Reproductive biomedicine online
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The possibility for healthy women to cryopreserve their oocytes in order to counter future infertility has gained momentum in recent years. However, women tend to cryopreserve oocytes at an age that is suboptimal from a clinical point of view--in their late thirties--when both oocyte quantity and quality have already considerably diminished and success rates for eventually establishing a pregnancy are thus limited. This also gives rise to ethical concerns, as the procedure is seen as giving false hope to (reproductively speaking) older women. ⋯ This also gives rise to ethical concerns, as the procedure is seen as giving false hope to (reproductively speaking) older women. We evaluate which measures can be taken to turn social freezing into a procedure that is both clinically and ethically better than the current practice and discern three different steps: creating public awareness; offering individualized, age-specific information and counselling; and offering predictive tests such as anti-Müllerian hormone measurements or antral follicle count. The main objective of these measures is to convince those women who are most likely to benefit from social freezing to present themselves before age 35 and to discourage fertility clinics from specifically targeting women who have already surpassed the age at which good results can be expected.
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Reprod. Biomed. Online · Nov 2011
Transnational commercial surrogacy in India: gifts for global sisters?
In this ethnography of transnational commercial surrogacy in a small clinic in India, the narratives of two sets of women involved in this new form of reproductive travel – the transnational clients and the surrogates themselves – are evaluated. How do these women negotiate the culturally anomalous nature of transnational surrogacy within the unusual setting of India? It is demonstrated that while both sets of women downplay the economic aspect of surrogacy by drawing on predictable cultural tools like 'gift', 'sisterhood' and 'mission', they use these tools in completely unexpected ways. Previous ethnographies of surrogacy in other parts of the world have revealed that women involved in surrogacy use these narratives to downplay the contractual nature of their relationship with each other. Ironically, when used in the context of transnational surrogacy in India, these narratives further highlight and often reify the inequalities based on class, race and nationality between the clients and suppliers of reproductive tourism in India.
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Reprod. Biomed. Online · Nov 2011
Assisted reproduction on treacherous terrain: the legal hazards of cross-border reproductive travel.
The growing phenomenon of cross-border reproductive travel has four significant legal dimensions. First, laws that ban or inhibit access to assisted reproductive procedures in one country lead patients and physicians to travel to other countries to acquire, to contribute to or to provide assisted reproductive services. Such laws may include provisions that criminalize those who assist or advise patients to undertake such travel. ⋯ Third, the law may interfere with the ultimate goal of reproductive travellers by refusing to recognize them as the parents of the child they have crossed borders to conceive. Finally, facilitating cross-border reproductive travel may expose physicians, attorneys and brokers to malpractice or other civil liability. This article explores these legal dimensions of cross-border reproductive care and uses the legal doctrines of proportionality, extraterritoriality and comity to assess the legality and normative validity of governmental efforts to curb or limit assisted reproductive practices.
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Reprod. Biomed. Online · Nov 2011
Extraterritoriality for cross-border reproductive care: should states act against citizens travelling abroad for illegal infertility treatment?
Since the development of assisted reproduction technologies, there has been discussion on which people should have access to these technologies and which treatments and techniques are morally acceptable. However, national legislation can no longer determine what citizens do. Some countries react to their citizens going abroad to evade restrictions by implementing even more restrictive laws. ⋯ The dissimilarity in these analogies shows that extraterritoriality is a radical position that is generally inappropriate in the case of CBRC. Subsequently, several potential state reactions to CBRC for law evasion are considered. It is concluded that legislation of CBRC should be modest, tolerant and nuanced.
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Reprod. Biomed. Online · Sep 2011
ReviewSocial egg freezing: the prospect of reproductive 'immortality' or a dangerous delusion?
Until recently there was little to offer young women with cancer facing chemotherapy, radiotherapy or surgery and the probability of premature menopause and sterility. The first 'frozen egg' baby was born in 1986, but success rates were so low that egg freezing was neglected. Three technological developments in assisted reproduction treatment (intracytoplasmic sperm injection, dehydro-cryoprotectants and vitrification) have transformed this picture and now young women with frozen eggs have the same probability of a live birth per embryo transfer as women undergoing conventional IVF. ⋯ Donor eggs are not an option for many because of supply constraints and ethical and cultural concerns. Freezing a woman's eggs at age 30 literally 'freezes in time' her fertility potential and gives her the chance of a healthy pregnancy at a time of her choosing. This paper discusses the role of oocyte cryopreservation in the context of social egg freezing.