Religion, women's health, and obstetrician-gynecologists.

Religions continue to be a strong moral, even political, force in the world. They are often seen to be in conflict with women's health; we argue that this should not continue to be the case. The conflict can be traced back to when religions had their birth and early development in patriarchal communities in which women were marginalized to the edges of society.

Ovarian hyperstimulation syndrome and thrombotic events.

Ovarian hyperstimulation syndrome (OHSS) is one of the most important complications of ovarian stimulation with severe morbidity and is still a threat to every patient undergoing ovulation induction. This manuscript reviews the current evidence regarding the relationship between OHSS and thromboembolism in infertile patients undergoing ovarian stimulation published in the world literature. The PubMed Database was searched for publications on reported cases of OHSS and thromboembolic phenomenon published between 1965 and 2013.

The risks and outcome of pregnancy in an advanced maternal age in oocyte donation cycles.

The maternal age at the first and repeated deliveries constantly rises in developed countries due to current social trends that favor values of personal achievements upon procreation. Assisted reproduction technologies and especially the availability of oocyte donation programs extend the age of fecundity to the fifth and sixth decades of life. The ability to conceive and deliver at such age raises serious medical, moral, social and legal concerns regarding the health and welfare of the mother and child will be presented and discussed here.

Human reproduction: Jewish perspectives.

Developments in science and technology and corresponding clinical applications raise new religious questions, often without clear answers. The role of theology in bioethics is integral to clarify perceived attitudes toward these developments for different religious communities. The Jewish attitude towards procreation is derived from the first commandment of God to Adam to 'Be fruitful and multiply'.

Parathyroid and calcium metabolism disorders during pregnancy.

Parathyroid disorders are not common among pregnant women, but harbor a significant morbidity and mortality potential if they remain unrecognized and untreated. The symptoms caused by abnormally low or high blood free calcium level are mostly non-specific in the initial stages, thus when recognized might pose a real danger. Here we will survey the alterations in calcium metabolism induced by pregnancy, and describe the clinical manifestations, diagnosis and treatment of parathyroid and other calcium metabolism disorders during pregnancy.

Thyroid disorders during pregnancy.

Thyroid physiology is altered during pregnancy as a result of an increase in thyroid-binding globulin, the stimulatory effect of hCG on TSH receptors, and increased peripheral thyroid hormone requirements. In addition, hyper and hypothyroid disorders are prevalent among women of reproductive age, and most of them have a significant impact on the gravida, fetus and neonate. Aberrant thyroid function can be readily recognized and treated during pregnancy, avoiding such complications.

Pregnancies beyond the human biological fecundity.

The maternal age at first delivery constantly rises in developed countries due to a social trend to postpone the age of parenting. Assisted reproduction technologies do extend the age of fecundity to some limit, but their success rate is inversely related to the patients' age. The major factor limiting human fecundity in the fifth decade of life is the quality of the human oocyte.

Cryopreservation of human genetic material.

Up-to-date cryopreservation is a central component of contemporary human-assisted reproduction and fertility preservation technologies. Presently, the preservation of seminal and testicular spermatozoa, embryos, and oocytes can be readily achieved with a high functional survival rate. Preservation of the ovarian cortex containing a greater number of female germ cells is an experimental procedure under extensive investigation in many centers.

Assisted reproductive technology: perspectives in Halakha (Jewish religious law).

The Jewish religion is characterized by a strict association between faith and practical precepts. In principle, Jewish law has two divisions, the Written and the Oral traditions. The foundation of the Written Law and the origin of authority is the Torah, the first five books of the Scripture.

The beginning of human life : status of embryo. Perspectives in Halakha (Jewish Religious Law).

Introduction: The Jewish religion is characterized by a strict association between faith and practical precept. Jewish law has two sections, the written and the oral tradition. The foundation of the written law and the origin of authority is the Torah, the first five books of the Scripture.

Cesarean section upon request: is it appropriate for everybody?

The request for cesarean section without medical indication has become one of the dilemmas faced by the obstetrician. Most recent studies that compare vaginal delivery with elective cesarean section find them equally safe. This comparison is lacking in the option of trial of labor, which may result in an assisted vaginal delivery or intrapartum cesarean section, both with increased morbidity and mortality for the mother and newborn.

Ethical consideration of intentioned preimplantation genetic diagnosis to enable future tissue transplantation.

Recently, a case was presented where a couple with one normal child requested preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) typing in order to conceive children who could serve as mutual donors for future transplantations if needed. While PGD for medical reasons is well defined and accepted, application for non-medical conditions is less obvious and still in debate. The present case calls to further extend the indications for PGD and raises a moral question as to whether to allow such intentioned treatment.

Maternal mortality following diagnostic 2nd-trimester amniocentesis.

We present 2 cases of maternal mortality after transabdominal amniocentesis performed during the 2nd trimester of pregnancy. In both these cases, blood cultures revealed Escherichia coli. Broad-spectrum intravenous antibiotic treatment started immediately after admission to the hospital did not change the rapid progression of the disease.

Ovarian tissue banking for cancer patients: is ovarian cortex cryopreservation presently justified?

The effect of chemotherapy and radiotherapy on future fertility is of concern to patients and their families. Whereas sperm banking is commonly performed, female gametes are not so amenable to cryopreservation. One alternative includes postponing cancer treatment to enable ovulation induction and oocyte aspiration.

Ethical aspects of advanced reproductive technologies.

The progress achieved during the last 25 years in the assisted reproductive technology field has been phenomenal. Many countries currently practice genetic material donation, human embryo cryopreservation, selective embryo reduction, preimplantation genetic diagnosis, and surrogacy. While embryo research and therapeutic cloning are carried out only in a few centers, thus far human cloning has been universally condemned.

Codes of perinatal ethics: an international perspective.

The research on different aspects of perinatal medicine offers valuable avenues into developmental biology and medicine that could markedly improve therapy of the pregnant patient and premature and newborn babies. Research with all sources of human cell stems should be supported to provide new therapeutic modalities. This research should be regulated, peer reviewed, and ethically controlled.

Gender selection: cultural and religious perspectives.

Objective: To review the current developments in the field of preconceptual sex selection and to discuss the cultural and religious perspectives as that accompany the scientific progress.

Design: A survey of the major publications in Judaism, Christianity and Islam regarding the issue of gender selection. Examination of current methods of preconceptual gender selection revealed that in vivo methods such as timing of intercourse, the use of ovulation induction medications, and artificial insemination do not appear to affect the sex ratio to a clinically significant degree.