Dissertations / Theses on the topic 'Artificial insemination, Human'

Thesis (MScMedSc)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: Male factor infertility is a general term that describes couples in which an inability to conceive is associated with a problem identified in the male partner. Intrauterine insemination (IUI) together with ovulation induction has been shown to be an effective treatment method for male factor infertility. Oocyte production by the ovaries is stimulated by the use of fertility drugs. A prepared sperm sample is then injected into the uterus through the vagina using an IUI catheter which brings the oocytes and spermatozoa into close proximity. Semen preparation is an integral part of an IUI cycle. In a developing country, a simple inexpensive semen preparation method for IUI procedures, not necessitating a lot of equipment, is essential. An example of such a method, the Sep-D Kit (Surelife Sep-D Kit, Surelife Media Technologies Pty Ltd, Singapore) has been proposed as a possible preparation method. In a pilot study performed by the principal investigator (Roxanne Gentis), comparing the Sep-D Kit and standard swim-up preparation methods, it was found that the Sep-D Kit compared very well with the swim-up method regarding most pre- and post-preparation semen parameters. The Sep-D Kit method, however, still needed further testing to see whether or not pregnancy rates resulting from the method are comparable with that resulting from the standard swim-up method, as this ultimately is the required result of an IUI. The primary aim of this study was to compare the Sep-D Kit method to the standard swim-up method with regards to biochemical pregnancy outcome, post-preparation sperm count, motility, total motile count (TMC), morphology, DNA compaction and fragmentation (CMA3 and TUNEL). The secondary aim was to evaluate which variables, male and female, affect biochemical pregnancy outcome. The study took place at Drs Aevitas Fertility Clinic, Vincent Pallotti Hospital, Pinelands. The study was a prospective analytical study and was conducted from December 2010 until October 2012. A total of 473 IUI cycles were evaluated. Results showed that the Sep-D Kit semen preparation method was non-inferior to the standard swim-up method with regards to biochemical pregnancy rates, post-preparation count and TMC. The swim-up method produced samples with a significantly higher post-preparation motility compared to the Sep-D Kit method, however both methods still managed to produce similar biochemical pregnancy rates (10.39% for the swim-up group versus 11.57% for Sep-D Kit group). For the total cohort of cycles analysed the only female parameter which significantly predicted biochemical pregnancy outcome in this study was age. Sperm motility (post-preparation) was the only male parameter that significantly affected biochemical pregnancy outcome. The Sep-D Kit method is more cost effective and also time saving compared to the swim-up method. There is also no need for expensive laboratory equipment or a trained embryologist using the Sep-D Kit preparation method. The Sep-D Kit may therefore be used with confidence as a standard semen preparation method, and may be implemented in developing countries for use in routine IUI procedures.
AFRIKAANSE OPSOMMING: Manlike faktor infertiliteit is 'n algemene term wat gebruik word om paartjies te beskryf wat 'n onvermoë toon om swanger te raak as gevolg van 'n probleem wat geassosieer word met die man. Die kombinasie van intra-uteriene inseminasie (IUI) en ovulasie induksie kan doeltreffend gebruik word om manlike faktor infertiliteit te behandel. Vrugbaarheidsmiddels word gebruik om oösietproduksie in die die eierstokke te stimuleer en 'n voorbereide spermmonster word dan transvaginaal in die baarmoeder ingespuit om sodoende die spermatozoa en oösiete na-aan mekaar te bring. Semenvoorbereiding is 'n integrale deel van 'n IUI siklus en in 'n ontwikkelende land is 'n eenvoudige, goedkoop semenvoorbereidingsmetode – wat die gebruik van duur toerusting uitsluit – noodsaaklik. Die Sep-D Kit metode (Surelife Sep-D Kit, Surelife Media Technologies Pty Ltd, Singapore) is 'n voorbeeld van so 'n voorbereidingsmetode. 'n Loodsstudie, uitgevoer deur die hoofnavorser, (Roxanne Gentis), het gewys dat die Sep-D Kit en standaard opswem voorbereidingmetodes goed vergelyk ten opsigte van meeste semenparameters voor- en na voorbereiding. Dit is egter ook noodsaaklikheid vir verdere navorsing om vas te stel of swangerskapuitkoms na die gebruik van die twee semenvoorbereidingsmetodess vergelykbaar is, aangesien dit die uiteindelike, verlangde uitkoms van 'n IUI is. Die primêre doel van hierdie studie was om die Sep-D Kit metode te vergelyk met die standaard opswemmetode met betrekking tot biochemiese swangerskapuitkoms asook spermtelling, motiliteit, totale motiele spermtelling (TMS), morfologie, DNA kompaksie en fragmentering (CMA3 en TUNEL) na spermvoorbereiding. Die sekondêre doel was om te evalueer watter veranderlikes, manlik en vroulik, die bichemiese swangerskapuitkoms beïnvloed. Die studie is uitgevoer by die Drs Aevitas Fertiliteitskliniek, Vincent Pallotti Hospitaal, Pinelands. Die studie was prospektief analities en het gestrek vanaf Desember 2010 tot en met Oktober 2012. 'n Totaal van 473 IUI siklusse is evalueer en ontleed. Die resultate van die studie het getoon dat die Sep-D Kit semenvoorbereidingsmetode nie ondergeskik aan die opswemmetode was ten opsigte van biochemiese swangerskap, spermtelling en TMS na semenvoorbereiding nie, Spermmotiliteit was betekenisvol hoër vir die opswemmetode vergelykend met die Sep-D Kit, maar ten spite van die verskil was die biochemiese swangerskapsyfers in die twee groepe nie verskillend nie (10.39% in die opswem groep en 11.57% in Sep-D Kit groep). In die totale kohort siklusse wat ontleed is was dit net die ouderdom van die vrou wat 'n betekenisvolle effek op biochemiese swangerskapuitkoms gehad het. Die enigste manlike faktor wat 'n betekenisvolle effek op biochemiese swangerskapuitkoms gehad het was die motiliteit na semenvoorbereiding. Die Sep-D Kit metode is meer koste-effektief en tydbesparend as die standard opswemmetode. Die uitvoer van die Sep-D Kit metode vereis ook ook geen duur apparaat of 'n opgeleide embrioloog nie. Die Sep-D Kit metode kan dus met vertroue gebruik word as 'n standaard semenvoorbereidingsmetode en kan in ontwikkelende lande vir gebruik tydens roetine IUI prosedures geïmplementeer word.

Much of the public debate surrounding new technologies and techniques in assisted reproductive technology (ART) is caught up in the speculative nature of imagined futures of 'science-fictive' proportions. This thesis, by contrast, examines a 'naturalized' ART donor insemination, discussing the manner in which couples (and occasionally single women) construct distributive and kinship networks as they move through the processes of fertility treatment and the selection of donor sperm.
This thesis follows a marketing trail for sperm from scientific journal, to the web, to conference floor. In doing so it examines and contrasts the information that is offered by companies distributing donor sperm and drawn upon by those making selective choices. It argues that the process of donor gamete selection---as mediated by Internet technologies---is characterized by a juxtapositioning of two trends: 'eugenic' promise, and expansion kinship networks based on 'like kinds'. This paper strives to explore these desires, beliefs and motivations at play in the commodification, distribution and consumption observed in the online marketing and sale of gametes.
This thesis contributes to the body of anthropological theorizing on gifting and commodification, and kinship, by arguing that donor sperm---in the context of current exchange practices---challenges a dichotomous categorization of gift/commodity, and is best understood as a hybrid item of exchange. Following Appadurai, the commodity candidacy of donor sperm, and the context of its commodification is explored, noting the manner in which kinship networks are extended and negotiated in the process.

Conselho Nacional de Desenvolvimento Científico e Tecnológico
Nesta dissertação de Mestrado em Direito Civil procura-se demonstrar que as inovações biotecnológicas, principalmente da área da medicina reprodutiva, têm trazido consequências impactantes no direito de família e das sucessões, criando, assim, a necessidade de (re)adaptar o sistema jurídico brasileiro à nova (e dinâmica) realidade social, à luz dos princípios e normas constitucionais. Nesse sentido, por exemplo, repensar e reestruturar o modelo tradicional de família parece ser um passo necessário para esta (re)adaptação, uma vez que novas tecnologias, como as técnicas de reprodução assistida, criam a possibilidade de interferência externa em processos naturais de procriação, de maneira não antes prevista pela sociedade e pelo Direito. Assim, verifica-se a possibilidade de procriação de um novo descendente anos após a morte do genitor. Este trabalho busca entender e examinar as implicações de tais inovações biotecnológicas para o sistema jurídico brasileiro. Mais especificamente, busca-se entender e examinar as consequências jurídicas da reprodução medicamente assistida post mortem no âmbito sucessório, demonstrando diversas dificuldades de ordem prática, a exemplo da necessidade do respeito à igualdade entre filhos, por um lado; e a necessidade de definição da questão sucessória, por outro. Busca-se também demonstrar o modo de garantir os direitos hereditários do filho póstumo, tanto na sucessão legítima, como na testamentária. Ademais, pretende-se provocar reflexões secundárias acerca da necessidade de autorização expressa do de cujus para implantação de seu material genético no útero materno, bem como a necessidade de existência de um prazo para essa utilização, evitando que haja insegurança jurídica.
This Master in Civil Law dissertation aims at demonstrating that biotechnological innovations, most especially in the field of reproductive medicine, have fundamental implications for family law and inheritance law, thus creating the need for (re)adapting the legal system to the new (and dynamic) social reality, in light of the Brazilian constitutional principles and norms. In this regard, for instance, rethinking and restructuring the traditional family model seems to be a necessary step within this legal (re)adaptation, since new technologies, such as techniques of assisted human reproduction, create the possibility of interfering in natural processes of procreation in ways not foreseen by society and the law. In this regard, it is now possible to imagine the birth of a child years after the death of the parent. This research seeks to understand and examine the implications of such biotechnological innovations for the Brazilian legal system. Most specifically, it aims at understanding and examining the implications of post mortem assisted reproduction for the law of succession, demonstrating and commenting on various practical difficulties, such as the need for respecting the equality of children, on the one hand, and the necessity of defining the succession problem, on the other. This work also seeks to demonstrate how to ensure the inheritance rights of the posthumous son, both in the legitimate succession and in the testament succession. Furthermore, it aims at suggesting and provoking secondary reflections on the need for previous and explicit authorization from the deceased parent for implanting his genetic material into the womb of the widow, and the need for clarifying and determining the period in which this use of genetic material may be authorized, avoiding legal uncertainty.

The cellular and molecular environment of the uterus during the pre - and peri - implantation period of early pregnancy is critical for implantation success and optimal fetal and placental development. Perturbations to this environment not only have consequences for the success of pregnancy and neonatal health and viability, but can also drive adverse health outcomes in the offspring after birth, particularly the development of metabolic disorders such as obesity, hypertension and insulin resistance. The influence of seminal plasma on the cytokine and immune uterine environment has been previously well characterised in mice, however the effects of disruption in uterine seminal plasma exposure for pregnancy outcome have not been investigated. The studies described in this thesis employed the use of surgical seminal vesicle ablation in males and embryo transfer experiments to investigate the physiological significance of uterine seminal plasma exposure on programming fetal and neonatal outcomes, and growth and metabolic status in adult offspring. We demonstrate that in the absence of seminal plasma, oocyte fertilisation and embryo implantation are reduced, showing that seminal plasma acts primarily to facilitate fertilisation, possibly by promoting sperm transport and survival in the reproductive tract. In addition we show that pregnancies initiated in the absence of seminal plasma give rise to offspring which display accelerated growth after birth and increased adiposity in adulthood, compared to those developed in a tract exposed to seminal plasma at the time of conception. Offspring conceived in the absence of seminal plasma also displayed alterations in serum leptin and adiponectin content, similar to those known to be associated with obesity in the mouse. Using embryo transfer experiments, we showed that some, but not all aspects of the perturbed postnatal development are recapitulated when embryos fertilised in the presence of what semen are transferred to a recipient tract which has not been exposed to seminal plasma. More severe perturbations were seen in 2 - cell transfer than in blastocyst transfer experiment. Additionally, there was a significant effect of the embryo transfer procedure, irrespective of seminal plasma exposure, on fetal and postnatal development that confounded interpretation of these experiments. In addition, we investigated the potential mechanisms by which the influence of seminal plasma is exerted. Mediators of pre - implantation embryo development, implantation and the modulation of the maternal immune response to pregnancy were all assessed for regulation by seminal plasma using QRT - PCR. It was demonstrated that seminal plasma exposure induces the up - regulation of key embryotrophic factors, LIF, GM - CSF and IL - 6, in the oviduct following insemination. Factors important in tissue remodelling required for implantation and angiogenesis, MMP - 2, MMP - 3 and VEGF - C, were also shown to be increased at the time of implantation after seminal plasma exposure. Additionally the generation of T - regulatory cells in uterine tissues, demonstrated by the up - regulation of the transcription factor FOXp3 was shown to be dependent on semen exposure. The influence of seminal plasma on embryonic development, implantation and modulation of the maternal immune response to pregnancy may therefore be mechanisms which contribute to the adverse outcomes seen in pregnancies initiated in the absence of seminal plasma. Together these experiments show a role for seminal plasma signalling at the time of insemination in influencing the pre - implantation embryo to program later fetal and neonatal development, thereby impacting on the metabolic health of offspring. We conclude that seminal plasma is not simply a transport medium for sperm, but acts also as a key regulator of a female tract environment providing optimal support for the developing embryo.
Thesis (Ph.D.)--School of Paediatrics and Reproductive Health, 2006.

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The present article deals with the subject related to the Legal aspects of the heterologue artificial insemination . The objective of the study was to analyze the main problems related to this kind of attended reproduction, among them: the probable users of this technique; to discuss the possibility of attribution of the paternity results of the permission given by the husband to the wife or by one companion to the other so that she submits herself to therapeutical procedure; to consider if the child born through the use of this technique can have access to the identity of the donator; to know if the donator can be considered the father of the child. The study is justified due to the scarce normative treatment given to the subject by the Civil Code. The article used method of qualitative bibliographical research. It had been examined some works of reference that had best dealt with the subject among available ones
A presente dissertação trata do tema relacionado aos Aspectos jurídicos da inseminação artificial heteróloga . Os objetivos da dissertação foram o de analisar os principais problemas relacionados a este tipo de reprodução assistida, entre eles: os prováveis destinatários dessa técnica; se a atribuição da paternidade pode decorrer do consentimento dado pelo marido ou convivente para que a mulher ou a companheira submeta-se ao procedimento terapêutico; se o nascido pela utilização desta técnica pode obter dados que revelem a identidade do doador; se o doador pode ser considerado o pai da criança. Justifica-se o estudo diante do escasso tratamento normativo dado ao tema pelo Código Civil. A dissertação obedeceu método de pesquisa bibliografica qualitativa. Foram examinadas algumas obras de referência que melhor trataram do assunto e que se encontravam disponíveis

Defence date: 4 June 2013
Examining Board: Professor Martin Kohli, EUI (Supervisor); Professor Joan Bestard Camps, University of Barcelona (External Co-supervisor); Professor Fabrizio Bernardi, EUI; Professor Enric Porqueres i Gené, EHESS.
PDF of thesis uploaded from the Library digital archive of EUI PhD theses
The phenomenon of people crossing regional and national borders to seek assisted reproduction occurs in many countries across the world and involves different actors, including patients, doctors, fertility clinic practitioners, law-makers, donors, surrogates, children, brokers, and others who take part in the globalised industry of assisted reproductive technologies. This dissertation focuses on the experience of Italian reproductive travellers who seek donor conception treatments outside national borders, as a reaction to Italian regulations on assisted reproduction banning gamete donation in Italy. Through the qualitative analysis of the narrations and practices of heterosexual couples, same-sex couples and single women, this work explores the ways in which people face different reproductive itineraries with the aim of achieving reproduction through donor conception in a context of law evasion. In particular, it takes into account the process that leads people to choose donor conception abroad and investigates the ways in which people make sense of this choice in relation to their understanding of kinship formation. The feelings that accompany this process, the concepts that people mobilise to make both law evasion and donor conception practice coherent with their reproductive goals, and the strategies that they employ to "kin" their donor-conceived children are presented and analysed. This study highlights the fact that Italian CBRC travellers who seek donation treatments abroad mainly consider their reproductive experience as a transgressive act, because by doing so they circumvent laws that forbid those treatments locally. They tend to support the moral validity of their choices by arguing that it aims to accomplish what they perceive as a "normal" goal (having a child). Nonetheless, the recourse to such a reproductive experience challenges existing cultural understandings and the social organisation of kinship.

This research aimed to explore the parenting experiences of lesbian women who chose to have children through artificial insemination. While this study aimed to explore the experience of being a lesbian parent in South Africa generally, its intent was to be primarily vigilant of the particular challenges that face lesbian parents having children (through sperm donation) within the broader context of heterosexuality in South Africa. Using the voice-centred relational method of analysis, two separate interviews with a lesbian parenting couple were analysed. The findings revealed a number of expected and some unexpected challenges that lesbian parents of sperm donor children reportedly contend with. The overall finding was that lesbian parenting is a significantly challenging experience. Whilst it can be argued that parenting for all individuals is fraught with difficulties, what this study highlights is that for lesbian parents, typical parenting difficulties are exacerbated by societal judgment and lack of support. It is hoped that this research will contribute to filing the vast gap in South African literature relating to lesbian parenting as well as provide the impetus for further research relating to this topic to be conducted within South Africa. This research also intends to provide an educational resource to potential lesbian mothers as well as to lesbian parents who may possibly seek solace in the awareness they are not alone in terms of the challenges which they may face. Last but certainly not least, it is hoped that the insights of this study may assist psychologists in improving their competency in working with same sex parent populations by cultivating knowledge, understanding, self reflection and empathy skills.
Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

There is a dearth of research that explores the lives and experiences of trans-identified parents. The goal of this study was to explore the experiences of trans people who sought or accessed AHR services in Ontario between 2007 and 2010. Qualitative data that was collected from 7 qualitative interviews with 9 trans people and their partners was analyzed for the present analysis. Results from this study indicate that AHR providers do not possess sufficient knowledge about trans people, trans identities and trans lives to adequately address the needs of trans service users. Specific provider practices that trans people experienced as being unhelpful are illuminated and implications for improving clinical practices are discussed.

Surrogate motherhood is one of the most controversial issues of our time. The increase in infertility and the shortage of babies available for adoption, have provided an incentive for research in assisted reproductive techniques. Rapid advances in this field have caught the legal system unprepared in many ways. The object of this thesis is to investigate the legal aspects of surrogate motherhood. A background is provided by an in depth examination and analysis of the practice of surrogacy in foreign jurisdictions. For this purpose a selection of interdisciplinary, medical and juridical reports, court decisions and legislation is analysed. The surrogacy agreement is affected by principles of both public and private law. As the agreement is based on consensus between the parties, Roman Law principles of the law of obligations, provided a valuable point of departure in establishing a theoretical basis for the classification of surrogacy agreements. Having determined the nature of the agreement, the content is analysed with due regard to statutory and other relevant considerations, such as the boni mores, and submissions made regarding the enforceability and legality of such agreements. A surrogate mother agreement model is proposed and analysed in the light of existing South African law. The various ways in which surrogacy contracts may be breached are examined and recommendations put forward regarding possible delictual or contractual remedies. The legal relationship between the surrogate child and its gestational (birth) mother and her husband on the one hand and the intended parents on the other is investigated. The role of the courts in custody issues - related to surrogacy - is examined and recommendations put forward as to how they may be included in the process by determining the best interest of the surrogate child prior to artificial insemination. The civil and criminal liability of medical practitioners involved in assisted reproductive technology and specifically surrogacy are expounded. Key issues in the practice of surrogate motherhood are interpreted in the light of existing statutory and common law principles. Recommendations are put forward on these issues and a bill proposed for the regulation of surrogate motherhood in South Africa.
Private Law
LLD

The cellular and molecular environment of the uterus during the pre - and peri - implantation period of early pregnancy is critical for implantation success and optimal fetal and placental development. Perturbations to this environment not only have consequences for the success of pregnancy and neonatal health and viability, but can also drive adverse health outcomes in the offspring after birth, particularly the development of metabolic disorders such as obesity, hypertension and insulin resistance. The influence of seminal plasma on the cytokine and immune uterine environment has been previously well characterised in mice, however the effects of disruption in uterine seminal plasma exposure for pregnancy outcome have not been investigated. The studies described in this thesis employed the use of surgical seminal vesicle ablation in males and embryo transfer experiments to investigate the physiological significance of uterine seminal plasma exposure on programming fetal and neonatal outcomes, and growth and metabolic status in adult offspring. We demonstrate that in the absence of seminal plasma, oocyte fertilisation and embryo implantation are reduced, showing that seminal plasma acts primarily to facilitate fertilisation, possibly by promoting sperm transport and survival in the reproductive tract. In addition we show that pregnancies initiated in the absence of seminal plasma give rise to offspring which display accelerated growth after birth and increased adiposity in adulthood, compared to those developed in a tract exposed to seminal plasma at the time of conception. Offspring conceived in the absence of seminal plasma also displayed alterations in serum leptin and adiponectin content, similar to those known to be associated with obesity in the mouse. Using embryo transfer experiments, we showed that some, but not all aspects of the perturbed postnatal development are recapitulated when embryos fertilised in the presence of what semen are transferred to a recipient tract which has not been exposed to seminal plasma. More severe perturbations were seen in 2 - cell transfer than in blastocyst transfer experiment. Additionally, there was a significant effect of the embryo transfer procedure, irrespective of seminal plasma exposure, on fetal and postnatal development that confounded interpretation of these experiments. In addition, we investigated the potential mechanisms by which the influence of seminal plasma is exerted. Mediators of pre - implantation embryo development, implantation and the modulation of the maternal immune response to pregnancy were all assessed for regulation by seminal plasma using QRT - PCR. It was demonstrated that seminal plasma exposure induces the up - regulation of key embryotrophic factors, LIF, GM - CSF and IL - 6, in the oviduct following insemination. Factors important in tissue remodelling required for implantation and angiogenesis, MMP - 2, MMP - 3 and VEGF - C, were also shown to be increased at the time of implantation after seminal plasma exposure. Additionally the generation of T - regulatory cells in uterine tissues, demonstrated by the up - regulation of the transcription factor FOXp3 was shown to be dependent on semen exposure. The influence of seminal plasma on embryonic development, implantation and modulation of the maternal immune response to pregnancy may therefore be mechanisms which contribute to the adverse outcomes seen in pregnancies initiated in the absence of seminal plasma. Together these experiments show a role for seminal plasma signalling at the time of insemination in influencing the pre - implantation embryo to program later fetal and neonatal development, thereby impacting on the metabolic health of offspring. We conclude that seminal plasma is not simply a transport medium for sperm, but acts also as a key regulator of a female tract environment providing optimal support for the developing embryo.
Thesis (Ph.D.)--School of Paediatrics and Reproductive Health, 2006.