Fertility treatment enables involuntary childless people to have genetically related children, something that, for many, is a valuable life project. In this paper, I respond to two sets of objections that have been raised against expanding state-funded fertility treatment provision for existing treatments, such as in vitro fertilisation (IVF), and against funding new treatments, such as uterine transplantation (UTx). Following McTernan, I refer to the first set of objections as the ‘one good among many’ objection. It purports that (...) it is unjustifiable for the state to prioritise the funding of the life project of becoming a parent through fertility treatment provision over the funding of other life projects that people might have. Following Lotz, I refer to the second set of objections as the ‘norm-legitimation’ objection. It maintains that the provision of costly forms of fertility treatment, such as UTx, would legitimise problematic social norms concerning genetic relatedness, reproduction and parenting, and that states should not engage in such a legitimation. In response to these objections, I defend the view that (reproductive) preferences ought to be taken more seriously when discussing fertility treatment provision and parental projects, and that not doing so can be costly, especially for women. The approach defended in this paper seeks to avoid disregarding and policing preferences and to reconcile their fulfilment with political projects aimed at improving the material and social conditions of sub-fertile people: people who, for social or biological reasons (or an intersection of the two), are unable to reproduce unassisted. (shrink)

A theory’s fertility is one of the standard theoretical virtues. But how is it to be construed? In current philosophical discourse, particularly in the realism debate, theoretical fertility is usually understood in terms of novel success: a theory is fertile if it manages to make successful novel predictions. Another, more permissible, notion of fertility can be found in the work of Ernan McMullin. This kind of fertility, McMullin claims, gives us just as strong grounds for realism. (...) My paper critically assesses McMullin’s notion of fertility and its realist rationale. It concludes that McMullin’s preferred example, namely the fertile development of the Bohr-Sommerfeld model of the atom, does not support McMullin’s argument for realism. Although the implications for the realism debate are as of yet unclear, the case study offers some important methodological lessons. (shrink)

the virtues which are desirable for scientific theories to possess. In this paper I discuss the several species of theoretical virtues called 'fertility', and argue in each case that the desirability of 'fertility' can be explicated in terms of other, more fundamental theoretical virtues.

Several philosophers have recently argued that policies aimed at reducing human fertility are a practical and morally justifiable way to mitigate the risk of dangerous climate change. There is a powerful objection to such “population engineering” proposals: even if drastic fertility reductions are needed to prevent dangerous climate change, implementing those reductions would wreak havoc on the global economy, which would seriously undermine international antipoverty efforts. In this article, we articulate this economic objection to population engineering and show (...) how it fails. We argue, first, that the economic objection paints an inaccurate picture of the complicated relationship between demographic change and economic growth, and second, that any untoward economic effects of fertility reduction can be mitigated with additional policies. Specifically, we argue that supplementing fertility reduction with policies that facilitate the emigration of younger people from developing nations to developed nations could allow for both global reductions in GHG emissions and continued economic stability. Further, we show that moral arguments against such unprecedented increases in immigration are unsuccessful. We conclude that population engineering is a practical and morally justifiable tool for addressing the twin evils of climate change and global poverty. (shrink)

BackgroundWhile fertility preservation is recommended practice for paediatric oncology patients, it is increasingly being considered for transgender children and young people in paediatric care. This raises ethical issues for clinicians, particularly around consent and shared decision-making in this new area of healthcare.MethodsA systematic review of normative literature was conducted across four databases in June 2020 to capture ethical considerations related to fertility counselling and preservation in paediatric transgender healthcare. The text of included publications was analysed inductively, guided by (...) the Qualitative Analysis Guide of Leuven.ResultsTwenty-four publications were identified for inclusion. Four key ethical considerations emerged from this literature: access to fertility preservation, conscientious objection, decision-making capacity of children and young people, and shared decision-making.ConclusionIn the identified literature, there is consensus that transgender children and young people should not be refused access to fertility preservation services solely due to their gender identity, and that clinicians with conscientious objections to fertility preservation for this group have an obligation to refer on to willing providers. Factors that create ethical complexity in this area of paediatric care include the child’s age, mental health, and parents’ views. (shrink)

Demographic research on fertility has almost exclusively focused on women, however, men’s fertility preferences are equally important to the understanding of the processes and mechanisms that affect fertility. This article analyzes the data from the qualitative study with young (19–34 year old) heterosexual childless Lithuanian men and ex­plores the relationship between fertility desires, visions of fatherhood and perceptions of masculinity. Our results show that independently of whether the study participants have internalized the “male breadwinner” norm, they (...) modelled their fertility desires according to their current financial situation and perceived future income. Their vi­sions of fatherhood were also often framed by the cultural ideal of a man who is strict, tough and is the main family provider. However, the vision of the father who actively participates in childrearing was also common. (shrink)

In the USA, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the survival rate has reached 80%. However, cancer treatments, such as chemotherapy and radiation, are likely to affect their fertility later in life, limiting their ability to conceive. To reduce this risk, ovarian tissue cryopreservation is a surgical procedure that allows the ovarian tissue to be retrieved and cryopreserved in order to be reimplanted back into the abdomen and restore (...) ovarian function in children who become infertile due to gonadotoxic treatments. A case study published in 2014 offered recommendations to help assess whether such a procedure should be offered to female patients who have not yet entered puberty. This paper will investigate whether, in light of more recent and updated literature, their recommendations may need to be revised. (shrink)

Australian women who are university graduates have fewer children than non-graduates. In most cases this appears to be the result of circumstantial pressures not preference. Long years of study fill the most fertile years of women students and new graduates need further time to establish their careers. The chance of medical infertility increases with age so, for some, this means that childbearing is not postponed but ruled out. Graduates who do make the transition from university to professional work find that (...) working hours are long and that professional occupations are now both highly demanding and insecure. Women who take time off to care for young children must depend on one insecure income (their partner’s) rather than two, and their return to work is uncertain. These difficulties of time, money and insecurity are compounded by problems in finding a suitable partner. They are magnified by the enduring tendency of women to marry up. Thus it can be more difficult for women graduates to find husbands than it is for women who are non-graduates. (shrink)

SummaryA sample of 104 British parents with criminal convictions had an average fertility of 3·91 children as compared with 2·21 for the general population. The result suggests that fertility for criminal behaviour is dysgenic involving an increase in the genes underlying criminal behaviour in the population.

Many states offer generous provision of fertility treatment, but this article asks whether and how such state funding can be justified. I argue that, at most, there is limited justification for state funding of fertility treatment as one good among many that could enable citizens to pursue valuable life projects, but not one that should have the privileged access to funding it is currently given. I then consider and reject reasons one might think that fertility treatment has (...) a special claim to funding, over the other goods that might enable life projects. First, I deny that fertility treatment has a special claim to funding on the grounds that infertility is a disease or disability. Second, I argue that individuals do not have a right to assistance with the project of having a child of their own. Third, I deny that providing fertility treatment is a special case on the grounds that having children is good for society. However, there may be one exception: states have a reason to fund fertility treatment for same sex couples that does not apply to heterosexual couples. (shrink)

Demographic transition faced by modern economies, including China, are among the most important long-term socio-economic challenges. In 2022, China observed its population decline for the first time since the early 1960s. The low fertility rate was of critical importance. The unprecedented one-child policy is quite commonly indicated as the main reason for the low fertility rate. However, the departure from this restrictive policy and the actions introduced under the two-child policy implemented from 2016, and then the three-child policy (...) from mid-2021, have not brought an improvement in fertility rates. The aim of the paper is to answer the following research questions: Should the decline and persistent low fertility rate in China be attributed solely or mainly to the unprecedented one-child policy, which was in force for over three decades? Fertility transition in China is the effect of several factors and depends largely on the studied period. In the 1970s and 1980s, the government’s family policy was a key determinant of the decline in fertility. However, contrary to the prevailing belief about the determining influence of the one-child policy, the first stage of the implementation of the birth control policy, the Wan, Xi, Shao program, had a greater impact. Since the 1990s, the low fertility rate has been mainly explained by the extraordinary socio-economic changes and rapidly increasing prosperity of the Chinese people. Since the beginning of the 21st century, cultural changes resulting mainly from the integration of the Chinese economy with the global system have been crucial. Cultural changes have affected reproductive behaviour, marriage patterns, marriage postponement, birth postponement, fertility, and family size in Chinese society, which is observed below-replacement fertility. China’s demographic future depends on the fertility trajectory. However, due to the size of the population, but also the position of the Chinese economy in the global economic system, Chinese demographic transition may also bring significant consequences for the global economy. (shrink)

Global reproductive landscapes and with them cross-border routes are rapidly changing. This paper examines the reproductive routes and choices of fertility travellers from China to Russia as reported by medical professionals and fertility service providers. Providing new empirical data, it raises new ethical questions on the facilitation of cross-border reproductive travel and the commercialisation of reproductive treatment. The relaxation of the one-child policy in 2014 in China, the increasing demand for ART exceeding the capacity of national fertility (...) clinics and the difficulty of accessing treatment with donor eggs concomitant with a growing economic power of the upper–middle class are shaping the ART industry in Asia in new ways. A new development is Chinese citizens increasingly seeking ART treatment in Russia, which has a long-standing practice of ART governed by a liberal legislation. Furthermore, as China prohibits the export of gametes, Chinese fertility travellers rely on acquiring donor gametes once starting treatment abroad. Clinicians in Russia report three strategies amongst their Chinese patients: One group is using donor eggs of women of Asian appearance living in Russia or is hiring women of resembling appearance from third-party countries to donate their eggs in Russia to create resemblance in their offspring. Another group is buying white donor gametes to create Eurasian mixed children and thus ‘enhance’ their offspring. Providing novel empirical data, this article informs ethical deliberation and raises imminent questions for further research in this understudied geographic region and on cross-border reproductive treatment. (shrink)

Over the last two decades, social scientists across disciplines have been researching how value is extracted and governed in the reproductive bioeconomy, which broadly refers to the various ways reproductive tissues, bodies, services, customers, workers, and data are inserted into capitalist modes of accumulation. While many of these studies are empirically grounded in single country–based analyses, this paper proposes an integrative political economy framework, structured around the concept of “global fertility chains.” The latter articulates the reproductive bioeconomy as a (...) nexus of intraconnected practices, operations, and transactions between enterprises, states, and households across the globe, through which reproductive services and commodities are produced, distributed, and consumed. Employing a diffractive reading of the literature on commodity chains and care chains, this unified approach scrutinizes the coproduction of value, biology, and technoscience and their governance mechanisms in the accumulation of capital by taking into account the unevenly developed geographies of global fertility chains, their reliance on women’s waged and unwaged reproductive labor, and the networked role of multiple actors at multiple scales without losing sight of the constitutive role of national states in creating demand, organizing supply, and accommodating the distribution of surplus value. We empirically ground this integrative political economy approach of the reproductive bioeconomy through collaborative, multisited fieldwork on transnational reproduction networks in Israel/palestine, Romania, Georgia, and Spain. (shrink)

We aim at investigating the connection between the negative change in fertility intentions and change in socio-economic resources (financial, mental, physical, life satisfaction) caused by COVID-19 containment measures for millennials in Lithuania. We use data from the Families and Inequalities Survey carried out in Lithuania in 2021. It is a representative dataset covering the cohort born between 1985 and 1989 (n = 1000). Analytically, we employ the multinomial logistic regression with robust standard errors. We find a positive association between (...) a likelihood of postponing fertility intentions and having a partner. Worsening life satisfaction is positively associated to downgrading fertility intentions. (shrink)

For half a century, humanity has been experiencing a sustained decline in its fertility rate. According to recent reports from the UN Population Division, it is highly likely that a period of human population decline will begin toward the end of this century. In this paper, we identify and analyze three causes that explain, at least partially, the phenomenon of the decline of the global fertility rate: the economic difficulties faced by young couples, the effects of the sexual (...) revolution, and the current zeitgeist. These causes help explain why people of reproductive age choose not to enter marriages open to life. We also define six desiderata that any solution to the challenge of the low fertility rate should meet from a Catholic moral perspective and offer two arguments in favor of an “openness to life” position. (shrink)

What is sex and why is it important? Does marriage have a basic rationale? How should couples manage their fertility, and when and how should pregnancy be achieved? How should we respond to 'embryo adoption', teenage pregnancy, population growth, HIV/AIDS and other STIs, same-sex attraction? This collection of original essays looks at these and other pivotal issues in reproductive and sexual ethics, from the perspectives of philosophy, theology, psychology and economic science.

Our objective is to test an optimality model of human fertility that specifies the behavioral requirements for fitness maximization in order (a) to determine whether current behavior does maximize fitness and, if not, (b) to use the specific nature of the behavioral deviations from fitness maximization towards the development of models of evolved proximate mechanisms that may have maximized fitness in the past but lead to deviations under present conditions. To test the model we use data from a representative (...) sample of 7,107 men living in Albuquerque, New Mexico, between 1990 and 1993. The model we test proposes that low fertility in modern settings maximizes number of grandchildren as a result of a trade-off between parental fertility and next generation fertility. Results do not show the optimization, although the data do reveal a trade-off between parental fertility and offspring education and income.We propose that two characteristics of modern economies have led to a period of sustained fertility reduction and to a corresponding lack of association between income and fertility. The first is the direct link between costs of investment and wage rates due to the forces of supply and demand for labor in competitive economies. The second is the increasing emphasis on cumulative knowledge, skills, and technologies in the production of resources. Together they produce historically novel conditions. These two features of modern economies may interact with evolved psychological and physiological mechanisms governing fertility and parental investment to produce behavior that maximizes the economic productivity of lineages at the expense of fitness. If cognitive processes evolved to track diminishing returns to parental investment and if physiological processes evolved to regulate fertility in response to nutritional state and patterns of breast feeding, we might expect non-adaptive responses when returns from parental investment do not diminish until extremely high levels are reached. With high economic payoffs from parental investment, people have begun to exercise cognitive regulation of fertility through contraception and family planning practices. Those cognitive processes maynot have evolved to handle fitness trade-offs between fertility and parental investment. (shrink)

Fertility preservation refers to a new reality (made possible by advances in biotechnologies) in which individuals can retain the ability to reproduce even after losing their natural reproductive function as a result of specific (in many cases lifesaving) clinical treatments.

Assessing what counts as infertility has practical implications: access to (state-funded) fertility treatment is usually premised on meeting the criteria that constitute the chosen definition of infertility. In this paper, I argue that we should adopt the expression “involuntary childlessness” to discuss the normative dimensions of people’s inability to conceive. Once this conceptualization is adopted, it becomes clear that there exists a mismatch between those who experience involuntary childlessness and those that are currently able to access fertility treatment. (...) My concern in this article is explaining why such a mismatch deserves attention and what reasons can be advanced to justify addressing it. My case rests on a three-part argument: that there are good reasons to address the suffering associated with involuntary childlessness; that people would decide to insure against it; and that involuntary childlessness is characterized by a prima facie exceptional kind of desire. (shrink)

This article reads the uptake of facial-matching algorithms by fertility clinics in Spain through the lens of ‘the fertility fix’: a software fix to the social reconfiguration of kinship and a fixed capital investment made by competing fertility companies and firms. ‘The fertility fix’ is proposed as a critical, ethical lens through which to situate algorithmic facial-matching in assisted reproduction in the context of the racial politics of the face and phenotype and the spatial politics of (...) market expansion. While an ‘infertility crisis’ is often mentioned when explaining the growth of the assisted reproductive technologies (ARTs) industry, the use of donated reproductive cells is tied up in societal, ecological and economic shifts. Combining Software Studies analysis with Marxist Feminist and trans*feminist perspectives on shifting re/production dynamics, the article details the role of computational technologies in promoting certain ideas and beliefs about family and fixing certain territories of capital flow. (shrink)

The sources, extent and margins of parental obligations in taking decisions regarding their children’s medical care are subjects of ongoing debates. Balancing children’s immediate welfare with keeping their future open is a delicate task. In this paper, we briefly present two examples of situations in which parents may be confronted with the choice of whether to authorise or demand non-therapeutic interventions on their children for the purpose of fertility preservation. The first example is that of children facing cancer treatment, (...) and the second of children with Klinefelter syndrome. We argue that, whereas decisions of whether to preserve fertility may be prima facie within the limits of parental discretion, the right to an open future does not straightforwardly put parents under an obligation to take actions that would detect or relieve future infertility in their children—and indeed in some cases taking such actions is problematic. (shrink)

Fertility preservation has become more common for various populations, including oncology patients, transgender individuals, and women who are concerned about age-related infertility. Little attention has been paid to fertility preservation for patients with differences/disorders of sex development (DSD). Our goal in this article is to address specific ethical considerations that are unique to this patient population. To this end, we present a hypothetical DSD case. We then explore ethical considerations related to patient’s age, risk of cancer, concern about (...) genetic transmission of a DSD condition to children, co-occurring gender dysphoria, and access to experimental fertility preservation procedures. Given the limitations of current technologies, we recommend offering fertility preservation to individuals living with DSD using an informed decision-making approach that instills realistic expectations and minimizes the potential for false hope. Finally, we conclude with practical recommendations for this case based on the ethical considerations. (shrink)

Freezing Fertility: Oocyte Cryopreservation and the Gender Politics of Aging is the fourth path-breaking monography in the flourishing literature on egg freezing in just a few years. In April 2019, The Oocyte Economy: The Changing Meaning of Human Eggs by the renowned Australian social scientist Catherine Waldby, was published, the first book to examine the emergence of a global market for eggs through biomedical innovation. In September 2019, sociologist Kylie Baldwin of De Montfort University published Egg Freezing, Fertility (...) and Reproductive Choice: Negotiating Responsibility, Hope and Modern Motherhood, in which she explores the experiences of some pioneering women who are having eggs frozen in the United... (shrink)

Fertility control refers to the power humankind has acquired but is constantly growing to make decisions concerning reproduction rather than leaving it to nature or human biology.

Ghanaian fertility decline may not be associated with women's having greater control over reproduction. Focus groups of young Ghanaian men and women indicate that attitudes supporting men's dominance in fertility decisions characterize even the highly educated. Young women with high fertility desires anticipate being able to stop childbearing when they want to, but they do not expect to be able to continue if their husband wants to stop. Those with low fertility desires do not anticipate being (...) able to stop without husband consent, but they envision support for continuing childbearing. Women's expected influence appears limited to situations where their fertility desires conform to normative expectations. (shrink)

Birth control is the use of methods or devices to prevent pregnancy.

Globally, mortality and fertility rates generally fall as resource abundance increases. This pattern represents an evolutionary paradox insofar as resource-rich ecological contexts can support higher numbers of offspring, a component of biological fitness. This paradox has not been resolved, in part because the relationships between fertility, life history strategies, reproductive behavior, and socioeconomic conditions are complex and cultural-historically contingent. We aim to understand how we might make sense of this paradox in the specific context of late-twentieth-century, mid–demographic transition (...) Chile. We use distribution-specific generalized linear models to analyze associations between fertility-related life-history traits—number of offspring, ages at first and last reproduction, average interbirth interval, and average number of live births per reproductive span year—and socioeconomic position (SEP) using data from a cohort of 6,802 Chilean women born between 1961 and 1970. We show that Chilean women of higher SEP have shorter average interbirth intervals, more births per reproductive span year, later age at first reproduction, earlier ages at last reproduction, and, ultimately, fewer children than women of lower SEP. Chilean women of higher SEP consolidate childbearing over a relatively short time span in the middle of their reproductive careers, whereas women of lower SEP tend to reproduce over the entirety of their reproductive lifespans. These patterns may indicate that different SEP groups follow different pathways toward declining fertility during the demographic transition, reflecting different life-history trade-offs in the process. (shrink)

A commentary on “Why We Should All Pay for Fertility Treatment: An Argument from Ethics and Policy,” from the March‐April 2013 issue.

It has been claimed that modern long-standing scientific theories are fertile, in the sense of having been progressively successfully modified to meet new experimental observations or theoretical developments in related areas, and that these modifications arise naturally from each preceding version of the theory. McMullin has advanced this form of fertility as a vindication of scientific realism, since if the theories did not approximate the real, the observation would be inexplicable. In response Nolan has denied the existence of (...) class='Hi'>fertility in this sense as an independent virtue. The present paper argues that the rebuttal is flawed. Introduction McMullin's P-fertility Fertility Explained Away as Novel Prediction Conclusion CiteULike Connotea Del.icio.us What's this? (shrink)

Reality TV is immensely popular, and various shows in this media genre involve a storyline of infertility and infertility treatment. Feminists argue that normative and constructed realities about infertility and infertility treatment, like those in reality TV, are central to the emancipation of women. Such realities are able to steer viewers' perceptions of the world. This article examines the emancipatory significance of representations of women on 'infertility reality TV shows'. While the women in these shows all have 'abnormal' qualities, we (...) consider their portrayal as figurations of monstrosity. In the literature, monstrosity is understood as a way to challenge nonemancipatory norms by offering an alternative identity. Through a content analysis of seven reality TV shows, we identified four types of in/fertile monsters: the cyborg, the freak, the abject, and the childless. We show that these monsters are predominantly non-emancipatory as they all involve mechanisms of altering, excluding, or condemning infertility in relation to what is considered normal and acceptable womanhood. Therefore, at the end of this article, we make a plea for more diverse and emancipatory representations of infertile women in popular culture. (shrink)

Using the matched wife fertility intention. The analysis used logistic regression models for predicting the effects of selected socioeconomic background characteristics on a couples fertility intention was associated with age, education, place of residence, frequency of television-watching and number of living children. Therefore, programme interventions aimed at promoting fertility reduction in Nigeria should convey fertility regulation messages to both husbands and wives.

During mammalian fertilization sperm bind to the egg's zona pellucida (ZP) after undergoing capacitation. Capacitated mouse sperm bind to mZP3 (one of three ZP glycoproteins), undergo the acrosome reaction, penetrate the ZP, and fuse with egg plasma membrane. Sperm protein 56 (sp56), a member of the C3/C4 superfamily of binding proteins, was identified nearly 20 years ago as a binding partner for mZP3 by photoaffinity cross‐linking of acrosome‐intact sperm. However, subsequent research revealed that sp56 is a component of the sperm's (...) acrosomal matrix and, for sperm with an intact acrosome, should be unavailable for binding to mZP3. Recently, this dilemma was resolved when it was recognized that some acrosomal matrix (AM) proteins, including sp56, are released to the sperm surface during capacitation. This may explain why uncapacitated mammalian sperm are unable to bind to the unfertilized egg ZP. (shrink)

Population is a key factor of national power. Declining fertility rates, especially in major economies, are reshaping global power dynamics by shrinking workforces amidst aging populations. In response, more nations are adopting techno-natalist policies, promoting reproductive technologies (“reprotech”) like IVF to increase birth rates. Advances in genetic embryo selection, gene editing, in vitro gametogenesis, and artificial wombs could further enhance these policies by improving birth rates, health, and human capital. This article examines current and emerging reprotechnologies, the policy landscape, (...) socioeconomic and geopolitical implications, and future research directions. By shaping national and global gene pools, reprotech policies and practices offer a paradigmatic case of gene–culture coevolution. If these technologies prove safe and effective, nations that embrace them are likely to gain geopolitical and evolutionary advantages over those that do not. (shrink)

Smartphones are increasingly entangled with the most intimate areas of everyday life, providing possibilities for the continued expansion of digital self-tracking technologies. Within this context, the development of smartphone applications targeted at female reproductive health are offering novel forms and practices of knowledge production about reproductive bodies and processes. This article presents empirical research from the United Kingdom on women’s use of fertility tracking applications, known more generally as fertility apps, while trying to conceive. Drawing on material from (...) interviews with women who had experience of using fertility apps, I demonstrate the significance of this particular form of fertility tracking for the embodied shift from pregnancy prevention to actively facilitating pregnancy, participants’ sense of self and identity and how they perceived the reproductive potentiality of their bodies. I argue that fertility apps are significantly involved in making fertility cycles known and thus configuring the pre-pregnant reproductive body. (shrink)

Fertility treatments raise a range of social and ethical issues regarding self-identity for family, sexual intimacy, and the interests and welfare of potential children. Eggs and sperm are combined to produce fertilized eggs. These eggs are then implanted as embryos and grow into viable fetuses, which are carried by the original mother or a surrogate mother. This artificial form of conception can challenge religious values and family structures. In-vitro fertilization (IVF) can be considered either as a medical miracle or (...) playing with divinity. What obligation do medical professionals have to infertile women and to what extent? The bioethical dilemma of IVF use encompasses different moral issues for all involved in the process. Ethical issues address respect for personal autonomy, access and care, and the duty of the health care provider to be compassionate to persons whose actions and moral values may be different from their own. Health care providers need to impart empathy, understanding and sensitivity towards this unique type of patient population. The conflict for those treating patients who are trying to conceive by IVF includes respect for personal autonomy, nonmaleficence, justice, utility and the ethics of care. As a registered nurse in a postpartum hospital unit, I have seen antepartum and postpartum women involved with this new technology. I have worked with mothers and their partners as they experience different levels of anxiety and hope for the future. There is an underlying psychosocial connection with patients who undergo IVF treatments. The purpose of this article is to explore the ethical use of IVF on older women. Is this type of biotechnolgy being applied for the right reasons and for the best patient population? (shrink)

A growing number of infertile couples and other individuals desiring children are seeking to fulfill their desire for parenthood transnationally through the use of donor gametes and a surrogate. The number of “fertility tourists” from developed countries to low-income countries is growing phenomenally. Indian women, too, are participating as (re)producers in these “biocrossings,” turning India into the surrogacy outsourcing capital of the world in the globalized bioeconomy of assisted reproduction. I argue for a ban on commercial egg donation and (...) surrogacy and a social-justice approach that would hold the state responsible for providing basic social goods to low-income households. I also argue for a gender-justice approach so that women would not be compelled to adopt surrogacy as a strategy for survival and upward social mobility. (shrink)

En busca de comprender los cambios en la fecundidad en el Noroeste argentino, este estudio tiene por objetivo analizar su comportamiento entre 2015 y 2020. La investigación se justifica por la relevancia de examinar cómo ha evolucionado en los últimos años en la región. Mediante un análisis cuantitativo y descriptivo, a partir de los datos obtenidos del Departamento de Estadísticas e Información de la Salud (DEIS), se calcularon Tasas Específicas de Fecundidad (TEF) y Tasas Globales de Fecundidad (TGF). Las TGF (...) fueron categorizadas entre aquellas que se situaron por debajo de 2.1 (nivel de reemplazo), 1.6 (nivel de baja fecundidad) y 1.3 (nivel de muy baja fecundidad) hijos en promedio por mujer. Se aplicaron los modelos de baja fecundidad que la ONU propuso en 1963 para analizar las TEF, identificando tres regímenes de fecundidad: temprano, dilatado y tardío. Se observó el cambio en las TEF de 15 a 19 años y su relación con el resto de los grupos etarios. Los resultados revelan que, durante el periodo 2015-2020, la fecundidad en el promedio regional y en las provincias del NOA experimentó un pronunciado descenso; que las TGF se situaron por debajo del umbral mínimo de reemplazo, e incluso en algunos casos alcanzaron niveles de baja y muy baja fecundidad, oscilando entre 1.6 y 1.3 hijos en promedio por mujer; y que se produjo una concentración de los nacimientos en el grupo de mujeres de 25 a 29 años. (shrink)

Many conserved eukaryotic traits, including apoptosis, two sexes, speciation and ageing, can be causally linked to a bioenergetic requirement for mitochondrial genes. Mitochondrial genes encode proteins involved in cell respiration, which interact closely with proteins encoded by nuclear genes. Functional respiration requires the coadaptation of mitochondrial and nuclear genes, despite divergent tempi and modes of evolution. Free‐radical signals emerge directly from the biophysics of mosaic respiratory chains encoded by two genomes prone to mismatch, with apoptosis being the default penalty for (...) compromised respiration. Selection for genomic matching is facilitated by two sexes, and optimizes fitness, adaptability and fertility in youth. Mismatches cause infertility, low fitness, hybrid breakdown, and potentially speciation. The dynamics of selection for mitonuclear function optimize fitness over generations, but the same selective processes also operate within generations, driving ageing and age‐related diseases. This coherent view of eukaryotic energetics offers striking insights into infertility and age‐related diseases. (shrink)

Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I (...) argue that the starting point for deliberating about a particular patient should be a rebuttable presumption that fertility preservation ought to be attempted. Consideration of the harms applicable to that specific patient may then override this presumption. I outline the benefits of attempting fertility preservation; these justify a presumption in favour of the treatment. I then discuss the potential harms associated with fertility preservation procedures, which may justify failing to attempt fertility preservation in an individual patient's particular case. Moving from a framework of offer to one of rebuttable presumption in favour of fertility preservation would have significant implications for medical practice, healthcare organizations and the state. (shrink)

Male fertility–related mHealth (MFmHealth), including smartphone applications that allow men to test their fertility at home, is getting some attention now and then. In this commentary, I argue that MFmHealth technology has the potential to undermine established norms around male reproduction but cannot be examined using traditional individualist frameworks in bioethics. Instead, theoretical literature on the concept of vulnerability in feminist bioethics allow a theoretical alliance with critical studies of men and masculinities. Proposed benefits like empowerment, shared responsibility, (...) and democratization may justify disruptive innovation but may also obscure more fundamental ethical concerns about vulnerability and social justice. (shrink)

Sustaining soil fertility is essential to the prosperity of many households in the mid-hills of Nepal, but there are concerns that the breakdown of the traditional linkages between forest, livestock, and cropping systems is adversely affecting fertility. This study used triangulated data from surveys of households, discussion groups, and key informants in 16 wards in eastern and western Nepal to determine the existing practices for soil fertility management, the extent of such practices, and the perception of the (...) direction of changes in soil fertility. The two principal practices for maintaining soil fertility were the application of farmyard manure (FYM) and of chemical fertilizer (mainly urea and diammonium phosphate). Green manuring, in-situ manuring, slicing terrace risers, and burning plant residues are rarely practiced. FYM usage was variable with more generally applied to khet land (average 6053 kg fresh weight manure ha−1) than to bari land (average 4185 kg fresh weight manure ha−1) with manure from goats and poultry preferred above that from cows and buffaloes. Almost all households (98%) apply urea to khet land and 87% to bari land, with 45% applying diammonium phosphate to both types of land. Application rates and timings of applications varied considerably both within and between wards suggesting poor knowledge transfer between the research and farming communities. The benefits of chemical fertilizers in terms of ease of application and transportation in comparison with FYM, were perceived to outweigh the widely reported detrimental hardening of soil associated with their continued usage. Among key informants, FYM applied in conjunction with chemical fertilizer was the most popular amendment, with FYM alone preferred more than chemical fertilizer alone – probably because of the latter’s long-term detrimental effects. Key informant and householder surveys differed in their perception of fertility changes in the last decade probably because of differences in age and site-specific knowledge. All key informants felt that fertility had declined but among households, only about 40% perceived a decline with the remainder about evenly divided between no change and an increase. Householders with small landholdings (< 0.5 ha) were more likely to perceive increasing soil fertility while those with larger landholdings (> 2 ha) were more likely to perceive declining fertility. Perceived changes in soil fertility were not related to food self-sufficiency. The reasons for the slow spread of new technologies within wards and the poor understanding of optimal use of chemical fertilizers in conjunction with improved quality FYM may repay further investigation in terms of sustaining soil fertility in this region. (shrink)

An ethical issue that has largely been overlooked and neglected is the potential conflict of interests faced by medical professionals in the recruitment, counselling and reimbursement of egg donors. It must be noted that fertility treatment in private practice is an overwhelmingly profit-driven enterprise. To attract more patients and generate more income, there is a strong incentive for fertility clinics and doctors to actively and aggressively recruit women for their egg donation programme. In some countries where substantial financial (...) remuneration for egg donation is permitted—for example, the United States,1 2 fertility doctors and clinical embryologists often act as the “middleman” or broker to facilitate the transaction of eggs between donor and recipient. Very often, the usual practice is for fertility clinics to charge patients a commission for sourcing egg donors, which is an additional profit on top of substantial medical fees that would be earned from provision of fertility treatment to the same patient. This is ethically contentious; because the money earned is not directly related to medical services rendered to the patient, but is instead attributed to the brokerage and transaction of donated human material.There is a risk that the welfare of the …. (shrink)

Fulfilling the "unmet need for contraceptives" in Latin America is still a contested rallying cry for local activists, policymakers, and physicians. It evokes both the consumerist aspiration to choose birth control methods, as well as implies the existence of health and welfare institutions that ought to guarantee a human right. In the 1940s, however, the "unmet need for contraceptives" was a fledgling notion that a group of experts had only begun to popularize through the use of a crucial population-making technology: (...) the fertility survey. This paper analyzes the role fertility surveyors played in the mid-twentieth century, framing Latin American populations as rapidly growing and likely... (shrink)

Although precision medicine cuts across a large spectrum of professions, interdisciplinary and cross-sectorial moral deliberation has yet to be widely enacted, let alone formalized in this field. In a recent research project on precision medicine, we designed a dialogical forum (i.e. ‘the Ethics Laboratory’) giving interdisciplinary and cross-sectorial stakeholders an opportunity to discuss their moral conundrums in concert. We organized and carried out four Ethics Laboratories. In this article, we use Simone de Beauvoir’s concept of moral ambiguity as a lens (...) to frame the participants’ experience with fluid moral boundaries. By framing our approach through this concept we are able to elucidate irremediable moral issues that are collectively underexplored in the practice of precision medicine. Moral ambiguity accentuates an open and free space where different types of perspectives converge and can inform each other. Based on our study, we identified two dilemmas, or thematic interfaces, in the interdisciplinary moral deliberations which unfolded in the Ethics Laboratories: (1) the dilemma between the individual and the collective good; and (2) the dilemma between care and choice. Through our investigation of these dilemmas, we show how Beauvoir’s concept of moral ambiquity not only serves as a fertile catalyst for greater moral awareness but, furthermore, how the concept can become an indispensable part of the practices of and the discourse about precision medicine. (shrink)

The behaviour and roles of the microtubule network and the microfilaments following fertilization in the mouse oocyte are described. The microtubule network is organized by multiple microtubule organizing centres (MTOCs) and these play a major role in establishing spindle structure and pronuclear movement following fertilization; in contrast to sea urchin and frog eggs, the sperm centriole plays little part in organization of the post‐fertilization spindle. The microfilaments are required for spindle rotation, polar body formation, certain changes in the egg cortex, (...) and also for pronuclear movement. Influences of the chromosomes on microtubule and microfilament organisation are also discussed. (shrink)

This article examines gynecological decision-making in clinical contexts where interventions carry significant implications for fertility and future reproductive possibilities. Conditions such as uterine fibroids, endometriosis, and ovarian cysts are commonly managed through treatments that differ in their potential impact on reproductive capacity, introducing an ethical dimension beyond immediate symptom management. This proposes a theological-bioethical framework of clinical discernment as a conceptual supplement to shared decision-making in reproductive healthcare. Drawing primarily on Karol Wojtyla’s personalist philosophy, it advances an account of (...) the human person as an irreducible moral subject whose embodied life carries existential and relational significance. Clinical discernment is understood as a structured ethical orientation that enhances standard biomedical reasoning by integrating attention to value-laden dimensions of fertility-related care. The framework articulates hope as an ethically relevant category referring to the openness of the patient’s future possibilities, and fertility as a dimension of embodied personhood with relational meaning beyond biological function. On this basis, the article outlines a fertility-sensitive approach to gynecological care emphasizing proportionality in intervention, clarity and responsibility in risk communication, and holistic patient accompaniment. The paper concludes that integrating clinical discernment into gynecological decision-making offers a philosophically and theologically grounded enrichment of contemporary reproductive healthcare by aligning biomedical practice with a personalist account of moral agency, embodied dignity, and future-oriented care. (shrink)