Intracytoplasmic sperm injection 30 years on: too much of a good thing?

Intracytoplasmic sperm injection (ICSI) was introduced for male infertility but is now used in many other techniques in assisted reproduction. Indications for ICSI use need to be re-evaluated to ensure appropriate application in infertility management.

The African American experience in reproductive medicine: provider, patient, and pipeline perspectives.

The goal of this Views and Reviews is to let colleagues and leaders well versed in the African American experience in reproductive medicine address the problems of racism affecting our trainees and patients and, more significantly, propose solutions. The areas in reproductive medicine that will be explored from the African American perspective include the pipeline of providers, health disparities, and access to infertility treatment.

What can be learned from the Chinese experience in response to infertility.

OBJECTIVES: The aims of the study were to reviews the history of China's population policy since 2011, and draw lessons from the Chinese experience in response to infertility. METHODS: Data from the Chinese infertility status survey report (2009) and national statistical yearbooks (2009-2019) are used to assess the severity of infertility and reproductive centers shortage in China. Lessons from China was informed by a review of existing literature. RESULTS: The proportion of couples suffering from infertility in China increased to 12.5% (166.8 million in 2009) from just 6.89% (86.6 million in 1988) two decades earlier, while the number of reproductive centers was one for every 3.1 million citizens. The total costs per live birth for medically assisted reproduction in Chinese public fertility clinics was 30,000 yuan in 2012. Among infertile couples, unemployed patients accounted for the largest proportion (21.9% in 2014). Currently in China, health regulations permit oocyte donation only from infertility patients who have 20 or more mature oocytes, of which at least 15 must be kept for their own treatment. CONCLUSION: It is necessary to integrate the reproductive health care of infertile people into the national public health service. In addition to relieving their economic burden, national policies should guide and support enterprises to guarantee employee medical leave for infertility. Growing numbers of bereaved older women who have lost their only child make it imperative to reconsider liberalizing the regulation of oocyte donation in China.

Ex ovo omnia? A letter to members of The Ovum Club on the 50th anniversary of the beginning of IVF.

This writing presents personal reflections on issues raised by the recent publication of texts concerning the developing story of infertility treatment since the delivery of Louise Brown in 1978. It is written by a woman whose own natural conception coincided with the commencement of Steptoe and Edwards's collaboration, and who herself received, as an adult, a treatment to which their work gave rise. It addresses itself to the as yet mostly anonymous and silent female subjects-the self-styled 'Ovum Club'-without whose involvement in the original research programme in Oldham in 1969-1978 Louise would never have been born, to be followed by millions of in vitro fertilisation (IVF) babies worldwide. It ponders a few of the characteristics of the celebratory narratives of the development of IVF as have so far been told and draws attention to some of the paradoxes, inconsistencies, misunderstandings and confusions apparent in texts which have played a crucial role in shaping public awareness of this branch of medical science for 50 years. In conclusion, it points out that without hearing a range of voices of those women involved in the original experimental research who mostly lost more than they gained, a more compassionate historiography, and a balanced and comprehensive History of this branch of medicine will never be attained.

Infertility and surrogacy first mentioned on a 4000-year-old Assyrian clay tablet of marriage contract in Turkey.

Mankind has been expressing the breeding topic for thousands of years. Reproduction is the primary instinct of human beings and it is a social, cultural, medical issue. Demographic infertility is one of them, which is defined infertility as the inability to become pregnant with a live birth, within five years of regular sexual contact based upon a consistent union status in marriage maintaining a desire for a child with the lack of contraceptive use and non-lactating. A first mentions about infertility and surrogacy is discovered on a 4000-year-old clay tablet of marriage contract belonging to the Assyrian period exhibited at Istanbul Archeology Museum in Turkey. In conclusion, there are many different ways to solve infertility problems like surrogacy as mentioned even 4000 years ago in this Assyrian clay tablet of marriage contract as the first time in the literature. Medical treatments in relation to human infertility will continue to be the focus of social and cultural debates. Hence, more legislation and regulation will come in many countries to control the unauthorized exploitation of the patient.

Race, Remarital Status, and Infertility in 1910: More Evidence of Multiple Causes.

The dominant approach to studying historical race-related fertility differences has been to limit samples to first-married and younger women. We argue that studying historical race-related fertility differences in the context of remarriage is also important: remarriage and fertility patterns are both rooted in the biosocial conditions that produce racial disparities in health. We employ a multiple causes framework that attributes variation in fertility patterns to voluntary limitation and involuntary factors (infecundity/subfecundity). We use data from the 1910 Integrated Public Use Microdata Series and estimate zero-inflated negative binomial models that simultaneously distinguish those who are infecund (vs. fecund) and estimate the number of remarital births among the fecund. Our approach allows us to evaluate historical remarital (in)fertility differences, accounting for marital, socioeconomic, and geographic influences on fecundity and fertility, while empirically accounting for the influence of children "missing" from the household due to mortality and fostering/aging out. Consistent with past studies that emphasized poorer African American health as a major influence on involuntary infertility, we find that African American women were more likely than white women to be in the always-zero (infecund) group and to have fewer remarital births. Supplemental analyses nuance these findings but indicate that these results are robust. Overall, we find support for a multiple-causes perspective: while the findings are consistent with the adoption of deliberate fertility control among urban and higher-status women at higher parities, remarital fertility differences in 1910 also reflected greater infecundity/subfecundity among subgroups of women, especially African American women.

Aristóteles y la medicina / Aristotle and the medicine

En su estado actual el Corpus Aristotelicum no contiene ningún tratado dedicado a la medicina, siendo esto causa suficiente como para que muchos estudiosos hayan dado por hecho que Aristóteles nunca la tomó como objeto de estudio. Otros, empero, pretenden justamente dar pruebas de que Aristóteles sí se interesó por el arte médico, que lo estudió y que es muy plausible que escribiera sobre medicina. Para ello traen a colación razones de diversa índole, aunque básicamente serán dos los argumentos en los que harán hincapié. El primero engloba las analogías médicas que Aristóteles utiliza en sus tratados, y el segundo recurre a las menciones a determinados libros de contenido médico a lo largo del Corpus Aristotelicum. A partir de un examen crítico de ambos argumentos este artículo pretende arrojar algo más de luz sobre el asunto a partir de los contenidos del papiro Anónimo de Londres (AU)

None of the treatises in the Corpus Aristotelicum is directly concerned to medicine, this leading the majority of scholars to contend that Aristotle did not paid attention to that discipline. But, in other way, there is who argues that Aristotle should have necessarily been acquainted with the principles of the medical art, so that it is very likely that Aristotle enquired on medicine. Almost two different reasons are adduced in this sense: the oft-repeated use of medical analogies in Aristotle’s opera, and the allusions to some medical writings by Aristotle himself. In giving a critical description and assessment of both arguments, this paper also aims at clarifying the issue by bringing up into discussion the contents in the Anonymus Londiniensis papyrus (AU)

Ovarian hyperstimulation: past, present, and future.

The good physician treats the disease; the great physician treats the patient who has the disease. -William Osler.

Social Perception of Infertility and Its Treatment in Late Medieval Italy: Margherita Datini, an Italian Merchant's Wife.

Because the perception of infertility in medieval Europe ranged from the extremely religious view of it as a malediction of God or the devil's work, to the reasonable medical conception of it as a sort of disease to treat, it is very difficult to determine the general attitudes of ordinary people towards infertility. This article seeks to elucidate the common social perception of infertility and its treatment in late medieval Europe by analyzing the case of Margherita Datini, an Italian merchant's wife who lived in the 1400s. It relies heavily on the documents left by her and her husband, Francesco Datini; the couple left many records, including letters of correspondence between them. Margherita and those around her regarded infertility not as the devil's curse or a punishment by God but as a disease that can be cured. Margherita and her husband, Francesco, tried hard to cure their infertility. They received treatment and prescriptions from several doctors while also relying on folk remedies, religious therapies, and even magical remedies. The comparative analysis of Datini documents, medical books, and theoretical treatises or prescriptive essays by clerics suggests that the general perception of infertility in medieval Europe was located between the extremely religious and modern medical conceptions of it.

DEVELOPMENT AND ACHIEVEMENTS OF ASSISTED REPRODUCTIVE TECHNOLOGY.

History of marital infertility is as long as history of human :ivilization. Becoming aware about the importance of procreation, as well as the problems with which people may confront, has been the subject of interest since the moment of the first human community creation. Historically, each stage of social development, hence the development of science, has carried within itself certain findings more or less acceptable from today's point of view. The development of human awareness and acquisition of findings based on empirical evidence have contributed to understanding and solution of the problem which was considered to be a result of force majeure until that moment and therefore could not be influenced. This paper deals with the previously mentioned issues through the review of historical development of assisted reproductive technology and its importance. The authors' intention was to present the developmental road of assisted reproductive technology through history succinctly with a special emphasis on the moments which have been of the crucial importance and which have marked certain stages of its development.

The invention of infertility in the classical Greek world: medicine, divinity, and gender.

The article examines the understandings of, and responses to, reproductive failure in the classical Greek world. It discusses explanations and treatments for non-procreation in a range of ancient Greek medical texts, focusing on the writings of the Hippocratic Corpus, which devote considerable energy to matters of fertility and generation, and places them alongside the availability of a divine approach to dealing with reproductive disruption, the possibility of asking various deities, including the specialist healing god Asclepius, for assistance in having children. Though the relations between these options are complex, they combine to produce a rich remedial array for those struggling with childlessness, the possibility that any impediment to procreation can be removed. Classical Greece, rather than the nineteenth century, or even 1978, is thus the time when "infertility," understood as an essentially reversible somatic state, was invented.

Contrasting selected reproductive challenges of today with those of antiquity--the past is prologue.

Viewing human history through a medical lens provides a renewed appreciation for today's vexing reproductive challenges, as some modern dilemmas are actually continuations of similar challenges experienced long ago. Certainly there are many examples of assisted fertility therapy that were entirely theoretical only a generation ago, but have become commonplace in modern practice and society. In particular posthumous birth and infertility have, over time, been the focus of compelling social interest, occasionally even impacting national security and dynastic succession. While the concepts have remained static, the tools available to extend and improve reproductive success have changed radically. Appropriately regarded as confidential and private, an individual's reproductive details are typically impervious to formal study. Yet, archival sources including ancient literature and formal court records can occasionally provide evidence of otherwise deeply personal concerns of a different era. Our assessment finds the issues, worries, and desires of patients of antiquity to align closely with contemporary reproductive challenges. Because children and family have always been central to the human experience, the consequences of reproduction (or the lack thereof) can make substantial imprints upon the cultural, economic, and political landscape-irrespective of civilization or century. In this article, selected motifs are described in a broad historical context to illustrate how challenges of human reproduction have remained essentially unchanged, despite a vast accumulation of knowledge made possible by gains in reproductive science and technology. Plus ça change, plus c'est la même chose. -Jean-Baptiste Alphonse Karr (1808-1890).