Ethical and legal dilemmas in infertility treatment

One of the main characteristics of the new millennium is the affirmation of human rights in all aspects of human existence, with the intention of turning declarative statements into reality. Development of up-to-date assisted reproductive technologies (ART) and their application in infertility treatment have raised numerous ethical, legal, religious, social and other questions. In vitro fertilization, donation of gametes, embryos and pre-embryos, cryopreservation of gametes, embryos, ovarian and testicular tissues, embryo transfer, genetic reproductive techniques, cloning and other sophisticated methods used in infertility treatment require cooperation between the medical and legal professions. Ethical aspects of human reproduction and assisted fertilization are based on full respect of the life of an individual even before conception, from pre-embryo stage, via embryo stage and fetus stage to a newborn infant. Regarding investigative and clinical projects, this standpoint implies the legalization of all ART procedures, unencumbered exchange of information and consensus about their application, and adherence to the basic ethical principles of autonomy benefit, justice and common welfare. Ethical postulates provide unequivocal directions in the creation of new life and resolve all possible ethical dilemmas, protecting the rights of doctors and participant in relevant procedures alike and reasserting the crucial principle - respect of human dignity

Therapy choice - Therapy possibility in PCOS infertility patients

BackgroundPolycystic ovarian syndrome (PCOS) constitutes the most common endocrinopathy of women of reproductive age. Infertility due to the PCOS is a complex and specific condition but the majority of the problem is the ovulatory dysfunction.AimsEvaluation of the therapy choice and reproductive therapy possibilities in PCOS infertility patients. Make it easier for clinicians.Methods Clinical experience based on review of the literature.Results The syndromes heterogeneity is reflected in the different response to the various ovulation inducting drugs. Management of anovulatory infertility associated with PCOS is based on the overall clinical picture. Lifestyle change programs, weight reduction diet and exercise, have been shown to be very effective in improving reproductive as well as metabolic characteristics of overweight and obese patients with PCOS. In women with anovulatory infertility, the first line of treatment for induction of ovulation is clomiphene citrate. Aromatase inhibitors have been suggested as an alternative treatment to clomiphene therapy. Gonadotropin treatment is effective, but there is a risk of ovarian hyperstimulation syndrome. Surgery, such as laparoscopic ovarian drilling should be considered in some patients. Reconsider a use of metformin and supplements.ConclusionUnderstanding specific features and metabolic implications of different PCOS patients, may guide us to treat individuals optimally, as well as to develop effective prevention strategies to reduce the risk of long term complications- consequences and improve reproductive outcomes. Individual treatment modalities in PCOS patients are imperative for successful therapy

Fetus Sound Stimulation: Cilia Memristor Effect of Signal Transduction

Background. This experimental study evaluates fetal middle cerebral artery (MCA) circulation after the defined prenatal acoustical stimulation (PAS) and the role of cilia in hearing and memory and could explain signal transduction and memory according to cilia optical-acoustical properties. Methods. PAS was performed twice on 119 no-risk term pregnancies. We analyzed fetal MCA circulation before, after first and second PAS. Results. Analysis of the Pulsatility index basic (PIB) and before PAS and Pulsatility index reactive after the first PAS (PIR 1) shows high statistical difference, representing high influence on the brain circulation. Analysis of PIB and Pulsatility index reactive after the second PAS (PIR 2) shows no statistical difference. Cilia as nanoscale structure possess magnetic flux linkage that depends on the amount of charge that has passed between two-terminal variable resistors of cilia. Microtubule resistance, as a function of the current through and voltage across the structure, leads to appearance of cilia memory with the “memristor” property. Conclusion. Acoustical and optical cilia properties play crucial role in hearing and memory processes. We suggest that fetuses are getting used to sound, developing a kind of memory patterns, considering acoustical and electromagnetically waves and involving cilia and microtubules and try to explain signal transduction

Microsatellite variation of ESR1, ESR2, and AR in Serbian women with primary ovarian insufficiency

OBJECTIVE: This study aimed to investigate the potential role of microsatellite polymorphisms of the estrogen receptor alpha gene (ESR1) TA repeat, estrogen receptor beta gene (ESR2) CA repeat, and androgen receptor gene (AR) CAG and GGN repeats among Serbian women with primary ovarian insufficiency (POI). These microsatellites have been reported to be associated with POI in different racial/ethnic populations. METHODS: A cohort of 196 POI cases matched with 544 fertile controls was recruited by the Institute for Endocrinology, Diabetes and Metabolic Disorders of Serbia between 2007 and 2010. DNA was extracted from saliva. The four microsatellites were genotyped using a PCR-based assay to determine the repeat lengths. RESULTS: POI patients carried shorter repeat lengths of ESR2 (CA)n than controls (P = 0.034), but the difference was small. ESR1 (TA)n was on the borderline of statistical differences between groups (P = 0.059). AR (CAG)n and (GGN)n showed no association with POI. CONCLUSIONS: We cautiously conclude that microsatellite polymorphisms of gonadal steroid receptor genes might contribute to the genetic basis of POI in Serbian women, but a larger-scale study and family-based studies are warranted to validate our findings even though the sample size in this study is larger than any previously published in this field