Reproductive technology
Reproductive technology encompasses all current and anticipated uses of technology in human and animal reproduction, including assisted reproductive technology (ART),<ref>Kushnir, Vitaly A.; Choi, Jennifer; Darmon, Sarah K.; Albertini, David F.; Barad, David H.; Gleicher, Norbert (August 2017). "CDC-reported assisted reproductive technology live-birth rates may mislead the public". Reproductive BioMedicine Online. 35 (2): 161–164. doi:10.1016/j.rbmo.2017.05.008. ISSN 1472-6483.</ref> contraception and others. It is also termed Assisted Reproductive Technology, where it entails an array of appliances and procedures that enable the realization of safe, improved and healthier reproduction. While this is not true of all people, for an array of married couples, the ability to have children is vital. But through the technology, infertile couples have been provided with options that would allow them to conceive children.<ref name="pmid27126581">Al-Inany HG, Youssef MA, Ayeleke RO, Brown J, Lam WS, Broekmans FJ (April 2016). "Gonadotrophin-releasing hormone antagonists for assisted reproductive technology" (PDF). The Cochrane Database of Systematic Reviews. 4 (8): CD001750. doi:10.1002/14651858.CD001750.pub4. PMC 8626739. PMID 27126581.</ref>
Overview
Assisted reproductive technology
Assisted reproductive technology (ART) is the use of reproductive technology to treat low fertility or infertility. Modern technology can provide infertile couples with assisted reproductive technologies. The natural method of reproduction has become only one of many new techniques used today. There are millions of couples that do not have the ability to reproduce on their own because of infertility and therefore, must resort to these new techniques. The main causes of infertility are that of hormonal malfunctions and anatomical abnormalities.<ref name=":2" /> ART is currently the only form of assistance for individuals who, for the time being, can only conceive through surrogacy methods).<ref>Campo H, Cervelló I, Simón C (July 2017). "Bioengineering the Uterus: An Overview of Recent Advances and Future Perspectives in Reproductive Medicine". Annals of Biomedical Engineering. 45 (7): 1710–1717. doi:10.1007/s10439-016-1783-3. PMID 28028711. S2CID 4130310.</ref> Examples of ART include in vitro fertilization (IVF) and its possible expansions, including:
- artificial insemination
- artificial reproduction
- cloning (see human cloning for the special case of human beings)
- cytoplasmic transfer
- cryopreservation of sperm, oocytes, embryos
- embryo transfer
- fertility medication
- hormone treatment
- in vitro fertilization
- intracytoplasmic sperm injection
- in vitro generated gametes
- preimplantation genetic diagnosis
Role of the Society for Assisted Reproductive Technology (SART)
In 1981, after the birth of Elizabeth Carr, the first baby in the United States to be conceived through in vitro fertilization (IVF). Her birth gave hope to many couples struggling with infertility. Dr. Howard Jones brought together the leading practitioners of the five US-based IVF programs (Norfolk,[clarification needed] Vanderbilt, University of Texas at Houston, and the University of Southern California, Yale) to discuss the establishment of a national registry for in vitro fertilization attempts and outcomes. 2 years later, in 1985 the society for assisted reproductive technology (SART) was founded as a special interest entity within the American Fertility Society.<ref>"Gosden, Prof. Roger Gordon, (born 23 Sept. 1948), Professor, and Director of Research in Reproductive Biology, Weill Medical College, Cornell University, 2004–10; Owner and Director, Jamestowne Bookworks, LLC, Williamsburg, Virginia", Who's Who, Oxford University Press, 1 December 2007, retrieved 20 October 2023</ref> SART has not only informed the evolution of infertility care but also improved success of antiretroviral therapy.<ref>Toner, James P.; Coddington, Charles C.; Doody, Kevin; Van Voorhis, Brad; Seifer, David B.; Ball, G. David; Luke, Barbara; Wantman, Ethan (September 2016). "Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update". Fertility and Sterility. 106 (3): 541–546. doi:10.1016/j.fertnstert.2016.05.026.</ref>
Prognostics
Reproductive technology can inform family planning by providing individual prognoses regarding the likelihood of pregnancy. It facilitates the monitoring of ovarian reserve, follicular dynamics and associated biomarkers in females,<ref>Nelson SM, Telfer EE, Anderson RA (2012). "The ageing ovary and uterus: new biological insights". Human Reproduction Update. 19 (1): 67–83. doi:10.1093/humupd/dms043. PMC 3508627. PMID 23103636.</ref> as well as semen analysis in males.<ref>Narvaez JL, Chang J, Boulet SL, Davies MJ, Kissin DM (August 2019). "Trends and correlates of the sex distribution among U.S. assisted reproductive technology births". Fertility and Sterility. 112 (2): 305–314. doi:10.1016/j.fertnstert.2019.03.034. PMID 31088685.</ref>
Contraception
Contraception, also known as birth control, is a form of reproductive technology that enables people to prevent pregnancy.<ref>Sunderam S, Kissin DM, Crawford SB, Folger SG, Boulet SL, Warner L, Barfield WD (February 2018). "Assisted Reproductive Technology Surveillance - United States, 2015". MMWR. Surveillance Summaries. 67 (3): 1–28. doi:10.15585/mmwr.ss6703a1. PMC 5829941. PMID 29447147.</ref> There are many forms of contraception, but the term covers any method or device which is intended to prevent pregnancy in a sexually active woman. Methods are intended to "prevent the fertilization of an egg or implantation of a fertilized egg in the uterus."<ref>"Definition of Birth control". MedicineNet. Archived from the original on August 6, 2012. Retrieved August 9, 2012.</ref> Different forms of birth control have been around since ancient times, but widely available effective and safe methods only became available during the mid-1900s.<ref name="Hopkins2010">Hanson SJ, Burke AE (2010). "Fertility control: contraception, sterilization, and abortion". In Hurt KJ, Guile MW, Bienstock JL, Fox HE, Wallach EE (eds.). The Johns Hopkins manual of gynecology and obstetrics (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 382–395. ISBN 978-1-60547-433-5.</ref>
Others
The following reproductive techniques are not currently in routine clinical use; most are still undergoing development:
Same-sex procreation
Research is currently investigating the possibility of same-sex procreation, which would produce offspring with equal genetic contributions from either two females or two males.<ref name = "Kissin_2019">Kissin DM, Adamson GD, Chambers G, DeGeyter C (4 July 2019). Assisted Reproductive Technology Surveillance. Cambridge University Press. ISBN 978-1-108-49858-6.</ref> This form of reproduction has become a possibility through the creation of either female sperm (containing the genetic material of a female) or male eggs (containing the genetic material of a male). Same-sex procreation would remove the need for lesbian and gay couples to rely on a third party donation of a sperm or an egg for reproduction.<ref>Gerkowicz SA, Crawford SB, Hipp HS, Boulet SL, Kissin DM, Kawwass JF (April 2018). "Assisted reproductive technology with donor sperm: national trends and perinatal outcomes". American Journal of Obstetrics and Gynecology. 218 (4): 421.e1–421.e10. doi:10.1016/j.ajog.2017.12.224. PMID 29291411. S2CID 27903207.</ref> The first significant development occurred in 1991, in a patent application filed by U.Penn. scientists to fix male sperm by extracting some sperm, correcting a genetic defect in vitro, and injecting the sperm back into the male's testicles.<ref name=":3">US 5858354 Repopulation of testicular Seminiferous tubules with foreign cells, corresponding resultant germ cells, and corresponding resultant animals and progeny</ref> While the vast majority of the patent application dealt with male sperm, one line suggested that the procedure would work with XX cells, i.e., cells from an adult woman to make female sperm.
In the two decades that followed, the idea of female sperm became more of a reality. In 1997, scientists partially confirmed such techniques by creating chicken female sperm in a similar manner.<ref>Tagami T, Matsubara Y, Hanada H, Naito M (June 1997). "Differentiation of female chicken primordial germ cells into spermatozoa in male gonads". Development, Growth & Differentiation. 39 (3): 267–71. doi:10.1046/j.1440-169X.1997.t01-2-00002.x. PMID 9227893. S2CID 35900043.</ref> They did so by injecting blood stem cells from an adult female chicken into a male chicken's testicles. In 2004, other Japanese scientists created two female offspring by combining the eggs of two adult mice.<ref>Kono T, Obata Y, Wu Q, Niwa K, Ono Y, Yamamoto Y, et al. (April 2004). "Birth of parthenogenetic mice that can develop to adulthood". Nature. 428 (6985): 860–4. Bibcode:2004Natur.428..860K. doi:10.1038/nature02402. PMID 15103378. S2CID 4353479.</ref><ref>Silva SG, Bertoldi AD, Silveira MF, Domingues MR, Evenson KR, Santos IS (January 2019). "Assisted reproductive technology: prevalence and associated factors in Southern Brazil". Revista de Saúde Pública. 53: 13. doi:10.11606/s1518-8787.2019053000737. PMC 6390642. PMID 30726494.</ref>
In 2008, research was done specifically for methods on creating human female sperm using artificial or natural Y chromosomes and testicular transplantation.<ref name=":0">"Color illustration of female sperm making process" (PDF). Human Samesex Reproduction Project.[permanent dead link]</ref> A UK-based group predicted they would be able to create human female sperm within five years. So far no conclusive successes have been achieved.<ref name=":2">MacRae F (February 2008). "Scientists turn bone marrow into sperm". Australia: The Courier and Mail.</ref>
In 2018 Chinese research scientists produced 29 viable mice offspring from two mother mice by creating sperm-like structures from haploid Embryonic stem cells using gene editing to alter imprinted regions of DNA. They were unable to get viable offspring from two fathers. Experts noted that there was little chance of these techniques being applied to humans in the near future.<ref>McRae M (11 October 2018). "Chinese Researchers Have Spawned Healthy Mice With 2 Biological Mothers And No Father". Science Alert. Retrieved 12 October 2018.</ref><ref name=":1">Li ZK, Wang LY, Wang LB, Feng GH, Yuan XW, Liu C, et al. (November 2018). "Generation of Bimaternal and Bipaternal Mice from Hypomethylated Haploid ESCs with Imprinting Region Deletions". Cell Stem Cell. 23 (5): 665–676.e4. doi:10.1016/j.stem.2018.09.004. PMID 30318303.</ref>
Ethics
Recent technological advances in fertility treatments introduce ethical problems, such as the affordability of the various procedures. The exorbitant prices can limit who has access.<ref name="Kissin_2019" /> The cost of performing ART per live birth varies among countries.<ref>Chambers, Georgina M.; Sullivan, Elizabeth A.; Ishihara, Osamu; Chapman, Michael G.; Adamson, G. David (June 2009). "The economic impact of assisted reproductive technology: a review of selected developed countries". Fertility and Sterility. 91 (6): 2281–2294. doi:10.1016/j.fertnstert.2009.04.029. ISSN 0015-0282.</ref> The average cost per IVF cycle in the United States is USD 9,266.<ref>Peipert, Benjamin J.; Montoya, Melissa N.; Bedrick, Bronwyn S.; Seifer, David B.; Jain, Tarun (4 August 2022). "Impact of in vitro fertilization state mandates for third party insurance coverage in the United States: a review and critical assessment". Reproductive Biology and Endocrinology. 20 (1). doi:10.1186/s12958-022-00984-5. ISSN 1477-7827. PMC 9351254.</ref> However, the cost per live birth for autologous ART treatment cycles in the United States, Canada, and the United Kingdom ranged from approximately USD 33,000 to 41,000 compared to USD 24,000 to 25,000 in Scandinavia, Japan, and Australia<ref>Reindollar, Richard H.; Regan, Meredith M.; Neumann, Peter J.; Levine, Bat-Sheva; Thornton, Kim L.; Alper, Michael M.; Goldman, Marlene B. (August 2010). "A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial". Fertility and Sterility. 94 (3): 888–899. doi:10.1016/j.fertnstert.2009.04.022. ISSN 0015-0282.</ref>
The funding structure for IVF/ART is highly variable among different nations. For example, no federal government reimbursement exists for IVF in the United States, although certain states have insurance mandates for ART<ref>Mladovsky, Philipa; Sorenson, Corinna (3 April 2009). "Public Financing of IVF: A Review of Policy Rationales". Health Care Analysis. 18 (2): 113–128. doi:10.1007/s10728-009-0114-3. ISSN 1065-3058.</ref>
Many issues of reproductive technology have given rise to bioethical issues, since technology often alters the assumptions that lie behind existing systems of sexual and reproductive morality. Other ethical considerations arise with the application of ART to women of advanced maternal age, who have higher changes of medical complications (including pre-eclampsia), and possibly in the future its application to post-menopausal women.<ref>Harrison BJ, Hilton TN, Rivière RN, Ferraro ZM, Deonandan R, Walker MC (16 August 2017). "Advanced maternal age: ethical and medical considerations for assisted reproductive technology". International Journal of Women's Health. 9: 561–570. doi:10.2147/IJWH.S139578. PMC 5566409. PMID 28860865.</ref><ref>Lung FW, Chiang TL, Lin SJ, Lee MC, Shu BC (April 2018). "Assisted reproductive technology has no association with autism spectrum disorders: The Taiwan Birth Cohort Study". Autism. 22 (3): 377–384. doi:10.1177/1362361317690492. PMID 29153004. S2CID 4921280.</ref><ref>Adashi EY, Rock JA, Rosenwaks Z (1996). Reproductive endocrinology, surgery, and technology. Philadelphia: Lippincott-Raven. pp. 1394–1410.</ref> Also, ethical issues of human enhancement arise when reproductive technology has evolved to be a potential technology for not only reproductively inhibited people but even for otherwise re-productively healthy people.<ref>Sunderam S, Kissin DM, Zhang Y, Folger SG, Boulet SL, Warner L, et al. (April 2019). "Assisted Reproductive Technology Surveillance - United States, 2016". MMWR. Surveillance Summaries. 68 (4): 1–23. doi:10.15585/mmwr.ss6804a1. PMC 6493873. PMID 31022165.</ref>
In fiction
- Films and other fiction depicting contemporary emotional struggles of assisted reproductive technology have had an upswing first in the latter part of the 2000s decade, although the techniques have been available for decades.<ref name="chicagotribune">Mastony C (21 June 2009). "Heartache of infertility shared on stage, screen". Chicago Tribune.</ref>
- Science fiction has tackled the themes of creating life through non-conventional methods since Mary Shelley's Frankenstein. In the 20th century, Aldous Huxley's Brave New World (1932) was the first major fictional work to anticipate the possible social consequences of reproductive technology. Its largely negative view was reversed when the author revisited the same themes in his utopian final novel, Island (1962).
