-
Journal of Reproductive Immunology Jun 2024This comprehensive review examines the multifaceted landscape of surrogacy, a revolutionary treatment for infertility. The study examines historical origins, shifting... (Review)
Review
This comprehensive review examines the multifaceted landscape of surrogacy, a revolutionary treatment for infertility. The study examines historical origins, shifting trends, medical considerations, psychological implications, legal complexities, international variations, and ethical dilemmas surrounding surrogacy. With the advent of assisted reproductive technology, gestational surrogacy allows intended parents a genetic connection to their child. Medical facets encompass indications for gestational surrogacy, drawing attention to maternal health risks and infertility factors. Evidence indicates that medical outcomes are comparable to conventional pregnancies, suggesting a viable reproductive solution for intended parents. Due to the complex nature of surrogacy psychological and emotional vulnerability is inevitable; yet studies underscore positive psychological well-being and satisfaction among gestational carriers (GCs), intended parents (IPs) and children. Surrogacy also has many religious dimensions, as each religion has its own perspective on the distinctive process of creating life and its outcomes, such as, the determination of the child's mother according to their beliefs. Legal considerations emerge as a fundamental aspect, with differing regulations globally. The review emphasizes the significance of comprehensive agreements to safeguard the rights and responsibilities of surrogates and IPs. The unique surrogacy laws in Israel serve as a noteworthy example, reflecting a progressive approach that provides a promising template to establish crucial international guidelines on surrogacy. The absence of international consensus necessitates attention from the global community to address key concerns, including the well-being of GCs, legal recognition for IPs, and the child's best interests, with the goal of establishing a universal standard of care in the field.
Topics: Humans; Surrogate Mothers; Female; Pregnancy; Reproductive Techniques, Assisted; Infertility; Parents; Israel
PubMed: 38669789
DOI: 10.1016/j.jri.2024.104247 -
Ciencia & Saude Coletiva Apr 2024Comprehensive access to medically assisted reproduction procedures and techniques in Argentina has been assured by National Law No. 26,862 since 2013. This Law does not...
Comprehensive access to medically assisted reproduction procedures and techniques in Argentina has been assured by National Law No. 26,862 since 2013. This Law does not include surrogacy procedures, and the lack of specific regulation shifts practices to a paralegal setting. In this context, planned parenthood by male couples through surrogacy is performed through actions that convey demands for access rights and active State policies. For these couples, the argument is that surrogacy is the only option to have a child with a genetic bond with at least one of the two parents and recognize both filiatory bonds. This work results from field work in progress with parents from the Province of Buenos Aires running this practice in Argentina. Based on in-depth interviews, we attempted to rebuild personal experiences and analyze the meanings that the narratives construct regarding their parenting, the biological connections in establishing or defining family relationships, and the importance of genetics in constructing and maintaining affiliations.
Topics: Argentina; Surrogate Mothers; Humans; Male; Female; Reproductive Techniques, Assisted; Parenting; Parents; Interviews as Topic; Decision Making; Choice Behavior; Family Relations; Adult
PubMed: 38655962
DOI: 10.1590/1413-81232024294.19122023 -
Ciencia & Saude Coletiva Apr 2024Considered until recently unfit to rear children, non-heterosexual people have been excluded from forming families in most countries. Many, worldwide, demand access to...
Considered until recently unfit to rear children, non-heterosexual people have been excluded from forming families in most countries. Many, worldwide, demand access to family formation, claiming the same aptitudes as heterosexual people for raising children. However, when non-heterosexual singles and couples want to become parents in Spain, they must consider transnational contexts, resorting to inter-country adoption or surrogacy abroad, processes that contribute to delay their family formation. They must consider not only Spanish sociocultural conditions, but other countries' legal restrictions regarding parents' gender, social status, and sexual identity. These families experience great difficulty in gaining access to reproductive health services. Based on multi-site ethnographic fieldwork, this text addresses how, despite legislative changes allowing homoparental family formation in Spain, these parents must overcome complex bureaucratic processes when they decide to have children, while facing homophobic attitudes and policies in their quests to become parents.
Topics: Spain; Humans; Female; Male; Parents; Adoption; Surrogate Mothers; Health Services Accessibility; Parenting; Homosexuality
PubMed: 38655961
DOI: 10.1590/1413-81232024294.18662023 -
Ciencia & Saude Coletiva Apr 2024Surrogacy (GS) has been established as a means of access to male homoparenting and, despite not being regulated in Argentina, it is negotiated in a "paralegal" scenario....
Surrogacy (GS) has been established as a means of access to male homoparenting and, despite not being regulated in Argentina, it is negotiated in a "paralegal" scenario. For some time now, LGBT organizations have proposed regulation based on the argument that GS represents the only option available for a male homosexual couple to have a child with a genetic link, albeit with only one of them, and consecutively acknowledge the family ties of both. By means of ethnographic work carried out within the scope of a postgraduate research project, our objective is to ascertain the experiences of male homosexual couples who seek the legitimacy of GS processes and equal access to the healthcare system. With this in mind, we seek a reflection that articulates the construction of public health policies and the claims of sectors of the LGBT movement, focusing on the meanings of the collective experience, on the ways in which these actors organize their family demands, and on the conceptions and practices that articulate these claims with the production of public policies.
Topics: Argentina; Humans; Male; Sexual and Gender Minorities; Surrogate Mothers; Health Services Accessibility; Female; Homosexuality, Male; Public Policy; Health Policy; Pregnancy
PubMed: 38655953
DOI: 10.1590/1413-81232024294.15192023 -
Annals of Emergency Medicine Jun 2024The emergency department clinical environment is unique, and guidelines for promoting supportive and equitable workplace cultures ensure success and longevity for...
The emergency department clinical environment is unique, and guidelines for promoting supportive and equitable workplace cultures ensure success and longevity for pregnant persons and parents in emergency medicine. There is paucity, variability, and dissatisfaction with current parental (historically referred to as maternity and paternity) leave policies. This paper describes the development of consensus-derived recommendations to serve as a framework for emergency departments across the country for incorporating family-friendly policies. Policies that foster a family-inclusive workplace by allowing for professional advancement without sacrificing personal values regardless of sex, gender, and gender identity are critical for emergency medicine recruitment and retention.
Topics: Humans; Parental Leave; Female; Emergency Medicine; Pregnancy; Adoption; Lactation; Consensus; Surrogate Mothers; Emergency Service, Hospital; Physicians; Organizational Policy; Male
PubMed: 38639673
DOI: 10.1016/j.annemergmed.2024.03.005 -
Human Reproduction (Oxford, England) Jun 2024Does BMI of gestational carriers (GCs) affect perinatal outcomes after embryo transfer?
STUDY QUESTION
Does BMI of gestational carriers (GCs) affect perinatal outcomes after embryo transfer?
SUMMARY ANSWER
Overweight and class I obesity in GCs does not affect the rate of good perinatal outcomes.
WHAT IS KNOWN ALREADY
The use of GCs is increasing, but uniform guidance regarding optimal BMI for GCs is lacking. Women with obesity who conceive without fertility treatment or through autologous or donor in vitro fertilization are at higher risk of adverse maternal and fetal outcomes, but data on obesity in GCs are very limited.
STUDY DESIGN, SIZE, DURATION
We performed a retrospective cohort study of 1121 GC cycles from January 2015 to December 2020 at US Fertility, the largest national partnership of fertility practices in the USA.
PARTICIPANTS/MATERIALS, SETTING, AND METHODS
All GC cycles performed at a large network of fertility practices were reviewed. Same-sex partners undergoing co-IVF were excluded. The primary outcome was good perinatal outcome from the first embryo transfer, defined as a singleton live birth at ≥37 weeks of gestation with birth weight between 2500 and 4000 g. Secondary outcome measures included frequencies of live birth, clinical pregnancy, miscarriage, full-term birth, low birth weight, large for gestational age, and cesarean delivery. A generalized linear model (log-binomial) was used for each to compare outcomes across BMI groups using normal BMI (20-24.9 kg/m2) as the reference group. Risk ratios and 95% CIs were estimated for each category group relative to normal BMI.
MAIN RESULTS AND THE ROLE OF CHANCE
We identified 1121 cycles in which GCs underwent first embryo transfer, of which 263 (23.5%) were in GCs with BMI >30. Demographics and reproductive history for GCs did not differ by BMI groups. The age of intended parents, use of frozen eggs, and fresh embryo transfers were higher with increasing BMI group. There were no statistically significant associations between BMI and good perinatal outcomes, live birth, clinical pregnancy, biochemical, spontaneous abortion, or low birth weight. However, among live births, higher BMI was significantly associated with birth by cesarean (P = 0.015) and large for gestational age infants (P = 0.023).
LIMITATIONS, REASONS FOR CAUTION
This was a retrospective study, and there may be unmeasured confounders. The number of patients with BMI <20 or ≥35 was small, limiting the power for these groups. We were not able to assess all maternal and fetal outcomes.
WIDER IMPLICATIONS OF THE FINDINGS
In this study, we did not identify any significant impact of BMI on the chances of having a good perinatal outcome. Prior research studies have been inconsistent and this is the largest study to date.
STUDY FUNDING/COMPETING INTEREST(S)
No external funding was received for this work. The authors do not have any conflicts of interest to declare.
TRIAL REGISTRATION NUMBER
N/A.
Topics: Humans; Female; Pregnancy; Retrospective Studies; Adult; Body Mass Index; Embryo Transfer; Pregnancy Outcome; Obesity; Surrogate Mothers; Infant, Newborn; Live Birth; Fertilization in Vitro; Cesarean Section; Pregnancy Complications
PubMed: 38636947
DOI: 10.1093/humrep/deae079 -
Journal of Developmental and Behavioral...Motor planning is the cognitive process of planning necessary steps for achieving a purposeful movement and is specifically reflected through object manipulation. This...
OBJECTIVES
Motor planning is the cognitive process of planning necessary steps for achieving a purposeful movement and is specifically reflected through object manipulation. This study aimed to investigate whether fine motor skills, a surrogate of the motor planning ability of object manipulation, in early childhood are associated with later social skills, in a general-population birth cohort.
METHODS
A total of 913 children, participating in the Hamamatsu Birth Cohort for Mothers and Children, were enrolled. Social skills were measured using the Vineland Adaptive Behavior Scales-II, Socialization domain, at age 6 years. Fine motor skills were measured using the Mullen Scales of Early Learning at 14, 24, and 32 months. The associations between fine motor skills at ages 14, 24, and 32 months and social skills at age 6 years were tested separately through multivariable linear regression after adjusting for covariates, including gross motor and language skills at the contemporaneous age, autistic symptoms at age 6 years, and demographic factors.
RESULTS
Fine motor skills at 24 and 32 months were significantly associated with social skills at age 6 years (at 24 months: nonstandardized regression coefficient = 1.38 [95% CI, 0.50-2.26], p = 0.002; at 32 months: 1.47 [0.56-2.38], p = 0.001).
CONCLUSION
Fine motor skills in early childhood predicted social skills at age 6 years, indicating an association between the complex motor planning ability of object manipulation and later social skills. Children who demonstrate fine motor delay at as early an age as 2 years should be closely monitored by child professionals.
Topics: Child, Preschool; Child; Female; Humans; Motor Skills; Social Skills; Cognition; Learning; Mothers
PubMed: 38619153
DOI: 10.1097/DBP.0000000000001258 -
Diagnostics (Basel, Switzerland) Apr 2024Cystic fibrosis (CF) is a chronic and potentially life-threatening condition, wherein timely diagnosis assumes paramount significance for the prompt initiation of... (Review)
Review
Cystic fibrosis (CF) is a chronic and potentially life-threatening condition, wherein timely diagnosis assumes paramount significance for the prompt initiation of therapeutic interventions, thereby ameliorating pulmonary function, addressing nutritional deficits, averting complications, mitigating morbidity, and ultimately enhancing the quality of life and extending longevity. This review aims to amalgamate existing knowledge to provide a comprehensive appraisal of contemporary diagnostic modalities pertinent to CF in the 21st century. Deliberations encompass discrete delineations of each diagnostic modality and the elucidation of potential diagnostic quandaries encountered in select instances, as well as the delineation of genotype-phenotype correlations germane to genetic counseling endeavors. The synthesis underscores that, notwithstanding the availability and strides in diagnostic methodologies, including genetic assays, the sweat test (ST) retains its position as the preeminent diagnostic standard for CF, serving as a robust surrogate for CFTR functionality. Prospective clinical investigations in the realm of CF should be orchestrated with the objective of discerning novel diagnostic modalities endowed with heightened specificity and sensitivity.
PubMed: 38611676
DOI: 10.3390/diagnostics14070763 -
World Journal of Experimental Medicine Mar 2024Gestational diabetes is typically diagnosed in the late second or third trimester of pregnancy. It is one of the most common metabolic disorders among expectant mothers,... (Review)
Review
Gestational diabetes is typically diagnosed in the late second or third trimester of pregnancy. It is one of the most common metabolic disorders among expectant mothers, with potential serious short- and long-term complications for both maternal and offspring health. C-peptide is secreted from pancreatic beta-cells into circulation in equimolar amounts with insulin. It is a useful biomarker to estimate the beta-cell function because it undergoes negligible hepatic clearance and consequently it has a longer half-life compared to insulin. Pregnancy induces increased insulin resistance due to physiological changes in hormonal and metabolic homeostasis. Inadequate compensation by islet beta-cells results in hyperglycemia. The standard oral glucose tolerance test at 24-28 wk of gestation sets the diagnosis. Accumulated evidence from prospective studies indicates a link between early pregnancy C-peptide levels and the risk of subsequent gestational diabetes. Elevated C-peptide levels and surrogate glycemic indices at the beginning of pregnancy could prompt appropriate strategies for secondary prevention.
PubMed: 38590302
DOI: 10.5493/wjem.v14.i1.89320 -
Asian Bioethics Review Apr 2024This paper provides an analysis of the complex global reproduction networks driving the rapidly expanding cross-border surrogacy industry in Asia's reproductive...
This paper provides an analysis of the complex global reproduction networks driving the rapidly expanding cross-border surrogacy industry in Asia's reproductive bioeconomy. It sheds light on the unique features of informal surrogacy networks, notable for their flexible business ties and non-standardized surrogate mother recruitment. These factors contribute to heightened vulnerability for surrogate mothers operating within these networks. While previous literature has underscored the merits of labor law in regulating the surrogacy industry, its application in informal cross-border surrogacy remains under-examined. To address this gap, this research delves into innovative labor law strategies with potential to better regulate the surrogacy sector. Drawing inspiration from progressive labor regulations and supply chain strategies in Bulgaria and Australia, the proposed model aims to redefine the traditional employment relationship. This shift is aimed at bolstering protection for surrogate mothers and enforcing accountability throughout the surrogacy business network. The model further advocates for a collective framework that fosters collaboration and mandates the documentation and registration of surrogacy contracts. Moreover, it underscores the critical significance of international collaboration in bridging regulatory gaps and distributing accountability across consumer and supply states.
PubMed: 38586575
DOI: 10.1007/s41649-023-00262-5