSI StrictTM vir kliniese gebruik bemark kan word moet die moontlike toksisiteit of nadelige effek van PVP en SpermSlowTM op spermatosoa uitgesluit word. Die primêre doel van hierdie studie was om die effek van PVP en SpermSlowTM op menslike spermatosoa na verskillende inkubasie tye te evalueer deur ʼn lewensvatbaarheid kleuring toets, twee sperm DNS toetse (CMA3 en TUNEL) en rekenaar geëvalueerde sperm beweeglikheid toetse te gebruik. Die sekondêre doel was om die effek van PVP en SpermSlowTM op menslike spermatosoa se ultrastruktuur deur middel van Transmissie Elektronmikroskopie te evalueer. Hierdie studie is by Drs Aevitas Fertiliteitskliniek (Vincent Pallotti Hospitaal, Kaapstad, Suid-Afrika) sowel as die Fertiliteitseenheid by Tygerberg Hospitaal (Kaapstad, Suid-Afrika) tussen Julie 2013 en Oktober 2014 uitgevoer. 'n Totaal van 90 semenmonsters vir die kwantitatiewe analise (primêre doel) en een vir die beskrywende analise (sekondêre doel) is ontleed. Resultate het getoon dat alhoewel PVP en SpermSlowTM geïnkubeerde spermuitkomste dikwels na ʼn tipiese statistiese analise betekenisvol verskil, hierdie twee mediums vir die geëvalueerde uitkomste klinies ekwivalent (bepaal deur middel van spesifieke statistiese toetse vir ekwivalensie) is. Die mediums het ook nie klinies 'n nadelige effek op sperm lewensvatbaarheid, beweeglikheid parameters, chromatien verpakking en DNS fragmentasie koers getoon nie. Die sekondêre ondersoek het getoon dat SpermSlowTM hoofsaaklik 'n effek van disintegrasie op verskeie spermmembrane getoon het. Hierdie nekrotiese proses kan lei tot verandering van chromatien en sitoskelet komponente. PVP medium het egter nie dieselfde disintegrerende effek getoon nie. Hierdie bevinding moet egter verder ondersoek word, aangesien slegs een semenmonster geëvalueer is. Alhoewel hierdie studie nie die tegniese aspekte van die gebruik van PVP en SpermSlowTM geëvalueer het nie, kan aanbeveel word dat óf PVP óf SpermSlowTM op grond van geëvalueerde uitkomste tydens die IMSI StrictTM sperm seleksie proses gebruik word.
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Al, farawati Samer. "Analysis of chromosomal abnormalities in human oocytes and embryos." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:da17212b-2713-4e6e-846a-e71549d6eb2f.
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The chromosome constitution of human cleavage stage embryos has been extensively investi-gated using a variety of techniques, revealing high levels of aneuploidy and mosaicism. However, the final phase of preimplantation development, the blastocyst stage has received relatively little attention mostly because it is only recently that embryo culture has become sufficiently well optimised to reliabley generate blastocysts. One of the aims of this study was to examine blastocyst cytogenetics, characterising the extent and variety of aneuploidy and, where possible, determining the origin of the abnormalities detected. Both the frequency of aneuploidy and the incidence of mosaicism were significantly lower in the 52 embryos generated by 20 patients that had successfully undergone the first cellular differentiation, producing trophectoderm (TE) and inner cell mass (ICM). Valuable tools for the detailed chromosomal analysis of blastocysts, used in both research and clinical contexts, were comparative genomic hybridization (CGH) and array CGH (aCGH). However, validation of these methods, especially aCGH, was required in order to verify accuracy. A low error rate and a low misdiagnosis risk were demonstrated. The morphology of 1397 embryos at the cleavage and blastocyst stages from 229 patients was evaluated in relation to their chromosomal complement. The results obtained during this part of the project showed that, in general, there is little correlation between cleavage stage morphology and chromosome status. A weak link between morphology and aneuploidy, however, was found for embryos at the blastocyst stage. Chromosomally normal female embryos had a tendency to grow faster than male embryos at the cleavage stage and therefore tended to achieve superior morphological scores, whereas the trend was reversed at the blastocyst stage. Abnormal embryos carrying types of aneuploidy compatible with formation of a clinically recognised pregnancy had morphologies indistinguishable from those of euploid embryos. This study also aimed to utilise aCGH for the preimplantation genetic diagnosis (PGD) of imbal-ances due to structural chromosome rearrangements (e.g. translocations) in 39 carriers, a total of 139 embryos were assessed. The data obtained revealed that carriers of Robertsonian translocations are at increased risk of aneuploidy affecting additional chromosomes not involved the translocation, a phenomenon known as an interchromosomal effect (ICE). Finally, the clinical outcomes of 300 patients undergoing preimplantation genetic screening (PGS) using aCGH, for various different indications, were evaluated at both the cleavage (795 embryos) and blastocyst stages (1097 embryos). The pregnancy rate following cleavage stage biopsy was significantly lower than following blastocyst stage biopsy. The miscarriage rate was significantly reduced following PGS for patients with recurrent miscarriages. This work provided promising data supporting the clinical use of comprehensive chromosome analysis for the screening or diagnosis of preimplantation embryos and also yielded scientifically useful information concerning the frequency and nature of aneuploidy at the final stage of development before implantation.
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Bevington, Linda K. "The creation of humankind in the image of God and the incarnation of Christ implications for human genetic engineering, reproductive technology, and cloning /." Theological Research Exchange Network (TREN), 1997. http://www.tren.com.
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Schmidt, Eric B. "Expanding the child's range of open futures : a proposed basis for the ethical assessment of parental genetic trait selections /." Thesis, Connect to this title online; UW restricted, 2004. http://hdl.handle.net/1773/5724.
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Swerhone, Patricia M. "The "artificial family" : adoption, new reproductive technologies, and the dominance of the biologically-based family /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0022/MQ39237.pdf.
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Cornet, Bartolomé David. "Molecular determinants of human oocyte quality in assisted reproduction." Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/667566.
Full textAbstract:
Infertility, defined by the World Health Organization (WHO) as the inability to conceive after a year of unprotected sex, is a disease that affects 1 in 9 couples of reproductive age worldwide. Most of these couples will only achieve pregnancy through assisted reproduction techniques. In recent decades, many improvements have been made in this field, but no method has been able to achieve 100% success. There are many variables that could affect the outcome of assisted reproduction cycles, one of the most important is the quality of the woman's oocytes. Maternal age is the most important factor affecting women’s ability to conceive and give birth, since female reproductive aging is associated with reduced oocyte quality; however, the underlying molecular mechanisms remain poorly understood. It is also well established that as woman age increases, her ovarian reserve diminishes. However, the role of ovarian reserve in the decline of oocyte quality with age is currently unknown.
The developmental competence of an oocyte is its ability to sustain embryonic development until embryonic genome activation. It is determined by the transcripts (coding and non-coding RNAs) accumulated during oocyte maturation. The lack of transcription during final oocyte maturation suggests that regulation of the genes involved in this process occurs at the post-transcriptional level. Among the possible mechanisms, alternative splicing (AS) of the messenger RNA could be involved. Studying oocyte gene expression and the spliced mRNA isoforms might provide novel information on the molecular mechanisms driving early development, and might be a source of potential biomarkers of oocyte quality.
The main objective of this thesis is to explore new possibilities for the identification of oocyte quality biomarkers at the molecular level in order to better understand the oocyte and how its developmental competence can be improved. For this, the results of oocytes from women with different age and ovarian reserve have been compared. In addition, to identify non-invasive biomarkers for oocyte developmental competence, the evaluation of the association between the expression analysis of different aging markers in human cumulus cells (CCs), the age and ovarian reserve and the oocyte maturation rates was conducted. Finally, because many of the oocytes used were vitrified, the effect of vitrification on oocyte developmental competence was analysed by comparing the reproductive outcomes of fresh and vitrified oocytes from the same stimulation cycle.
The results suggest an important role for ncRNAs and alternative splicing in human oocyte biology. Age and ovarian reserve have been shown to independently affect the ncRNAs transcriptome of in vivo matured oocytes. These results might provide valuable information for the search of oocyte quality markers, and for the (re)interpretation of existing dataset. On the other hand, differences in transcribed splicing variants can also provide biomarkers of oocyte quality, since the profile of confirmed AS events could determine the specific transcriptome of the mature oocyte.
The expression of common somatic aging markers in CCs didn’t show a clear correlation between the analysed genes and age, suggesting that CCs of reproductively old women do not present the typical transcriptome of aged tissues. In addition, when looking at future clinical applications, these markers have not been found useful for the development of non-invasive markers for oocyte developmental competence, since no correlation was observed either with the ovarian reserve or the oocyte maturation rates.
Finally, this study showed that oocyte vitrification per se maintained the developmental potential of human oocytes within a reasonable biological range, clinically comparable to fresh oocytes. As a consequence, we established that the main reason for the reported lower clinical results in vitrified cycles has to be attributed to the loss of oocytes during the warming step. This has important repercussions in the clinical practice, as measures can be easily put in place to offset oocyte loss.La competencia de desarrollo ovocitaria se define como la capacidad del ovocito para mantener el desarrollo embrionario hasta que el embrión activa su propio genoma. Está determinada por los transcritos (ARN codificantes y no codificantes) acumulados durante la maduración de los ovocitos. La falta de transcripción durante la maduración final de los ovocitos sugiere que la regulación de los genes involucrados en este proceso ocurre a nivel postranscripcional. Entre los posibles mecanismos, el “splicing alternativo” del ARN mensajero, podría estar involucrado. El objetivo principal de esta tesis es explorar nuevas posibilidades para la identificación de biomarcadores de calidad de ovocitos a nivel molecular con el fin de comprender mejor el ovocito y cómo se puede mejorar su competencia de desarrollo. Además, para identificar biomarcadores no invasivos de la competencia de desarrollo de ovocitos, se ha evaluado la expresión de diferentes marcadores de envejecimiento somático en células de cúmulos humanos que rodean los ovocitos, y se ha correlacionado con la edad y la reserva ovárica de las mujeres y con las tasas de maduración de los ovocitos. Finalmente, debido a que muchos de los ovocitos utilizados estaban vitrificados, se ha analizado el efecto de la vitrificación sobre la competencia de desarrollo de los ovocitos comparando los resultados reproductivos de ovocitos frescos y vitrificados del mismo ciclo de estimulación. Los resultados sugieren que los ARNs no codificantes y el splicing alternativo representan un papel importante en el proceso de adquisición de la competencia de desarrollo en ovocitos humanos. Estos resultados pueden proporcionar información valiosa para la búsqueda de marcadores de calidad de ovocitos y para la (re)-interpretación de conjuntos de datos existentes. El estudio de la expresión de marcadores de envejecimiento somático en células de cúmulos humanos no ha mostrado una clara correlación entre los genes analizados y la edad, lo que sugiere que las células del cúmulo de mujeres de edad reproductiva avanzada no presentan el transcriptoma típico de los tejidos envejecidos. Finalmente, este estudio ha demostrado que la vitrificación de ovocitos mantiene per se el potencial de desarrollo de los ovocitos humanos dentro de un rango biológico razonable, clínicamente comparable a los ovocitos frescos.
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Cota, Ana Márcia de Miranda [UNESP]. "Agonista versus antagonista do GnRH em ciclos de reprodução assistida: morfologia oocitária." Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/99221.
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Na reprodução assistida, a seleção de gametas com o objetivo de alcançar melhores resultados clínicos é uma tarefa crucial dos embriologistas. A qualidade do oócito é um fator chave na fertilidade feminina, refletindo o potencial intrínseco de desenvolvimento do gameta, além de ter um papel crucial não só na fecundação, mas também no desenvolvimento embrionário subsequente. Após a desnudação, consegue-se definir a maturidade oocitária, com a identificação do primeiro corpúsculo polar, além de permitir a avaliação da morfologia oocitária, analisando as características da zona pelúcida, do espaço perivitelino e do citoplasma. Os dismorfismos oocitários são classificados em 2 tipos: citoplasmáticos, que incluem a presença de granulações e/ou de inclusões citoplasmáticas (vacúolos, corpos refrativos, agregados do retículo endoplasmático) e extracitoplasmáticos (alterações na forma do oócito, alterações na zona pelúcida, no espaço perivitelino e alterações do corpúsculo polar). Essas variações na morfologia oocitária podem ocorrer devido a fatores como idade da mulher, problemas genéticos e alterações no ambiente hormonal a que o oócito é exposto com a hiperestimulação ovariana. A classificação da morfologia oocitária, bem como sua correlação com o desenvolvimento embrionário e taxa de gravidez são bastante controversas na literatura. Vários estudos não demonstram nenhuma associação entre os dismorfismos oocitários e os resultados da fertilização in vitro, enquanto outros relatam uma associação entre a morfologia oocitária e desenvolvimento embrionário. Essas diferenças nos resultados podem ser explicadas devido a utilização de diferentes critérios morfológicos e devido...
The selection of developmentally competent human gametes may increase the efficiency of assisted reproduction. Spermatozoa and oocytes are usually assessed according to morphologic criteria. Oocyte morphology can be affected by the age of the female, genetic aspects, and factors related to controlled ovarian stimulation. However, there is a lack of evidence in the literature concerning the effect of gonadotropin-releasing hormone (GnRH) analogues, either agonists or antagonists, on oocyte morphology. The aim of this randomized study was to investigate if the prevalence of oocyte dysmorphism is influenced by the type of pituitary suppression used in ovarian stimulation. A total of 64 patients at the first intracytoplasmic sperm injection (ICSI) cycle, were prospectively randomized to receive treatment with either a GnRH agonist with a long-term protocol (n: 32) or a GnRH antagonist with a multi-dose protocol (n: 32). Before being subjected to ICSI, the oocytes at metaphase II from both groups were morphologically analyzed under an inverted light microscope at a 400x magnification. The oocytes were classified as follows: normal or with cytoplasmic dysmorphism, extracytoplasmic dysmorphism, or both. The resulting measure was the detection of dysmorphic oocytes among the total number of oocytes analyzed. Out of a total of 681 oocytes, 189 (27.8%) were morphologically normal, 220 (32.3%) showed cytoplasmic dysmorphism, 124 (18.2%) showed extracytoplasmic alterations, and 148 (21.7%) exhibited both types of dysmorphisms. No significant difference was observed in oocyte dysmorphisms between the agonist- and antagonisttreated groups (P>0.05). Analysis for each dysmorphism revealed that the most common conditions were alterations in polar body shape (31.3%) and presence of diffuse cytoplasmic granulations (22.8%), refractile bodies (18.5%) and central cytoplasmic... (Complete abstract click access electronic below)
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Cota, Ana Márcia de Miranda. "Agonista versus antagonista do GnRH em ciclos de reprodução assistida : morfologia oocitária /." Botucatu : [s.n.], 2012. http://hdl.handle.net/11449/99221.
Full textAbstract:
Orientador: Joao Batista Alcantara OliveiraCoorientador: Claudia Guilhermino Petersen
Banca: Mario Cavagna
Banca: Anice Maria Vieira de Camargo Martins
Resumo: Na reprodução assistida, a seleção de gametas com o objetivo de alcançar melhores resultados clínicos é uma tarefa crucial dos embriologistas. A qualidade do oócito é um fator chave na fertilidade feminina, refletindo o potencial intrínseco de desenvolvimento do gameta, além de ter um papel crucial não só na fecundação, mas também no desenvolvimento embrionário subsequente. Após a desnudação, consegue-se definir a maturidade oocitária, com a identificação do primeiro corpúsculo polar, além de permitir a avaliação da morfologia oocitária, analisando as características da zona pelúcida, do espaço perivitelino e do citoplasma. Os dismorfismos oocitários são classificados em 2 tipos: citoplasmáticos, que incluem a presença de granulações e/ou de inclusões citoplasmáticas (vacúolos, corpos refrativos, agregados do retículo endoplasmático) e extracitoplasmáticos (alterações na forma do oócito, alterações na zona pelúcida, no espaço perivitelino e alterações do corpúsculo polar). Essas variações na morfologia oocitária podem ocorrer devido a fatores como idade da mulher, problemas genéticos e alterações no ambiente hormonal a que o oócito é exposto com a hiperestimulação ovariana. A classificação da morfologia oocitária, bem como sua correlação com o desenvolvimento embrionário e taxa de gravidez são bastante controversas na literatura. Vários estudos não demonstram nenhuma associação entre os dismorfismos oocitários e os resultados da fertilização in vitro, enquanto outros relatam uma associação entre a morfologia oocitária e desenvolvimento embrionário. Essas diferenças nos resultados podem ser explicadas devido a utilização de diferentes critérios morfológicos e devido... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The selection of developmentally competent human gametes may increase the efficiency of assisted reproduction. Spermatozoa and oocytes are usually assessed according to morphologic criteria. Oocyte morphology can be affected by the age of the female, genetic aspects, and factors related to controlled ovarian stimulation. However, there is a lack of evidence in the literature concerning the effect of gonadotropin-releasing hormone (GnRH) analogues, either agonists or antagonists, on oocyte morphology. The aim of this randomized study was to investigate if the prevalence of oocyte dysmorphism is influenced by the type of pituitary suppression used in ovarian stimulation. A total of 64 patients at the first intracytoplasmic sperm injection (ICSI) cycle, were prospectively randomized to receive treatment with either a GnRH agonist with a long-term protocol (n: 32) or a GnRH antagonist with a multi-dose protocol (n: 32). Before being subjected to ICSI, the oocytes at metaphase II from both groups were morphologically analyzed under an inverted light microscope at a 400x magnification. The oocytes were classified as follows: normal or with cytoplasmic dysmorphism, extracytoplasmic dysmorphism, or both. The resulting measure was the detection of dysmorphic oocytes among the total number of oocytes analyzed. Out of a total of 681 oocytes, 189 (27.8%) were morphologically normal, 220 (32.3%) showed cytoplasmic dysmorphism, 124 (18.2%) showed extracytoplasmic alterations, and 148 (21.7%) exhibited both types of dysmorphisms. No significant difference was observed in oocyte dysmorphisms between the agonist- and antagonisttreated groups (P>0.05). Analysis for each dysmorphism revealed that the most common conditions were alterations in polar body shape (31.3%) and presence of diffuse cytoplasmic granulations (22.8%), refractile bodies (18.5%) and central cytoplasmic... (Complete abstract click access electronic below)
Mestre
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Sullivan, Camille. "Two's legal but three's a crowd : law, morality and three-parent embryos: regulation of mitochondrial replacement therapy." Thesis, Canberra, ACT : The Australian National University, 2013. http://hdl.handle.net/1885/109247.
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Nuojua-Huttunen, S. (Sinikka). "Intrauterine insemination (IUI) treatment in subfertility." Doctoral thesis, University of Oulu, 1999. http://urn.fi/urn:isbn:9514251717.
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Abstract
The effectiveness of intrauterine insemination (IUI) combined with controlled ovarian hyperstimulation (COH) in the treatment of subfertility was investigated in the present study. For this purpose the prognostic factors associated with success of clomiphene citrate (CC)/human menopausal gonadotrophin (HMG)/IUI were identified in 811 treatment cycles. Furthermore, a long gonadotrophin-releasing hormone agonist (GnRHa)/HMG stimulation protocol was compared with a standard CC/HMG protocol. In addition, the usefulness of alternative insemination techniques including fallopian tube sperm perfusion (FSP) and intrafollicular insemination (IFI) was investigated. Finally, the obstetric and perinatal outcome of pregnancies after COH/IUI was examined and compared with those of matched spontaneous and in vitro fertilization(IVF) pregnancies.
Female age, duration of infertility, aetiology of infertility, number of large preovulatory follicles and number of the treatment cycle were predictive as regards pregnancy after CC/HMG/IUI. The highest pregnancy rate (PR) was obtained in women of < 40 years of age with infertility duration ≤ 6 years, who did not suffer from endometriosis. A multifollicular ovarian response to CC/HMG resulted in better treatment success than a monofollicular response, indicating the necessity of COH combined with IUI. A significantly higher PR was achieved in the first treatment cycles compared with the others, and 97% of the pregnancies were obtained in the first four treatment cycles.
The PR per cycle did not differ significantly between a long GnRHa/HMG and a standard CC/HMG protocol, but the average medication expense of GnRHa/HMG stimulation was four times the cost of CC/HMG stimulation. Therefore, the routine use of a long GnRHa/HMG protocol in IUI treatment remains questionable.
The FSP procedure was easy to perform by using a paediatric Foley catheter. The success rate in couples with either FSP or standard IUI did not differ significantly, although there was a trend towards a lower PR in the FSP group. The FSP technique should not replace the simpler and less time-consuming IUI technique in routine use. The IFI technique was also simple to perform and convenient for patients. However, only one normal singleton intrauterine pregnancy resulted in 50 IFI-treated women, indicating that IFI is inefficacious for treating subfertility.
The IUI parturients differed from average Finnish parturients in respect to higher maternal age, more frequent primiparity and a higher incidence of multiple pregnancies. The use of antenatal care services was significantly lower in IUI singleton pregnancies compared with IVF singletons, although there were no more complications in IVF pregnancies. The hospitalization and Caesarean section rates were generally high in all pregnancies. The mean birthweight of IUI singletons was significantly lower than that in spontaneous pregnancies, but comparable to that in IVF pregnancies. However, the incidence of preterm birth, low birth weight and other variables describing the outcome of infants were similar in IUI, IVF and spontaneous pregnancies. In summary, the IUI procedure itself does not seem to affect adversely the obstetric and perinatal outcome of pregnancy, and patient characteristics and multiplicity may be more important in this respect.
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Lariviere, Robert Dean. "A critique of the Instruction on respect for human life in its origin and on the dignity of procreation, in relation to Catholic revisionist moral theology." Theological Research Exchange Network (TREN), 1989. http://www.tren.com.
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Valenzuela, Alcaraz Brenda I. "Cardiovascular assessment in fetuses and children conceived by assisted reproductive technologies." Doctoral thesis, Universitat de Barcelona, 2016. http://hdl.handle.net/10803/401805.
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BACKGROUND: Approximately, five million children have been born as a result of using assisted reproductive technologies (ART). Although the majority of ART children are born healthy; there are several reports of increased rate of pregnancy complications and worse perinatal outcomes in this population that may contribute to long-term health consequences according to the fetal programming hypothesis. Due to these techniques are relatively new, the effect of ART on later stages of development and adult susceptibility are uncertain. The main hypothesis of this thesis is that fetuses conceived by ART present worse perinatal outcomes together with primary cardiovascular remodeling and dysfunction as compared to those spontaneously conceived (SC), changes that persist postnatally and leads to increased cardiovascular risk in adulthood. METHODS: Cardiovascular morphology and functional assessment was performed in singleton and twin fetuses conceived by ART and spontaneously conceived; together with the presence of adverse perinatal outcomes. Finally, follow-up of these cohorts was made and cardiac and vascular function was assessed in childhood. RESULTS: ART fetuses showed: larger atria, shorter ventricles with lower sphericity index together with thicker myocardial walls. Systolic motion was decreased as measured by M-Mode and tissue Doppler; there were also sings of impaired relaxation, as demonstrated by a longer IRT and decreased deceleration time of E wave. All these changes were independent of the presence of been small for gestational age (SGA) due to these groups showed different cardiac phenotypes. ART children showed persistence of changes in cardiac morphology and function together with vascular remodeling (increased blood pressure and thicker carotid intima media). CONCLUSIONS: Adverse pregnancy outcomes seem to be present in infertile women, regardless of the use of ART. Singleton and twin ART fetuses present cardiovascular remodeling and subclinical dysfunction that persist postnatally in childhood. These changes are independent of the presence of SGA. These findings need to be take into account for further studies regarding higher cardiovascular risks in adulthood in this population.INTRODUCCION: Aproximadamente, 5 millones de niños han nacido en el mundo gracias al uso de las tecnicas de reproduccion asistida (TRA). La mayoría de éstos niños son sanos al nacer; pero diversos estudios mencionan la presencia de peores resultados perinatales en esta población; los cuáles podrían tener consecuencias a largo plazo de acuerdo con la teoría de la programación fetal. Estas técnicas son relativamente nuevas, por lo que sus efectos en la vida adulta aún son desconocidos. La hipótesis principal de ésta tesis es que los fetos concebidos mediante TRA, presentan peores resultados perinatales que aquellos concebidos de manera espontánea (CE), junto con la presencia de cambios cardíacos morfológicos y funcionales que persisten de manera postnatal y que condicionaría un incremento del riesgo cardiovascular en la vida adulta. METODOS: Se llevó a cabo la evaluación cardiovascular morfológica y funcional de fetos únicos y gemelares concebidos por TRA comparados con fetos CE; junto con la presencia de resultados perinatales adversos. Se realiza un seguimiento y evaluación cardiovascular de dichas cohortes hasta la infancia. RESULTADOS: Los fetos TRA presentaron cambios al comparlos con los CE: aurículas más grandes, ventrículos más cortos junto con un menor índice de esfericidad así como paredes engrosadas. presentaron función sistólica disminuída de acuerdo con las mediciones de Doppler tisular y modo-M; también signos de disfunción diastólica demostrado por IRT alargados y disminución del tiempo de deceleración de la onda E. Todos estos cambios fueron independientes de la presencia de fetos pequeños para la edad gestacional (PEG), ya que dichos grupos presentaron fenotipos cardiacos diferentes. En la infancia, los niños TRA mostraron persistencia de dichos cambios cardíacos morfológicos y funcionales subclínicos, junto con remodelado vascular (presion arterial más alta y paredes engrosadas de la intima media de las carótidas). CONCLUSIONES: Las mujeres infértiles presentan resultados perinatales adversos independiente de el método de TRA usado. Los fetos concebidos mediante TRA presentan remodelado cardiovascular el cuál persiste postnatalmente en la infancia. Dichos cambios fueron independientes de la presencia de PEG. Estos hallazgos deben ser tomados en cuentra en futuros estudios del incremento de riesgo cardiovascular en la vida adulta de ésta población.
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Misri, Anita P. "A feminist interpretation of the implications and consequences of new reproductive technologies /." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=28032.
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The development of pre-conception and post-conception reproductive technologies has substantial implications and consequences for women. To better establish the impact of the eugenic and sexist traditions which support the elimination of disability/defect and the propagation of "designer babies," a survey of literature outlining the scientific, feminist, legal, cultural, and social perspectives regarding new reproductive technologies was undertaken. Three conclusions of this review are that while new reproductive technologies are not responsible for the environment which fosters bias and intolerance towards oppressed members of society, they have created eugenic demands by supporting genetic perfection; they have informally displaced women's rights to bodily autonomy in favour of the fetus' or potential future person's rights by supporting fetal personhood; and they have perpetuated sexism within the Indian community in Canada by supporting patriarchal institutions.
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Smith, Malcolm. "Regulating IVF and pre-implantation tissue-typing for the creation of "saviour siblings" : a harm analysis." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/35798/1/Malcolm_Smith_Thesis.pdf.
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Scientific discoveries, developments in medicine and health issues are the constant focus of media attention and the principles surrounding the creation of so called ‘saviour siblings’ are of no exception. The development in the field of reproductive techniques has provided the ability to genetically analyse embryos created in the laboratory to enable parents to implant selected embryos to create a tissue-matched child who may be able to cure an existing sick child. The research undertaken in this thesis examines the regulatory frameworks overseeing the delivery of assisted reproductive technologies (ART) in Australia and the United Kingdom and considers how those frameworks impact on the accessibility of in vitro fertilisation (IVF) procedures for the creation of ‘saviour siblings’. In some jurisdictions, the accessibility of such techniques is limited by statutory requirements. The limitations and restrictions imposed by the state in relation to the technology are analysed in order to establish whether such restrictions are justified. The analysis is conducted on the basis of a harm framework. The framework seeks to establish whether those affected by the use of the technology (including the child who will be created) are harmed. In order to undertake such evaluation, the concept of harm is considered under the scope of John Stuart Mill’s liberal theory and the Harm Principle is used as a normative tool to judge whether the level of harm that may result, justifies state intervention or restriction with the reproductive decision-making of parents in this context. The harm analysis conducted in this thesis seeks to determine an appropriate regulatory response in relation to the use of pre-implantation tissue-typing for the creation of ‘saviour siblings’. The proposals outlined in the last part of this thesis seek to address the concern that harm may result from the practice of pre-implantation tissue-typing. The current regulatory frameworks in place are also analysed on the basis of the harm framework established in this thesis. The material referred to in this thesis reflects the law and policy in place in Australia and the UK at the time the thesis was submitted for examination (December 2009).
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Vilela, João Rocha. "Histerossonografia em mulheres inférteis candidatas às ténicas de reprodução assistida /." Botucatu, 2011. http://hdl.handle.net/11449/99215.
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Orientador: Anaglória PontesCoorientador: Maria Teresinha de Oliveira Cardoso.
Banca: Paulo Sérgio França
Banca: Adriano Bueno Tavares
Resumo: A histerossonografia (HSN) foi descrita pela primeira vez há três décadas. A infusão de solução salina na cavidade uterina favorece sua exploração e proporciona excelente visualização da anatomia e do interior da cavidade do útero melhor do que com ultrassonografia transvaginal convencional (USG). Para verificar o papel atual da HSN na avaliação da cavidade uterina de mulheres com sangramento uterino anormal (SUA) e assintomática, foi realizado revisão bibliográfica de estudos que compararam a HSN com a USG ou histeroscopia diagnóstica ambulatorial (HTDx). Para isso, pesquisou-se estudos relevantes em bases de dados eletrônicas Medline/PubMed, SciELO/LILACS. A HSN é procedimento ambulatorial, "não invasivo", de melhor custo-benefício, com melhor sensibilidade e especificidade na identificação de anomalias uterinas, causando desconforto mínimo e com baixo índice de complicações. Foi objeto de revisões, não existindo mais dúvidas quanto a sua acurácia. Pode-se concluir que a HSN é ferramenta útil na propedêutica de avaliação da cavidade uterina de mulheres sintomáticas com SUA, infertilidade e perdas gestacionais repetidas, falhas de implantação embrionária em programas com técnicas de reprodução assistida (TRA) / fertilização in vitro (FIV) e naquelas com qualquer alteração uterina intra ou extracavitária na USG. Portanto, está indicada como método de avaliação inicial da cavidade uterina antes de indicar HTDx
Abstract: Sonohysterography (HSN) was firstly described three decades ago. The saline solution infusion into the uterine cavity favors its use and provides excellent visualization of the anatomy and the inner cavity of the uterus better than the conventional transvaginal sonography (USG). To check the current role of HSN in the uterine cavity assessment in women with abnormal uterine bleeding (AUB) and asymptomatic, a literature review comparing HSN with USG and/or ambulatory diagnostic hysteroscopy (HTDx) was carried out. To this end, relevant studies were researched in electronic databases Medline/PubMed, SciELO/LILACS. The HSN is an ambulatory procedure, non-invasive, better cost-benefit, better sensitivity and specificity to identify uterine abnormalities, causing minimal discomfort and low complications rate. It was subject to revision which there is no more doubt about its accuracy. It can be concluded that the HSN is a useful tool in the propedeutics to assess uterine cavity of symptomatic patients with SUA, infertility, recurrent miscarriages, and embryonic implantation failures in assisted reproduction treatment (ART) / in vitro fertilization (FIV) and in any other intra and extra uterine cavity alteration. Hence, USG is indicated as an initial method of assessment of the uterine cavity previously to HTDx
Mestre
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Wong, Yim-kuk Aileen, and 黃艷菊. "Stress and coping for women from infertility to assisted reproductive treatments." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31250907.
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LaPerrière, Maureen C. "The evolution of mothering : images and impact of the mother-figure in feminist utopian science-fiction." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68114.
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Within the latitude of a science-fictional elsewhere and elsewhen, women can establish their own social norms and accepted praxis. The modification encountered in alternate feminist spacetimes specifically incorporate many new ideologies concerning motherhood. Central to this discussion is the means by which feminist authors regard the influences of patriarchal institutions and the subsequent changes in society because of, or in spite of, these changes. The male-dominated fields of technological patriarchy (reproduction and fertility "specialists") and the military, for example, are areas upon which feminist authors speculate. Three feminist strategies for coping with a patriarchal social order, as seen in the works of science-fiction, are entrance into the male world and attempts to change it, competition in the patriarchal world on its own terms and total retreat from an oppressive society, accompanied by the creation of a feminist utopian otherworld. These feminist spacetimes share a number of convictions. Most important, conception is never an unwilled experience. The "maternal instinct", is redefined as a calling which, in some cases, extends to males and non-biological mothers. Traits that are salient in the childraisers are those which are mirrored by these alternate feminist spacetimes as a whole and which contribute to the definition of these societies as utopias. The treatment and/or possession of children as property is frowned upon in the novels. Some points of dissent amongst feminist SF authors include the existence of technology in an utopian or dystopian future for motherhood, and whether or not males are permitted and/or encouraged to participate in society as a whole and more precisely in the experience of mothering. The dystopia, for its part, can thus be regarded as a warning against the encroachment of rampant patriarchal enterprises through their representation of the extrapolation of male-centred value systems. (Abstract shortened by UMI.)
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Coleman, Stephen 1968. "The ethical implications of human ectogenesis." Monash University, School of Philosophy, Linguistics and Bioethics, 2001. http://arrow.monash.edu.au/hdl/1959.1/8904.
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Beitz, Ulrike. "Zur Reformbedürftigkeit des Embryonenschutzgesetzes eine medizinisch-ethisch-rechtliche Analyse anhand moderner Fortpflanzungstechniken." Frankfurt, M. Berlin Bern Bruxelles New York, NY Oxford Wien Lang, 2008. http://d-nb.info/990963055/04.
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Hansson, Mats G. "Human dignity and animal well-being a Kantian contribution to biomedical ethics /." Uppsala : Stockholm, Sweden : [Uppsala University] ; Distributor, Almqvist & Wiksell International, 1991. http://catalog.hathitrust.org/api/volumes/oclc/24766855.html.
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McKenna, Kenneth A. (Kenneth Allen). "Assessing the Psychological Impact of Fertility Treatment." Thesis, University of North Texas, 1997. https://digital.library.unt.edu/ark:/67531/metadc277704/.
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This controlled descriptive study was designed to investigate the psychological status of couples who are engaged in advanced fertility treatments. A battery of psychological test instruments, including the Millon Behavioral Health Inventory (MBHI), the Health Attribution Test (HAT), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Marlowe-Crowne Social Desirability Scale (MCSDS), was used to measure psychological variables that have been shown in the infertility research literature to be associated with the psychological experiences of infertility patients. The scores from the four assessment instruments were compared with those of pregnant couples in childbirth education classes to differentiate the impact of stress associated with fertility treatment from the stress experienced by third trimester pregnant couples. Eighty-five subjects (42 male and 43 female) volunteered for the study and completed packets of questionnaires. The groups were designated Treatment (infertile couples) and Control (pregnant couples). The resulting data were collected and analyzed on the basis of group mean scores on the test instruments.
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Fasano, Giovanna. "Contribution of vitrification to human assisted reproduction." Doctoral thesis, Universite Libre de Bruxelles, 2013. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209484.
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La cryopréservation, dans le domaine de la reproduction médicalement assistée, constitue depuis de nombreuses années une branche suscitant beaucoup d’intérêts et d’espoirs. En effet, de nombreuses équipes de recherche se sont attelées à mettre au point et à améliorer des protocoles permettant de conserver les gamètes, les embryons et les tissus reproducteurs.Malgré le fait que la cryopréservation soit une technique très attractive, elle peut avoir des effets délétères sur les cellules. Les protocoles expérimentaux visent donc à minimiser ces effets afin d’augmenter la survie et la compétence cellulaire après décongélation.
Les deux méthodes les plus utilisées, la congélation lente et la vitrification, présentent chacune des avantages et des inconvénients. En effet, la première ne permet pas d’éliminer la cristallisation intracellulaire. Quant à la seconde, elle empêche la formation de cristaux de glace mais pourrait provoquer une toxicité due à la forte concentration des cryoprotecteurs.
Cette thèse de doctorat propose plusieurs objectifs :
•\
Doctorat en Sciences biomédicales et pharmaceutiques
info:eu-repo/semantics/nonPublished
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Botha, Matthys Hendrik. "Endocrine function and fertility preservation in women surviving cancer : a study on cancer treatment and fertility." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5145.
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Thesis (DMed (Obstetrics and Gynaecology))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: Chapter 1 is a literature review investigating the incidence of cancer in children and young adults. It describes the most important treatment options including chemotherapy, radiotherapy and surgery and the effect of treatment on future endocrine development and fertility. Different primary cancer sites are discussed in more detail. Chapter 2 is a literature review on the effects of cancer surgery in women and the options for fertility sparing. Cervical cancer and pre-cancer are discussed in detail with options for more conservative surgery in selected patients. A summary of the available published cases of trachelectomy with pregnancy outcomes is included. Other gynaecological cancers requiring surgery are also discussed with reference to conservative options. Chapter 3 is a literature review about the medical (pharmacological) options for protection of ovarian function in patients undergoing oncotherapy. The role of gonadotrophin releasing hormone analogues and hormonal contraceptives in ovarian suppression is discussed in detail. Chapter 4 This chapter examines germ cell physiology with reference to cryopreservation. It includes two major parts. Part 1 is the description of germ cell- and follicle physiology, the principles of cryobiology followed by a review of oocyte cryopreservation and ovarian tissue preservation. Both slow freezing and vitrification techniques are described. The second part of chapter 4 is a report on a randomised controlled evaluation of two different slow freezing cryopreservation protocols. This experimental study compared ultrastructural changes in fresh and previously cryopreserved ovarian cortical tissue after equilibration and thawing using two different cryoprotectants. This is the first randomised investigation into DMSO and PROH as cryoprotectants. Chapter 5 is an investigation into cryopreservation of ovarian tissue as a strategy to protect hormonal function and fertility against gonadotoxic treatment. This chapter consists of two parts. The first part is a thorough literature review of all the published work about grafting of previously cryopreserved ovarian tissue. The largest case series found from a single institution was five patients. Another report of six patients included patients from various sites in Denmark. Part 2 is a description of a cohort of patients followed up after re-implantation of previously cryopreserved ovarian cortical tissue. Follow-up hormone levels of 13 individual cases are described in detail. This is the largest case series ever reported. The experimental study described in Chapter 4 and the clinical study described in Chapter 5 was approved by the ethical research committee of the Faculty of Health Sciences, Stellenbosch University, project number N05/10/182. Chapter 6 provides an integrated overview of the incidence and treatment of cancer in young women and how its negative effects may be prevented or mitigated. Aspects of chemotherapy, radiotherapy and surgery are evaluated where it may affect future reproductive health. The role of oocyte and ovarian tissue cryopreservation is discussed. Guidelines are provided for clinicians.
AFRIKAANSE OPSOMMING: Hoofstuk 1 Hierdie is ‘n literatuuroorsig wat die insidensie van kanker in kinders en jong volwassenes ondersoek. Dit sluit die mees belangrike behandelingsopsies in, naamlik chemoterapie, radioterapie en chirurgie en die effek wat behandeling mag hê op toekomstige endokriene ontwikkeling en fertiliteit. ‘n Verskeidenheid kanker tipes word in meer detail beskryf. Hoofstuk 2 Hoofstuk 2 is ‘n literatuuroorsig oor die effekte van kankerchirurgie in vroue en die geleenthede tot beskerming van fertiliteit. Servikale kanker en voorlopers van servikale kanker word bespreek en die opsies vir konserwatiewe chirurgie in uitgesoekte pasiënte word gegee. ‘n Opsomming van die inligting wat beskikbaar is oor tragelektomie en swangerskap uitkomste word ingesluit. Ander ginekologiese kankers wat chirurgie mag benodig, word ook bespreek met verwysing na konserwatiewe hantering. Hoofstuk 3 ‘n Literatuuroorsig oor die mediese (farmakologiese) opsies vir die beskerming van ovariële funksie in pasiënte wat behandeling ontvang vir kanker. Die rol van gonadotropien-vrystellingshormoon-analoë en hormonale kontrasepsie vir ovariële onderdrukking word in detail bespreek. Hoofstuk 4 Hierdie hoofstuk ondersoek kiemselfisiologie met verwysing na vriesbewaring. Dit is verdeel in twee dele. Deel 1 is ‘n beskrywing van kiemsel- en follikelfisiologie en die beginsels van vriesbiologie. Dit word gevolg deur ‘n oorsig van oösiet vriesbewaring en ovariële weefselbewaring. Stadige bevriesing en vitrifikasie- metodes word bespreek. Die tweede deel van hoofstuk 4 is ‘n verslag oor ‘n gerandomiseerde, gekontroleerde evaluasie van twee stadige bevriesingsmetodes. Hierdie eksperimentele studie het die ultrastrukturele veranderinge vergelyk in vars en voorheen bevrore ovariële kortikale weefsel na ekwilibrasie en ontdooiing met twee verskillende vriesbeskermers. Dit is die eerste gerandomiseerde studie oor DMSO en PROH as vriesbeskermers. Hoofstuk 5 Hierdie hoofstuk handel oor ‘n ondersoek na vriesbewaring van ovariële weefsel as ‘n benadering tot beskerming van hormonale funksie en fertiliteit teen gonadotoksiese behandeling. Die hoofstuk bestaan uit twee dele. Die eerste deel is ‘n deeglike oorsig van die literatuur oor al die beskikbare werk wat handel oor terugplasing van voorheen bevrore ovariële weefsel. Die grootste pasiëntreeks van ‘n enkel instelling was slegs vyf pasiënte. ‘n Ander beskrywing van ses pasiënte het pasiënte van verskeie eenhede in Denemarke ingesluit. Deel 2 is ‘n beskrywing van ‘n groep pasiënte wat opgevolg is na oorplanting van voorheen bevrore ovariële kortikale weefsel. Opvolg hormoonvlakke van 13 gevalle word in detail bespreek. Hierdie is die grootste pasiëntreeks wat tot nog toe beskryf is. Die eksperimentele studie wat in hoofstuk 4 beskryf word en die kliniese studie wat in hoofstuk 5 beskryf word, is goedgekeur deur die etiese navorsingskomitee van die Fakulteit Gesondheidswetenskappe van die Universiteit Stellenbosch met die projeknommer N05/10/182 Hoofstuk 6 Hierdie is ‘n geïntegreerde oorsig van die voorkoms en behandeling van kanker in jong vroue en hoe die negatiewe effekte daarvan voorkom of verminder kan word. Aspekte van chemoterapie, radioterapie en chirurgie word geëvalueer ten opsigte van die effek op toekomstige reproduktiewe gesondheid. Die rol van oösiet- en ovariële weefselvriesbewaring word bespreek. Riglyne vir klinici word gegee.
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Burger, Riana. "Evaluation of spermatozoa DNA tests for an assisted reproductive techniques (ART) program : correlation with semen parameters and ART outcome." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80343.
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Thesis (MScMedSc)--Stellenbosch University, 2013.ENGLISH ABSTRACT: CHAPTER 1 A review of the application of traditional semen parameters for the investigation and diagnosis of male infertility and the role of predictive values in assisted reproductive techniques (ART) is presented. The importance of sperm morphology, with special emphasis on sperm morphology evaluation, is discussed. Also presented is an overview of the physiology of sperm DNA, the process of spermatogenesis, as well as the contribution of the spermatozoon to the embryo. The different causes of sperm DNA damage and techniques to determine DNA damage in spermatozoa are described. A survey is presented of the correlation of sperm DNA with sperm morphology. CHAPTER 2 All the materials and methods applicable to this study are described. Sperm morphology assessment and two different sperm DNA tests, the chromomycin A3 (CMA3) staining test and the terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick-end labelling (TUNEL) assay, are discussed in detail. CHAPTER 3 Results obtained in this study are presented. Results include the prevalence of abnormal sperm DNA and association with sperm morphology, specifically in the p-pattern and g-pattern morphology groups. Further results include the correlation of sperm morphology and sperm DNA with fertilization in vitro, embryo quality and pregnancy outcome. The percentage CMA3 positive spermatozoa (abnormal DNA) and percentage TUNEL positive spermatozoa (abnormal DNA) had a significant negative association with normal sperm morphology. P-pattern and g-pattern morphology groups differed significantly from each other for both CMA3 and TUNEL. A significant positive association between CMA3 and TUNEL was observed. No association between the percentage normal sperm morphology, percentage CMA3 positive spermatozoa and percentage TUNEL positive spermatozoa and IUI pregnancy outcome was observed. A significant negative association between the percentage TUNEL positive spermatozoa and IVF/ICSI pregnancy outcome was established. The percentage CMA3 positive spermatozoa had a significant positive (unexpected) association with IVF/ICSI pregnancy outcome. There was no association between the three variables and IVF/ICSI fertilization rates. A significant positive association between the percentage normal sperm morphology and IVF/ICSI embryo quality was found. There was a significant positive association between the percentage CMA3 positive spermatozoa and IVF/ICSI embryo quality (unexpected). The percentage TUNEL positive spermatozoa and IVF/ICSI embryo quality was negatively associated. CHAPTER 4 Interpretation of the results and future perspectives are discussed. The CMA3 staining test and TUNEL assay has a limited ability to distinguish between the p-pattern and g-pattern morphology groups. P-pattern spermatozoa are more likely to possess poor chromatin packaging and show increased levels of DNA fragmentation, but some p-pattern patients also may have normal DNA and g-pattern patients abnormal DNA. It is recommended that a sperm DNA test should be implemented routinely in andrology laboratories for the clinical diagnosis of sperm DNA damage in patients.
AFRIKAANSE OPSOMMING: HOOFSTUK 1 'n Samevatting wat handel oor die toepassing van tradisionele semen parameters vir die evaluasie en diagnose van manlike infertiliteit, asook die rol van voorspellingswaardes in kunsmatige voortplantingstegnieke word voorgelê. Die belangrikheid van sperm morfologie, met die klem op sperm morfologie evaluering, word ook bespreek. 'n Oorsig van sperm DNS fisiologie, die proses van spermatogenese, sowel as die sperm se bydrae tot die embrio word hier aangebied. Die verskillende oorsake van sperm DNS skade en die tegnieke om sperm DNS skade vas te stel, asook die die korrelasie tussen sperm DNS en sperm morfologie word ook bespreek. HOOFSTUK 2 Alle materiale en metodes wat van toepassing is op hierdie studie word beskryf. Sperm morfologie evaluering en twee verskillende sperm DNS toetse, die chromomycin A3 (CMA3) kleuringstoets en die “terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick-end labelling (TUNEL)" toets, word ook in meer besonderhede aangebied. HOOFSTUK 3 Resultate wat verkry is tydens hierdie studie word hier uiteengesit. Resultate behels die voorkomsyfer van abnormale DNS en die assosiasie met sperm morfologie, spesifiek in die p-patroon en g-patroon. Verdere resultate sluit die korrelasie van sperm morfologie en sperm DNS met bevrugting in vitro, embriokwaliteit en swangerskap uitkomste in. Die persentasie CMA3 positiewe sperme (abnormale DNS) en persentasie TUNEL positiewe sperme (abnormale DNS) het 'n betekenisvolle negatiewe assosiasie met normale sperm morfologie getoon. P-patroon en g-patroon morfologie groepe het betekenisvol van mekaar verskil vir beide CMA3 en TUNEL. 'n Betekenisvolle positiewe assosiasie is tussen CMA3 en TUNEL waargeneem. Geen assosiasie is tussen die persentasie normale sperm morfologie, persentasie CMA3 positiewe sperme en persentasie TUNEL positiewe sperme en IUI swangerskap uitkomste waargeneem nie. 'n Betekenisvolle negatiewe assosiasie is tussen die persentasie TUNEL positiewe sperme en IVB/ICSI swangerskap uitkomste vasgestel. Die persentasie CMA3 positiewe sperme het 'n betekenisvolle positiewe (onverwags) assosiasie met IVB/ICSI swangeskap uitkomste opgewys. Daar was geen assosiasie tussen die drie veranderlikes en IVB/ICSI bevrugting nie. 'n Betekenisvolle positiewe assosiasie is tussen die persentasie normale sperm morfologie en IVB/ICSI embryo kwaliteit waargeneem. Daar was 'n betekenisvolle positiewe assosiasie tussen die persentasie CMA3 positiewe sperme en IVB/ICSI embrio kwaliteit (onverwags). Die persentasie TUNEL positiewe sperme het 'n negatiewe assosiasie met IVB/ICSI embrio kwaliteit getoon. HOOFSTUK 4 Interpretasie van die resultate en toekomstige vooruitsigte is bespreek. Die CMA3 kleuringstoets en TUNEL toets het 'n beperkte vermoë om tussen die p-patroon en g-patroon morfologie groepe te onderskei. P-patroon spermatozoa sal heel waarskynlik oor swakker chromatien verpakking en meer DNS fragmentasie beskik. Sommige p-patroon pasiënte mag egter normale DNS toon, terwyl g-patroon pasiënte abnormale DNS het. Die implementering van 'n sperm DNS toets in andrologie laboratoriums, vir die kliniese diagnose van sperm DNS skade in pasiënte, word aanbeveel.
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Novaes, Thiago O. S. 1979. "Anonimozegratuitos = a transformação da pessoa em informação e da informação em pessoa." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/281389.
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Orientador: Mauro William Barbosa de AlmeidaDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas
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Resumo: A dissertação apresenta um novo conceito, anonimozegratuitos, que pretende realizar uma dupla operação: a transformação da pessoa em informação e da informação em pessoa. Inserindose nos correntes debates da antropologia da ciência e da técnica, o texto descreve o funcionamento de três objetos técnicos na Internet - a WikiPedia, o WikiLeaks e o BitTorrent - relacionando-os às noções de autoria, propriedade intelectual, troca e gratuidade. Trata ainda das técnicas de reprodução assistida em relação à doação anônima e gratuita de sêmen, que provoca uma ruptura sobre o auto-reconhecimento da unidade da espécie humana, situando a emergência da eugenia liberal junto ao modelo tecnocientífico que viabiliza a procriação autônoma de mulheres solteiras e a seleção de material genético para melhoramento da saúde humana
Abstract: The dissertation presents a new concept, anonimozegratuitos, which promotes a double operation: the transformation of person in information and information in person. Attentive to the current discussions of the anthropology of science and technology, the text describes the operation of three technical objects on the Internet - the WikiPedia, WikiLeaks and BitTorrent - relating them to the notions of authorship, intellectual property and free exchange. It also discusses the techniques of assisted reproduction in relation to free and anonymous donation of sperm, which causes a disruption of the self-recognition of the unity of the human species, placing the emergence of liberal eugenics with the technoscientific model that enables the autonomous reproduction of single women and selection of genetic material for improving human health
Mestrado
Antropologia Social
Mestre em Antropologia Social
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Thakur, Sanjay, and n/a. "The ethics of preimplantation genetic diagnosis." University of Otago. Department of Philosophy, 2006. http://adt.otago.ac.nz./public/adt-NZDU20060816.105106.
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Preimplantation genetic diagnosis is a technique used in the field of assisted reproduction. The technique is applied to embryos that have been created in vitro, in order to facilitate the selection of embryos according to particular genetic parameters. The use of preimplantation genetic diagnosis by prospective parents at high risk for having a child affected by a genetic disorder has facilitated the birth of unaffected children. Preimplantation genetic diagnosis has already been used for other purposes, such as screening for gender, and could in principle be used to screen for a wide range of genetic traits. The aim of this thesis is to provide good answers to the ethical questions provoked by the advent and continuing development of preimplantation genetic diagnosis.
The thesis is divided into four parts. Part One provides a brief overview of the science of genetic selection. Part Two is centred on a discussion of two ethical principles. The principle of procreative liberty is based upon the idea that acts of interference in the reproductive lives of others should be avoided unless there is good justification for such acts. The principle of procreative beneficence is based upon the idea that prospective parents should select the child, of the possible children they could have, who is expected to have the best life. I will argue that the principle of procreative liberty should be applied to acts of interference in individuals� freedom to use preimplantation genetic diagnosis, while the principle of procreative beneficence should be applied to acts of selecting children.
In Part Three, I will endorse a position that accords embryos a relatively low moral status, reject the arguments of the disability rights critique, argue that the eugenic aspects of preimplantation genetic diagnosis do not warrant much concern, and develop a framework for critically evaluating slippery slope arguments. Finally, in Part Four, specific applications of preimplantation genetic diagnosis will be examined in detail. Although each application raises unique ethical questions, this thesis aims to demonstrate that the consistent application of the principles and preliminary conclusions developed in Parts Two and Three provides the best means for determining how PGD should be used and which uses should be restricted.
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Oehninger, Sergio C. "The interaction between human spermatozoa and its homologous zona pellucida : scientific advances and clinical significance." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53132.
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Thesis (PhD)--Stellenbosch University, 2002.ENGLISH ABSTRACT: Infertility is a very common problem worldwide. Recent data have shown that disorders of the male represent the most common single defined cause of infertility. This proposal examines the clinical significance and fundamental physiological aspects of human gamete interaction. These studies are focused on the assessment of the cellular-molecular mechanisms involved in human sperm binding to its homologous zona pellucida resulting in the physiologic induction of the acrosome reaction. We have developed and validated in vitro bioassays that assess specific steps of the fertilization process that are critical for early embryo development. The results of our translational research have already had a significant impact on the overall evaluation of male infertility and on the clinical management of the infertile man in the assisted reproduction arena. Furthermore, the unveiling of the basic mechanisms involved in human gamete interaction will ultimately allow for both (i) the development of new male reproductive diagnostic capabilities and (ii) the design of improved and safer therapies aiding conception in childless couples suffering from male infertility.
AFRIKAANSE OPSOMMING: Menslike onvrugbaarheid is 'n algemene wêreldwye probleem en onlangse data toon aan dat die manlike factor die grootste enkel bydraende factor tot hierdie toestand is. Die werk loods 'n intensiewe ondersoek na die kliniese betekenis en basiese fisiologiese aspekte wat 'n rol tydens spermsel en eisel interaksie speel. Hoofstuk 3 fokus op die sellulêre en molekulêre meganismes wat betrokke is tydens spermsel en eisel binding wat gevolglik lei tot akrosoomreaksie van die spermsel. Die werk verteenwoordig die resultate van 10 jaar se navorsing tussen die kandidaat en die promoter. Dit gee oorsprong aan 'n reeks bio-toetse wat die bevrugtingsproses koriografiese ontleed en verskaf dus 'n stap-vir-stap uiteenseting van menslike bevrugting en gevolglike embrio ontwikkeling. Die resultate in Hoostuk 4 bring vernuwing in die begrippe van die manlike faktor en die rol in die kinderlose huwelik. Die resulate soos in Hoofstuk 3 en 4 uiteengesit, vorm nie net die basis vir die moontlike ontwikkeling van nuwe diagnostiese benaderings tot die hantering van die man nies maar speel oojk 'n rol die daarstelling van verbeterde terapeutiese hantering van die kinderlose egpaar. Hoofstuk 5 gee kortliks riglyne en aanbevelings tot opsigte van die gebruik van die spermsel-zona pellucida bindingstoets en akrosomreaksie. Die kandidaat bevel aan dat die genoemde twee bio-toetse deel van die laboratorium ondersoeke van die man gebruik moet word.
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Williams, Nicola Jane. "Pre-implantation and pre-natal selection of offspring : can there be a duty to select against disability?" Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/preimplantation-and-prenatal-selection-of-offspring-can-there-be-a-duty-to-select-against-disability(00aa8d13-c161-46cc-a338-9cf49106dacc).html.
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The question of whether there might be a moral obligation to select against disability in our offspring has received considerable attention and attracted great controversy within both the philosophical community and beyond over the last couple of decades. Within this thesis I examine this question, taking as a basis for discussion the view that prospective parents should be formally free to choose whether or not to select against disability in their offspring in the absence of adequate justifying reasons to the contrary. I then move on to examine and outline arguments that suggest variously and for a plethora of different reasons that selection against disability should be condemned morally or required. After this is done and it is noted that the sheer volume of different positions and arguments requires a more specific focus I, in my thesis articles take what I view to be the strongest of moral reasons, person-affecting reasons, and look to the question of whether it is possible ground a moral obligation to select against disability in our offspring in the person affecting harms that our reproductive choices might produce. In the first paper I ask whether the non- identity problem really poses such an insurmountable obstacle to the claim that to select against disability may harm those that are created as a result of our selection choices. This leads to the conclusion that on certain accounts of personal identity over time and trans-world identity it is possible to determine harm in a number of previously non-identity cases of which the selection against disability case is one. In the second paper I broaden my focus slightly by looking to the possible harms that our procreative choices might impose on others than the children we may create: ourselves, our existing dependents and existing members of society. In doing this it is shown that our reproductive choices do, at least in societies with advanced social and medical welfare systems, have the potential to impose significant burdens on others. However, whilst this is so, it is also demonstrated that this is not necessarily a decisive reason to condemn a reproductive choice to select for or to fail to select against disability in our offspring. In my final paper I take a slightly different approach, focusing less on the question of whether there should be a moral obligation to select against disability in our offspring and more on the question of whether there should exist a legal imperative to do so. Taking as a basis a liberal approach to the moral limits of law I suggest that impingements on individual liberty may only be justified when it can be shown that our reproductive choices cause significant harms or offence to others, I ask whether the recent insertion into English and Welsh Law of a prohibition on selection for disability can be justified. In line with the findings of the previous two papers which are far from conclusive and by examining the reasons given in legal and policy documents in England and Wales relating to this prohibition I suggest that as it stands such a prohibition cannot be justified. This ultimately leads to a rather unsatisfying – but perhaps inevitable, in light of the messy nature of reproduction – conclusion: It is possible to discuss the ethics of selection against and for disability on person-affecting accounts of morality and to discuss the matter in this way offers sensitive and sensible prescriptions. However, such discussions turn out to be, in virtue of the many competing claims of those affected by reproductive decisions and policy, far more complex than might be assumed and do not fit neatly with the commonly held moral intuition that it is always morally preferable to select against disability in our offspring.
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Crespo, Mirasol Esther. "Percepciones de las mujeres, parejas y profesionales durante el embarazo, parto y posparto tras someterse a técnicas de reproducción asistida." Doctoral thesis, Universitat de Barcelona, 2015. http://hdl.handle.net/10803/351715.
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INTRODUCCIÓN: En la sociedad española actual y, particularmente, en Cataluña, observamos cómo ha ido disminuyendo la tasa de natalidad y la tasa bruta de nupcialidad, existe menor población en edad reproductiva y cambios en los flujos migratorios externos, a la vez que han aumentado los nacimientos en mujeres mayores de 35 años y existe mayor diversidad familiar. Por otro lado, las parejas que presentan subfertilidad representan aproximadamente un 10-15%. Las principales tendencias derivadas de los datos sociodemográficos y políticas desarrolladas, favorecen el incremento del uso de técnicas de reproducción asistida, con lo que los/as hijos/as de mujeres catalanas sometidas a un tratamiento de reproducción asistida representan el 4,3% de los nacimientos (Departament de Salut, 2014).
El embarazo tras el éxito de los tratamientos está asociado a una mayor incidencia de gestaciones múltiples y complicaciones obstétricas y perinatales en gestaciones únicas, no necesariamente atribuibles a la técnica en sí misma: prematuridad, neonatos pequeños para la edad gestacional, preeclampsia, diabetes gestacional, anomalías placentarias y un mayor índice de cesárea.
Se presupone que el embarazo y la maternidad/paternidad después de padecer infertilidad y tras los tratamientos está exenta de problemas y es gratificante. Sin embargo, la revisión de la literatura mostrada a lo largo de la presente investigación pone de manifiesto la complejidad de las consecuencias sociales y psicológicas del embarazo, el parto y posparto tras reproducción asistida.
El objetivo principal del presente trabajo de investigación es identificar las percepciones de las mujeres gestantes y sus parejas después de someterse a tratamientos de reproducción asistida y la de los/as profesionales sanitarios implicados en todo el proceso.
MÉTODOS: Se ha optado por un enfoque etnográfico. La pertinencia de este enfoque, reside en que permite relacionar cómo se experimenta y se da sentido a las nuevas tecnologías, desde el momento en que se conoce el embarazo, en la unidad de reproducción asistida, el seguimiento gestacional, la asistencia al parto y el posparto. La etnografía nos permite relacionar los hechos biológicos de la reproducción humana con su significado social, siendo el marco social de la reproducción la construcción de relaciones de parentesco.
Para hacer explícita esta cultura del parentesco y las percepciones de los/las protagonistas tras los tratamientos, se llevó a cabo observación participante y se realizaron entrevistas individuales a 30 mujeres, 21 parejas y 25 profesionales implicados en algún momento del proceso, además de entrevistas informales y análisis documental, desde noviembre del 2010 a abril del 2014.
Los datos obtenidos a través de la trascripción se subdividió en códigos o unidades de análisis que se fueron agrupando en subcategorías y que dieron lugar a los grandes temas derivados del fenómeno estudiado para el posterior análisis y discusión de los datos.
Las unidades de observación han sido el Hospital Clínic de Barcelona y Centros de Atención Primaria de Barcelona ciudad.
DISCUSIÓN Y CONCLUSIONES: Se presupone que el embarazo y la transición a la maternidad/ paternidad después de padecer infertilidad está exenta de problemas y es gratificante. Sin embargo, ante la medicalización de un proceso fisiológico inicialmente natural como el embarazo, es necesario atribuir un significado social, existiendo variabilidad en las percepciones de la infertilidad como problema, así como tras el éxito de los tratamientos.
Observamos como existe un balance constante en torno al valor genético y cultural en la definición de la identidad de los/las hijos/as en estos procesos de ayuda médica al parentesco.INTRODUCTION: In Spain, particularly in Catalonia, birth and marriage rates have declined, the reproductive-aged population has decreased and there have been changes in external migration flows. At the same time, births have increased in women over 35 years old and there is greater family diversity. On the other hand, subfertility now affects approximately 10-15% of reproductive-aged couples and current trends suggest that the infertility rate will rise, which will increase the use of assisted reproductive techniques. In Catalonia, infants conceived by assisted reproduction treatment now comprise 4.3% of the region's births (Department of Health, 2014). Conception by assisted reproduction is associated with an increased incidence of multiple gestations and various obstetric and perinatal complications in singleton pregnancies, even while these complications wasn’t caused necessarily by the use of assisted reproduction techniques in themselves. These complications include prematurity, small for gestational age, preeclampsia, gestational diabetes, placental abnormalities and increased rate of caesarean section. The reasons for this increase in adverse outcomes are unclear. Although is assumed that pregnancy and parenthood after infertility are unproblematic and gratifying, treatments are not risk-free and the literature cited in our study highlights the unmet psychosocial needs of women and their partners as they make the transition to parenthood after assisted reproduction. The overall objective of this research is to identify the perceptions of pregnant women, their partners and health professionals after successful fertility treatments. The research explores the effects of successful assisted reproduction on beliefs and practices of kinship in pregnancy and parenthood. Its ethnographic methods of study illustrate the experiences of women and their partners after successful assisted reproduction and explore the biological facts of human reproduction and their social significance of kinship. The research also examines the perceptions of the health professionals and the health service delivery model. METHODS: We used an ethnographic approach to relate the manner in which women, partners and professionals experience and understand assisted reproduction, at the moment when pregnancy is attained, in the assisted reproduction unit, the antenatal clinic, delivery suite and postpartum period. Ethnography allows us to relate the biological facts of human reproduction with its social meaning, understanding that the social frame of reproduction is the structure upon which relations of kinship were built. In our study, which was completed between November 2010 and April 2014, we illustrated this culture of kinship and the perceptions of the protagonists after the treatments by conducting participant observation. We also conducted individual interviews with 30 women, 21 partners and 25 health professionals, informal interviews and documentary analysis. The data obtained in our transcriptions were subdivided into codes or units of analysis. These were collected into subcategories and helped to profile the main issues arising from the phenomenon being studied so that the data could be further analyzed and discussed. The observational area was Hospital Clinic de Barcelona in Barcelona, Spain, and that city's primary health care centers. DISCUSSION AND CONCLUSION: It is assumed that pregnancy and parenthood after infertility are unproblematic and gratifying. However, because natural physiological processes like pregnancy are also medicalized, we need to give these processes social meaning and, in our particular area of study, address the variability in protagonists' perceptions of infertility as a problem and their experience of pregnancy following assisted reproduction. Finally in this section, we observe that there is a constant balance between the genetic and cultural values of kinship in defining the identity of the children who are born after assisted reproduction.