Editing Reproductive technology

{{Short description|Uses of technology in human and animal reproduction}}
{{Use dmy dates|date=November 2018}}'''Reproductive technology''' encompasses all current and anticipated uses of technology in human and animal reproduction, including assisted reproductive technology (ART),<ref>{{Cite journal |last=Kushnir |first=Vitaly A. |last2=Choi |first2=Jennifer |last3=Darmon |first3=Sarah K. |last4=Albertini |first4=David F. |last5=Barad |first5=David H. |last6=Gleicher |first6=Norbert |date=August 2017 |title=CDC-reported assisted reproductive technology live-birth rates may mislead the public |url=http://dx.doi.org/10.1016/j.rbmo.2017.05.008 |journal=Reproductive BioMedicine Online |volume=35 |issue=2 |pages=161–164 |doi=10.1016/j.rbmo.2017.05.008 |issn=1472-6483|url-access=subscription }}</ref> [[contraception]] and others. It is also termed Assisted Reproductive Technology, where it entails an array of appliances and procedures that enable the realization of safe, improved and healthier [[reproduction]]. While this is not true of all people, for an [[array]] of married couples, the ability to have children is vital. But through the [[technology]], infertile couples have been provided with options that would allow them to conceive children.<ref name="pmid27126581">{{cite journal | vauthors = Al-Inany HG, Youssef MA, Ayeleke RO, Brown J, Lam WS, Broekmans FJ | title = Gonadotrophin-releasing hormone antagonists for assisted reproductive technology | journal = The Cochrane Database of Systematic Reviews | volume = 4 | pages = CD001750 | date = April 2016 | issue = 8 | pmid = 27126581 | doi = 10.1002/14651858.CD001750.pub4 | pmc = 8626739 | url = http://dspace.library.uu.nl/bitstream/1874/338399/1/CD001750.pdf }}</ref>

==Overview==
===Assisted reproductive technology===
{{Main|Assisted reproductive technology}}
Assisted reproductive technology (ART) is the use of reproductive technology to treat low fertility or [[infertility]]. Modern technology can provide infertile couples with assisted reproductive technologies. The natural method of reproduction has become only one of many new techniques used today. There are millions of couples that do not have the ability to reproduce on their own because of infertility and therefore, must resort to these new techniques. The main causes of infertility are that of [[Hormone|hormonal]] malfunctions and anatomical abnormalities.<ref name=":2" /> ART is currently the only form of assistance for individuals who, for the time being, can only conceive through [[surrogacy]] methods).<ref>{{cite journal | vauthors = Campo H, Cervelló I, Simón C | title = Bioengineering the Uterus: An Overview of Recent Advances and Future Perspectives in Reproductive Medicine | journal = Annals of Biomedical Engineering | volume = 45 | issue = 7 | pages = 1710–1717 | date = July 2017 | pmid = 28028711 | doi = 10.1007/s10439-016-1783-3 | s2cid = 4130310 }}</ref> Examples of ART include [[In vitro fertilisation|''in vitro'' fertilization (IVF)]] and its possible expansions, including:

* [[artificial insemination]]
* [[artificial reproduction]]
* [[cloning]] (see [[human cloning]] for the special case of human beings)
* [[cytoplasmic transfer]]
* [[cryopreservation]] of [[Spermatozoon|sperm]], [[oocyte]]s, [[embryos]]
* [[embryo transfer]]
* [[fertility medication]]
* [[hormone treatment]]
* [[in vitro fertilization]]
* [[intracytoplasmic sperm injection]]
*[[in vitro generated gametes]]
* [[preimplantation genetic diagnosis]]

=== Role of the Society for Assisted Reproductive Technology (SART) ===
In 1981, after the birth of Elizabeth Carr, the first baby in the United States to be conceived through in vitro fertilization (IVF). Her birth gave hope to many couples struggling with infertility. Dr. Howard Jones brought together the leading practitioners of the five US-based IVF programs ([[Norfolk]],{{clarify|date=October 2023|reason=not the English county?}} [[Vanderbilt University|Vanderbilt]], [[University of Texas Health Science Center at Houston|University of Texas at Houston]], and the [[University of Southern California]], [[Yale University|Yale)]] to discuss the establishment of a national registry for in vitro fertilization attempts and outcomes. 2 years later, in 1985 the society for assisted reproductive technology (SART) was founded as a special interest entity within the American Fertility Society.<ref>{{Citation |title=Gosden, Prof. Roger Gordon, (born 23 Sept. 1948), Professor, and Director of Research in Reproductive Biology, Weill Medical College, Cornell University, 2004–10; Owner and Director, Jamestowne Bookworks, LLC, Williamsburg, Virginia |date=2007-12-01 |url=http://dx.doi.org/10.1093/ww/9780199540884.013.u17652 |work=Who's Who |access-date=2023-10-20 |publisher=Oxford University Press}}</ref> SART has not only informed the evolution of infertility care but also improved success of antiretroviral therapy.<ref>{{Cite journal |last=Toner |first=James P. |last2=Coddington |first2=Charles C. |last3=Doody |first3=Kevin |last4=Van Voorhis |first4=Brad |last5=Seifer |first5=David B. |last6=Ball |first6=G. David |last7=Luke |first7=Barbara |last8=Wantman |first8=Ethan |date=September 2016 |title=Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update |url=https://linkinghub.elsevier.com/retrieve/pii/S0015028216612931 |journal=Fertility and Sterility |language=en |volume=106 |issue=3 |pages=541–546 |doi=10.1016/j.fertnstert.2016.05.026|doi-access=free }}</ref>

===Prognostics===
Reproductive technology can inform [[family planning]] by providing individual prognoses regarding the likelihood of pregnancy. It facilitates the monitoring of [[ovarian reserve]], [[Ovarian follicle|follicular]] dynamics and associated [[female reproductive biomarkers|biomarkers]] in females,<ref>{{cite journal | vauthors = Nelson SM, Telfer EE, Anderson RA | title = The ageing ovary and uterus: new biological insights | journal = Human Reproduction Update | volume = 19 | issue = 1 | pages = 67–83 | year = 2012 | pmid = 23103636 | pmc = 3508627 | doi = 10.1093/humupd/dms043 }}</ref> as well as  [[semen analysis]] in males.<ref>{{cite journal | vauthors = Narvaez JL, Chang J, Boulet SL, Davies MJ, Kissin DM | title = Trends and correlates of the sex distribution among U.S. assisted reproductive technology births | journal = Fertility and Sterility | volume = 112 | issue = 2 | pages = 305–314 | date = August 2019 | pmid = 31088685 | doi = 10.1016/j.fertnstert.2019.03.034 | doi-access = free }}</ref>

===Contraception===
{{Main|Contraception}}
[[Contraception]], also known as ''birth control'', is a form of reproductive technology that enables people to prevent [[pregnancy]].<ref>{{cite journal | vauthors = Sunderam S, Kissin DM, Crawford SB, Folger SG, Boulet SL, Warner L, Barfield WD | title = Assisted Reproductive Technology Surveillance - United States, 2015 | journal = MMWR. Surveillance Summaries | volume = 67 | issue = 3 | pages = 1–28 | date = February 2018 | pmid = 29447147 | pmc = 5829941 | doi = 10.15585/mmwr.ss6703a1 | url = https://stacks.cdc.gov/view/cdc/51694 }}</ref> There are many forms of contraception, but the term covers any method or device which is intended to prevent pregnancy in a [[Human sexual activity|sexually active]] woman. Methods are intended to "prevent the [[Fertilisation|fertilization]] of an egg or implantation of a [[Zygote|fertilized egg]] in the [[uterus]]."<ref>{{cite web|title=Definition of Birth control|url=http://www.medterms.com/script/main/art.asp?articlekey=53351|url-status=live|archive-url=https://web.archive.org/web/20120806234913/http://www.medterms.com/script/main/art.asp?articlekey=53351|archive-date=August 6, 2012|access-date=August 9, 2012|work=MedicineNet|df=mdy-all}}</ref> Different forms of birth control have been around since ancient times, but widely available effective and safe methods only became available during the mid-1900s.<ref name="Hopkins2010">{{cite book|title=The Johns Hopkins manual of gynecology and obstetrics|vauthors=Hanson SJ, Burke AE|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|year=2010|isbn=978-1-60547-433-5|veditors=Hurt KJ, Guile MW, Bienstock JL, Fox HE, Wallach EE|edition=4th|location=Philadelphia|pages=382–395|chapter=Fertility control: contraception, sterilization, and abortion|chapter-url=https://books.google.com/books?id=4Sg5sXyiBvkC&pg=PR232}}</ref>

===Others===
The following reproductive techniques are not currently in routine clinical use; most are still undergoing development: 
*[[Artificial uterus|artificial wombs]]
* [[germinal choice technology]]
* ''in vitro'' [[parthenogenesis]]
* [[reprogenetics]]

====Same-sex procreation====
Research is currently investigating the possibility of same-sex procreation, which would produce offspring with equal genetic contributions from either two females or two males.<ref name = "Kissin_2019">{{cite book |url= https://books.google.com/books?id=dIOWDwAAQBAJ&pg=PR10 |title=Assisted Reproductive Technology Surveillance |last1=Kissin |first1=Dmitry M. |last2=Adamson |first2=G. David |last3=Chambers |first3=Georgina |last4= DeGeyter |first4=Christian | name-list-style = vanc |date=2019-07-04 |publisher=Cambridge University Press |isbn=978-1-108-49858-6 }}</ref> This form of reproduction has become a possibility through the creation of either [[female sperm]] (containing the genetic material of a female) or [[male egg]]s (containing the genetic material of a male). Same-sex procreation would remove the need for lesbian and gay couples to rely on a third party donation of a sperm or an egg for reproduction.<ref>{{cite journal | vauthors = Gerkowicz SA, Crawford SB, Hipp HS, Boulet SL, Kissin DM, Kawwass JF | title = Assisted reproductive technology with donor sperm: national trends and perinatal outcomes | journal = American Journal of Obstetrics and Gynecology | volume = 218 | issue = 4 | pages = 421.e1–421.e10 | date = April 2018 | pmid = 29291411 | doi = 10.1016/j.ajog.2017.12.224 | s2cid = 27903207 | pmc = 11056969 }}</ref>
The first significant development occurred in 1991, in a patent application filed by U.Penn. scientists to fix male sperm by extracting some sperm, correcting a genetic defect in vitro, and injecting the sperm back into the male's testicles.<ref name=":3">{{Patent|US|5858354|Repopulation of testicular Seminiferous tubules with foreign cells, corresponding resultant germ cells, and corresponding resultant animals and progeny}}</ref> While the vast majority of the patent application dealt with male sperm, one line suggested that the procedure would work with XX cells, i.e., cells from an adult woman to make female sperm.

In the two decades that followed, the idea of female sperm became more of a reality. In 1997, scientists partially confirmed such techniques by creating chicken female sperm in a similar manner.<ref>{{cite journal | vauthors = Tagami T, Matsubara Y, Hanada H, Naito M | title = Differentiation of female chicken primordial germ cells into spermatozoa in male gonads | journal = Development, Growth & Differentiation | volume = 39 | issue = 3 | pages = 267–71 | date = June 1997 | pmid = 9227893 | doi = 10.1046/j.1440-169X.1997.t01-2-00002.x | s2cid = 35900043 | doi-access = free }}</ref> They did so by injecting blood stem cells from an adult female chicken into a male chicken's testicles. In 2004, other Japanese scientists created two female offspring by combining the eggs of two adult mice.<ref>{{cite journal | vauthors = Kono T, Obata Y, Wu Q, Niwa K, Ono Y, Yamamoto Y, Park ES, Seo JS, Ogawa H | display-authors = 6 | title = Birth of parthenogenetic mice that can develop to adulthood | journal = Nature | volume = 428 | issue = 6985 | pages = 860–4 | date = April 2004 | pmid = 15103378 | doi = 10.1038/nature02402 | bibcode = 2004Natur.428..860K | s2cid = 4353479 }}</ref><ref>{{cite journal | vauthors = Silva SG, Bertoldi AD, Silveira MF, Domingues MR, Evenson KR, Santos IS | title = Assisted reproductive technology: prevalence and associated factors in Southern Brazil | journal = Revista de Saúde Pública | volume = 53 | pages = 13 | date = January 2019 | pmid = 30726494 | pmc = 6390642 | doi = 10.11606/s1518-8787.2019053000737 | url = https://www.scielosp.org/article/rsp/2019.v53/13/ }}</ref>

In 2008, research was done specifically for methods on creating human female sperm using artificial or natural [[Y chromosome]]s and testicular transplantation.<ref name=":0">{{cite web|url=http://www.samesexprocreation.com/archive/sprmpict.pdf|title=Color illustration of female sperm making process|publisher=Human Samesex Reproduction Project}}{{dead link|date=December 2017 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> A UK-based group predicted they would be able to create human female sperm within five years. So far no conclusive successes have been achieved.<ref name=":2">{{cite news |url= https://www.perthnow.com.au/news/nsw/scientists-turn-bone-marrow-into-sperm-ng-59b4273be880d39210e725126b676986 |title=Scientists turn bone marrow into sperm |last=MacRae |first=Fiona | name-list-style = vanc |date= February 2008 |publisher=The Courier and Mail | location = Australia }}</ref>

In 2018 Chinese research scientists produced 29 viable mice offspring from two mother mice by creating sperm-like structures from haploid [[Embryonic stem cell]]s using [[Genome editing|gene editing]] to alter imprinted regions of DNA. They were unable to get viable offspring from two fathers. Experts noted that there was little chance of these techniques being applied to humans in the near future.<ref>{{Cite news|url=https://www.sciencealert.com/genomic-imprinting-silenced-in-haploid-stem-cells-produces-fatherless-mice|title=Chinese Researchers Have Spawned Healthy Mice With 2 Biological Mothers And No Father|last=McRae|first=Mike | name-list-style = vanc |date=11 October 2018|work=Science Alert|access-date=12 October 2018}}</ref><ref name=":1">{{cite journal | vauthors = Li ZK, Wang LY, Wang LB, Feng GH, Yuan XW, Liu C, Xu K, Li YH, Wan HF, Zhang Y, Li YF, Li X, Li W, Zhou Q, Hu BY | display-authors = 6 | title = Generation of Bimaternal and Bipaternal Mice from Hypomethylated Haploid ESCs with Imprinting Region Deletions | journal = Cell Stem Cell | volume = 23 | issue = 5 | pages = 665–676.e4 | date = November 2018 | pmid = 30318303 | doi = 10.1016/j.stem.2018.09.004 | doi-access = free }}</ref>

==Ethics==
{{Main|Bioethics|Human enhancement}}
Recent technological advances in fertility treatments introduce ethical problems, such as the affordability of the various procedures. The exorbitant prices can limit who has access.<ref name="Kissin_2019" /> The cost of performing ART per live birth varies among countries.<ref>{{Cite journal |last=Chambers |first=Georgina M. |last2=Sullivan |first2=Elizabeth A. |last3=Ishihara |first3=Osamu |last4=Chapman |first4=Michael G. |last5=Adamson |first5=G. David |date=June 2009 |title=The economic impact of assisted reproductive technology: a review of selected developed countries |url=http://dx.doi.org/10.1016/j.fertnstert.2009.04.029 |journal=Fertility and Sterility |volume=91 |issue=6 |pages=2281–2294 |doi=10.1016/j.fertnstert.2009.04.029 |issn=0015-0282|doi-access=free }}</ref> The average cost per IVF cycle in the United States is USD 9,266.<ref>{{Cite journal |last=Peipert |first=Benjamin J. |last2=Montoya |first2=Melissa N. |last3=Bedrick |first3=Bronwyn S. |last4=Seifer |first4=David B. |last5=Jain |first5=Tarun |date=2022-08-04 |title=Impact of in vitro fertilization state mandates for third party insurance coverage in the United States: a review and critical assessment |url=http://dx.doi.org/10.1186/s12958-022-00984-5 |journal=Reproductive Biology and Endocrinology |volume=20 |issue=1 |doi=10.1186/s12958-022-00984-5 |issn=1477-7827|doi-access=free |pmc=9351254 }}</ref> However, the cost per live birth for autologous ART treatment cycles in the United States, Canada, and the United Kingdom ranged from approximately USD 33,000 to 41,000 compared to USD 24,000 to 25,000 in Scandinavia, Japan, and Australia<ref>{{Cite journal |last=Reindollar |first=Richard H. |last2=Regan |first2=Meredith M. |last3=Neumann |first3=Peter J. |last4=Levine |first4=Bat-Sheva |last5=Thornton |first5=Kim L. |last6=Alper |first6=Michael M. |last7=Goldman |first7=Marlene B. |date=August 2010 |title=A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial |url=http://dx.doi.org/10.1016/j.fertnstert.2009.04.022 |journal=Fertility and Sterility |volume=94 |issue=3 |pages=888–899 |doi=10.1016/j.fertnstert.2009.04.022 |issn=0015-0282|doi-access=free |url-access=subscription }}</ref>

The funding structure for IVF/ART is highly variable among different nations. For example, no federal government reimbursement exists for IVF in the United States, although certain states have insurance mandates for ART<ref>{{Cite journal |last=Mladovsky |first=Philipa |last2=Sorenson |first2=Corinna |date=2009-04-03 |title=Public Financing of IVF: A Review of Policy Rationales |url=http://dx.doi.org/10.1007/s10728-009-0114-3 |journal=Health Care Analysis |volume=18 |issue=2 |pages=113–128 |doi=10.1007/s10728-009-0114-3 |issn=1065-3058|url-access=subscription }}</ref>

Many issues of reproductive technology have given rise to [[bioethics|bioethical]] issues, since technology often alters the assumptions that lie behind existing systems of sexual and reproductive [[morality]]. Other ethical considerations arise with the application of ART to women of advanced maternal age, who have higher changes of medical complications (including [[pre-eclampsia]]), and possibly in the future its application to post-[[Menopause|menopausal]] women.<ref>{{cite journal | vauthors = Harrison BJ, Hilton TN, Rivière RN, Ferraro ZM, Deonandan R, Walker MC | title = Advanced maternal age: ethical and medical considerations for assisted reproductive technology | journal = International Journal of Women's Health | volume = 9 | pages = 561–570 | date = 16 August 2017 | pmid = 28860865 | pmc = 5566409 | doi = 10.2147/IJWH.S139578 | url =  | doi-access = free }}</ref><ref>{{cite journal | vauthors = Lung FW, Chiang TL, Lin SJ, Lee MC, Shu BC | title = Assisted reproductive technology has no association with autism spectrum disorders: The Taiwan Birth Cohort Study | journal = Autism | volume = 22 | issue = 3 | pages = 377–384 | date = April 2018 | pmid = 29153004 | doi = 10.1177/1362361317690492 | s2cid = 4921280 }}</ref><ref>{{cite book | first1 = Eli Y. | last1 = Adashi | first2 = John A. | last2 = Rock | first3 = Zev | last3 = Rosenwaks  | name-list-style = vanc |title=Reproductive endocrinology, surgery, and technology |location = Philadelphia | publisher = Lippincott-Raven |date=1996 |pages= 1394–1410}}</ref> Also, ethical issues of [[human enhancement]] arise when reproductive technology has evolved to be a potential technology for not only reproductively inhibited people but even for otherwise re-productively healthy people.<ref>{{cite journal | vauthors = Sunderam S, Kissin DM, Zhang Y, Folger SG, Boulet SL, Warner L, Callaghan WM, Barfield WD | display-authors = 6 | title = Assisted Reproductive Technology Surveillance - United States, 2016 | journal = MMWR. Surveillance Summaries | volume = 68 | issue = 4 | pages = 1–23 | date = April 2019 | pmid = 31022165 | pmc = 6493873 | doi = 10.15585/mmwr.ss6804a1 }}</ref>

==In fiction==
{{Further|Assisted reproductive technology#Fictional representation|Reproduction and pregnancy in speculative fiction}}
*Films and other fiction depicting contemporary emotional struggles of [[assisted reproductive technology]] have had an upswing first in the latter part of the 2000s decade, although the techniques have been available for decades.<ref name="chicagotribune">{{cite web|url=https://www.chicagotribune.com/2009/06/21/the-heartache-of-infertility-shared-on-stage-screen/|title=Heartache of infertility shared on stage, screen|work=Chicago Tribune| first = Colleen | last = Mastony | name-list-style = vanc |date=21 June 2009}}</ref>
*Science fiction has tackled the themes of creating life through non-conventional methods since [[Mary Shelley]]'s ''[[Frankenstein]]''. In the 20th century, [[Aldous Huxley]]'s ''[[Brave New World]]'' (1932) was the first major fictional work to anticipate the possible social consequences of reproductive technology. Its largely negative view was reversed when the author revisited the same themes in his utopian final [[novel]], ''[[Island (Huxley novel)|Island]]'' (1962).

== References ==
{{Reflist}}

{{Medical ethics}}

{{DEFAULTSORT:Reproductive Technology}}
[[Category:Bioethics]]
[[Category:Human reproduction]]
[[Category:Fertility medicine]]
[[Category:Medical technology]]