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 Table of Contents  
EDITORIAL
Year : 2017  |  Volume : 4  |  Issue : 1  |  Page : 1-7

Dilemmas in ART – Looking for solutions


Editor-in-Chief, Fertility Science and Research, 23-24, Gagan Vihar, Main Road (Near Karkardooma Flyover), Delhi, India

Date of Web Publication16-Mar-2018

Correspondence Address:
Kuldeep Jain
Editor-in-Chief, Fertility Science and Research, 23-24, Gagan Vihar, Main Road (Near Karkardooma Flyover), Delhi 110051
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/fsr.fsr_5_18

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How to cite this article:
Jain K. Dilemmas in ART – Looking for solutions. Fertil Sci Res 2017;4:1-7

How to cite this URL:
Jain K. Dilemmas in ART – Looking for solutions. Fertil Sci Res [serial online] 2017 [cited 2018 Apr 23];4:1-7. Available from: http://www.fertilityscienceresearch.org/text.asp?2017/4/1/1/227780

Though the assisted reproductive technology (ART) has given hope to a large number of couples suffering from infertility, it has also hosted innumerable technical, ethical, legal, and social challenges for the future.

Advancements in the field have resulted in a landmark shift in the way physicians and the general population perceive infertility and related issues. The reproductive science is unswervingly challenging the society to re-evaluate the way in which human life, social justice, and claims to resulting genetic offspring are viewed. These issues will challenge the technology and legal organizations to modify existing laws to accommodate its unique situations.

We also need to devote resources and energies to identify and remove the environmental and physical causes of infertility. Prevention, education, and increased access to appropriate and cost-effective fertility care, including insurance coverage, are also imperative so that more families throughout the world are able to have children when they are ready safely.


  HISTORY AND EVOLUTION OF IN-VITRO FERTILIZATION GLOBALLY Top


The beginning

The history of in-vitro fertilization (IVF) and embryo transfer (ET) dates back as early as the 1890s when Walter Heape, a professor, and physician at the University of Cambridge, England, who had been conducting research on reproduction in a number of animal species, reported the first known case of embryo transplantation in rabbits, long before the applications to human fertility were even suggested.

In 1934, Pincus and Enzmann,[1] from the Laboratory of General Physiology at Harvard University, published a paper in the Proceedings of the National Academy of Sciences of the USA, raising the possibility that mammalian eggs can undergo normal development in vitro. Fourteen years later, in 1948, Miriam Menken and John Rock[2] retrieved more than 800 oocytes from women during operations for various conditions. One hundred and thirty-eight of these oocytes were exposed to spermatozoa in vitro. In 1948, they published their experiences in the American Journal of Obstetrics and Gynaecology.

However, it was not until 1959 that the indisputable evidence of IVF was obtained by Chang[3] who was the first to achieve births in a mammal (a rabbit) by IVF. The newly ovulated eggs were fertilized, in vitro by incubation with capacitated sperm in a small Carrel flask for 4 h, thus opening the way to assisted procreation.

Professionals in the fields of microscopy, embryology, and anatomy laid the foundations for future achievements. The recent rapid growth of IVF–ET and related techniques worldwide are further supported by the social and scientific climate which favors their continuation.

Through the years, numerous modifications have been made in the development of IVF–ET in humans: refinement of fertilization and embryo culture media; earlier transfer of the embryo; improvements in equipment; use of a reduced number of spermatozoa in the fertilization dish, embryo biopsy among others.

The purpose of this introduction is to acknowledge those who initiated new steps in the development of the treatment protocols and techniques that we now use facilitating such simple and promising IVF–ET procedures.



Evolving assisted reproductive technology in modern era

In 1978, the world witnessed the birth of the first “test tube baby.”[9] Since then, there have been explosive advances in ARTs. Current optimizations surrounding the delivery of IVF including the utilization of minimal stimulation protocols and gonadotropin-releasing hormone (GnRH) agonist cycle triggers are being increasingly utilized to maximize patient safety. Modifications, such as IVM and cryopreservation seen in the embryology laboratory, continue to improve pregnancy rates. Concurrent with these advancements in IVF has been the emergence of related technologies, such as embryonic genetic diagnostic and screening and oocyte freezing, which potentially has broad applications for both fertile and infertile couples. Another technology such as time-lapse imaging may be a powerful tool to select embryos best suited for uterine transfer in IVF cycles. As these relevant applications of ART become increasingly utilized, it is incumbent on the society to ensure that these resources are made available in a morally responsible and equitable manner.

Many aspects of clinical practice in ART raise challenging issues, controversies, and dilemmas for service providers:

(1) Surrogacy: Central concern surrounding the use of surrogates and gestational carriers is the possibility that financial pressures could lead to the exploitation and commercialization of the service.[91] Additionally, the rights of the surrogate or gestational carrier to not relinquish the infant after delivery are not well described.[92]

At present, issues surrounding the individual rights, exploitation, and citizenship of the resulting offspring of international gestational carriers are largely unresolved internationally.[93] The proposed Indian Surrogacy (Regulation) Bill, 2016, inter alia, provides) to allow ethical altruistic surrogacy to the intending infertile Indian married couple only between the age of 23–50 years and 26–55 years for female and male respectively; (c) the intending couples should be legally married for at least five years and should be Indian citizens to undertake surrogacy or surrogacy procedures and prohibits surrogacy for international patients and commercial surrogacy.[94]

One need to debate keeping the individual need of infertile couple who do not have an option other than surrogacy and do not have one in family, whether banning the commercial surrogacy is justified or it requires a regulation.

(2) Donor conception: It would be a challenging issue in coming decades. With growing information and technology, the clientele may not agree for donor cycles. Stimulation protocols and stem cells would play an important role.

(3) PGD: In the near future, with refinements in microarray technology and the definition of genetic sequences associated with certain physical characteristics, it is conceivable that specific physical or mental characteristics may be evaluated to guide the decision as to which embryos to transfer.[95]

(4) Cryofrozen embryos: Embryo freezing is a robust and routine part of the IVF process, and approximately 60% of patients end up with some embryos in storage. This process provides patients with a “back-up” in case the initial fresh ET does not result in a pregnancy and if patients come back after few years to have a second child. Cryofrozen embryos of patients with single child norms would flood our cryobiology laboratories with challenges in disposing them.

However, the legal issues of whether an unborn is entitled to any rights, and if so what they are, have appeared in several different areas of law and need to be resolved.[96]

(5) Fertility preservation: Fertility preservation for patients with cancer using IVM, oocyte Vitrification, and the freezing of intact human ovaries with their vascular pedicles have also been reported.[97] However, this technology at present, in many countries, is only available to those with financial means. This poses ethical and social issues that will certainly see more attention in the future.

(6) Deteriorating male factor: Deteriorating male factor is the reduction of normal sperm count, motility, and morphology, and this increase in the deterioration of male factor and fertility fecundity has been a concern for ages. Various lifestyle factors such as tobacco smoking, chewing, and alcohol use as well as exposure to toxic agents might be attributed to the risk of declining semen quality and increase in oxidative stress and sperm DNA damage.[98] To achieve an acceptable pregnancy rate in such cases, ISCI is the only option. This could be a big challenge in the countries which do not believe in sperm donation. Stem cell biology would play a major role in such cases.

(7) Posthumous use of gametes: Posthumous use of gametes occurs when the surviving partner of a person dying on a battlefield or due to other reasons wishes to obtain and use their gametes (sperm) to conceive a child to continue his lineage. It is not permitted in most of the countries. It is important to refer to the law in each state/territory, and/or National Health and Medical Research Council, to determine whether the removal and or use of gametes after a person dies is permissible, and if so the circumstances in which this may occur because posthumous use of gametes can pose legal issues such as legitimacy of child born, inheritance rights of a child, and lifelong psychosocial implications.[99]

(8) Legal issues: Because of the rapidly evolving nature of the ART, legislation is often unable to keep pace and address all of the ethical and legal issues that are constantly emerging in the field. It is therefore incumbent upon physicians to continually monitor these issues and ensure that ART technologies are offered and delivered in a manner that balances patient care with social and moral responsibility.


  Conclusion Top


ART as is a field that is dynamic and ever-changing. As technologies continue to proliferate, ethical and social challenges multiply, with complex questions of justice, rights, and conflicting principles continually rising. As an evolving society, we are long overdue to discuss these issues and to guard against leaving them solely in the province of researchers and reproductive medicine specialist.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Penicus G, Enzmann EV. Can mammalian eggs undergo normal development in vitro? Proc Natl Acad Sci USA 1934;20:121-2.  Back to cited text no. 1
    
2.
Menkin MF, Rock J. In vitro fertilization and cleavage of human ovarian eggs. Am J Obstet Gynecol 1948; 55: 440-52.  Back to cited text no. 2
    
3.
Chang MC. Fertilization of rabbit ova in vitro. Nature 1959; 184(Suppl 7):466.  Back to cited text no. 3
    
4.
Nezhat C. Nezhat’s History of Endoscopy. [Chapter 17]. Society of Laparoscopic Surgeons; 1940. Retrieved January 1, 2016.  Back to cited text no. 4
    
5.
Edwards RG, Donahue RP, Baramki TA, Jones HW Jr. Preliminary attempts to fertilize human oocytes matured in vitro. Am J Obstet Gynecol 1966;96:192-200.  Back to cited text no. 5
    
6.
De Kretzer D, Dennis P, Hudson B, Leeton J, Lopata A, Outch K et al. Transfer of a human zygote. Lancet 1973;2:728-9.  Back to cited text no. 6
    
7.
Menezo Y. Synthetic medium for gamete survival and maturation and for the culture of fertilized eggs. C R Acad Sci Hebd Seances Acad Sci D 1976;282:1967-70.  Back to cited text no. 7
    
8.
Steptoe PC, Edwards RG. Reimplantation of a human embryo with subsequent tubal pregnancy. Lancet 1976;1:880-2.  Back to cited text no. 8
    
9.
Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet 1978;2:366.  Back to cited text no. 9
    
10.
Kumar A. Architect of India’s first test tube baby: Dr Subhas Mukerji, 16 January 1931 to 19 July 1981. Curr Sci 1997;72:526-31.  Back to cited text no. 10
    
11.
Lopata A, Johnston IW, Hoult IJ, Speirs AI. Pregnancy following intrauterine implantation of an embryo obtained by in vitro fertilization of a preovulatory egg. Fertil Steril 1980;33:117-20.  Back to cited text no. 11
    
12.
Pez JP, Cohen J. Recherche d’une concordance entre l’échographie et l’observation par coelioscopie des follicules stimulés par les inducteurs de l’ovulation. 178 soireé gynéco-obstricale de St Maurice le 9.10.79. Milupa. Bagnolet; 1979.  Back to cited text no. 12
    
13.
Mohr LR, Trounson AO. The use of fluorescein diacetate to assess embryo viability in the mouse. J Reprod Fertil 1980;58:189-96.  Back to cited text no. 13
    
14.
Wood C, Leeton J, Talbot JM, Trounson AO. Technique for collecting mature human oocytes for in vitro fertilization. Br J Obstet Gynaecol 1981;88:756-60.  Back to cited text no. 14
    
15.
Trounson AO, Leeton JF, Wood C, Webb J, Wood J. Pregnancies in humans by fertilization in vitro and embryo transfer in the controlled ovulatory cycle. Science 1981;212:681-2.  Back to cited text no. 15
    
16.
Testart J, Frydman R, Feinstein MC, Thebault A, Roger M, Scholler R. Interpretation of plasma luteinizing hormone assay for the collection of mature oocytes from women: Definition of a luteinizing hormone surge-initiating rise. Fertil Steril 1981;36:50-4.  Back to cited text no. 16
    
17.
Hamberger L, Wikland M, Nilsson L, Janson PO, Sjögren A, Hillensjö T. Methods for aspiration of human oocytes by various techniques. Acta Med Rom 1982;20:370-8.  Back to cited text no. 17
    
18.
Feichtinger W, Szalay S, Kemeter P, Beck A, Janisch H. Twin pregnancy after laparoscopic oocyte recovery, in-vitro fertilization and embryo transfer. [Author’s transl.]. Geburtshilfe Frauenheilkd 1982;42:197-9.  Back to cited text no. 18
    
19.
Fleming R, Adam AH, Barlow DH, Black WP, MacNaughton MC, Coutts JR. A new systematic treatment for infertile women with abnormal hormone profiles. Br J Obstet Gynaecol 1982;89:80-3.  Back to cited text no. 19
    
20.
Trounson AO, Mohr LR, Wood C, Leeton JF. Effect of delayed insemination on in-vitro fertilization, culture, and transfer of human embryos. J Reprod Fertil 1982;64:285-94.  Back to cited text no. 20
    
21.
Lenz S, Lauritsen JG. Ultrasonically guided percutaneous aspiration of human follicles under local anesthesia: A new method of collecting oocytes for in vitro fertilization. Fertil Steril 1982;38:673-7.  Back to cited text no. 21
    
22.
Trounson A, Leeton J, Besanko M, Wood C, Conti A. Pregnancy established in an infertile patient after transfer of a donated embryo fertilized in vitro. Br Med J (Clin Res Ed) 1983;286:835-8.  Back to cited text no. 22
    
23.
Trounson A, Mohr L. Human pregnancy following cryopreservation thawing and transfer of an eight-cell embryo. Nature 1983;305:707-9.  Back to cited text no. 23
    
24.
Veeck LL, Wortham JW Jr, Witmyer J, Sandow BA, Acosta AA, Garcia JE et al. Maturation and fertilization of morphologically immature human oocytes in a program of in vitro fertilization. Fertil Steril 1983;39:594-602.  Back to cited text no. 24
    
25.
Buster JE, Bustillo M, Thorneycroft IH, Simon JA, Boyers SP, Marshall JR et al. Non-surgical transfer of in vivo fertilized donated ova to five infertile women: Report of two pregnancies. Lancet 1983;2:223-4.  Back to cited text no. 25
    
26.
Casper RF, Wilson E, Collins JA, Brown SF, Parker JA. Enhancement of human implantation by exogenous chorionic gonadotropin. Lancet 1983;2:1191.  Back to cited text no. 26
    
27.
Trounson A, Mohr L. Human pregnancy following cryopreservation, thawing, and transfer of an eight-cell embryo. Nature 1983;305:707-9.  Back to cited text no. 27
    
28.
Asch RH, Ellsworth LR, Balmaceda JP, Wong PC. Pregnancy after translaparoscopic gamete intrafallopian transfer. Lancet 1984;2:1034-5.  Back to cited text no. 28
    
29.
Lutjen P, Trounson A, Leeton J, Findlay J, Wood C, Renou P. The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure. Nature 1984;307:174-5.  Back to cited text no. 29
    
30.
Cohen J, Fehilly CB, Fishel SB, Edwards RG, Hewitt J, Rowland GF et al. Male infertility successfully treated by in-vitro fertilization. Lancet 1984;1:1239-40.  Back to cited text no. 30
    
31.
Fishel SB, Edwards RG, Evans CJ. Human chorionic gonadotropin secreted by preimplantation embryos cultured in vitro. Science 1984;223:816-8.  Back to cited text no. 31
    
32.
Temple-Smith PD, Southwick GJ, Yates CA, Trounson AO, de Kretser DM. Human pregnancy by in vitro fertilization (IVF) using sperm aspirated from the epididymis. J In Vitro Fert Embryo Transf 1985;2:119-22.  Back to cited text no. 32
    
33.
Strickler RC, Christianson C, Crane JP, Curato A, Knight AB, Yang V. Ultrasound guidance for human embryo transfer. Fertil Steril 1985;43:54-61.  Back to cited text no. 33
    
34.
Cohen J, Simons RF, Fehilly CB, Fishel SB, Edwards RG, Hewitt J et al. Birth after replacement of hatching blastocyst cryopreserved at the expanded blastocyst stage. Lancet 1985;1:647.  Back to cited text no. 34
    
35.
Quinn P, Kerin JF, Warnes GM. Improved pregnancy rate in human in vitro fertilization with the use of a medium based on the composition of human tubal fluid. Fertil Steril 1985;44:493-8.  Back to cited text no. 35
    
36.
Strickler RC, Christianson C, Crane JP, Curato A, Knight AB, Yang V. Ultrasound guidance for human embryo transfer. Fertil Steril 1985;43:54-61.  Back to cited text no. 36
    
37.
Devroey P, Braeckmans P, Smitz J, Van Waesberghe L, Wisanto A, Van Steirteghem A et al. Pregnancy after translaparoscopic zygote intrafallopian transfer in a patient with sperm antibodies. Lancet 1986;1:1329.  Back to cited text no. 37
    
38.
Szollosi D, Mandelbaum J, Plachot M, Salat-Baroux J, Cohen J. Ultrastructure of the human preovulatory oocyte. J In Vitro Fert Embryo Transf 1986;3:232-42.  Back to cited text no. 38
    
39.
Laws-King A, Trounson A, Sathananthan H, Kola I. Fertilization of human oocytes by microinjection of a single spermatozoon under the zona pellucida. Fertil Steril 1987;48:637-42.  Back to cited text no. 39
    
40.
Patrizio P, Silber S, Ord T, Balmaceda JP, Asch RH. Two births after microsurgical sperm aspiration in congenital absence of vas deferens. Lancet 1988;2:1364.  Back to cited text no. 40
    
41.
Cohen J, Malter H, Fehilly C, Wright G, Elsner C, Kort H et al. Implantation of embryos after partial opening of oocyte zona pellucida to facilitate sperm penetration. Lancet 1988;2:162.  Back to cited text no. 41
    
42.
Lanzendorf SE, Maloney MK, Veeck LL, Slusser J, Hodgen GD, Rosenwaks Z. A preclinical evaluation of pronuclear formation by microinjection of human spermatozoa into human oocytes. Fertil Steril 1988;49:835-42.  Back to cited text no. 42
    
43.
Tadir Y, Wright WH, Vafa O, Ord T, Asch RH, Berns MW. Micromanipulation of sperm by a laser generated optical trap. Fertil Steril 1989;52:870-3.  Back to cited text no. 43
    
44.
Gonen Y, Casper RF, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: A possible predictor of implantation in in vitro fertilization. Fertil Steril 1989;52:446-50.  Back to cited text no. 44
    
45.
Wilton LJ, Trounson AO. Biopsy of preimplantation mouse embryos: Development of micromanipulated embryos and proliferation of single blastomeres in vitro. Biol Reprod 1989;40:145-52.  Back to cited text no. 45
    
46.
Gordts S, Roziers P, Campo R, Noto V. Survival and pregnancy outcome after ultrarapid freezing of human embryos. Fertil Steril 1990;53:469-72.  Back to cited text no. 46
    
47.
Cohen J, Elsner C, Kort H, Malter H, Massey J, Mayer MP et al. Impairment of the hatching process following IVF in the human and improvement of implantation by assisting hatching using micromanipulation. Hum Reprod 1990;5:7-13.  Back to cited text no. 47
    
48.
Verlinsky Y, Ginsberg N, Lifchez A, Valle J, Moise J, Strom CM. Analysis of the first polar body: Preconception genetic diagnosis. Hum Reprod 1990;5:826-9.  Back to cited text no. 48
    
49.
Cha KY, Koo JJ, Ko JJ, Choi DH, Han SY, Yoon TK. Pregnancy after in vitro fertilization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their transfer in a donor oocyte program. Fertil Steril 1991;55:109-13.  Back to cited text no. 49
    
50.
Navot D, Bergh PA, Williams MA, Garrisi GJ, Guzman I, Sandler B et al. Poor oocyte quality rather than implantation failure as a cause of age-related decline in female fertility. Lancet 1991;337:1375-7.  Back to cited text no. 50
    
51.
Hurley VA, Osborn JC, Leoni MA, Leeton J. Ultrasound-guided embryo transfer: A controlled trial. Fertil Steril 1991;55:559-62.  Back to cited text no. 51
    
52.
Cohen J, Alikani M, Trowbridge J, Rosenwaks Z. Implantation enhancement by selective assisted hatching using zona drilling of human embryos with poor prognosis. Hum Reprod 1992;7:685-91.  Back to cited text no. 52
    
53.
Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 1992;340:17-8.  Back to cited text no. 53
    
54.
Patrizio P, Silber S, Ord T, Marello E, Balmaceda JP, Asch RH. Replacement of frozen embryos generated from epididymal spermatozoa: The first two pregnancies. Hum Reprod 1992;7:652-3.  Back to cited text no. 54
    
55.
Feichtinger W, Strohmer H, Radner KM. Erbium YAG laser for micromanipulation of oocytes and spermatozoa. Lancet 1992;340:115-6.  Back to cited text no. 55
    
56.
Hamberger xx. In: Gordts S, editor. Proceedings of European Symposium on Micromanipulation. Drukkerij Nauwelaerts, Leuven, Belgium; 1993. p. 85.  Back to cited text no. 56
    
57.
Patrizio P, Asch RH, Handelin B, Silber SJ. Aetiology of congenital absence of vas deferens: Genetic study of three generations. Hum Reprod 1993;8:215-20.  Back to cited text no. 57
    
58.
Silber SJ, Nagy ZP, Liu J, Godoy H, Devroey P, Van Steirteghem AC. Conventional in-vitro fertilization versus intracytoplasmic sperm injection for patients requiring microsurgical sperm aspiration. Hum Reprod 1994;9:1705-9.  Back to cited text no. 58
    
59.
Devroey P, Liu J, Nagy Z, Goossens A, Tournaye H, Camus M et al. Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod 1995;10:1457-60.  Back to cited text no. 59
    
60.
Barnes FL, Crombie A, Gardner DK, Kausche A, Lacham-Kaplan O, Suikkari AM et al. Blastocyst development and birth after in-vitro maturation of human primary oocytes, intracytoplasmic sperm injection and assisted hatching. Hum Reprod 1995;10:3243-7.  Back to cited text no. 60
    
61.
Gil-Salom M, Romero J, Minguez Y, Rubio C, De los Santos MJ, Remohí J et al. Pregnancies after intracytoplasmic sperm injection with cryopreserved testicular spermatozoa. Hum Reprod 1996;11:1309-13.  Back to cited text no. 61
    
62.
Reijo R, Alagappan RK, Patrizio P, Page DC. Severe oligozoospermia resulting from deletions of azoospermia factor gene on Y chromosome. Lancet 1996;347:1290-3.  Back to cited text no. 62
    
63.
Casper RF, Meriano IS, Iarvi KA, Cowan L, Lucato ML. The hypo-osmotic swelling test for selection of viable sperm for intracytoplasmic sperm injection in men with complete asthenozoospermia. Fertil Steril 1996;65:972.  Back to cited text no. 63
    
64.
Sun JG, Jurisicova A, Caspe RF. Detection of deoxyribonucleic acid fragmentation in human sperm: Correlation with fertilization in vitro. Biol Reprod 1997;56:602-7.  Back to cited text no. 64
    
65.
Porcu E, Fabbri R, Seracchioli R, Ciotti PM, Magrini O, Flamigni C. Birth of a healthy female after intracytoplasmic sperm injection of cryopreserved human oocytes. Fertil Steril 1997;68:724–6.  Back to cited text no. 65
    
66.
Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod 1998;13:3434-40.  Back to cited text no. 66
    
67.
Palermo GD, Schlegel PN, Sills ES, Veeck LL, Zaninovic N, Menendez S et al. Births after intracytoplasmic injection of sperm obtained by testicular extraction from men with nonmosaic Klinefelter’s syndrome. N Engl J Med 1998;338:588-90.  Back to cited text no. 67
    
68.
Xu K, Shi ZM, Veeck LL, Hughes MR, Rosenwaks Z. First unaffected pregnancy using preimplantation genetic diagnosis for sickle cell anemia. JAMA 1999;281:1701-6.  Back to cited text no. 68
    
69.
Kuleshova L, Gianaroli L, Magli C, Ferraretti A, Trounson A. Birth following vitrification of a small number of human oocytes: Case report. Hum Reprod 1999;14:3077-9.  Back to cited text no. 69
    
70.
Chian RC, Gülekli B, Buckett WM, Tan SL. Priming with human chorionic gonadotrophin before retrieval of immature oocytes in women with infertility due to the polycystic ovary syndrome. N Engl J Med 1999;341:1624-6.  Back to cited text no. 70
    
71.
Oktay K, Karlikaya G. Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N Engl J Med 2000;342:1919.  Back to cited text no. 71
    
72.
Ali Shahata MA, Al-Natsha SD. Formulation of a protein-free medium for human assisted reproduction. Hum Reprod 2000;15:145-56.  Back to cited text no. 72
    
73.
Chian RC, Gülekli B, Buckett WM, Tan SL. Pregnancy and delivery after cryopreservation of zygotes produced by in-vitro matured oocytes retrieved from a woman with polycystic ovarian syndrome. Hum Reprod 2001;16:1700-2.  Back to cited text no. 73
    
74.
De Boer K, McArthur S, Murray C, Jansen R. First live birth following blastocyst biopsy and PGD analysis. Reprod Biomed Online 2002;4:35.  Back to cited text no. 74
    
75.
Wells D, Escudero T, Levy B, Hirschhorn K, Delhanty JD, Munné S. First clinical application of comparative genomic hybridization and polar body testing for preimplantation genetic diagnosis of aneuploidy. Fertil Steril 2002;78:543-9.  Back to cited text no. 75
    
76.
Beckers NG, Macklon NS, Devroey P, Platteau P, Boerrigter PJ, Fauser BC. First live birth after ovarian stimulation using a chimeric long-acting human recombinant follicle-stimulating hormone (FSH) agonist (recFSH-CTP) for in vitro fertilization. Fertil Steril 2003;79:621-3.  Back to cited text no. 76
    
77.
Barash A, Dekel N, Fieldust S, Segal I, Schechtman E, Granot I. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization. Fertil Steril 2003;79:1317-22.  Back to cited text no. 77
    
78.
Kattera S, Chen C. Normal birth after microsurgical enucleation of tripronuclear human zygotes: Case report. Hum Reprod 2003;18:1319-22.  Back to cited text no. 78
    
79.
Donnez J, Dolmans MM, Demylle D, Jadoul P, Pirard C, Squifflet J et al. rebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004;364:1405-10.  Back to cited text no. 79
    
80.
Gardner DK, Surrey E, Minjarez D, Leitz A, Stevens J, Schoolcraft WB. Single blastocyst transfer: A prospective randomized trial. Fertil Steril 2004;81:551-5.  Back to cited text no. 80
    
81.
Verlinsky Y, Rechitsky S, Sharapova T, Morris R, Taranissi M, Kuliev A. Preimplantation HLA testing. JAMA 2004;291:2079-85.  Back to cited text no. 81
    
82.
Porcu E, Fabbri R, Damiano G, Fratto R, Giunchi S, Venturoli S. Oocyte cryopreservation in oncological patients. Eur J Obstet Gynecol Reprod Biol 2004;113(Suppl 1):S14-6.  Back to cited text no. 82
    
83.
Ao A, Jin S, Rao D, Son WY, Chian RC, Tan SL. First successful pregnancy outcome after preimplantation genetic diagnosis for aneuploidy screening in embryos generated from natural-cycle in vitro fertilization combined with an in vitro maturation procedure. Fertil Steril 2006;85:1510.e9-e11.  Back to cited text no. 83
    
84.
Bedaiwy MA, Hussein MR, Biscotti C, Falcone T. Cryopreservation of intact human ovary with its vascular pedicle. Hum Reprod 2006;21:3258-69.  Back to cited text no. 84
    
85.
Arav A, Pasquale P. Yale Practice. 2007;12:2.  Back to cited text no. 85
    
86.
Jones GM, Cram DS, Song B, Kokkali G, Pantos K, Trounson AO. Novel strategy with potential to identify developmentally competent IVF blastocysts. Hum Reprod 2008;23:1748-59.  Back to cited text no. 86
    
87.
Porcu E, Venturoli S, Damiano G, Ciotti PM, Notarangelo L, Paradisi R et al. Healthy twins delivered after oocyte cryopreservation and bilateral ovariectomy for ovarian cancer. Reprod Biomed Online 2008;17:265-7.  Back to cited text no. 87
    
88.
Fishel S, Gordon A, Lynch C, Dowell K, Ndukwe G, Kelada E et al. Live birth after polar body array comparative genomic hybridization prediction of embryo ploidy − The future of IVF? Fertil Steril 2010;93:1006.e7-e10.  Back to cited text no. 88
    
89.
Sagi M, Weinberg N, Eilat A, Aizenman E, Werner M, Girsh E et al. Preimplantation genetic diagnosis for BRCA1/2-A novel clinical experience. Prenat Diagn 2009;29:508-13.  Back to cited text no. 89
    
90.
Prasath EB, Chan ML, Wong WH, Lim CJ, Tharmalingam MD, Hendricks M et al. First pregnancy and live birth from cryopreserved embryos obtained from in vitro matured oocytes after oophorectomy in ovarian cancer patient. Hum Reprod 2014;29:276-8.  Back to cited text no. 90
    
91.
Gamble N. Crossing the line: The legal and ethical problems of foreign surrogacy. Reprod Biomed 2009;19:151-2.  Back to cited text no. 91
    
92.
James S, Chilvers R, Havemann D, Phelps JY. Avoiding legal pitfalls in surrogacy arrangements. Reprod Biomed 2010;21:862-7.  Back to cited text no. 92
    
93.
Humbyrd C. Fair trade international surrogacy. Dev World Bioeth 2009;9:111-8.  Back to cited text no. 93
    
94.
The Surrogacy (Regulation) Bill; 2016. Available from: www.dhr.gov.in/sites/default/files/surrogacyregbill.  Back to cited text no. 94
    
95.
Brezina PR, Zhao Y. The ethical, legal and social issues impacted by modern assisted reproductive technologies. Obstet Gynecol Int 2012;686253.  Back to cited text no. 95
    
96.
Sublet MF. Frozen embryos: What are they and how should the law treat them. Clev State Law Rev 1990;38:585.  Back to cited text no. 96
    
97.
Rao GD, Chian RC, Son WS. Fertility preservation in women undergoing cancer treatment. Lancet 2004;363:1829-30.  Back to cited text no. 97
    
98.
Kumar S, Murarka S, Mishra VV, Gautam AK. Environmental & lifestyle factors in deterioration of male reproductive health. Indian J Med Res 2014;140:S29-35.  Back to cited text no. 98
    
99.
Ahluwalia U, Arora M. Posthumous reproduction and its legal perspective. Int J Infertil Fetal Med 2011;2:9-14.  Back to cited text no. 99
    




 

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