Reimagining autonomy in reproductive medicine

"Do the reproductive choices of prospective parents truly align with their values and priorities? How do doctors, reproductive technologies, and the law influence those choices? And why should certain women receive medical assistance to establish a pregnancy, while others are put in jail when they miscarry? A new Hastings Center special report, Just Reproduction: Reimagining Autonomy in Reproductive Medicine, considers these and related questions. It is a supplement to the Hastings Center Report, November-December 2017.

The report originated from presentations given at the Center for Bioethics at Harvard Medical School's 2017 conference entitled "The Ethics of 'Making Babies.'" Editors of the report are Louse P. King, assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School and the director of reproductive bioethics at its Center for Bioethics; Rachel L. Zacharias, project manager and research assistant at The Hastings Center; and Josephine Johnston, The Hastings Center's director of research.

"In today's dialogue about reproduction, medicine, and ethics in the United States, old ethical issues -- such as whether women ought to be allowed to access pregnancy termination -- are more contested than they have been in decades, while new technologies -- like those used to edit the genes of human embryos -- suggest that our species could face unprecedented questions about who should exist," states the introduction. In addition, there are socioeconomic and geographic disparities in access to assisted reproduction technologies, as well as in the enforcement of laws that affect reproduction..."

Learn More:

https://www.sciencedaily.com/releases/2017/11/171127173222.htm

 

Novel tool helps women answer the question: "How many eggs should I freeze?"

via smartfertilitychoices.com

"The American Society for Reproductive Medicine lifted the experimental status for egg freezing in October 2012, and since then the popularity of elective egg freezing has been on the rise. Although primarily intended for women whose fertility may be in jeopardy due to treatment for cancer or other illnesses, egg freezing has become an attractive option for women who are electively delaying childbearing for a variety of reasons. But, because this option is relatively new, and the majority of women who have frozen their eggs have not yet returned to use them, the likelihood of a frozen egg resulting in a healthy baby is largely unknown.

Furthermore, freezing eggs can be costly. While some of the largest tech companies have offered egg-freezing as a benefit, the majority of women face out-of-pocket costs that climb upward of $6,000, excluding medications, for one egg-freezing cycle that, depending on personal characteristics, results in a variable number of eggs suitable for freezing. Also not known: how many frozen eggs are necessary to have a child in the future? What if the woman would like to have more than one child? These questions often leave a woman unsure of whether she should repeat a cycle in order to store more eggs and potentially increase her future chances of having a baby.

To address these issues, researchers led by Janis H. Fox, MD, an attending reproductive endocrinologist in the Center for Infertility and Reproductive Surgery at Brigham and Women's Hospital, have developed a novel, personalized model to guide the conversation between a woman and her physician."We wanted to create a tool that is evidence-based in order to provide the best possible guidance for our patients, who are making big decisions about their lives, their families, and their finances," said Fox, who is also an assistant professor at Harvard Medical School and senior author of the paper describing this new model, published in Human Reproduction on February 6, 2017..."

Learn more:

https://www.sciencedaily.com/releases/2017/02/170207142731.htm

Diagnostic Tests of Reproductive Medicine

Diagnostic Tests of Reproductive Medicine | WOMEN'S TESTS

"...Because the woman’s reproductive system is more complicated and more peculiar many more tests have been developed for her. The regular tests such as testing of hormones and all microbiology markers should be tested in case of infections.

However, the most important part offered by our international labs is the specific immune tests that account for more than 80% for reproductive issues.

Female diagnostic for ovary reserve and quality: inhibin B and AMH : INHIBIN B

Inhibin-B serum concentration provides a new measure of ovarian reserve. Ovarian reserve describes the ovary’s capacity to respond to gonadotropin stimulation by producing a sufficient number of good quality eggs capable of generating normal embryos. Granulosa cells of the ovarian follicle secrete Inhibin-B..."

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