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1
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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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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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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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.<br>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.
7
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.
9
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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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.<br>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.<br>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.
11
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.<br>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.
13
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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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.<br>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.<br>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.
15
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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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.<br>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.<br>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.
17
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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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.
Full textAbstract:
Thesis (MMed)--Stellenbosch University, 2105.<br>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.<br>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.
19
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.
Full textAbstract:
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.
20
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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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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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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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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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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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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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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Nuojua-Huttunen, S. (Sinikka). "Intrauterine insemination (IUI) treatment in subfertility." Doctoral thesis, University of Oulu, 1999. http://urn.fi/urn:isbn:9514251717.
Full textAbstract:
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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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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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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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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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.)
32
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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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.<br>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.
34
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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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/.
Full textAbstract:
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.
36
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.
Full textAbstract:
Thesis (DMed (Obstetrics and Gynaecology))--University of Stellenbosch, 2010.<br>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.<br>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.
37
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.
Full textAbstract:
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cota_amm_me_botfm.pdf: 542817 bytes, checksum: 25407ae609f35711de3e74eccfa2d0a3 (MD5)<br>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)<br>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...<br>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)
38
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 Oliveira<br>Coorientador: Claudia Guilhermino Petersen<br>Banca: Mario Cavagna<br>Banca: Anice Maria Vieira de Camargo Martins<br>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)<br>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)<br>Mestre
39
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.
Full textAbstract:
Thesis (MScMedSc)--Stellenbosch University, 2013.<br>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.<br>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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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.
Full textAbstract:
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.<br>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.
41
Vilela, João Rocha. "Histerossonografia em mulheres inférteis candidatas às ténicas de reprodução assistida /." Botucatu, 2011. http://hdl.handle.net/11449/99215.
Full textAbstract:
Orientador: Anaglória Pontes<br>Coorientador: Maria Teresinha de Oliveira Cardoso.<br>Banca: Paulo Sérgio França<br>Banca: Adriano Bueno Tavares<br>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<br>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<br>Mestre
42
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.
Full textAbstract:
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.
Full textAbstract:
Thesis (PhD)--Stellenbosch University, 2002.<br>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.<br>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.
44
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.
Full textAbstract:
Orientador: Mauro William Barbosa de Almeida<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas<br>Made available in DSpace on 2018-08-20T00:51:52Z (GMT). No. of bitstreams: 1
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Previous issue date: 2012<br>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<br>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<br>Mestrado<br>Antropologia Social<br>Mestre em Antropologia Social
45
Windt, Marie-Lena. "Human gamete micromanipulation and intracytoplasmic sperm injection (ICI) : its impact on severe male infertility." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51790.
Full textAbstract:
Thesis (PhD)--Stellenbosch Uni versity, 2000.<br>ENGLISH ABSTRACT: Intracytoplasmic sperm injection (ICSI) introduced a revolutionary way of treatment for male
factor infertility. With the exception of some cases of non-obstructive azoospermia, all other
male factor infertility cases have the potential to be successfully treated with ICS!. The only
prerequisite seems to be the presence of a motile or viable immotile sperm cell for each oocyte.
In this study we report on our own experience with the development and implementation of the
ICSI method in the Reproductive Biology Unit at Tygerberg Hospita!. An analysis of 5 years of
ICSI experience showed that semen parameters, sperm morphology, motility and concentration
did not influence fertilization and pregnancy rates adversely. In most cases, patients who could
not be treated with in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT), due to poor
semen parameters or fertilization failure, were treated successfully with ICS!. Even a case of
globozoospermia was treated successfully with ICS!.
Testicular spermatozoa, fresh or frozen-thawed, also resulted in excellent fertilization and
pregnancy rates. Cryopreservation of testicular samples facilitated the management of the
infertile couple, aiding the coordination of the recovery of vital gametes from both partners and
also limiting the repetition of testicular biopsies. Incubation (maturation) of testicular spermatozoa
also induced an enhancement in pregnancy rates.
It can be concluded that ICSI proved to be a treatment method with success similar to that of in
vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT), in spite of a severe male factor.
The study also indicated transfer route and embryo quality (viability) to be very important factors
in the success of ICS!. The tubal transfer route was shown to be a significant contributor to the
pregnancy success (compared to uterine transfer) as was the transfer of embryos that showed
early division to the 2-cell stage, 26 hours post injection. The transfer of early dividing embryos
into the fallopian tube resulted in a pregnancy rate of almost 40%, a result similar to that of GIFT
with a mild male factor.
The role of the oocyte in fertilization and pregnancy success was also revealed indirectly by the
introduction of ICS!. Visual observation of denuded oocytes was possible and many
morphological features, normal and abnormal, can be observed. Immature oocytes can also be
identified and it was shown that they could be successfully matured in vitro before injection.
In this study transmission electron microscopy (TEM) was used to study abnormalities in oocyte
morphology. The standard method was adapted and modified for single cell TEM. The
abnormalities observed included lysosomal and non-lysosomal degeneration (yellowish or darkly
coloured oocytes), degeneration and vacuole formation (vacuolated oocytes), large secondary
lysosomes filled with multiple small lipid droplets - lipofuscin body (refractile body) and a
fragmented oocyte. It was also possible to study at ultrastructural level, possible reasons for
fertilization failure in ICS!. Different stages of oocyte activation failure, cytoplasmic immaturity,
sperm cell extrusion, abnormal sperm cell decondensation, female spindle abnormalities and
technique related factors were observed. TEM was also successfully implemented to elucidate the reason for infertility in a patient with a
longstanding, unexplained history of infertility. TEM evaluation of two of the patient's unfertilized
oocytes revealed a spindle abnormality with contributing cytoskeletal anomalies at ultrastructural
level. The modified TEM technique offers a valuable tool to study this small, but important group
of patients with unexplained infertility. ThisTEM study opened up a new, valuable and interesting
avenue of research with both diagnostic and prognostic value for patients with unexplained
infertility.
ICSI is therefore a valuable method in the treatment of especially male factor infertility. It is the
most advanced fertilization technique developed in the last decade in this field. Not only can
almost all male factor patients be treated, but unexplained female infertility can also be exposed,
studied and hopefully in future also be treated with micromanipulation methods.<br>AFRIKAANSE OPSOMMING: Die ontwikkeling van die mikromanipulasie tegniek "Intracytoplasmic sperm injection" (ICSI)
het die behandeling van die manlike faktor in infertiliteit, revolusionêr verander. Met die
uitsondering van sommige gevalle van nie-obstruktiewe asoospermia, kan potensieel alle
ander manlike infertiliteits faktore suksesvol met ICSI behandel word. Die enigste voorvereiste
blyk "n bewegende of "n nie-bewegende, maar bewese lewende spermsel te wees.
In hierdie studie word verslag gedoen oor die ontwikkeling en toepassing van die ICSI metode in
die Eenhed vir Reproduktiewe Biologie by Tygerberg Hospitaal. 'n Analise van 5 jaar se resultate
na die implementering van die ICSI metode het gewys dat die semen parameters, sperm
morfologie, motiliteit en konsentrasie, nie "n effek op bevrugting- en swangerskapsyfers gehad
het nie. Pasiënte wat, as gevolg van ontoereikende semen parameters, nie met die klassieke
metodes, in vitro bevrugting (IVB) of gameet intrafallopiusbuis terugplasing (GIFT) behandel kon
word nie, kon suksesvol met ICSI behandel word. Daar was selfs "n geval van manlike infertiliteit
as gevolg van globosoospermie, wat suksesvol met ICS behandel is.
Die ICSI metode het dit ook moontlik gemaak om uitstekende bevrugting- en swangerskap
resultate met testikulêre spermatosoa .(vars en gevries) te bereik. Die bevriesing van
testisweefsel het ook bygedra tot beter hantering van sulke pasiënte. Herhaalde testisbiopsies
word uitgeskakel en die koórdinasie van die verkryging van die manlike en vroulike gamete, word
ook vergemaklik wanneer testisweefsel in gevriesde vorm beskikbaar is. Die studie het verder
getoon dat wanneer testikulêre weefsel geïnkubeer word (om spermatosoa te laat matureer), die
swangerskapsyfers verhoog was.
Dit is dus duidelik dat die ICSI metode net so suksesvol soos die IVB en GIFT metodes toegepas
kan word, selfs en veral in gevalle van erge manlike faktor infertiliteit.
Die studie het ook verder getoon dat die plek waar embrios teruggeplaas word, asook die
embriokwalitiet van teruggeplaasde embrios, belangrike bydraende faktore in die ICSI
swangerskapsukses was. Embrioterugplasing in die buis van fallopius en terugplasing van
embrios wat vroeë 2-sel deling, 26 uur na ICSI getoon het, is uitgewys as faktore wat ICSI
swangerskap betekenisvol verbeter het. Dit was moontlik om "n swangerskapsyfer van ongeveer
40%, sootgelyk aan die van GIFT sonder "n erge manlike faktor, te bereik met die terugplasing
van ten minste een vroeë deler embrio in die fallopiese buis.
Die ICSI tegniek het ook indirek bygedra tot nuwe insigte met betrekking tot die rol wat die
vroulike eiersel (oësief in ICSI bevrugting speel. Oósiete word gestroop van hulomringende selle
vir die ICSI proses en kan dan maklik vir hul normale en abnormale morfologiese eienskappe
evalueer word. Oësiete wat immatuur is kan ook so geïdentifiseer word en dit is moontlik om hulle
suksesvol te matureer voor mikro-inspuiting.
Transmissie-elektronmikroskopie (TEM) is in die studie gebruik om die ultrastruktuur van
onbevrugde en abnormale oësiete te bestudeer. Hiervoor is "n bestaande tegniek gemodifiseer vir die hantering van "n enkele sel, in hierdie geval die oosiet. Lisasomale en nie-lisosomale degenerasie (oósiete wat geelof donker van kleur voorkom), degeneratiewe tekens en vakuole
(oësiete met vakuole), groot sekondêre lisosome gevul met klein lipieddruppels ('refractile body')
en 'n gefragmenteerde oosiet was van die morfologies abnormale eienskappe wat ultrastruktureel
geïdentifiseer is. Moontlike faktore wat 'n rol kan speel in nie-bevrugting na ICSI kon ook op
ultrastrukturele vlak met die tegniek geïdentifiseer word. Hierdie faktore het die volgende
ingesluit: die onvermoë van verskillende stadiums van oosiet aktivering, sitoplasmatiese
immaturiteit, uitwerping van die spermsel na die periviteliene spasie, abnormale spermsel
dekondensasie, vroulike spoelvormings abnormaliteite en tegniekgekoppelde faktore.
Die TEM tegniek is ook suksesvol aangewend om die infertiliteitsprobleem van 'n pasiënt wat vir
etlike jare aan onverklaarbare infertiliteit gely het, te identifiseer. TEM het op die ultrastrukturele
vlak gewys dat daar 'n spoel abnormaliteit in twee van haar onbevrugde oëslete was. TEM kan
dus baie vrugbaar gebruik word in hierdie groep pasiënte om onverklaarbare infertiliteit, wat
andersins ongeïdentifiseerd sou bly, te verklaar.
Die ICSI metode is die mees revolusionêre tegniek wat die afgelope dekade vir die behandeling
van veral manlike infertiliteit ontwikkel en baie suksesvol toegepas is. Die metode ook kan 'n
bydraende rol speel in die hantering van onverklaarbare infertiliteit veral ten opsigte van die
vroulike gameet. In die toekoms is dit moontlik dat selfs hierdie probleem met nuwe
mikromanipulasietegnieke opgelos sal kan word.
46
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.
Full textAbstract:
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.<p>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.<p><p>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. <p><p>Cette thèse de doctorat propose plusieurs objectifs :<p><p>•\<br>Doctorat en Sciences biomédicales et pharmaceutiques<br>info:eu-repo/semantics/nonPublished
47
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.
Full textAbstract:
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.
48
Cailleau, Françoise. "D'une matrice à l'autre: dialogique de la filiation et de la parentalité dans la gestation pour autrui." Doctoral thesis, Universite Libre de Bruxelles, 2011. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209817.
Full textAbstract:
La présente recherche porte sur les processus de filiation et de parentalité chez les couples demandeurs d'une aide médicale à la procréation nécessitant le recours à une mère porteuse.Pour aborder la spécificité et la complexité de ces situations, nous avons élaboré un modèle théorique paradigmatique qui propose un rapport dialogique entre les concepts de filiation et de parentalité. Cette modélisation se présente sous forme matricielle. Elle permet de connecter des savoirs issus de diverses disciplines et ouvre sur la possibilité de repenser nos schémas conceptuels de la filiation et la parentalité à l'ère des modifications des conditions de la reproduction, de la gestation et de la naissance.<br>Doctorat en Sciences Psychologiques et de l'éducation<br>info:eu-repo/semantics/nonPublished
49
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.
Full textAbstract:
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.<br>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.
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Urel, Isadora. "Técnicas de reprodução humana assistida - entre a medicina e o direito: as famílias do amanhã." Pontifícia Universidade Católica de São Paulo, 2017. https://tede2.pucsp.br/handle/handle/20680.
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Previous issue date: 2017-11-30<br>Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq<br>The purpose of this dissertation is to demonstrate the absence of laws regarding assisted human
reproduction techniques (TRHAs) and the disorders caused, especially in family law, that this
legislative vacuum has provoked. The use of TRHAs and other means that also include the
“surrogacy”, have been increasingly accessible to the different social strata of the Brazilian
population. There seems to be a need for broad and consistent legislation on the subject in a
country where the first “test-tube baby” was born more than three decades ago. Although Brazil
has not legislated on the subject already exist alien legislations that will be approached<br>A presente dissertação tem por objetivo demonstrar a ausência de leis a respeito das
Técnicas de Reprodução Humana Assistida (TRHAs) e os transtornos causados, em
especial no Direito de Família, que esse vácuo legislativo tem provocado. A utilização das
TRHAs e outros meios que também incluem a “barriga de aluguel”, têm sido acessíveis,
cada vez mais, às diferentes camadas sociais da população brasileira. Tudo indica que se
faz necessário uma legislação ampla e consistente a respeito do assunto em questão, num
país em que o primeiro “bebê de proveta” nasceu há mais de três décadas. Apesar do Brasil
não ter legislado sobre o tema já existem legislações alienígenas que serão abordadas