Deceased donor sperm recovery and conception

I guess it's a case of deceased donor transplantation of sorts. Above the Law has the story:

Posthumous Conception: It Happens More Often Than You Think by Ellen Trachman

 "In the latest high-profile controversy over posthumous conception, last month, we learned of the birth of a baby girl to an Australian woman named Ellidy Pullin, the widow of Olympic snowboarder Alex “Chumpy” Pullin. The Olympian died tragically in a diving accident in 2020.

"Ellidy Pullin turned to their fertility doctor, Andrew Davidson, and asked that her spouse’s sperm be harvested from his body after his death. Davidson described how he entered fertility medicine never expecting to do posthumous sperm retrievals, but now, those requests are becoming more common. The doctor noted that he has done two other posthumous sperm retrievals since the Olympian’s death.

"The process was successful for Pullin — as Davidson notes, it usually is, so long as the sperm is successfully retrieved within 48 hours of death.

...

"In the United States, the hospital itself is the most frequent obstacle that prevents a surviving loved one from having a chance to conceive with the DNA of their deceased spouse or partner. Many hospitals are unwilling to permit the retrieval of reproductive material without specific written consent. And by specific consent, that frequently means not just that the deceased wanted to have children with the survivor. The bar is often set higher. The consent must be that the deceased specifically agreed for their sperm or eggs to be harvested and used for reproductive purposes after their death."

An IVF mixup of babies

 Here are the stories, from the Guardian, and the NY Times:

Guardian:

California women gave birth to each other’s babies after IVF mix-up. Couples to sue clinic after raising girls for months that were not theirs, says lawsuit, before babies were swapped back

"Two California couples gave birth to each other’s babies after a mix-up at a fertility clinic and spent months raising children that were not theirs before swapping the infants, according to a lawsuit filed in Los Angeles.

"Daphna Cardinale said she and her husband, Alexander, had immediate suspicions that the girl she gave birth to in late 2019 was not theirs due to the child’s darker complexion.

"They suppressed their doubts because they fell in love with the baby and trusted the in vitro fertilisation process and their doctors, she said. Learning months later that she had been pregnant with another couple’s baby, and that another woman had been carrying her child, caused enduring trauma, she said.

...

"The two other parents involved in the alleged mix-up wish to remain anonymous and plan a similar lawsuit in the coming days, according to the attorney Adam Wolf, who represents all four parents.

"The lawsuit claims CCRH mistakenly implanted the other couple’s embryo into Daphna and transferred the Cardinales’ embryo – made from Daphna’s egg and Alexander’s sperm – into the other woman.

"The babies, both girls, were born a week apart in September 2019. Both couples unwittingly raised the wrong child for nearly three months before DNA tests confirmed that the embryos were swapped, according to the filing.

“The Cardinales, including their young daughter, fell in love with this child, and were terrified she would be taken away from them,” the complaint says. “All the while, Alexander and Daphna did not know the whereabouts of their own embryo, and thus were terrified that another woman had been pregnant with their child – and their child was out in the world somewhere without them.”

"The babies were swapped back in January 2020.

"Mix-ups like this are exceedingly rare, but not unprecedented. In 2019, a couple from Glendale, California, sued a separate fertility clinic, claiming their embryo was mistakenly implanted in a New York woman, who gave birth to their son as well as a second boy belonging to another couple.

*******

NY Times:

‘We Had Their Baby, and They Had Our Baby’: Couple Sues Over Embryo ‘Mix-Up’  Daphna and Alexander Cardinale, the plaintiffs in a lawsuit against a Los Angeles-area fertility clinic, say they endured a painful custody exchange after DNA testing.  By Neil Vigdor

...

"Peiffer Wolf Carr Kane & Conway, the law firm representing the Cardinales, estimated that the couple had paid $50,000 to the fertility clinic for the treatments.

...

"Mr. Cardinale, 41, said during the news conference on Monday that the most upsetting aspect of the ordeal had been breaking the news to the couple’s older daughter, who begged her parents to keep the baby.

“How do you explain that to a 5-year-old?” Mr. Cardinale said."

Oocyte ethics: financial compensation for human eggs

 New ethical guidance on egg donation, following an antitrust settlement regarding price fixing.

Financial compensation of oocyte donors: an Ethics Committee opinion.  by The Ethics Committee of the American Society for Reproductive Medicine, American Society for Reproductive Medicine, Birmingham, Alabama, Fertility and Sterility® Vol. 116, No. 2, August 2021

"Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery and not vary according to the planned use of the oocytes or the number or quality of oocytes retrieved. This document replaces the document of the same name published in 2016. (Fertil Steril
2021;116:319-25. 2021 by American Society for Reproductive Medicine.)

"ESSENTIAL POINTS:

Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds.

Compensation is in accord with principles of fairness, occurring within the framework of a professional relationship.

Compensation should acknowledge the donor’s time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery. Compensation should not vary according to the planned use of the oocytes (reproductive or research) or the number or quality of oocytes retrieved.

Compensation should be fair and should not be an undue enticement that negatively impacts a donor’s ability to make an informed decision about the donation process and the risks involved with donation.

All oocyte-donor recruitment programs, including agencies, egg banks, and fertility clinics, should individually adopt and implement effective processes for information disclosure and counseling in order to promote informed decision-making by prospective donors.

Treating physicians owe the same professional duties to oocyte donors as to all other patients.

Programs should ensure equitable and fair provision of services to oocyte donors.

Programs should individually adopt and disclose policies regarding coverage of an oocyte-donor’s medical costs should she experience complications associated with the oocyte retrieval process."

...

" Because the burdens of donation are similar regardless of the ultimate use of the oocytes, compensating donors of oocytes for research is also ethically justified. There has been some movement at the state level to permit compensation to research donors, which stands in contrast to the approach articulated by the National Academy of Sciences with respect to compensation for oocyte donation for stem-cell research (21). In 2009, New York became the first US state to implement a policy permitting researchers to use public funds to reimburse women who donate oocytes directly and solely for stem-cell research, not only for the woman’s outof-pocket expenses, but also for the time, burden, and discomfort associated with the donation process (22). A law enacted in California in 2019 likewise requires women who provide human oocytes for research to be compensated for their time, discomfort, and inconvenience in the same manner as other research subjects, removing a previous prohibition of compensation of research donors (11).

...

"It is ethically permissible for a program to refuse to accept a prospective oocyte donor if they become aware that a prospective oocyte recipient or recruiting agency has offered gifts or payments that the program, in the exercise of its own ethical judgment, believes compromise the donor’s free choice or are otherwise ethically inappropriate. Programs should not assume that known donors, such as family or friends, are not being financially compensated. In one study of recipients using both known and anonymous donors, 19 of 20 of the known donors had been compensated, and there were no differences in the amounts provided to known and anonymous donors (27).

...

"This report was developed under the direction of the Ethics Committee of the American Society for Reproductive Medicine (ASRM) as a service to its members and other practicing clinicians. Although it reflects appropriate management of a problem encountered in the practice of reproductive medicine, it is not intended to be the only approved standard of practice or to dictate an exclusive course of treatment. Other plans of management may be appropriate, taking into account the needs of the individual patient, available resources, and institutional or clinical practice limitations. 

**************

That last paragraph may be a bow to the antitrust settlement discussed in the post below:

Friday, May 3, 2019

Donating eggs for fertility: an update

Same sex marriage now legal in Switzerland, by popular referendum

 The BBC has the story (it happened last month, but I wasn't paying attention):

Switzerland same-sex marriage: Two-thirds of voters back yes

"Some 64% supported the measure, making it one of the last countries in western Europe to legalise same-sex marriage.

...

"In the build up to the vote, church groups and conservative political parties opposed the idea, saying it would undermine the traditional family.

"Switzerland has allowed same-sex couples to register partnerships since 2007, but some rights are restricted.

"The measure will make it possible for same-sex couples to adopt unrelated children and for married lesbian couples to have children through sperm donation.

"It makes Switzerland the 30th country in the world to adopt same-sex marriage.

...

"Justice Minister Karin Keller-Sutter said the first same-sex marriages would take place in July next year.

"Whoever loves each other and wants to get married will be able to do so, regardless of whether it is two men, two women, or a man and a woman," she said.

...

"Over the last 20 years, most countries in western Europe have recognised same-sex marriage. However, in Switzerland many big decisions go to a nationwide ballot, and this can slow down major changes to social legislation.

"The new law, which had the backing of the Swiss government and all major political parties except the People's Party, was passed by parliament in December."

Surrogacy law under review in New Zealand

 From the U. of Canterbury:

Who are my parents? Why New Zealand’s ‘creaky’ surrogacy laws are overdue for major reform by Debra Wilson, Annick Masselot,  and Martha Ceballos 

"several separate pieces of legislation cover the two types of surrogacy: gestational, where the child is not genetically related to the surrogate parent; and traditional, where the child is genetically related.

The resulting legal confusion is now the subject of a Law Commission review, which proposes significant reform based on the guiding principle that “the best interests of the child should be paramount”.

Right now, that cannot be said of the way surrogate children and their parents are treated under law that even judges have described as “creaky” and “inadequate”.

 ...

Surrogacy is regulated through the Human Assisted Reproductive Technology Act, which prohibits commercial surrogacy and requires gestational surrogacy to be approved by an ethics committee.

But that act is silent on the legal parentage of the child, leaving this to be determined by the Status of Children Act. Effectively, the woman who gives birth and her partner (if the partner consents to the assisted reproduction) are the child’s legal parents.

This means the intended parents have no legal rights to the child – even if they are the genetic parents – until they adopt the child under the Adoption Act.

But legal parentage is important. Legal parents transfer citizenship to their children and act on their behalf, such as giving consent to medical treatment or travel."

Surrogacy still repugnant (and illegal) in Michigan

Michigan is now one of only a handful of U.S. states that criminalize commercial surrogacy and/or don't recognize (or severely restrict) parental rights in gestational surrogacy. The NY Times has the story about Michigan resident surrogate parents of twins, from their own eggs and sperm, who have to jump through hoops to adopt them.

Couple Forced to Adopt Their Own Children After a Surrogate Pregnancy. Tammy and Jordan Myers will have to adopt their twins after two Michigan judges denied them parental rights because the children had been carried by a surrogate.  By Maria Cramer

"Twice, judges have denied their requests to be declared the legal parents of the twins, even though a fertility doctor said in an affidavit that the babies are the couple’s biological children. In separate affidavits, the surrogate and her husband have agreed that the Myerses are the parents of the twins.

"The Myerses have started the adoption process, which will entail home visits from a social worker, personal questions about their upbringing and their approach to parenting, and criminal background checks. They said they have already submitted their fingerprints.

...

In 2020, New York passed a law that lifted its ban against compensating women who act as surrogates. Louisiana prohibits compensating surrogates but recognizes agreements or contracts in which a woman has volunteered to be a surrogate, Mr. Vaughn said. The state allows such agreements only for married heterosexual couples.

"But Michigan has a far-reaching law that does not recognize any agreement with a woman who agrees to be inseminated or implanted with an embryo, he said. The law also does not recognize the parental rights of the intended parents.

...

"Under Michigan’s law, paying a woman to act as a surrogate is a felony punishable by up to five years in prison and a $50,000 fine, said Melissa Neckers, the lawyer for the couple.

...

"In 2015, the Myerses were trying to have a second child when Ms. Myers, 39, learned she had breast cancer. She immediately had her eggs harvested before undergoing multiple surgeries, including a partial hysterectomy and a bilateral mastectomy.

...

"In a post on Facebook, the couple described their story and need to find an unpaid volunteer who would be willing to help them have a baby. Ms. Vermilye, 35, who also lives in Grand Rapids, read the post and sent them a note saying she was interested.

“My husband and I had talked about how I had a gift of carrying and delivering very easily,” said Ms. Vermilye, who has a girl and a boy who are 6 and 9. “We felt like it was kind of unfair that we had it so easy and have friends and family that don’t."

**************

The United States Surrogacy Law Map.  State-by-State Gestational Surrogacy Law & Statutes

The demand for a uterus transplant among transgender women (a survey study)

 A couple of years ago I gave a Department of Surgery Grand Rounds (a dawn seminar) at Stanford. Much later in the day, at dinner with transplant surgeons and others, someone asked me what other kinds of work I did.  So I started to tell them about my work on repugnant transactions and controversial markets, and used surrogacy as my main example. I pointed out that Sweden, where surrogacy is illegal, had pioneered uterus transplantation as an alternative that worked for some. But I suggested it wouldn't work for same-sex male couples, who are among those who use the well established legal market for surrogates in California.  The conversation quickly turned to why I was wrong.  As I recall what they said, the uterus is just a muscle, so could be transplanted into a man. Ovaries would be a problem, so in-vitro fertilization (IVF) would be needed to start the pregnancy, and of course the baby would have to be delivered via a C-section...

Since then, uterus transplantation has become somewhat more widespread, from both living and deceased donors.  As far as I know, no one is actually proposing to transplant a uterus into a man--for one thing, the demand may not be there.  But that's not the case with another group of people born without a uterus, namely transgender women.

Here's a recent survey from JAMA on just that, which shows that in fact there are transgender women who are open to bearing a child through a uterus transplant:

Jones BP, Rajamanoharan A, Vali S, et al. Perceptions and Motivations for Uterus Transplant in Transgender Women. JAMA Netw Open. 2021;4(1):e2034561. doi:10.1001/jamanetworkopen.2020.34561

"Key Points

"Question  What are the perceptions and motivations of transgender women for uterus transplant?

"Findings  This survey study of 182 transgender women found that to more than 90% of the respondents indicated that uterus transplant may improve quality of life in transgender women, alleviate dysphoric symptoms, and enhance feelings of femininity.

"Meaning  This report on the desire and willingness of transgender women to undergo uterus transplant may support the need for further animal and cadaveric model research, which is necessary to assess the feasibility of performing this procedure in transgender women"

Another pandemic shortage: donor sperm

 Sperm from conventional sperm banks is now in short supply. But there are "known donor" peer to peer websites and Facebook groups for direct donation, without a sperm bank:

The NY Times has the story:

The Sperm Kings Have a Problem: Too Much Demand  By Nellie Bowles

"Many people want a pandemic baby, but some sperm banks are running low. So women are joining unregulated Facebook groups to find willing donors, no middleman required.

...

"“We’ve been breaking records for sales since June worldwide not just in the U.S. — we’ve broken our records for England, Australia and Canada,” said Angelo Allard, the compliance supervisor of Seattle Sperm Bank, one of the country’s biggest sperm banks. He said his company was selling 20 percent more sperm now than a year earlier, even as supplies dwindled.

...

"Michelle Ottey, director of operations at Fairfax Cryobank, another large sperm bank, said demand was up for access to its catalog for online sperm shopping because “people are seeing that there is the possibility of more flexibility in their lives and work.”

...

"About 20 percent of sperm bank clients are heterosexual couples, 60 percent are gay women, and 20 percent are single moms by choice, the banks said.

...

"Each vial from a premium bank can cost up to $1,100. The bank guarantees a vial will have 10 million or 15 million total motile sperm. Each month, during ovulation, a prospective mother (or her doctor) unthaws a vial and injects the sperm.

"The recommendation is to buy four or five vials per desired child, since it can easily take a few months of trying to get pregnant. And since donors sell out fast, if a woman wants two children with the same donor, she needs to be ready with about $10,000.

...

"Apps for finding donors, like Modamily and Just a Baby, popped up. So did Known Donor Registry, where some 50,000 members arrange the giving and receiving of sperm. Facebook groups with tens of thousands of members — where men will post pictures of themselves, often with their own children — began advertising themselves to interested parties.

...

"The legal risk for both parties — risk that a mother will ask the donor for child support, and risk that a donor will want custody — is high, and the laws around this are not consistent in every state. The women who turn to Facebook groups for sperm tend to be unable to afford traditional sperm banks.

Matching for platonic co-parenting

 The Guardian has the story, if you're looking for a co-parent rather than a life partner:

‘I wanted to meet a mate and have a baby without wasting time’: the rise of platonic co-parenting--They’re ready to start a family, but can’t wait for The One. As ‘mating’ sites boom under lockdown, we meet those hoping for a better way to raise a child

"In a world where biological science and equal rights have diversified ways to start a family, platonic co-parenting – the decision to have a child with someone you are not romantically involved with and, in most cases, choose not to live with – remains a relatively new phenomenon.

"Well established in gay communities, along with egg and sperm donation, it is on the rise among heterosexual singles. Tens of thousands have signed up to matchmaking sites at a cost of around £100 a year. On Coparents.co.uk, which launched in Europe in 2008, two-thirds of its 120,000 worldwide members are straight. Modamily, which launched in LA in 2012, has 30,000 international members, of whom 80% are straight and 2,000 are British. UK-based competitor PollenTree.com has 53,000 members, split 60/40 women to men, and ranks its domestic market as its strongest. During lockdown, the latter two sites reported traffic surges of 30-50%."

Crispr gene editing is apparently not yet so well understood

 The NY Times has the story:

Crispr Gene Editing Can Cause Unwanted Changes in Human Embryos, Study Finds--Instead of addressing genetic mutations, the Crispr machinery prompted cells to lose entire chromosomes.  By Katherine J. Wu.

"A powerful gene-editing tool called Crispr-Cas9, which this month nabbed the Nobel Prize in Chemistry for two female scientists, can cause serious side effects in the cells of human embryos, prompting them to discard large chunks of their genetic material, a new study has found.

Administered to cells to repair a mutation that can cause hereditary blindness, the Crispr-Cas9 technology appeared to wreak genetic havoc in about half the specimens that the researchers examined, according to a study published in the journal Cell on Thursday.

"The consequences of these errors can be quite serious in some cases, said Dieter Egli, a geneticist at Columbia University and an author of the study. Some cells were so flummoxed by the alterations that they simply gave up on trying to fix them, jettisoning entire chromosomes, the units into which human DNA is packaged, Dr. Egli said."

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Previous post:

Monday, December 14, 2015

Technology watch: does Crispr create a new class of repugnant transactions?

Assisted reproductive technology in Japan's national health insurance

 The Financial Times has the story:

Prime minister floats fertility treatment to boost Japan’s birth rate--Critics say making IVF cheaper will not address economic insecurity of raising children by Robin Harding

"Japan has spent 50 years fretting about its low birth rate and declining population but new prime minister Yoshihide Suga has hit on a different solution: fertility treatment.

"In his leadership campaign, Mr Suga called for in vitro fertilisation to be covered on national health insurance. The prime minister wants to make it affordable in a country where the average age of first-time mothers is now above 30 and nearly one in five couples has had tests or treatment for infertility.

"Mr Suga hopes the policy will raise Japan’s fertility rate, which stood at 1.36 children per woman in 2019. The fertility rate has been below the replacement level of 2.1 since the 1970s, locking in decades of future population decline with profound consequences for Japan’s society, economy and national security.

"But while subsidies for fertility treatment reflect a slow shift in Japan towards supporting parents rather than criticising the childless, experts said it still did little to address the economic insecurity and gender inequality that discouraged marriage and raising children."

Egg trading by hermaphrodite fish--evolutionary game theory by Peña, Nöldeke, and Puebla

Game theory is about how payoffs among multiple parties change the way they interact with each other. One of the most interesting areas of application is in the study of evolution of populations.  Here's a paper about reciprocity in reproductive strategies that depend on the thickness of various aspects of the market...

The Evolution of Egg Trading in Simultaneous Hermaphrodites
Jorge Peña, Georg Nöldeke, and Oscar Puebla

Abstract: Egg trading—whereby simultaneous hermaphrodites exchange each other’s eggs for fertilization—constitutes one of the few rigorously documented and most widely cited examples of direct reciprocity among unrelated individuals. Yet how egg trading may initially invade a population of nontrading simultaneous hermaphrodites is still unresolved. Here, we address this question with an analytical model that considers mate encounter rates and costs of egg production in a population that may include traders (who provide eggs for fertilization only if their partners also have eggs to reciprocate), providers (who provide eggs regardless of whether their partners have eggs to reciprocate), and withholders (cheaters who mate only in the male role and just use their eggs to elicit egg release from traders). Our results indicate that a combination of intermediate mate encounter rates, sufficiently high costs of egg production, and a sufficiently high probability that traders detect withholders (in which case eggs are not provided) is conducive to the evolution of egg trading. Under these conditions, traders can invade—and resist invasion from—providers and withholders alike. The prediction that egg trading evolves only under these specific conditions is consistent with the rare occurrence of this mating system among simultaneous hermaphrodites.

Here's the full text.

Matching for platonic co-parenting: "like a divorce, without the wedding or the arguments."

The WSJ has the story, about two web sites that are trying to pioneer matching for people who want to conceive a child who will have two involved parents, who won't be married to each other:

Co-Parenting Sites Skip Love and Marriage, Go Right to the Baby Carriage
A new kind of online service matches people who want to have children, but not necessarily romance 
By Julie Jargon

"When Jenica Andersen felt the tug for a second child at age 37, the single mom weighed her options: wait until she meets Mr. Right or choose a sperm donor and go it alone.

"The first option didn’t look promising. The idea of a sperm donor wasn’t appealing, either, because she wanted her child to have an active father, just like her 4-year-old son has. After doing some research, Ms. Andersen discovered another option: subscription-based websites such as PollenTree.com and Modamily that match would-be parents who want to share custody of a child without any romantic expectations. It’s a lot like a divorce, without the wedding or the arguments."
...
"Given the prominence in today’s society of both single parenthood and online dating, this digital approach could be seen as a natural progression. It could also be considered shocking or even, as some have called it, an affront to marriage.
***********

Here's Pollentree.com: https://www.pollentree.com/, which also offers to match prospective moms with sperm donors.

And here's Modafamily: https://modamily.com/, which speaks of romantic, co-parenting, or known-donor relationships.

Will IVF become more widely legal in France?

The Washington Post has the story:

Why an IVF bill is the next fault line for the French republic  By Camille Robcis

"Since 1994, France has banned surrogacy and restricted access to reproductive technologies to heterosexual couples who have been married or living together for more than two years, forcing single women and lesbian couples to travel to neighboring countries for fertility treatments, and gay men to resort to surrogates in countries such as the United States or the United Kingdom. On Tuesday, the French National Assembly is scheduled to vote on a bill that would finally allow access to assisted reproductive technologies, including IVF, for unmarried women and lesbian couples. Under the proposed law, the treatments would be reimbursed by Social Security, and French doctors helping these women with fertility treatments would no longer face legal sanctions. Surrogacy, however, would remain illegal.
...
"After a month of fierce legislative debates that have resulted in more than 2,000 proposed amendments to the bill, an estimated 75,000 marchers took to the streets of Paris on Oct. 6 in opposition. "

Different misconduct in sperm donation

One reason it is rewarding to study unregulated markets is that it gives you some idea of why some regulation might be desirable.  The growth in DNA registries has allowed many children of sperm donors to identify their biological father, and it also allows donors to identify their children, sometimes with unsettling results.

Here's a story from the Washington Post:

Sperm donor says fertility clinic ‘lied’ after discovering he fathered 17 kids ― most in the same area

"It was 1989 when he gave his sperm to the fertility clinic at Oregon Health & Science University, where he was a first-year medical student, believing his donation would help infertile couples and advance science. The facility promised that once his sperm had conceived five babies in mothers living on the East Coast, the rest would be used for research, Cleary said at a Wednesday news conference. He had assured his wife that the donor kids were far enough away that their own four children could never run into them in their Oregon town, or unwittingly befriend them or fall in love with them.

“So you can imagine his shock,” his attorney Chris Best said at the news conference, “when, after 30 years, Dr. Cleary recently [learned] that no less than 17 children have been born from his donations” ― all of whom were born in the state of Oregon and the Pacific Northwest."

Reproductive technology and ethical dilemmas: are artificial wombs on the horizon? Will they change the meaning of abortion?

Assisted reproductive technology (ART) has brought us some modern possibilities that are sometimes viewed as repugnant.  In vitro fertilization has become a standard part of treatment for some kinds of infertility.  It also makes possible gestational surrogacy, in which the surrogate may or may not be paid, and the legality of both those things (surrogacy and commercial surrogacy) varies around the world.

There's a still nascent technology of artificial wombs--probably not coming to a hospital near you anytime soon--that raise questions about abortion.  But it's not too early to ask if a new technology could help resolve an old ethical question (while perhaps creating new ones...).

The NY Times takes up the story:

The Abortion Debate Is Stuck. Are Artificial Wombs the Answer?
The technology would allow fetuses to develop outside the female womb so women would no longer have to be pregnant.  By Zoltan Istvan

"Could an emerging technology reshape the battle lines in the abortion debate? Since Roe v. Wade was decided in 1973, that fight has been defined by the interlocking, absolute values of choice and life: For some, a woman’s right to choose trumps any claim to a right to life by the fetus; for others, it’s the reverse. But what if we could separate those two — what if a woman’s choice to terminate a pregnancy no longer meant terminating the fetus itself?
...
"Artificial human wombs are still far in the future, and there are of course other ethical issues to consider. But for now, the technology is developed enough to raise new questions for the abortion debate.

"In a 2017 issue of the journal Bioethics, two philosophers, Jeremy V. Davis, a visiting professor at the United States Military Academy at West Point, and Eric Mathison, a postdoctoral associate at Baylor College of Medicine, argue that while a woman has a right to remove a fetus from her body, she does not have the right to kill it. The problem is that, for now, the latter is inherent in the former.

"Their argument builds upon that of the pro-choice philosopher Judith Jarvis Thompson, who famously argued in her 1971 paper “A Defense of Abortion” that women have a right to not carry a fetus for nine months — but that women do not have a right to be guaranteed the death of the fetus.
...
"Biobag technology could be available for humans in as little as one to three years, according to Dr. Alan Flake, a fetal surgeon in charge of the Children’s Hospital of Philadelphia artificial womb experiments. Another team performing ectogenesis research at the University of Michigan also believes they could have devices ready for humans in a similar time frame."
**************

In an article published in 2017, also in the NYT, Dr Flake thought these questions would arise only in the more distant future:
Weighing the Ethics of Artificial Wombs

"Dr. Flake agreed that what the field did not need was another intervention for premature infants that creates more problems than it solves. “This system will either work and work very well, or I won’t apply it,” he said."

Surrogacy among religious Jews in Israel

Surrogacy law is not entirely simple in Israel (e.g. the intended parents must be a heterosexual married couple), but it appears that there isn't a religious barrier.  Here's a story in the Jerudalem Post of a religious woman who was a commercial surrogate for a religious couple:

BREAKING THE STIGMA OF SURROGACY... among the religious
BY GADI DEUTSCH

"How did this become more popular among religious women?
“It was after the Carmel Forest fire disaster. One of the people who died was 16-year-old Elad Riban, who’d been an only child. His mother wanted to have another child to help her overcome her trauma, and a married friend of hers agreed to serve as a surrogate, for no fee.

“So they approached Rabbi Shlomo Amar, who said that through a ruling that had been made by Rabbi Ovadia Yosef, they’d found a way to allow it. Once this was allowed for one baby, that set a precedent for others. In other words, not only was there no concern of the baby having mamzer status [an illigitemate child] according to Jewish law, but it was officially allowed. The Puah Institute has also officially allowed married women to act as surrogates. Another advantage for surrogates being married is that they can receive support from their spouses throughout the pregnancy and birth.”
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Here's a related earlier post:

Sunday, March 9, 2014  Surrogacy law in Israel

Sperm selection

I've blogged before about selection of sperm donors, but here's a story from the NY Times about the selection of sperm itself:

Tinder for Sperm: Even in the Petri Dish, Looks and Athleticism Are Prized
What makes one sperm cell — a blob of DNA with a tail — stand out? The selection process is like a microscopic Mr. America contest.
By Randi Hutter Epstein

“Not that one with the droopy head,” Lo said, pointing to a sperm that looked like a deflated balloon sagging over its string. He rejected a sperm with a thickened midpiece that he described as a “turtleneck,” and said he also avoids sperm with curlicue tails or an extra tail. Slow pokes and non-swimmers are spurned as well.

...
"When a sperm cell reaches the egg, it releases hyaluronidase, an enzyme that dissolves the cumulus, a layer of cells surrounding the egg. Next, the acrosome, a vesicle inside the sperm cell’s head, fuses with the outer layer of the egg, igniting the release of enzymes that ease the route inside. The sperm’s vigorously waving tail provides an extra push to help it through. Once inside, proteins within the sperm cell’s head prompt the oocyte to finish maturing and to release chemicals that harden the outer shell of the egg, preventing other sperm from barging in.

"These days, many leading fertility centers use techniques that allow them to bypass all these steps. Instead, they pick a single sperm and inject it into the egg, a technique called intracytoplasmic sperm injection or ICSI (pronounced ICK-see). ICSI was designed to help men with few or defective sperm, but has become so common that it’s used in more than half* of all I.V.F. procedures.
...
"In addition to having a keen eye for promising sperm, an embryologist must have excellent hand-eye coordination. Even then, learning to identify and successfully catch a single sperm before it swims away can take months of practice, said Lo. “I told my parents those years of video game playing, they’ve really paid off.”

* From The Lancet: "Globally, between 2008 and 2010, more than 4·7 million treatment cycles of assisted reproduction techniques were performed, of which around half involved intracytoplasmic sperm injection (ICSI), leading to the birth of 1·14 million babies.

Abortions, when abortion was illegal

The Washington Post reprints a concise version of some of its stories from 1966, with stories of successful and unsuccessful illegal abortions:

When abortion was illegal: A 1966 Post series revealed how women got them anyway
Before Roe v. Wade, women died trying to end their pregnancies

"By Elisabeth Stevens

In January 1966, The Washington Post ran a four-part series on how women in the Washington area obtained abortions. At the time, abortion was illegal with few exceptions in the District of Columbia, Maryland and Virginia. Now, nearly a half-century after Roe v. Wade, new abortion restrictions are being imposed in Alabama, Georgia, Missouri, Ohio, Utah and other states. Below is an abridged version of The Post’s four-part series, edited to highlight personal experiences. The original headlines of the series are now subheads for each section.

Surrogacy in NY...remains complicated

Surrogacy is a subject that brings out both sides of arguments about repugnant transactions. Vivian Wang does a great job of covering the story in the NY Times:

Surrogate Pregnancy Battle Pits Progressives Against Feminists
A bill to legalize paid surrogacy in New York passed the State Senate, but has found opposition from prominent feminists, including Gloria Steinem.

"The proposal to legalize surrogacy in New York was presented as an unequivocal progressive ideal, a remedy to a ban that burdens gay and infertile couples and stigmatizes women who cannot have children on their own.

"And yet, as the State Legislature hurtles toward the end of its first Democrat-led session in nearly a decade, the bill’s success is anything but certain.

"Long-serving female lawmakers have spoken out against it. Prominent feminists, including Gloria Steinem, have denounced it. Women’s rights scholars have argued that paid surrogacy turns women’s bodies into commodities and is coercive to poor women given the sizable payments it can bring.
...
"Surrogacy arrangements in the United States can cost anywhere from $20,000 to more than $200,000, according to a report from Columbia Law School.

Ms. Glick added, “It is pregnancy for a fee, and I find that commodification of women troubling.”

"But Senator Brad Hoylman, one of the bill’s sponsors, said the legislation showed “the importance of the L.G.B.T.Q. community to the State of New York.

“I think that’s a mark of progress for our community and a mark of progress for human rights in general,” said Mr. Hoylman, who is the state’s only openly gay senator and has two daughters who were born through surrogacy in California.
...
"Washington State and New Jersey legalized paid surrogacy last year, joining about a dozen other states. Many other states allow it under certain circumstances or have no laws on the topic, effectively permitting it.

"Between 1999 and 2014 in the United States, more than 18,400 infants were born through gestational surrogacy, where the carrier is not related to the fetus. Of those, 10,000 were born after 2010, according to data from the Centers for Disease Control and Prevention.

"Yet the opposite has happened internationally. Surrogacy is illegal in most of Europe. And India — where so-called fertility tourism brought in $400 million each year — outlawed commercial surrogacy last year, over worries about exploitation."