Battle for Baby : Proposed Legislation for Custody Battles over Frozen Pre-Embryos

Rachel E. Krmenec 이화여자대학교 생명의료법연구소 2016 Asia Pacific Journal of Health Law & Ethics Vol.10 No.1

The use of in vitro fertilization to have a biological child is on the rise due to rising infertility and the desire of same-sex couples to have a biological child. In vitro fertilization allows for a couple who may not otherwise be able to have a biological child have one by combining sperm and eggs in a laboratory and cryogenically freezing the resulting embryo for implantation. As the use of in vitro fertilization is on the rise, so too are the complications that come with the use of in vitro fertilization. For example, courts handle custody battles over the use or disposition of the frozen pre-embryos, often with dire consequences for one or both sides. By having state legislatures propose and adopt legislation concerning in vitro fertilization and custody battles over frozen pre-embryos, the courts will avoid messy custody battles over the embryos. This comment calls for nationwide implementation of state statutes regarding the custody aspect of frozen pre-embryos begotten through in vitro fertilization. After providing a general overview of the in vitro fertilization process and how the courts have handled disputes over frozen pre-embryos, the author sets out the necessary components of a proposed state statute regarding disputes over frozen pre-embryos.

Comparison of preimplantation development of in-vitro fertilized mouse embryos using sperm experiencing capacitation by a variety of inducers

Song Baek,Min-Hee Park,Hye-Jin Park,Seung-Tae Lee,Jung-Im Yun 한국수정란이식학회 2017 한국수정란이식학회 학술대회 Vol.2017 No.05

Post-ejaculation of sperms into the female reproductive tract, acquisition of sperm capacitation is an essential step in the fertilization process. Accordingly, during in-vitro fertilization, the successful fertilization requires necessarily induction of capacitation in the retrieved sperms. To date, many candidate substances have been considered as capacitation inducers. However, there were no reports about the comparison of efficiency inducing sperm capacitation among diverse capacitation inducers. Therefore, we tried to determine an inducer showing the best capacitation performance in mouse sperms by comparing the preimplantation development of in-vitro-fertilized embryos using sperms experiencing capacitation by a variety of capacitation inducers. For these, calcium, progesterone, bovine serum albumin (BSA), heparin, lysophosphaticylcholine (Lyso-PC) were used as candidate capacitation inducers. Optimized concentration of each inducer were determined by accessing ratio of sperms experiencing acrosome reaction using coomassie G-250 blue staining. Subsequently, in vitro fertilization was performed using sperms incubated in each optimized concentration inducer. The ratio of fertilized oocytes was observed. As the results, Calcium at 2.7 mM and 0.3% (w/v) BSA showed the highest fertilization rates compared to 15 μM progesterone, 50 mM heparin, and 100 μM Lyso-PC. From these results, we found that 2.7 mM calcium and 0.3% (w/v) BSA were the most effective sperm capacitation inducers of mouse sperm for in vitro fertilization. From these results, we could identify that, among diverse sperm capacitation inducers, 2.7mM calcium and 0.3% (w/v) BSA were the most effective inducers for in vitro fertilization.

시험관 아기 시술을 시행하는 난임 여성의 미술치료 체험연구

이혜연(Hye Yeon Lee),장연집(Yeon Jip Chang) 한국심리치료학회 2019 한국심리치료학회지 Vol.11 No.1

본 연구는 시험관 아기 시술을 시행하는 난임 여성들이 미술치료에서 체험하는 내용들을 총체적으로 탐구하고 상세히 기술하여 그 본질과 의미가 무엇인지 알고자 하는 것을 목적으로 수행되었다. 이를 위해 난임 병원에서 시험관 아기시술을 시행하는 중에, 집단미술치료, 개인미술치료의 형태로 해당 병원에서 수행된 미술치료를 체험한 난임 여성을 연구 참여자로 한정하여, 서울에 위치한 A, B, C 난임 병원에서 최소 7회기에서 최대 36회기의 각기 다른 미술치료에 참여한, 30세 이상 43세 이하의 여성, 총 7명을 선정하였다. 보다 풍성하고 구체적인 경험을 전달하게 위해 Max van Menen의 해석학적 현상학적 연구방법을 적용하고, 2018년 6월부터 2018년 8월에 걸쳐 일대일 심층 면담을 통하여 자료를 수집하였다. 이를 토대로 자료를 분석한 결과, 다음과 같이 10개의 본질적 주제와 29개의 하위주제가 도출되었다. 이것을 기반으로 내린 연구 결론는 다음과 같다. 첫째, 시험관 아기 시술을 시행하는 난임 여성을 위한 미술치료는 난임 여성의 억압되었던 감정을 표출시키고 자아를 강화하여, 내면의 힘을 발견토록 이끌어준다. 둘째, 시험관 아기 시술을 시행하는 난임 여성은 특히, 집단미술치료 안에서 난임 치료에서의 심리적 어려움에 대한 보편성을 확보하고, 이타성으로 확장하여 긍정적 정서 상태에 이르는 것을 체험한다. 셋째, 시험관 아기 시술을 시행하는 난임 여성이 특히, 시술을 실패했을 경우, 그 심리적 어려움을 미술치료로 극복할 수 있고, 이후 난임 치료를 재시도할 수 있는 자기 회복력을 갖는다. 넷째, 시험관 아기 시술을 시행하는 병원에서 미술치료의 기회를 제공하였을때, 난임 여성들은 시술 치료와 병행된 심리치료로서의 미술치료로 심리적 안정감을 얻는 체험을 함을 알게 되었다. The purpose of this study was to describe in detail the vivid contents that infertile women is being experience in opportunity of art therapy session and to explore their various experiences so that establish what is their original nature and meaning. Participants in this study were women who experienced group art therapy, individual art therapy, or art therapy performed in two forms while performing In Vitro Fertilization-Embryo Transfer in A, B, C hospitals located in Seoul, and it consisted of total 7 women who aged 30 to 43 years and participated in a minimum of 7 sessions and a maximum of 36 sessions of art therapy. To convey a richer and more concrete experience, Max van Manen’s Hermeneutic Phenomenological Methodology was applied and the data of study was collected from June, 2018 to August, 2018. As a result that analyses the date the total of 10 essential themes and 29 sub-themes were derived. The conclusions of this study on the art therapy experience of women with infertile women who perform In Vitro Fertilization-Embryo Transfer based on the existential subject, hermeneutic phenomenological writing, and discussion are as follows. First, art therapy for women with infertile women who perform In Vitro Fertilization-Embryo transfer leads to expresses the oppressed emotions of the infertile women and to strengthens the self, and to discovery of the inner strength. Second, the women who perform In Vitro Fertilization-Embryo Transfer experience to reach a positive emotional state by gaining the universality of psychological difficulties particularly in infertility treatment and expanding it to altruism. Third, in the event that infertile women who perform In Vitro Fertilization-Embryo Transfer fails in procedure, the psychological difficulties can be overcome by art therapy and it gave courage to restart the infertility treatment. Forth, when the opportunity of art therapy has been provided by hospital which is perform In Vitro Fertilization-Embryo, the infertile women experience psychological help from art therapy as psychotherapy combined with procedure treatment.

저출산 극복을 위한 난임 치료 시술에 따른 비용 분석 - 일 산부인과전문병원을 중심으로 -

김윤정,황병덕 한국보건사회학회 2015 보건과 사회과학 Vol.0 No.40

In this study, we analyzed the success of pregnancy and the cost required depending on the result of artificial fertilization and external fertilization which are included in the infertility treatment project for couples. To achieve this, cross analysis, ANOVA and T-test were conducted for 230 subjects who underwent treatment of infertility in one obstetrics and gynecology specialized hospital for two years from 2012 to 2013. In the result, the number of the thirties(71.3%), cases without diseases related to infertility(67.4%) and cases without experience of childbirth(83.5%) were the highest among infertile patients who got treatment, respectively. The average cost of artificial fertilization and external fertilization to be pregnant was 879,000 won and 3,439,000 won, respectively. When both artificial fertilization and external fertilization were conducted for one person, the average cost was 4,664,000 won. The cost of external fertilization was 3.9-fold higher than that of artificial fertilization. In case of both artificial fertilization and external fertilization conducted for one person, it was 5.3-fold higher than that of artificial fertilization. The average number of procedures to be successfully pregnant was 1.61 in artificial fertilization alone, 2.07 in external fertilization alone and 4.36 in both artificial fertilization and external fertilization conducted for one person. The average number in external fertilization was 1.29-fold higher than that in artificial fertilization and 2.71-fold higher in both artificial fertilization and external fertilization conducted for one person. Therefore, policies, such as provision of health benefits on treatment costs and expansion of the total recipients in the infertility treatment project for couples which is one of methods to reduce current severe low fertility and an aging population, are required. 본 연구는 난임부부지원사업의 대상인 인공수정과 체외수정의 시술 결과에 따른 임신여부와 소요되는 비용을 분석하였다. 이를 위하여 2012년부터 2013년까지 2년간 일 산부인과전문병원에서 난임 시술을 받은 230명을 대상으로 교차분석, ANOVA 그리고 T-test를 실시하였다. 연구 결과 난임 시술자는 30대(71.3%), 난임과 관련된 질병이 없는 경우(67.4%), 출산자녀가 없는 경우(83.5%)가 가장 많았다. 시술별 임신성공 평균 비용은 인공수정이 879,000원, 체외수정이 3,439,000원, 인공수정과 체외수정을 모두 시술한 경우는 4,664,000원 이었다. 인공수정 시술비용에 비하여 체외수정 비용은 3.9 배, 인공수정과 체외수정을 모두 시술한 비용은 5.3배가 높았다. 시술별 임신성공 평균 횟수는 인공수정이 1.61회, 체외수정이 2.07회, 인공수정과 체외수정을 모두 시술한 경우는 4.36회 이었다. 인공수정 시술 횟수에 비하여 체외수정 횟수는 1.29배, 인공수정과 체외수정을 모두 시술한 횟수는 2.71배높았다. 따라서 본 연구가 현재의 심각한 저출산 현상과 고령화를 줄일 수 있는 방법 중의 하나인 난임부부지원사업의 시술비 급여화 및 전체 대상자 확대 등 정책 수립이 필요한 것으로 사료된다.

Effect of plasmin on sperm penetration and zona pellucida solubility in pigs

Yong Hwangbo,Hee-Tae Cheong,Boo-Keun Yang,Choon-Keun Park 한국수정란이식학회 2018 한국수정란이식학회 학술대회 Vol.2018 No.11

In our previous study, exogenous plasminasminogen activators (PAs) influenced to fertility of boar spermatozoa via reduction of zona pellucida (ZP) resistance against protease and number of sperm binding ZP. plasminasmin (plasmin), is converted by PAs, is an important enzyme to degrade extracellular matrix and it is closely associated with fertilization process. Therefore, the aim of present study was to confirm changes of sperm penatration and ZP solubility by plasmin during in vitro fertilization (IVF). The cumulus-oocyte complasminexes (COCs) were aspirated from the antral follicles 3-6 mm in diameter and matured for 44 hours. Then, the cumulus cells were removed and denuded oocytes were co-incubated with spermatozoa for 18-20 hours in IVF medium containing 100 ng/ml plasmin. The number of sperm binding ZP and ZP solubility were measured using hoechst 33342 and 0.5% (w/v) pronase, respectively. Aceto-orcein stain was used to assess fertilization parameters. In results, sperm penetration did not affect by plasmin treatment during fertilization. Hoewever, treatment of plasmin decreased monospermic fertilization and IVF efficiency compared with control group (p<0.05). Furthermore, the number of penetrated sperm and pronucleus formation per zygote in plasmin group was significantly increased compared with control group (p<0.05). Despite of reduced monospermic fertilization by plasmin treatment, the number of sperm binding ZP was significantly higher in non-treated zygote than plasmin-treated zygote (p<0.05). Similar with previous study, ZP digestion time was reduced by plasmin treatment (p<0.05). These findings shown that plasminasmin during fertilization enhance the penetration of spermatozoa into ZP via increasing of ZP solubility and it was correspond with our previous results that fertility of spermatozoa during IVF was increased by exogenous urokinase-type PA treatment via sperm-ZP binding and increase of ZP solubility. Therefore, during the fertilization process, plasmin that is converted by PAs from oviduct epithelial cells might be closely associated with degradation of ZP proteins for penetration of sperm. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Education) (2016R1D1A1B03931746).

체외수정란 이식시 수태율에 미치는 요인에 관한 연구

김성기,노상호,이은송,이병천,황우석,Kim, Sung-ki,Roh, Sang-ho,Lee, Eun-song,Lee, Byeong-chun,Hwang, Woo-suk 대한수의학회 1996 大韓獸醫學會誌 Vol.36 No.4

In the last few years, methods for in vitro culture of early embryo stages from oocytes matured and fertilized in vitro using suitable cell culture systems have been established. But the factors affecting pregnancy rates following transfer of bovine embryos produced in vitro were not evaluated enough. So this study was performed to investigate the effects of quality and stage of embryos, parity and Corpus Luteum quality of recipients on pregnancy rates following non-surgical transfer of bovine embryos produced in vitro. Oocytes aspirated from small antral follicles of ovaries obtained at a local slaughter house were matured, fertilized with frozen-thawed semen and co-cultured for 6-7 days by utilizing co-culture system with bovine oviduct epithelial cell in vitro. After co-culture, embryos were transfered to recipients on day 7 (estrus=day 0). Recipients were monitored by ultrasonic scanning method or observation for estrus and rectal palpation after 50 days from transfer. The results of this study are follows. 1. Of the 70 recipients, 70%(49 of 70) had not showed estrus sign between day 0 and day 50, but 22.9%(16 of 70) was diagnosed not pregnant. Therefore the overall pregnancy rate of this study was 47.1%(33 of 70). 2. The pregnancy rate of recipients transfered with excellent(66.7%) and good(54.5%) embryos were higher than that of recipients transfered with fair embryos(15.8%) (p<0.05). 3. The pregnancy rate of recipients transfered with morula, compacted morula, blastocyst and expanded blastocysts were 46.2, 55.0, 62.5 and 50.0%, respectively. 4. The pregnancy rates of recipients transfered to heifer and cow were 54.5 and 55.2%, respectively. 5. The pregnancy rates of recipients with CL score I, II(66.7, 63.6%) were higher than those of recipients with CL score III (10%), (p<0.05). Success of transfer of embryos produced in vitro depends on many variables. The important factors identified in this study were the quality of embryos and the CL score of recipient animals after non-surgical transfer of embryos matured, fertilized and cultured in vitro.

Optimization of in vitro fertilization technique for oocytes of indigenous zebu cows

Mohammad Moshiur Rahman,Md. Masudur Rahman,Nasrin Sultana Juyena,Mohammad Musharraf Uddin Bhuiyan 한국동물생명공학회(구 한국동물번식학회) 2020 Journal of Animal Reproduction and Biotechnology Vol.35 No.2

The research work was undertaken to determine an effective fertilization medium, sperm separation method and sperm capacitating agent for optimum in vitro fertilization (IVF) rates of indigenous zebu cow oocytes. In experiment 1, tissue culture medium (TCM 199), Tyrode’s albumin lactate pyruvate (TALP) and Brackett and Oliphant (BO) medium were used as basic medium for IVF of oocytes of indigenous zebu cows. In experiment 2, three sperm separation methods namely centrifugation, swim up and percoll gradient methods were used for separation of motile and viable spermatozoa for IVF. In experiment 3, for capacitation of spermatozoa, IVF medium supplemented with the heparin, mixture of penicillamine, hypotaurine and epinephrine (PHE) or the combination of heparin with PHE were used for fertilization. In vitro culture (IVC) of presumptive zygotes was done in modified synthetic oviduct fluid (mSOF) medium using standard procedure 24 h after sperm-oocytes co-culture. The cleavage rate was determined to evaluate the efficacy of fertilization medium, sperm separation method and sperm capacitating agent 24 h after IVC. The cleavage rate was higher in oocytes fertilized in TALP (63.3%) than in TCM 199 (47.5%) (p < 0.05). The cleavage rate was higher in oocytes fertilized by spermatozoa separated by percoll gradient method (62.3%) than by centrifugation (51.6%) (p < 0.05). The cleavage rate of oocytes was higher when insemination was done with spermatozoa capacitated in TALP supplemented with heparin and PHE (61.3%) compared to control (40.9%) (p < 0.05). In conclusions, TALP based medium and percoll gradient sperm separation followed by capacitation with combination of heparin and PHE are suitable for IVF of indigenous zebu cow oocytes in Bangladesh.

시험관 수정에 대한 신학적 고찰

김승호(Sung-Ho Kim) 영남신학대학교 2019 신학과 목회 Vol.51 No.-

The purpose of this study is focused on the Korean Churches’ theological position to In-vitro fertilization. At the present, theological positions are divided into two: one argues In-vitro fertilization has to be strictly banned, and the other proposes it has to be limitedly permitted. In this context, this study is divided into five parts: Firstly, we examine two positions (prohibition and approval) of In-vitro fertilization in the Korean Churches. Secondly, we analyze two ethical debates on In-vitro fertilization: one is the connection between love and birth versus the principle of benevolence, and the other is residual embryo issue. Thirdly, we look into the method of dealing with bioethical issues in Christian perspectives. Fourthly, we study supplemental considerations on the issue in relation to Christian hospital. In conclusion, this study gives some suggestions for further study on this issue.

체외수정에 반복적으로 실패한 자궁선근증을 동반한 난임환자 치험 1례

정명주,Jung, Myung-Ju 대한한방부인과학회 2017 大韓韓方婦人科學會誌 Vol.30 No.4

Objectives: To report the efficacy of traditional Korean medicine to an infertile patient who repeatedly failed in vitro fertilization. Methods: The patient was diagnosed with adenomyosis and failed in vitro fertilization 9 times. Her dysmenorrhea and physical symptoms were improved through traditional Korean medicine and she was pregnant with the 10th attempt of in vitro fertilization. She had bleeding during pregnancy due to adenomyosis and took herbal medicines to maintain stable condition. Results: During the treatment period, the uterine thickness due to adenomyosis was reduced and her dysmenorrhea was improved. She was pregnant by in vitro fertilization and gave birth to a healthy child by Caesarean section. Conclusions: This case report shows that traditional Korean medical treatments work to improve the success rate of in vitro fertilization.

Effect of Tris, Sodium Bicarbonate and Caffeine in Fertilization Medium on In Vitro Fertilizability of Boar Spermatozoa Frozen in Straws

Eunsong Lee 한국동물생명공학회(구 한국동물번식학회) 2008 Reproductive & developmental biology Vol.32 No.4

The objective of this study was to examine the effect of caffeine and sodium bicarbonate in a fertilization medium on the fertilizability of boar spermatozoa that were frozen in straws. Boar spermatozoa were extended with Beltsville F5 extender and frozen in 0.25‐ml straws. In vitro matured porcine oocytes were fertilized in vitro (IVF) with frozen‐thawed boar spermatozoa for 6 h in a modified tris‐buffered medium (mTBM) or in its modified medium by substituting the tris with 25 mM sodium bicarbonate (modified bicarbonate‐buffered medium; mBBM). Some of inseminated oocytes were fixed and stained for examination of sperm penetration. IVF embryos were cultured in a North Carolina State University‐23 medium for embryo development. The percentage of live sperm was 47±4% and morphological abnormality of acrosome was found in 14±3% of spermatozoa. Optimal sperm concentration for IVF was 0.75~1.0×106 sperms/ml when mTBM containing 5 mM caffeine was used as the fertilization medium. Sperm penetration was significantly (p<0.05) stimulated by increasing caffeine concentration in the IVF medium. In addition, mBBM significantly (p<0.05) increased sperm penetration (92%) compared to mTBM (65%). More (p<0.05) blastocysts (22% vs. 32%) developed from the oocytes that were fertilized in mBBM containing 1 mM caffeine than from those fertilized in mTBM with 5 mM caffeine. Our results indicate that boar spermatozoa can be frozen successfully in straws with holding their normal fertilizability and that caffeine and sodium bicarbonate stimulates sperm penetration in vitro.