I decided not to blog today & instead let you guys read something that every Indian should. The following is our President Abdul Kalam's speech to the IT Industry yuppies at Bangalore.
"I have three visions for India.
In 3000 years of our history people from all over the world have come and invaded us, captured our lands, conquered our minds. From Alexander onwards.The Greeks, the Turks, the Moguls, the Portuguese, the British, the French, the Dutch, all of them came and looted us, took over what was ours.
Yet we have not done this to any other nation. We have not conquered anyone. We have not grabbed their land, their culture, their history and tried to enforce our way of life on them. Why? because we respect the freedom of others.
That is why my first vision is that of FREEDOM. I believe that India got its first vision of this in 1857, when we started the war of independence. It is this freedom that we must protect and nurture and build on. If we are not free, no one will respect us.
My second vision for India is DEVELOPMENT. For fifty years we have been a developing nation. It is time we see ourselves as a developed nation. We are among top 5 nations of the world in terms of GDP. We have 10 percent growth rate in most areas. Our poverty levels are falling. Our achievements are being globally recognized today. Yet we lack the self-confidence to see ourselves as a developed nation, self- reliant and self-assured. Isn't this incorrect?
I have a THIRD vision. India must stand up with our own STRENGTH to the world. Because I believe that unless India stands up to the world, no one will respect us. Only strength respects strength. We must be strong not only as a military power but also as an economic power. Both must go hand-in-hand. My good fortune was to have worked with three great minds. Dr. Vikram Sarabhai of the Dept. of space, Professor Satish Dhawan, who succeeded him and Dr.Brahm Prakash, father of nuclear material. I was lucky to have worked with all three of them closely and consider this the great opportunity of my life.
I see four milestones in my career:
ONE: Twenty years I spent in ISRO. I was given the opportunity to be the project director for India's first satellite launch vehicle, SLV3. The one that launched Rohini. These years played a very important role in my life of Scientist.
TWO: After my ISRO years, I joined DRDO and got a chance to be the part of India's guided missile program. It was my second bliss when Agni met its mission requirements in 1994.
THREE: The Dept. of Atomic Energy and DRDO had this tremendous partnership in the recent nuclear tests, on May 11 and 13. This was the third bliss. The joy of participating with my team in these nuclear tests and proving to the world that India can make it, that we are no longer a developing nation but one of them. It made me feel very proud as an Indian.The fact that we have now developed for Agni a re-entry structure,for which we have developed this new material. A very light material called carbon-carbon.
FOUR: One day an orthopaedic surgeon from Nizam Institute of Medical Sciences visited my laboratory. He lifted the material and found it so light that he took me to his hospital and showed me his patients. There were these little girls and boys with heavy metallic callipers weighing over three Kg each, dragging their feet around. He said to me: Please remove the pain of my patients. In three weeks, we made these Floor reaction Orthosis 300 gram callipers and took them to the orthopaedic centre. The children didn't believe their eyes. From dragging around a three kg. load on their legs, they could now move around! Their parents had tears in their eyes. That was my fourth bliss!
Why is the media here so negative? Why are we in India so embarrassed to recognize our own strengths, our achievements? We are such a great nation. We have so many amazing success stories but we refuse to acknowledge them. Why?
We are number one in the world in milk production. We are number one in Remote Sensing satellites. We are the second largest producer of wheat. We are the second largest producer of rice. Look at Dr. Sudarshan, he has transformed the tribal village into a self-sustaining, self-driving unit. There are millions of such achievements but our media is only obsessed in the bad news and failures and disasters.
I was in Tel Aviv once and I was reading the Israeli newspaper. It was the day after a lot of attacks and bombardments and deaths had taken place. The Hamas had struck. But the front page of the newspaper had the picture of a Jewish gentleman who in five years had transformed his desert land into an orchard and a granary. It was this inspiring picture that everyone woke up to. The gory details of killings, bombardments, deaths, were inside in the newspaper, buried among other news. In India we only read about death, sickness, terrorism, crime. Why are we so NEGATIVE?
Another question:
Why are we, as a nation, so obsessed with foreign things? We want foreign TVs, we want foreign shirts. We want foreign technology. Why this obsession with everything imported?. Do we not realize that self-respect comes with self-reliance? I was in Hyderabad giving this lecture, when a 14 year old girl asked me for my autograph. I asked her what her goal in life is:
She replied: I want to live in a developed India. For her, you and I will have to build this developed India. You must proclaim. India is not an under-developed nation; it is a highly developed nation.
YOU say that our government is inefficient. YOU say that our laws are too old. YOU say that the municipality does not pick up the garbage. YOU say that the phones don't work, the railways are a joke, the airline is the worst in the world, mails never reach their destination. YOU say that our country has been fed to the dogs and is the absolute pits. YOU say, say and say. What do YOU do about it? Take a person on his way to Singapore. Give him a name - YOURS. Give him a face - YOURS. YOU walk out of the airport and you are at your International best. In Singapore you don't throw cigarette butts on the roads or eat in the stores. YOU are as proud of their Underground Links as they are. You pay $5 approx. Rs.60) to drive through Orchard Road (equivalent of Mahim Causeway or Pedder Road) between 5 PM and 8 PM. YOU comeback to the parking lot to punch your parking ticket if you have over stayed in a restaurant or a shopping mall irrespective of your status identity. In Singapore you don't say anything, DO YOU?
YOU wouldn't dare to eat in public during Ramadan, in Dubai. YOU would not dare to go out without your head covered in Jeddah. YOU would not dare to buy an employee of the telephone exchange in London at 10 pounds (Rs.850) a month to, "see to it that my STD and ISD calls are billed to someone else." YOU would not dare to speed beyond 55 mph (88 kmph) in Washington and then tell the traffic cop, "Jaanta hai sala main kaun hoon (Do you know who I am?). I am so and so's son. Take your two bucks and get lost." YOU wouldn't chuck an empty coconut shell anywhere other than the garbage pail on the beaches in Australia and New Zealand. Why don't YOU spit Paan on the streets of Tokyo? Why don't YOU use examination jockeys or buy fake certificates in Boston? We are still talking of the same YOU. YOU who can respect and conform to a foreign system in other countries But cannot in your own. You who will throw papers and cigarettes on the road the moment you touch Indian ground. If you can be an involved and appreciative citizen in an alien country why cannot you be the same here, in India.
Once in an interview, the famous Ex-municipal commissioner of Bombay Mr.Tinaikar had a point to make. "Rich people's dogs are walked on the streets to leave their affluent droppings all over the place," he said. "And then the same people turn around to criticize and blame the authorities for inefficiency and dirty pavements. What do they expect the officers to do?
Go down with a broom everytime their dog feels the pressure in his bowels? In America every dog owner has to clean up after his pet has done the job. Same in Japan. Will the Indian citizen do that here?" He's right.We go to the polls to choose a government and after that forfeit all responsibility. We sit back wanting to be pampered and expect the Government to do everything for us whilst our contribution is totally negative. We expect the government to clean up but we are not going to stop chucking garbage all over the place nor are we going to stop to pick up a stray piece of paper and throw it in the bin. We expect the railways to provide clean bathrooms but we are not going to learn the proper use of bathrooms. We want Indian Airlines and Air India to provide the best of food and toiletries but we are not going to stop pilfering at the least opportunity. This applies even to the staff who is known not to pass on the service to the public.
When it comes to burning social issues like those related to women, dowry, girl child and others, we make loud drawing room protestations and continue to do the reverse at home. Our excuse? "It's the whole system which has to change, how will it matter if I alone forego my sons' rights to a dowry." So who's going to change the system? What does a system consist of? Very conveniently for us it consists of our neighbors, other households, other cities, other communities and the government. But definitely not me and YOU. When it comes to us actually making a positive contribution to the system we lock ourselves along with our families into a safe cocoon and look into the distance at countries far away and wait for a Mr. Clean to come along & work miracles for us with a majestic sweep of his hand. Or we leave the country and run away. Like lazy cowards hounded by our fears we run to America to bask in their glory and praise their system.
When New York becomes insecure we run to England. When England experiences unemployment, we take the next flight out to the Gulf.When the Gulf is war struck, we demand to be rescued and brought home by the Indian Government. Everybody is out to abuse and rape the country. Nobody thinks of feeding the system. Our conscience is mortgaged to money."
I thought this speech is highly thought provoking, calls for a great deal of introspection and pricks one's conscience too....I am echoing John F. Kennedy's words to his fellow Americans to relate to Indians....."ASK WHAT WE CAN DO FOR INDIA AND DO WHAT HAS TO BE DONE TO MAKE INDIA WHAT AMERICA AND OTHER WESTERN COUNTRIES ARE TODAY"
Let us all get our friends to read this speech. Maybe it will make a difference & we do a RDB to the system.
Sunday, July 15, 2007
Saturday, July 14, 2007
Little Zach
Little Zachary, a Jewish kid, was doing very badly in maths. His parents had tried everything: tutors, mentors, flash cards, special learning centres, in short, everything they could think of to help his maths.
Finally, in a last ditch effort, they took Zachary down and enrolled him in the local Catholic school. After the first day, little Zachary came home with a very serious look on his face. He didn't even kiss his mother hello. Instead, he went straight to his room and started studying. Books and papers were spread all over the room and little Zachary was hard at work. His mother was amazed. She called him down to dinner, to her shock, the minute he was done, he marched back to his room without a word, and in no time, he was back hitting the books as hard as before.
This went on for some time, day after day while the mother tried to understand what made all the difference. Finally, little Zachary brought home his report card. He quietly laid it on the table, went up to his room, and hit the books. With great trepidation his mum looked at it and to her great surprise, little Zachary got an "A" in maths. She could no longer hold her curiosity. She went to his room and said: "Son, what was it?" Was it the nuns?" Little Zachary looked at her and shook his head, no. "Well then," she replied, "was it the books, the discipline, the structure, the uniforms? WHAT was it?" Little Zachary looked at her and said, "Well, on the first day of school, what did it for me was when I looked up and saw that guy nailed to the plus sign, I knew they weren't messing around."
Have a nice weekend:)
Finally, in a last ditch effort, they took Zachary down and enrolled him in the local Catholic school. After the first day, little Zachary came home with a very serious look on his face. He didn't even kiss his mother hello. Instead, he went straight to his room and started studying. Books and papers were spread all over the room and little Zachary was hard at work. His mother was amazed. She called him down to dinner, to her shock, the minute he was done, he marched back to his room without a word, and in no time, he was back hitting the books as hard as before.
This went on for some time, day after day while the mother tried to understand what made all the difference. Finally, little Zachary brought home his report card. He quietly laid it on the table, went up to his room, and hit the books. With great trepidation his mum looked at it and to her great surprise, little Zachary got an "A" in maths. She could no longer hold her curiosity. She went to his room and said: "Son, what was it?" Was it the nuns?" Little Zachary looked at her and shook his head, no. "Well then," she replied, "was it the books, the discipline, the structure, the uniforms? WHAT was it?" Little Zachary looked at her and said, "Well, on the first day of school, what did it for me was when I looked up and saw that guy nailed to the plus sign, I knew they weren't messing around."
Have a nice weekend:)
Friday, July 13, 2007
Meet The Ancestors
An American boy has found out the identity of his anonymous sperm donor using an online genealogy DNA testing firm, New Scientist magazine reports. His story means that donor anonymity can no longer be assured, according to an accompanying editorial. The boy, aged 15 at the time, sent off a cheek swab to a genealogy website, which lead to the discovery of two men with Y-chromosome DNA very similar to his own. But unlike most people who contact the service, he was not interested in sketching the far reaches of his family tree. His mother had conceived using donor sperm and he wanted to track down his genetic father.
The teenager tracked down his father from his Y chromosome. The Y is passed from father to son virtually unchanged, like a surname. So the pattern of gene variants it carries can help identify which paternal line an individual has descended from and can also be linked to a man's surname.
The boy paid www.FamilyTreeDNA.com $289 for the service. His genetic father had never supplied his DNA to the site, but all that was needed was for someone in the same paternal line to be on file. After nine months of waiting and having agreed to have his contact details available to other clients, the boy was contacted by two men with Y chromosomes closely matching his own. The two did not know each other, but the similarity between their Y chromosomes suggested there was a 50 per cent chance that all three had the same father, grandfather or great-grandfather. Importantly, the men both had the same last name, albeit with different spellings. This was the vital clue the boy needed to start his search in earnest. Though his donor had been anonymous, his mother had been told the man's date and place of birth and his college degree. Using another online service, Omnitrace.com, he purchased the names of everyone that had been born in the same place on the same day. Only one man had the surname he was looking for, and within 10 days he had made contact. According to Oxford geneticist Bryan Sykes, the case raises serious questions about whether past promises of anonymity can be honored. He also said that it was particularly interesting, because confidential information had been obtained without any unethical practice being undertaken. 'Fifteen years ago, when the father donated his sperm, nobody in the world could have known this would be possible', he said.
In the Indian context, the ICMR proposed guidelines assure anonymity to semen donors, but there is nothing to stop individuals from using other methods to identify these people.. That the boy succeeded using only the DNA test, genealogical records and some internet searches has huge implications for the hundreds of thousands of people who were conceived using donor sperm. With the explosion of information about genetic inheritance, any man who has donated sperm could potentially be found by his biological offspring. Absent and unknown fathers will also become easier to trace.
"This is the first time that I know of it being done," says Bryan Sykes, a geneticist at the University of Oxford and chairman of OxfordAncestors.com, a genetic genealogy service. The case raises serious questions about whether past promises of anonymity can be honoured, he says.
As more genetic information becomes available online, finding a donor father can only get easier. FamilyTreeDNA.com is running 2400 projects to trace particular surnames and has a database of over 45,000 Y chromosome signatures. The Sorenson Molecular Genealogy Foundation, based in Salt Lake City, Utah, promises to go even further. It is recruiting people from around the world and hopes to compile a database of about 500,000 representative individuals, with confirmed pedigrees going back at least four generations. The foundation will keep a database of information on Y chromosome markers, mitochondrial DNA (passed down through the maternal line) and 170 other genetic markers.
The news will be especially unsettling for men who donated anonymously before the power of genetics was fully appreciated. Donors were often college students who traded their sperm for beer money. Many have not told their wives or children and have never considered the implications of having a dozen offspring suddenly wanting to meet them. "The case shows that there are ethical and social concerns about assisted reproduction that we did not think about," says Trudo Lemmens, a bioethicist at the University of Toronto, Canada. So, welcome to the new world.
The teenager tracked down his father from his Y chromosome. The Y is passed from father to son virtually unchanged, like a surname. So the pattern of gene variants it carries can help identify which paternal line an individual has descended from and can also be linked to a man's surname.
The boy paid www.FamilyTreeDNA.com $289 for the service. His genetic father had never supplied his DNA to the site, but all that was needed was for someone in the same paternal line to be on file. After nine months of waiting and having agreed to have his contact details available to other clients, the boy was contacted by two men with Y chromosomes closely matching his own. The two did not know each other, but the similarity between their Y chromosomes suggested there was a 50 per cent chance that all three had the same father, grandfather or great-grandfather. Importantly, the men both had the same last name, albeit with different spellings. This was the vital clue the boy needed to start his search in earnest. Though his donor had been anonymous, his mother had been told the man's date and place of birth and his college degree. Using another online service, Omnitrace.com, he purchased the names of everyone that had been born in the same place on the same day. Only one man had the surname he was looking for, and within 10 days he had made contact. According to Oxford geneticist Bryan Sykes, the case raises serious questions about whether past promises of anonymity can be honored. He also said that it was particularly interesting, because confidential information had been obtained without any unethical practice being undertaken. 'Fifteen years ago, when the father donated his sperm, nobody in the world could have known this would be possible', he said.
In the Indian context, the ICMR proposed guidelines assure anonymity to semen donors, but there is nothing to stop individuals from using other methods to identify these people.. That the boy succeeded using only the DNA test, genealogical records and some internet searches has huge implications for the hundreds of thousands of people who were conceived using donor sperm. With the explosion of information about genetic inheritance, any man who has donated sperm could potentially be found by his biological offspring. Absent and unknown fathers will also become easier to trace.
"This is the first time that I know of it being done," says Bryan Sykes, a geneticist at the University of Oxford and chairman of OxfordAncestors.com, a genetic genealogy service. The case raises serious questions about whether past promises of anonymity can be honoured, he says.
As more genetic information becomes available online, finding a donor father can only get easier. FamilyTreeDNA.com is running 2400 projects to trace particular surnames and has a database of over 45,000 Y chromosome signatures. The Sorenson Molecular Genealogy Foundation, based in Salt Lake City, Utah, promises to go even further. It is recruiting people from around the world and hopes to compile a database of about 500,000 representative individuals, with confirmed pedigrees going back at least four generations. The foundation will keep a database of information on Y chromosome markers, mitochondrial DNA (passed down through the maternal line) and 170 other genetic markers.
The news will be especially unsettling for men who donated anonymously before the power of genetics was fully appreciated. Donors were often college students who traded their sperm for beer money. Many have not told their wives or children and have never considered the implications of having a dozen offspring suddenly wanting to meet them. "The case shows that there are ethical and social concerns about assisted reproduction that we did not think about," says Trudo Lemmens, a bioethicist at the University of Toronto, Canada. So, welcome to the new world.
Thursday, July 12, 2007
Sperm Banks - An Antiquarian
When Rotunda – The Center For Human Reproduction and its Human Sperm Banking Division opened its doors in 1996, the technology for preserving or "banking" human sperm by cryogenic methods, while nearly a quarter century old, was still in its infancy in India.
The prefix "cryo" comes from the Greek work "kryos," meaning cold or frost. The science of cryogenics deals with the effects of extremely cold temperatures on matter. Applying this technology to preservation of sperm was a natural outgrowth of the development of artificial insemination.
Although we tend to think of artificial insemination as a modern technology, it has a history dating back to 1779. That was the year an Italian priest and physiologist named Lazaro Spallanzani performed a laboratory experiment that revolutionized scientific thinking. Until that time, our understanding of reproduction was based on our understanding of how plants grow. It was believed that the embryo was the "product of male seed, nurtured in the soil of the female." Spallanzani's experiment established for the first time, that for an embryo to develop, there must be actual physical contact between the egg and the sperm. Armed with this new understanding, Spallanzani successfully inseminated frogs, fish and dogs. But while the artificial insemination of animals was quickly propelled into an industry, the application of this technology to "growing" of human babies proceeded cautiously.
The first successful artificial insemination of a woman was recorded just eleven years after Spallanzani's experiment. In 1790, the renowned Scottish anatomist and surgeon, Dr. John Hunter, reported that he had successfully inseminated the wife of a linen draper, using her husband's sperm. For over a century nothing more was heard on the subject. Then, in 1909, a letter appeared in the American journal, Medical World, spotlighting another aspect of the little known procedure. In the letter, the author, Addison Davis Hard, claimed that the first human donor insemination had been performed at the Jefferson Medical College in Philadelphia in 1884 -- twenty-five years earlier. According to Hard's letter, the mother, a patient of Dr. William Pancoast, was the Quaker wife of a local merchant, fifteen years her senior. The couple had come to the doctor seeking advise about her inability to have children. Extensive examinations of the woman revealed no abnormality. Finally, the husband was examined. It was discovered that he was azoospermic, or sterile. According to Hard's letter, when Dr. Pancoast discussed the case with his medical students, including Hard, someone in the group suggested that semen should be collected from the "best looking" member of the class, and used to inseminate the woman. Dr. Pancoast agreed to the experiment. Without informing either the woman or her husband of his intentions, he called the merchants wife back under the pretense of doing another examination. The woman was anesthetized, and the procedure was carried out. It wasn't until it became evident that the woman had actually conceived that her husband was informed. Fortunately, he was pleased. At his request, his wife was never told how she became pregnant. Hard's letter went on to say that, as a result of this medical school experiment, the merchant's wife gave birth to a son, who became the first known child by donor insemination (DI).
The idea of applying artificial insemination to human propagation was difficult enough for turn-of-the-century society to accept: to use the sperm of a man other than the woman's husband was scandalous. Hard's letter triggered heated debate among lawyers, moralists, theologians and medical practitioners. However, after a year of debates, the controversy, as the practice itself, appears to have faded into oblivion. If any doctors were treating infertility through DI, they were doing it
with the utmost discretion. DI remained virtually unknown to the public until 1954. That was the year the first comprehensive account of the process was published in The British Medical Journal. As it had before, donor insemination provoked heated public debate. The Archbishop of Canterbury established the first in a long procession of commissions that, over the years,
inquired into the development of the practice. The first commission produced a report strongly critical of DI, and recommended that the practice be made a criminal offense. A Parliamentary Commission agreed. In Italy, the Pope
declared DI a sin, and proposed that anyone using the procedure be sent to prison.
In that same year (1954), on this side of the ocean, the Supreme Court of Cook County ruled that regardless of a husband's consent, DI was "contrary to public policy and good morals, and considered adultery on the mother's part." The ruling went on to say that, "A child so conceived, was born out of wedlock and therefore illegitimate. As such, it is the child of the mother, and the father has no rights or interest in said child." This perspective was maintained as late as 1963, when a court in the United States held that a DI child was illegitimate because the sperm donor was not married to the child's mother. Regardless of her husband's consent, the court stated, the woman's insemination constituted adultery. But a year later, there were signs that attitudes were changing. In 1964 Georgia became the first state to pass a statute legitimizing children conceived by DI, on the condition that both the husband and wife consented in writing. In 1973 the Commissioners on Uniform State Laws, and a year later, the American Bar Association, approved the Uniform Parentage Act. This act provides that if a wife is artificially inseminated with donor semen under a physician's supervision, and with her husband's consent, the law treats the husband as if he were the natural father of the DI child. The laws most states have enacted pertaining to DI have been based on this act. In every case, the statute makes it clear that the donor who provides the doctor or sperm
bank with sperm is not the legal father of any child conceived by that sperm.
One court ruling in particular is relevant: the 1968 People V. Sorensen. While an earlier (1945) oral opinion in an Illinois case held that donor insemination was neither adultery nor grounds for divorce; it was not until the Sorensen case that a court ruled the DI child was legitimate. In the Sorensen case, the California Supreme Court upheld the criminal conviction of a man
for not supporting a DI child conceived with his consent during marriage. Sorensen claimed the child was not his, therefore he had no obligation to support it. The court ruled that the sperm donor had no more responsibility for the use of his sperm than a blood donor had for his blood. The court noted, "since there is no 'natural father', we can only look for a lawful father." And that was Sorensen.
The father of artificial insemination marked up another first in reproductive biology. It is believed that Spallanzani was the first to report the effects of cooling on human sperm when he noted, in 1776, that sperm cooled by snow became motionless. But efforts to actually freeze sperm did not begin until the mid 1800s. In 1866 a man by the name of Montegazza was the first to envision banks for frozen human sperm. He suggested that "a man dying on a battlefield may beget a legal heir with his semen frozen and stored at home." While it took some 150 years, during the Gulf war crises
in 1992, Montegazza's vision became a reality. Service men were able, and indeed some opted to freeze and store specimens of their sperm before leaving for battle.
Between the years 1938 and 1945, a number of scientists observed that sperm could survive freezing and storage temperatures as low as minus 321 degrees Fahrenheit. But surviving is one thing; being able to successfully function in the conception process is another. The first major breakthrough in that area came in 1949 when A.S. Parkes and two British
scientists developed a method of using a syrupy substance known as glycerol to protect semen from injury during freezing. The process was further refined in 1953 by Dr. Jerome K. Sherman, an American pioneer in sperm freezing. Sherman introduced a simple method of preserving human sperm using glycerol, but he combined this with a slow cooling of sperm, and storage with solid carbon dioxide as a refrigerant. Sherman also demonstrated for the first time that frozen sperm, when thawed, were able to fertilize an egg and induce its normal development. As a result of this research, the first successful human pregnancy with frozen spermatozoa was reported in 1953. (Shortly before the Cook County Supreme Court ruled DI was "contrary to public policy and good morals.") Considering the hostile climate for DI at the time, it is not surprising that nearly a decade passes before the first public announcement of a successful birth from frozen sperm. The announcement, made the 11th International Congress of Genetics in 1963, triggered interest in the possibility of sperm banks. Approximately a decade later, in the early 70s, the first commercial sperm bank opened.
When we (Gautam Allahbadia and Swati Allahbadia) established Rotunda – The Center For Human Reproduction in 1996, we had a specific vision for their new undertaking. I was a consultant at the Bombay Hospital, and Swati, a lecturer at Sion Hospital and we saw this new reproductive potential as a practical, viable solution to a painful dilemma we had witnessed in the practice of our professions: the often traumatic effect of sterility on men. Our observations concurred with the findings of Dr. Patricia Schreiner-Engle of the Mt. Sinai School of Medicine. According to Dr. Schreiner-Engle, the loss of a man's ability to father children often has a shattering impact on his self-esteem. It doesn't matter whether the sterilization is the result of a voluntary vasectomy, or of cancer or some other disease which requires surgery, chemotherapy or radiation. Whatever the reason, a man's loss of his ability to perpetuate his family name often triggers a crises in identity -- a sense of diminished masculinity. Infertility is still perceived by many to be a female problem. However, for nearly half of the
20 million infertile couples in the India, the problem stems from the infertility of the male. A University of Wisconsin survey, which was sent out to doctors throughout the United States who were treating problems of infertility, revealed that a surprising number of those doctors were quietly treating infertility with donor insemination. The physicians performing the procedure were using fresh semen, and usually selected the donors themselves, most often medical students, residents of other hospital personnel. Most of these doctors reported an effort to select donors who matched the husband in such things
as height, hair, skin and eye color, blood type, religious or ethnic background and educational level. Donor screening for genetic disease was usually limited to a medical history. Few of the doctors performed any biochemical tests on the donors.
The publishing of the University of Wisconsin survey generated an increased demand for anonymous donor insemination. Sperm banks across the USA responded. By the beginning of the eighties, meeting this need had become their main focus. In India, even in the early 1990s, there was only one recognised banking service in Mumbai.
At first some doctors resisted the use of frozen sperm for donor insemination. The job of a fertility specialist is to help a woman get pregnant. Research the time suggested the chances were slightly better with fresh sperm than with frozen sperm.
Over the years, expanded demand for DI, convenience, and the number and variety of donor prospects offered by sperm banks slowly eroded this resistance. Then in 1985, something happened that dramatically hastened the transition to the predominate use of frozen sperm for DI: the identification of a devastating newly recognized sexually transmitted disease --
HIV. A year later, in response to this new threat, the American Association of Tissue Banks began discouraging the use of fresh semen among its member sperm banks. In February 1988, the American Fertility Society (now, the American Society for Reproductive Medicine), the Food and Drug Administration, and the Center for Disease Control all recommended that
only frozen semen be used for DI, in conjunction with a minimum 6 month quarantine period. It became clear to the scientific community that the best way to ensure semen was not infected with HIV, hepatitis or other sexually transmitted disease is to freeze and quarantine the specimen for 6 months, at which time the donor is retested. This reduces the possibility that the donor had the virus at the time the specimen was collected and frozen. Today, the majority of sperm used for DI is frozen, clearly giving sperm banks a critical role in reproductive biology.
We have come a long way since the days when the only viable alternative an infertile couple had to become parents was adoption. The ability to freeze and store sperm has contributed greatly to this process. It has played an integral part in the development of today's more effective reproductive technologies. Fortunately, male factor infertility no longer means a couple must forgo the experience of pregnancy and childbirth. Thanks to modern reproductive technology and sperm banks, many of these couples have the option of becoming parents by using artificial insemination. While couples and individuals requiring sperm for artificial insemination make up most of the people who use today's sperm banks, these institutions also provide help for other individuals with reproductive problems. Among them, men facing voluntary sterilization, or
sterilization resulting from medical conditions or treatments. There is a medical and legal consensus today that men facing the possibility of sterilization, reduction in fertility potential or exposure to reproductive hazards should be fully informed of the option of semen storage. This practice is frequently followed by physicians treating men who are facing vasectomy, orchiectomy, chemotherapy, radiation therapy, or high risk occupational exposure to radiation or toxic substances. Our current environmental crisis has also generated a need for sperm bank services. Men who work in industries where there is the danger of exposure to radiation, toxins or other genetically threatening environmental pollutants are using sperm banks to preserve their sperm as insurance against possible accidents that could leave them infertile, impotent, or genetically damaged. In addition to these typical uses for sperm bank services, Rotunda –The Center For Human Reproduction has responded to some unique requests; of fathers donating sperm for infertile sons and brothers donating sperm for infertile brothers.
If you are a couple with a male factor reproductive problem, or a single woman who has chosen to become a mother, you may be considering using the services of a sperm bank. Your first step should be to discuss the possibility with your doctor. His or her knowledge of your physical condition, and your doctor's experience in reproductive medicine can provide
you with insight into whether a sperm bank can help you meet your specific reproductive goals or needs. Ultimately, however, only you can make that decision. It will depend as much on who you are and your feelings and beliefs about what you are doing, as it will on what you are seeking to accomplish. But before you can make that decision, you need to understand precisely what a sperm bank can and cannot do for you.
* A sperm bank can freeze and store sperm for a man facing voluntary or medically induced sterilization. Sperm that can be thawed at a later date and used for artificial insemination.
* A sperm bank can freeze and store the sperm of a man whose vocation places him at risk for an environmental accident that could leave him infertile, impotent, or genetically damaged.
* A sperm bank can store a husband's sperm for AIH or other modern reproductive technologies that require sperm for use during ovulation.
* A sperm bank can provide safe, disease-tested sperm for artificial insemination from a wide selection of carefully screened and tested anonymous donors.
* A sperm bank can provide recipients seeking sperm from an anonymous donor with accurate and comprehensive information about their prospective donors, so that the recipients can select the donor best suited to meet their specific requirements.
In other words, a sperm bank can test, freeze, store and provide safe, disease-screened sperm for use in various reproductive technologies.
* A sperm bank cannot guarantee successful conception.
* A sperm bank cannot guarantee a healthy pregnancy or child.
* A sperm bank cannot genetically determine or in any way manipulate the intelligence, talents or physical characteristics of any child conceived from the sperm it supplies.
Legend has it that the world renowned dancer, Isadora Duncan once wrote to George Bernard Shaw, "You have the greatest brain in the world, and I have the most beautiful body, so we ought to produce the most perfect child." To which Shaw is alleged to have answered, "My dear woman, what if the child inherits my body and your brains?"
Shaw fully understood the element of chance involved in procreation; the innumerable possibilities that come into play with the union of sperm and egg. The laws of nature that dictate those possibilities remain intact whether the conception is the result of normal sexual intercourse or reproductive intervention.
1. How Safe Is The Donor Sperm Provided By Sperm Banks?
While in India, only the state of Delhi has laws at present governing the operation of sperm banks, the American Society for Reproductive Medicine and the American Association of Tissue Banks have established guidelines which most professional sperm banks the world over follow. Rotunda Sperm Bank adheres to these principles. These guidelines require the rigorous screening of donors.
So thorough is this screening process that a user of donor sperm from an accredited sperm bank probably knows more about her anonymous donor than any bride knows about the man she is about to marry. Or for that matter, more than many women know about their husbands even after ten years of marriage. Accredited sperm banks not only screen all donors for an array of genetic and sexually transmitted diseases, but freeze and quarantine all anonymous donor sperm for six months
so they can retest the donor to make sure he tests negative for HIV, hepatitis and other sexually transmitted diseases (STD). Only when this testing reveals that the donor is free of these diseases is his frozen sperm released for use. Safety is the primary advantage of using a sperm bank.
2. Are There Any Risks Involved In Being Artificially Inseminated With Frozen Sperm?
Nothing in life is without risk. In this case, however, the potential risk is not in the use of thawed frozen sperm, but in the insemination process itself. Artificial insemination is an invasive procedure, therefore there is always the possibility of infection. There is also the normal risk of defects and complications associated with any pregnancy, particularly when the woman is over forty, as is the case with many of the women who choose artificial insemination.
3. How Can I Be Sure I Am Getting The Correct Sperm?
There have been reports in the newspaper in recent years of lawsuits alleging mix-ups in sperm specimens supplied by sperm banks. Since one man's sperm cannot be distinguished from another, even under the most powerful microscope, such a mix-up is not beyond possibility, either during processing or in the doctor's office during the administration of the
insemination. Rotunda – The Center For Human Reproduction, Bandra, Mumbai In Collaboration with Andrology Laboratory Services, Incorporated, Chicago, USA has introduced the DNA-ID check which confirms your infant's identity using saliva.
What Is THE DNA-IDCHECK?
DNA-IDCHECK is an infant identification and parentage confirmation system. Using state-of-the-art DNA technology, the test is inexpensive, efficient and non-intrusive, requiring no more than a small saliva sample from the parent(s)
and infant. When a DNA mismatch occurs, the DNA-IDCHECK System can establish if you are NOT the father. Our DNA-IDCHECK System is an inexpensive screening test to decide you might require more extensive, legally certifiable
testing. The DNA-IDCHECK System, using a special analysis for matching parent-to-infant genetic code, can only identify an individual or prove if an adult is not the genetic parent of a particular infant. In other words, they convey no relevant genetic information during the testing procedure: The test reveals nothing else about the tested individual. Confidentiality and privacy issues are never violated. For more details log on to www.iwannagetpregnant.com or contact Rotunda-The Center For Human Reproduction, Bandra, Mumbai at 26553000/2000 or goralgandhi@gmail.com
However, well-run, professional cryobanks follow rigid labeling, processing and storage procedures that make such confusion unlikely. The best way to avoid this problem is to choose an experienced, efficiently operated professional sperm bank that adheres to the guidelines set up by the American Society for Reproductive Medicine. Sperm banks will, of course, never supplant the natural process for conceiving a child. But in combination with artificial insemination and other modern reproductive technologies, and by working along side reproductive care physicians, today they offer many couples and
individuals who are unable to conceive naturally the possibility of experiencing pregnancy and the birth of their desired child.
The prefix "cryo" comes from the Greek work "kryos," meaning cold or frost. The science of cryogenics deals with the effects of extremely cold temperatures on matter. Applying this technology to preservation of sperm was a natural outgrowth of the development of artificial insemination.
Although we tend to think of artificial insemination as a modern technology, it has a history dating back to 1779. That was the year an Italian priest and physiologist named Lazaro Spallanzani performed a laboratory experiment that revolutionized scientific thinking. Until that time, our understanding of reproduction was based on our understanding of how plants grow. It was believed that the embryo was the "product of male seed, nurtured in the soil of the female." Spallanzani's experiment established for the first time, that for an embryo to develop, there must be actual physical contact between the egg and the sperm. Armed with this new understanding, Spallanzani successfully inseminated frogs, fish and dogs. But while the artificial insemination of animals was quickly propelled into an industry, the application of this technology to "growing" of human babies proceeded cautiously.
The first successful artificial insemination of a woman was recorded just eleven years after Spallanzani's experiment. In 1790, the renowned Scottish anatomist and surgeon, Dr. John Hunter, reported that he had successfully inseminated the wife of a linen draper, using her husband's sperm. For over a century nothing more was heard on the subject. Then, in 1909, a letter appeared in the American journal, Medical World, spotlighting another aspect of the little known procedure. In the letter, the author, Addison Davis Hard, claimed that the first human donor insemination had been performed at the Jefferson Medical College in Philadelphia in 1884 -- twenty-five years earlier. According to Hard's letter, the mother, a patient of Dr. William Pancoast, was the Quaker wife of a local merchant, fifteen years her senior. The couple had come to the doctor seeking advise about her inability to have children. Extensive examinations of the woman revealed no abnormality. Finally, the husband was examined. It was discovered that he was azoospermic, or sterile. According to Hard's letter, when Dr. Pancoast discussed the case with his medical students, including Hard, someone in the group suggested that semen should be collected from the "best looking" member of the class, and used to inseminate the woman. Dr. Pancoast agreed to the experiment. Without informing either the woman or her husband of his intentions, he called the merchants wife back under the pretense of doing another examination. The woman was anesthetized, and the procedure was carried out. It wasn't until it became evident that the woman had actually conceived that her husband was informed. Fortunately, he was pleased. At his request, his wife was never told how she became pregnant. Hard's letter went on to say that, as a result of this medical school experiment, the merchant's wife gave birth to a son, who became the first known child by donor insemination (DI).
The idea of applying artificial insemination to human propagation was difficult enough for turn-of-the-century society to accept: to use the sperm of a man other than the woman's husband was scandalous. Hard's letter triggered heated debate among lawyers, moralists, theologians and medical practitioners. However, after a year of debates, the controversy, as the practice itself, appears to have faded into oblivion. If any doctors were treating infertility through DI, they were doing it
with the utmost discretion. DI remained virtually unknown to the public until 1954. That was the year the first comprehensive account of the process was published in The British Medical Journal. As it had before, donor insemination provoked heated public debate. The Archbishop of Canterbury established the first in a long procession of commissions that, over the years,
inquired into the development of the practice. The first commission produced a report strongly critical of DI, and recommended that the practice be made a criminal offense. A Parliamentary Commission agreed. In Italy, the Pope
declared DI a sin, and proposed that anyone using the procedure be sent to prison.
In that same year (1954), on this side of the ocean, the Supreme Court of Cook County ruled that regardless of a husband's consent, DI was "contrary to public policy and good morals, and considered adultery on the mother's part." The ruling went on to say that, "A child so conceived, was born out of wedlock and therefore illegitimate. As such, it is the child of the mother, and the father has no rights or interest in said child." This perspective was maintained as late as 1963, when a court in the United States held that a DI child was illegitimate because the sperm donor was not married to the child's mother. Regardless of her husband's consent, the court stated, the woman's insemination constituted adultery. But a year later, there were signs that attitudes were changing. In 1964 Georgia became the first state to pass a statute legitimizing children conceived by DI, on the condition that both the husband and wife consented in writing. In 1973 the Commissioners on Uniform State Laws, and a year later, the American Bar Association, approved the Uniform Parentage Act. This act provides that if a wife is artificially inseminated with donor semen under a physician's supervision, and with her husband's consent, the law treats the husband as if he were the natural father of the DI child. The laws most states have enacted pertaining to DI have been based on this act. In every case, the statute makes it clear that the donor who provides the doctor or sperm
bank with sperm is not the legal father of any child conceived by that sperm.
One court ruling in particular is relevant: the 1968 People V. Sorensen. While an earlier (1945) oral opinion in an Illinois case held that donor insemination was neither adultery nor grounds for divorce; it was not until the Sorensen case that a court ruled the DI child was legitimate. In the Sorensen case, the California Supreme Court upheld the criminal conviction of a man
for not supporting a DI child conceived with his consent during marriage. Sorensen claimed the child was not his, therefore he had no obligation to support it. The court ruled that the sperm donor had no more responsibility for the use of his sperm than a blood donor had for his blood. The court noted, "since there is no 'natural father', we can only look for a lawful father." And that was Sorensen.
The father of artificial insemination marked up another first in reproductive biology. It is believed that Spallanzani was the first to report the effects of cooling on human sperm when he noted, in 1776, that sperm cooled by snow became motionless. But efforts to actually freeze sperm did not begin until the mid 1800s. In 1866 a man by the name of Montegazza was the first to envision banks for frozen human sperm. He suggested that "a man dying on a battlefield may beget a legal heir with his semen frozen and stored at home." While it took some 150 years, during the Gulf war crises
in 1992, Montegazza's vision became a reality. Service men were able, and indeed some opted to freeze and store specimens of their sperm before leaving for battle.
Between the years 1938 and 1945, a number of scientists observed that sperm could survive freezing and storage temperatures as low as minus 321 degrees Fahrenheit. But surviving is one thing; being able to successfully function in the conception process is another. The first major breakthrough in that area came in 1949 when A.S. Parkes and two British
scientists developed a method of using a syrupy substance known as glycerol to protect semen from injury during freezing. The process was further refined in 1953 by Dr. Jerome K. Sherman, an American pioneer in sperm freezing. Sherman introduced a simple method of preserving human sperm using glycerol, but he combined this with a slow cooling of sperm, and storage with solid carbon dioxide as a refrigerant. Sherman also demonstrated for the first time that frozen sperm, when thawed, were able to fertilize an egg and induce its normal development. As a result of this research, the first successful human pregnancy with frozen spermatozoa was reported in 1953. (Shortly before the Cook County Supreme Court ruled DI was "contrary to public policy and good morals.") Considering the hostile climate for DI at the time, it is not surprising that nearly a decade passes before the first public announcement of a successful birth from frozen sperm. The announcement, made the 11th International Congress of Genetics in 1963, triggered interest in the possibility of sperm banks. Approximately a decade later, in the early 70s, the first commercial sperm bank opened.
When we (Gautam Allahbadia and Swati Allahbadia) established Rotunda – The Center For Human Reproduction in 1996, we had a specific vision for their new undertaking. I was a consultant at the Bombay Hospital, and Swati, a lecturer at Sion Hospital and we saw this new reproductive potential as a practical, viable solution to a painful dilemma we had witnessed in the practice of our professions: the often traumatic effect of sterility on men. Our observations concurred with the findings of Dr. Patricia Schreiner-Engle of the Mt. Sinai School of Medicine. According to Dr. Schreiner-Engle, the loss of a man's ability to father children often has a shattering impact on his self-esteem. It doesn't matter whether the sterilization is the result of a voluntary vasectomy, or of cancer or some other disease which requires surgery, chemotherapy or radiation. Whatever the reason, a man's loss of his ability to perpetuate his family name often triggers a crises in identity -- a sense of diminished masculinity. Infertility is still perceived by many to be a female problem. However, for nearly half of the
20 million infertile couples in the India, the problem stems from the infertility of the male. A University of Wisconsin survey, which was sent out to doctors throughout the United States who were treating problems of infertility, revealed that a surprising number of those doctors were quietly treating infertility with donor insemination. The physicians performing the procedure were using fresh semen, and usually selected the donors themselves, most often medical students, residents of other hospital personnel. Most of these doctors reported an effort to select donors who matched the husband in such things
as height, hair, skin and eye color, blood type, religious or ethnic background and educational level. Donor screening for genetic disease was usually limited to a medical history. Few of the doctors performed any biochemical tests on the donors.
The publishing of the University of Wisconsin survey generated an increased demand for anonymous donor insemination. Sperm banks across the USA responded. By the beginning of the eighties, meeting this need had become their main focus. In India, even in the early 1990s, there was only one recognised banking service in Mumbai.
At first some doctors resisted the use of frozen sperm for donor insemination. The job of a fertility specialist is to help a woman get pregnant. Research the time suggested the chances were slightly better with fresh sperm than with frozen sperm.
Over the years, expanded demand for DI, convenience, and the number and variety of donor prospects offered by sperm banks slowly eroded this resistance. Then in 1985, something happened that dramatically hastened the transition to the predominate use of frozen sperm for DI: the identification of a devastating newly recognized sexually transmitted disease --
HIV. A year later, in response to this new threat, the American Association of Tissue Banks began discouraging the use of fresh semen among its member sperm banks. In February 1988, the American Fertility Society (now, the American Society for Reproductive Medicine), the Food and Drug Administration, and the Center for Disease Control all recommended that
only frozen semen be used for DI, in conjunction with a minimum 6 month quarantine period. It became clear to the scientific community that the best way to ensure semen was not infected with HIV, hepatitis or other sexually transmitted disease is to freeze and quarantine the specimen for 6 months, at which time the donor is retested. This reduces the possibility that the donor had the virus at the time the specimen was collected and frozen. Today, the majority of sperm used for DI is frozen, clearly giving sperm banks a critical role in reproductive biology.
We have come a long way since the days when the only viable alternative an infertile couple had to become parents was adoption. The ability to freeze and store sperm has contributed greatly to this process. It has played an integral part in the development of today's more effective reproductive technologies. Fortunately, male factor infertility no longer means a couple must forgo the experience of pregnancy and childbirth. Thanks to modern reproductive technology and sperm banks, many of these couples have the option of becoming parents by using artificial insemination. While couples and individuals requiring sperm for artificial insemination make up most of the people who use today's sperm banks, these institutions also provide help for other individuals with reproductive problems. Among them, men facing voluntary sterilization, or
sterilization resulting from medical conditions or treatments. There is a medical and legal consensus today that men facing the possibility of sterilization, reduction in fertility potential or exposure to reproductive hazards should be fully informed of the option of semen storage. This practice is frequently followed by physicians treating men who are facing vasectomy, orchiectomy, chemotherapy, radiation therapy, or high risk occupational exposure to radiation or toxic substances. Our current environmental crisis has also generated a need for sperm bank services. Men who work in industries where there is the danger of exposure to radiation, toxins or other genetically threatening environmental pollutants are using sperm banks to preserve their sperm as insurance against possible accidents that could leave them infertile, impotent, or genetically damaged. In addition to these typical uses for sperm bank services, Rotunda –The Center For Human Reproduction has responded to some unique requests; of fathers donating sperm for infertile sons and brothers donating sperm for infertile brothers.
If you are a couple with a male factor reproductive problem, or a single woman who has chosen to become a mother, you may be considering using the services of a sperm bank. Your first step should be to discuss the possibility with your doctor. His or her knowledge of your physical condition, and your doctor's experience in reproductive medicine can provide
you with insight into whether a sperm bank can help you meet your specific reproductive goals or needs. Ultimately, however, only you can make that decision. It will depend as much on who you are and your feelings and beliefs about what you are doing, as it will on what you are seeking to accomplish. But before you can make that decision, you need to understand precisely what a sperm bank can and cannot do for you.
* A sperm bank can freeze and store sperm for a man facing voluntary or medically induced sterilization. Sperm that can be thawed at a later date and used for artificial insemination.
* A sperm bank can freeze and store the sperm of a man whose vocation places him at risk for an environmental accident that could leave him infertile, impotent, or genetically damaged.
* A sperm bank can store a husband's sperm for AIH or other modern reproductive technologies that require sperm for use during ovulation.
* A sperm bank can provide safe, disease-tested sperm for artificial insemination from a wide selection of carefully screened and tested anonymous donors.
* A sperm bank can provide recipients seeking sperm from an anonymous donor with accurate and comprehensive information about their prospective donors, so that the recipients can select the donor best suited to meet their specific requirements.
In other words, a sperm bank can test, freeze, store and provide safe, disease-screened sperm for use in various reproductive technologies.
* A sperm bank cannot guarantee successful conception.
* A sperm bank cannot guarantee a healthy pregnancy or child.
* A sperm bank cannot genetically determine or in any way manipulate the intelligence, talents or physical characteristics of any child conceived from the sperm it supplies.
Legend has it that the world renowned dancer, Isadora Duncan once wrote to George Bernard Shaw, "You have the greatest brain in the world, and I have the most beautiful body, so we ought to produce the most perfect child." To which Shaw is alleged to have answered, "My dear woman, what if the child inherits my body and your brains?"
Shaw fully understood the element of chance involved in procreation; the innumerable possibilities that come into play with the union of sperm and egg. The laws of nature that dictate those possibilities remain intact whether the conception is the result of normal sexual intercourse or reproductive intervention.
1. How Safe Is The Donor Sperm Provided By Sperm Banks?
While in India, only the state of Delhi has laws at present governing the operation of sperm banks, the American Society for Reproductive Medicine and the American Association of Tissue Banks have established guidelines which most professional sperm banks the world over follow. Rotunda Sperm Bank adheres to these principles. These guidelines require the rigorous screening of donors.
So thorough is this screening process that a user of donor sperm from an accredited sperm bank probably knows more about her anonymous donor than any bride knows about the man she is about to marry. Or for that matter, more than many women know about their husbands even after ten years of marriage. Accredited sperm banks not only screen all donors for an array of genetic and sexually transmitted diseases, but freeze and quarantine all anonymous donor sperm for six months
so they can retest the donor to make sure he tests negative for HIV, hepatitis and other sexually transmitted diseases (STD). Only when this testing reveals that the donor is free of these diseases is his frozen sperm released for use. Safety is the primary advantage of using a sperm bank.
2. Are There Any Risks Involved In Being Artificially Inseminated With Frozen Sperm?
Nothing in life is without risk. In this case, however, the potential risk is not in the use of thawed frozen sperm, but in the insemination process itself. Artificial insemination is an invasive procedure, therefore there is always the possibility of infection. There is also the normal risk of defects and complications associated with any pregnancy, particularly when the woman is over forty, as is the case with many of the women who choose artificial insemination.
3. How Can I Be Sure I Am Getting The Correct Sperm?
There have been reports in the newspaper in recent years of lawsuits alleging mix-ups in sperm specimens supplied by sperm banks. Since one man's sperm cannot be distinguished from another, even under the most powerful microscope, such a mix-up is not beyond possibility, either during processing or in the doctor's office during the administration of the
insemination. Rotunda – The Center For Human Reproduction, Bandra, Mumbai In Collaboration with Andrology Laboratory Services, Incorporated, Chicago, USA has introduced the DNA-ID check which confirms your infant's identity using saliva.
What Is THE DNA-IDCHECK?
DNA-IDCHECK is an infant identification and parentage confirmation system. Using state-of-the-art DNA technology, the test is inexpensive, efficient and non-intrusive, requiring no more than a small saliva sample from the parent(s)
and infant. When a DNA mismatch occurs, the DNA-IDCHECK System can establish if you are NOT the father. Our DNA-IDCHECK System is an inexpensive screening test to decide you might require more extensive, legally certifiable
testing. The DNA-IDCHECK System, using a special analysis for matching parent-to-infant genetic code, can only identify an individual or prove if an adult is not the genetic parent of a particular infant. In other words, they convey no relevant genetic information during the testing procedure: The test reveals nothing else about the tested individual. Confidentiality and privacy issues are never violated. For more details log on to www.iwannagetpregnant.com or contact Rotunda-The Center For Human Reproduction, Bandra, Mumbai at 26553000/2000 or goralgandhi@gmail.com
However, well-run, professional cryobanks follow rigid labeling, processing and storage procedures that make such confusion unlikely. The best way to avoid this problem is to choose an experienced, efficiently operated professional sperm bank that adheres to the guidelines set up by the American Society for Reproductive Medicine. Sperm banks will, of course, never supplant the natural process for conceiving a child. But in combination with artificial insemination and other modern reproductive technologies, and by working along side reproductive care physicians, today they offer many couples and
individuals who are unable to conceive naturally the possibility of experiencing pregnancy and the birth of their desired child.
Wednesday, July 11, 2007
Age, Infertility & Donor Eggs
While most healthy older women who become pregnant have uneventful pregnancies and healthy babies, thousands more are unable to achieve pregnancy because of declining ovarian function. A decline in ovarian function is normal with increasing age. A woman's number of eggs steadily decreases from a peak at mid-gestation of 7 million to approximately 400,000 at puberty. Certain tests can reflect gradations in ovarian reserve status and predict a woman's potential fertility. The most important lab test is the day 2/3 follicle-stimulating hormone level.
Women with declining ovarian responsiveness and clinical outcomes consistent with declining ovarian reserve have decreased day 3 serum inhibin B levels despite having non-elevated day 3 serum FSH concentrations. Declining ovarian reserve may be demonstrated by a decrease in day 3 inhibin B levels before a rise in day 3 FSH levels. A constant source of frustration in fertility centers is that patients are referred to the specialty clinic too late, when diminished ovarian reserve is so marked that treatment success is severely limited. Earlier assessment of ovarian function would alter this unfortunate trend.
Reproductive failure in women of older age appears to be directly related to ovarian age. It seems that the age-related decline in fertility may be due more to degenerative oocytes than to aneuploidy. The decline in female fertility occurs primarily as a result of a decline in oocyte quality as well as quantity A decline in the number of oocytes retrieved with age may be of less importance than the decline in oocyte quality. Embryo implanting ability and survival decline gradually after 30 years of age, but by more than two thirds after 40 years and in younger women with reduced ovarian capacity. The frequency of chromosomal anomalies in recognized abortuses increases in parallel with the age-specific rise in the incidence of spontaneous abortions. Recent techniques such as cytoplasmic or germinal vesicle transfer are designed to replace the senescent cellular machinery believed to be responsible for genetic errors that occur during early cell division. PGD can accurately identify embryos with genetic deficiencies prior to implantation.
Research indicates that much of the decline in fecundity can be attributed to an increasing risk of fetal loss with maternal age. Much of this fetal loss is due to chromosomal abnormalities--a result of ageing oocytes. Fecundability, on the other hand, does not begin to decline until the early 40s. This is also a result of ageing at the ovarian level, namely follicular atresia, in the years just prior to menopause. The irregularity of menstrual cycles--longer cycles and increasingly variable hormonal patterns--at these ages may be a direct result of the small and rapidly dwindling remaining pool of follicles. The number of small antral follicles in both ovaries as measured by vaginal ultrasonography is clearly related to reproductive age and could well reflect the size of the remaining primordial follicle pool.
There is a significant decline in human fecundity with advancing age. A significant decrement in success rates is also seen in older women undergoing assisted reproduction, including in-vitro fertilization. We have observed a drop in the ongoing pregnancy rate per patient, from about 32 % in women aged less 30 years to lesss than 28 % in women aged more than 35 years. Embryo implantation rates also decline in a linear fashion, from 5 % in women less than 30 years to approximately 2 % at age over 40 years. We observed that the impaired implantation efficiency seen in older women is apparently independent of the magnitude of their stimulation response. Although no statistically significant relationships were found between serum FSH concentrations as obtained in the early follicular phase and the number of oocytes collected, or the total dose, there was a trend to poorer response as the FSH approached closer to 10 mIU/mL. The decline in number of oocytes retrieved with increasing age can be at times overcome by augmenting the daily dose of gonadotropins to as much as 1050 mIU/mL. Oocyte factors are felt to be primarily responsible; however, some available data suggest that uterine factors, e.g. diminished endometrial receptivity, may also play a role.
Natural fertility rates decline in most animals with age, becoming dramatically apparent in women as they enter the fifth decade of life. By the time of the perimenopause, pregnancy rarely occurs, whether or not assisted reproductive techniques are initiated. However, if oocytes are donated by young women to older women, both embryo implantation and pregnancy rates are restored to normal levels in recipients. These results strongly suggest the pregnancy wastage experienced by older women is largely a result of degenerative changes within the aging oocyte(egg), rather than senescent changes in the uterus. The poor prognosis for fertility in older women can be reversed through oocyte donation from younger individuals.
There are presently no treatment strategies apart from oocyte donation, which have been shown to significantly improve implantation efficiency in older women. Women in the older age group have a higher chance of achieving pregnancy from ovum-donation programs than by persisting in using their own aged eggs, which have a very poor prognosis for success.
However, recent efforts have focused on the continued development of improved stimulation protocols in higher doses, facilitation of embryo implantation by zona pellucida micromanipulation, and the possibility of screening preimplantation embryos for aneuploidy. Elderly women with partners who have suboptimal sperm parameters reflected by low fertilization capacity scores may benefit from micro-manipulation procedures. Egg Donation is the only answer presently until maybe Cytoplasmic Transfer becomes routine- maybe a decade from now.
Women with declining ovarian responsiveness and clinical outcomes consistent with declining ovarian reserve have decreased day 3 serum inhibin B levels despite having non-elevated day 3 serum FSH concentrations. Declining ovarian reserve may be demonstrated by a decrease in day 3 inhibin B levels before a rise in day 3 FSH levels. A constant source of frustration in fertility centers is that patients are referred to the specialty clinic too late, when diminished ovarian reserve is so marked that treatment success is severely limited. Earlier assessment of ovarian function would alter this unfortunate trend.
Reproductive failure in women of older age appears to be directly related to ovarian age. It seems that the age-related decline in fertility may be due more to degenerative oocytes than to aneuploidy. The decline in female fertility occurs primarily as a result of a decline in oocyte quality as well as quantity A decline in the number of oocytes retrieved with age may be of less importance than the decline in oocyte quality. Embryo implanting ability and survival decline gradually after 30 years of age, but by more than two thirds after 40 years and in younger women with reduced ovarian capacity. The frequency of chromosomal anomalies in recognized abortuses increases in parallel with the age-specific rise in the incidence of spontaneous abortions. Recent techniques such as cytoplasmic or germinal vesicle transfer are designed to replace the senescent cellular machinery believed to be responsible for genetic errors that occur during early cell division. PGD can accurately identify embryos with genetic deficiencies prior to implantation.
Research indicates that much of the decline in fecundity can be attributed to an increasing risk of fetal loss with maternal age. Much of this fetal loss is due to chromosomal abnormalities--a result of ageing oocytes. Fecundability, on the other hand, does not begin to decline until the early 40s. This is also a result of ageing at the ovarian level, namely follicular atresia, in the years just prior to menopause. The irregularity of menstrual cycles--longer cycles and increasingly variable hormonal patterns--at these ages may be a direct result of the small and rapidly dwindling remaining pool of follicles. The number of small antral follicles in both ovaries as measured by vaginal ultrasonography is clearly related to reproductive age and could well reflect the size of the remaining primordial follicle pool.
There is a significant decline in human fecundity with advancing age. A significant decrement in success rates is also seen in older women undergoing assisted reproduction, including in-vitro fertilization. We have observed a drop in the ongoing pregnancy rate per patient, from about 32 % in women aged less 30 years to lesss than 28 % in women aged more than 35 years. Embryo implantation rates also decline in a linear fashion, from 5 % in women less than 30 years to approximately 2 % at age over 40 years. We observed that the impaired implantation efficiency seen in older women is apparently independent of the magnitude of their stimulation response. Although no statistically significant relationships were found between serum FSH concentrations as obtained in the early follicular phase and the number of oocytes collected, or the total dose, there was a trend to poorer response as the FSH approached closer to 10 mIU/mL. The decline in number of oocytes retrieved with increasing age can be at times overcome by augmenting the daily dose of gonadotropins to as much as 1050 mIU/mL. Oocyte factors are felt to be primarily responsible; however, some available data suggest that uterine factors, e.g. diminished endometrial receptivity, may also play a role.
Natural fertility rates decline in most animals with age, becoming dramatically apparent in women as they enter the fifth decade of life. By the time of the perimenopause, pregnancy rarely occurs, whether or not assisted reproductive techniques are initiated. However, if oocytes are donated by young women to older women, both embryo implantation and pregnancy rates are restored to normal levels in recipients. These results strongly suggest the pregnancy wastage experienced by older women is largely a result of degenerative changes within the aging oocyte(egg), rather than senescent changes in the uterus. The poor prognosis for fertility in older women can be reversed through oocyte donation from younger individuals.
There are presently no treatment strategies apart from oocyte donation, which have been shown to significantly improve implantation efficiency in older women. Women in the older age group have a higher chance of achieving pregnancy from ovum-donation programs than by persisting in using their own aged eggs, which have a very poor prognosis for success.
However, recent efforts have focused on the continued development of improved stimulation protocols in higher doses, facilitation of embryo implantation by zona pellucida micromanipulation, and the possibility of screening preimplantation embryos for aneuploidy. Elderly women with partners who have suboptimal sperm parameters reflected by low fertilization capacity scores may benefit from micro-manipulation procedures. Egg Donation is the only answer presently until maybe Cytoplasmic Transfer becomes routine- maybe a decade from now.
Tuesday, July 10, 2007
Necrozoospermia
Necrozoospermia is a condition in which all of the sperm in a man's ejaculate are dead. In point of fact, there are a number of reasons for a man to be afflicted with necrozoospermia. Indeed, necrozoospermia can be the result of everything from diet, disease, injury, medications, alcohol or illicit drug use and other factors. In many instances, if the underlying cause of necrozoospermia is resolved, the condition of necrozoospermia likewise will be rectified.
If you have been told by your doctor that you suffer from necrozoospermia, it is important that you do seek further medical attention. In some instances, necrozoospermia can be a symptom of a serious problem that can have very serious additional consequences beyond necrozoospermia. For example, in some instances, necrozoospermia is the sign of another condition or disease that could even end up resulting in erectile dysfunction. Although allopathy has no answers for this condition, some Indian Ayurvedic formulations seem to have shown improvement with this condition in isolated case reports.
For the doctor, he must distinguish between live –immotile sperms and dead-immotile sperms. Assisted Reproductive Techniques can help patients whose sperms are alive but immotile. We had a patient; the individual simply didn't follow proper collection technique and had been using a lubricant gel. As soon as he collected without the lubricant, his motility was in the normal range. One should also test the semen for autoantisperm antibodies that might have been caused by a different habit of sex, eg. Anal sex. Usually, with such severe motility problems, the patient has to undergo Intracytoplasmic Sperm Injection (ICSI). Let me start a thread here for the medical bloggers.
For a man with 100% immotile sperm in the ejaculate, of which 10% are live, are pregnancy rates better with ICSI (after selecting live sperm with a hypo-osmotic swelling test); or is it better to offer TESE-ICSI (ICSI with testicular sperm extraction)?
10% viable sperms should be good enough for ICSI. Why TESE-ICSI, if one can get 10% viable sperms in the ejaculate? Moreover, TESE is associated with complications - like fibrosis. TESE because you cannot pick out which of the 10% are viable sperm to inject with good reliability. HOS test may help but data on it's use for ICSI involves small numbers. You are much more likely to have higher viability from the testis (assuming no motile sperm are found in the vas or epididymis) than from the ejaculate. Surgical retrieval of sperm is an option that should not be ignored in such cases, as we all are driven to achieve the best possible outcomes for our patients. Do a testicular retrieval fresh at the time of IVF/ICSI. You will probably find motile (twitching) sperm. This is much more reliable than trying to identify viable sperm in a 0% immotile ejaculate.
The task of selecting a single sperm for injection, from the stated 10% viable population from the sample of zero motility, on the basis of the HOS test, is no way nearly as easy as some colleagues would like you to believe. It is technically difficult to pick up curled sperm which have been exposed to HOS solution. But you can pick the sperm up from culture media, transfer your needle into a drop of HOS solution, hold the sperm near the opening of the needle and allow the HOS solution to diffuse into the needle and you can watch the sperm start to curl inside the ICSI needle. As soon as you see the sperm tail curl, you can move to a PVP drop, break the tail and perform the ICSI.
Our experience with such situation is that (1) the outcome (in terms of fertilization and pregnancy rates) is the same between viable (non-motile) testicular sperm and viable (non-motile) ejaculated sperm; (2) motile spermatozoa can be found in some (about 40%) of the patients with 100% immotile sperm in ejaculated semen. This is the only reason that testicular biopsy is carried out in patients with 100% non-motile ejaculated sperm in our Center.
First, a viability test is essential. Alternatives to HOS are Eosin Y or Trypan blue staining, or use of a fluorescent DNA-binding probe such as Hoechst 33258. If all the sperm in semen are 'dead', we would not suggest ICSI using them. In our practice, we determine whether there is an immediate possible cause of cell death such as high reactive oxygen species generation by leukocytes, which might be addressed. If not, a vas or testicular aspiration is considered. We have seen normal (for the site)
motility from either vas or testis when semen sperm motility is poor. Second, if some of the sperm are apparently live, we would attempt to stimulate motility using pentoxifylline. Surprisingly, this has worked in some cases of 0% motility. The induced motility may or may not be of sufficient quality and quantity to consider IUI or IVF. But, even if there is only twitching motility, this may be sufficient to choose sperm for ICSI. The pentoxifylline is washed out of the sperm preparation before any of the insemination procedures. This also avoids having to use HOS to choose non-motile sperm. Third, if no sperm respond to pentoxifylline, medical, genetic, or electron microscopic evidence could be gathered to rule out an immotile cilia syndrome, followed by genetic counseling.
If you have been told by your doctor that you suffer from necrozoospermia, it is important that you do seek further medical attention. In some instances, necrozoospermia can be a symptom of a serious problem that can have very serious additional consequences beyond necrozoospermia. For example, in some instances, necrozoospermia is the sign of another condition or disease that could even end up resulting in erectile dysfunction. Although allopathy has no answers for this condition, some Indian Ayurvedic formulations seem to have shown improvement with this condition in isolated case reports.
For the doctor, he must distinguish between live –immotile sperms and dead-immotile sperms. Assisted Reproductive Techniques can help patients whose sperms are alive but immotile. We had a patient; the individual simply didn't follow proper collection technique and had been using a lubricant gel. As soon as he collected without the lubricant, his motility was in the normal range. One should also test the semen for autoantisperm antibodies that might have been caused by a different habit of sex, eg. Anal sex. Usually, with such severe motility problems, the patient has to undergo Intracytoplasmic Sperm Injection (ICSI). Let me start a thread here for the medical bloggers.
For a man with 100% immotile sperm in the ejaculate, of which 10% are live, are pregnancy rates better with ICSI (after selecting live sperm with a hypo-osmotic swelling test); or is it better to offer TESE-ICSI (ICSI with testicular sperm extraction)?
10% viable sperms should be good enough for ICSI. Why TESE-ICSI, if one can get 10% viable sperms in the ejaculate? Moreover, TESE is associated with complications - like fibrosis. TESE because you cannot pick out which of the 10% are viable sperm to inject with good reliability. HOS test may help but data on it's use for ICSI involves small numbers. You are much more likely to have higher viability from the testis (assuming no motile sperm are found in the vas or epididymis) than from the ejaculate. Surgical retrieval of sperm is an option that should not be ignored in such cases, as we all are driven to achieve the best possible outcomes for our patients. Do a testicular retrieval fresh at the time of IVF/ICSI. You will probably find motile (twitching) sperm. This is much more reliable than trying to identify viable sperm in a 0% immotile ejaculate.
The task of selecting a single sperm for injection, from the stated 10% viable population from the sample of zero motility, on the basis of the HOS test, is no way nearly as easy as some colleagues would like you to believe. It is technically difficult to pick up curled sperm which have been exposed to HOS solution. But you can pick the sperm up from culture media, transfer your needle into a drop of HOS solution, hold the sperm near the opening of the needle and allow the HOS solution to diffuse into the needle and you can watch the sperm start to curl inside the ICSI needle. As soon as you see the sperm tail curl, you can move to a PVP drop, break the tail and perform the ICSI.
Our experience with such situation is that (1) the outcome (in terms of fertilization and pregnancy rates) is the same between viable (non-motile) testicular sperm and viable (non-motile) ejaculated sperm; (2) motile spermatozoa can be found in some (about 40%) of the patients with 100% immotile sperm in ejaculated semen. This is the only reason that testicular biopsy is carried out in patients with 100% non-motile ejaculated sperm in our Center.
First, a viability test is essential. Alternatives to HOS are Eosin Y or Trypan blue staining, or use of a fluorescent DNA-binding probe such as Hoechst 33258. If all the sperm in semen are 'dead', we would not suggest ICSI using them. In our practice, we determine whether there is an immediate possible cause of cell death such as high reactive oxygen species generation by leukocytes, which might be addressed. If not, a vas or testicular aspiration is considered. We have seen normal (for the site)
motility from either vas or testis when semen sperm motility is poor. Second, if some of the sperm are apparently live, we would attempt to stimulate motility using pentoxifylline. Surprisingly, this has worked in some cases of 0% motility. The induced motility may or may not be of sufficient quality and quantity to consider IUI or IVF. But, even if there is only twitching motility, this may be sufficient to choose sperm for ICSI. The pentoxifylline is washed out of the sperm preparation before any of the insemination procedures. This also avoids having to use HOS to choose non-motile sperm. Third, if no sperm respond to pentoxifylline, medical, genetic, or electron microscopic evidence could be gathered to rule out an immotile cilia syndrome, followed by genetic counseling.
Monday, July 9, 2007
Making Babies The Gay Way
Today being Sunday, I had a wee bit more time to blog & thought I should write on a subject close to my heart. The gay pride or simply pride campaign has three main premises: that people should be proud of their sexual orientation and gender identity, that sexual diversity is a gift, and that sexual orientation and gender identity are inherent and cannot be intentionally altered. Marches celebrating Pride (pride parades) are celebrated worldwide. Symbols of gay pride include the Rainbow colored flag, Greek lambda symbol, and also the pink and black triangles (You can see these logos on our homepage).
The average family exists only on paper.
-- Sylvia Porter, U.S. economist
Contrary to popular belief, gay men and women often want children. The only difference is, like a straight couple with fertility problems, they are somewhat limited by biology. Gay parents aren't something new – they are already out there and have been for some time. In the United States, 1 in 10 gay men identify themselves as fathers , and according to the 2000 US Census Report, one in five gay male couples have children under 18 years of age living in their households. Some gay men and women had children when they were in previous heterosexual relationships but a growing number of gay couples are now choosing to start a family together. The growing trend among gay male couples toward planning families together follows in the wake of the so-called lesbian baby boom and comes at a time when all same-sex couples are increasingly struggling for equal rights, including the right to marry and have children. Moreover, gay men are seeking to become fathers at a time of increased interest in fatherhood itself.
There are a four main ways that gay men and women can have children:
Adoption
Co-parenting arrangements (Between Lesbians & Male gay couples)
Donor insemination
Surrogacy
Why do gay men want to become fathers? They are motivated by the same needs as those of heterosexual men: the desire to nurture and raise children, wanting the constancy of children in their lives, wanting to achieve the sense of family that children provide, and wanting a sense of generativity and immortality through having children. Gay men who are planning to become fathers appear to give the idea much more thought than do heterosexual men. Yet because of entrenched stereotypes, social acceptance of gay men as fathers is far from universal. Common concerns are that children of gay men will be stigmatized, that children of homosexual fathers are more likely to become homosexual themselves, and that gay males are likely to be sexual predators who may molest their own children. Although research has largely discredited those prejudices, these preconceived notions nevertheless remain and may be one reason that some fertility programs appear reluctant to respond to appeals from gay men to achieve fatherhood through assisted reproduction. It is notable that a recent
survey of ART programs in the United States found that fertility centers routinely accept lesbians but are less likely to accept gay males as patients , despite the support for nondiscrimination in gay and lesbian parenting by such prominent
mainstream organizations as the Child Welfare League of America, the American Academy of Pediatrics, the American Academy of Family Physicians, the American Psychiatric Association, the American Psychological Association, the
National Association of Social Workers, and the American Bar Association. Indeed, the Ethics Committee of the American Society for Reproductive Medicine recently published a statement in support of fertility treatment for gays, lesbians, and unmarried persons.
Let us go through some heart-warming stories that got a lot of media attention recently. Attractive thirty some-things, Heather and David are the happily married parents of Rissa, an engaging and precocious six-year-old . He's a high-school teacher, she's a stay-at-home mom. They have a Chevy minivan, an aged Toyota Tercel, two cats with clever names, a dog and a mortgage. A Canadian flag flutters on the front porch of their two-storey red-brick home. As contemporary family portraits go, this one is a classic.Which proves the rule about appearances and deceptiveness. Mr. and Mrs. Average Canadian -- that is, David Hoare and Heather Jopling -- boast what is an emphatically non-average familial distinction in this age of shifting social landscapes. "We're another chapter of alternative families," says Jopling, 38, a writer, actor and former Ottawan. "We're straights, we've got our one child, we've got pets, we own a house, we've got cars -- and we just also happen to have been a surrogate and a sperm donor for gay and lesbian families."
In 2003, Hoare was a sperm donor for Toronto lesbian friends Virginia West and Cheryl Reid, who are today the doting parents of Rowan, their two-year-old son. A few months after that, Jopling offered to become surrogate mother for the child their gay friends in Ottawa, Michael Mancini and Ernst Hupel, were hoping for. That couple's daughter Milena is now 19 months old, little sister to Klara, Hupel's daughter with another surrogate mother. The three families maintain contact and get together from time to time, despite the geography that separates them, openly acknowledging all their connections. Rissa knows, for instance, that she has a half-brother in Rowan (whose birthday she shares) and a half-sister in Milena, both of whom will be told the same thing when they get older. The diversity runs even deeper. Hoare's parents split up when his mother, an Anglican priest, came out as a lesbian. She and her partner, along with Hoare's father and his new partner -- who have introduced Jamaican and Filipino influences into the family portrait -- have provided Jopling with three wonderful mothers-in-law, she says, and extended Rissa's grandparental range. On Jopling's side, there are only two grandparents, though her father, a retired Air Force lieutenant-colonel, adds the variety of a military touch to the cultural mixed bag.
On a recent spring morning, Lura Stiller sat in her stocking feet in a sunny cottage in Cambridge, Massachusetts, helping Cary Friedman and his partner, Rick Wellisch, calm their daughter, a 3-month-old in a pink T-shirt. Stiller, 34, a homemaker from the Dallas, Texas, suburbs, likes to say that the number of gay people in her acquaintance before she met Friedman, a psychiatrist, and Wellisch, an internist, amounted to zero. "Everything I knew about gay people I knew from TV, which meant that everything I knew about gay people I learned from 'Will & Grace' and 'The L Word,"' she said. In December, Stiller gave birth to the baby, named Samantha, for Friedman and Wellisch, conceived with a donor egg and the sperm from one of the partners. (They chose not to know which.) In her decision to work with them, Stiller is part of a small but growing movement of surrogate mothers choosing gay couples over traditional families.
As legislatures debate giving gay couples the right to marry - hundreds of couples are finding ways to create families with or without marriage through surrogates like Stiller, who are willing to help them have children genetically linked to them and to bypass the often difficult legal challenges gay men face in adoption. John Weltman, a Boston lawyer, had a challenging time finding women to carry children for gay men when he founded Circle Surrogacy a decade ago. Today, he said, 80 percent of the surrogate mothers who come to him say they would be willing to work with gay couples, and half prefer to work with gay couples. In Los Angeles, Growing Generations, a company formed to help gay couples become parents through egg donation and surrogacy, is responsible for more than 300 births, increasing from four births in 1998 to 108 within the last 17 months Dawn Buras, a Baltimore mother of four, has been to a fertility clinic in Los Angeles three times to receive embryonic transplants for a male couple in Boston. Each time the men, one of whom works in television, accompanied her. They took adjacent hotel rooms, dined out and provided a visit to the set of "Desperate Housewives." The pregnancy attempts failed, but still the men try, refusing to work with anyone else. Some surrogates also say they find the sense of defiance in providing gay couples with children to be meaningful. "In all honesty, there's a bit of a rebellious nature in me," acknowledged Shannon Klein, a mother of three in Cypress, California, who home-schools her children. "I know that there are people who wouldn't approve of being a surrogate for gay parents, and that has made it more intriguing." Klein has borne two children for two gay couples, and she is pregnant with twins for a third.
From the current literature, we know a great deal about the psychological well-being of lesbian mothers and their children— offspring planned and conceived through assisted reproduction (20–24)—but there are as yet no studies of gay fathers utilizing ART to create a family. We, at Rotunda should have the lead to publish in scientific journals by the year 2008. The existing literature on gay fatherhood is derived from studies of children who were born within a heterosexual marriage and whose fathers later identified themselves as gay. Although the investigators found no differences between groups in terms of intimacy and involvement with their children, there were significant differences between gay and non-gay fathers in terms of limit setting, responsiveness, and reasoning guidance. Gay fathers were more consistent about setting and enforcing limits on their children’s behavior, and gay fathers tended to be more responsive to their children’s needs.
Researchers have looked at whether children had social stigma as a result of having a gay father. Most studies noted that gay fathers reported that their children appeared to have normal social relationships with their peers and found little cause for concern about stigmatization resulting from fathers’ homosexuality. Several studies examined the sexual orientation of young adult offspring of gay fathers. In terms of gender identity and sexual preference, children of gay fathers appear to fall within normal limits and are not more likely to be homosexual then children reared by heterosexual fathers.
Future research I’m sure, will address the experience of gay male couples, and of their children who are planned and conceived through assisted reproduction. For the present, although anecdotal and media reports reveal that some programs including ours, have welcomed gay men into their fertility practices. Gay male couples increasingly are coming to the conclusion that their homosexuality need not prevent them from becoming fathers and planning a family together. Many are turning to reproductive medical centers for help in their quest for fatherhood. These gay-father families deserve the same attention (and lack of discrimination) in their care that other couples, lesbian and heterosexual, receive in fertility centers around the globe.
The average family exists only on paper.
-- Sylvia Porter, U.S. economist
Contrary to popular belief, gay men and women often want children. The only difference is, like a straight couple with fertility problems, they are somewhat limited by biology. Gay parents aren't something new – they are already out there and have been for some time. In the United States, 1 in 10 gay men identify themselves as fathers , and according to the 2000 US Census Report, one in five gay male couples have children under 18 years of age living in their households. Some gay men and women had children when they were in previous heterosexual relationships but a growing number of gay couples are now choosing to start a family together. The growing trend among gay male couples toward planning families together follows in the wake of the so-called lesbian baby boom and comes at a time when all same-sex couples are increasingly struggling for equal rights, including the right to marry and have children. Moreover, gay men are seeking to become fathers at a time of increased interest in fatherhood itself.
There are a four main ways that gay men and women can have children:
Adoption
Co-parenting arrangements (Between Lesbians & Male gay couples)
Donor insemination
Surrogacy
Why do gay men want to become fathers? They are motivated by the same needs as those of heterosexual men: the desire to nurture and raise children, wanting the constancy of children in their lives, wanting to achieve the sense of family that children provide, and wanting a sense of generativity and immortality through having children. Gay men who are planning to become fathers appear to give the idea much more thought than do heterosexual men. Yet because of entrenched stereotypes, social acceptance of gay men as fathers is far from universal. Common concerns are that children of gay men will be stigmatized, that children of homosexual fathers are more likely to become homosexual themselves, and that gay males are likely to be sexual predators who may molest their own children. Although research has largely discredited those prejudices, these preconceived notions nevertheless remain and may be one reason that some fertility programs appear reluctant to respond to appeals from gay men to achieve fatherhood through assisted reproduction. It is notable that a recent
survey of ART programs in the United States found that fertility centers routinely accept lesbians but are less likely to accept gay males as patients , despite the support for nondiscrimination in gay and lesbian parenting by such prominent
mainstream organizations as the Child Welfare League of America, the American Academy of Pediatrics, the American Academy of Family Physicians, the American Psychiatric Association, the American Psychological Association, the
National Association of Social Workers, and the American Bar Association. Indeed, the Ethics Committee of the American Society for Reproductive Medicine recently published a statement in support of fertility treatment for gays, lesbians, and unmarried persons.
Let us go through some heart-warming stories that got a lot of media attention recently. Attractive thirty some-things, Heather and David are the happily married parents of Rissa, an engaging and precocious six-year-old . He's a high-school teacher, she's a stay-at-home mom. They have a Chevy minivan, an aged Toyota Tercel, two cats with clever names, a dog and a mortgage. A Canadian flag flutters on the front porch of their two-storey red-brick home. As contemporary family portraits go, this one is a classic.Which proves the rule about appearances and deceptiveness. Mr. and Mrs. Average Canadian -- that is, David Hoare and Heather Jopling -- boast what is an emphatically non-average familial distinction in this age of shifting social landscapes. "We're another chapter of alternative families," says Jopling, 38, a writer, actor and former Ottawan. "We're straights, we've got our one child, we've got pets, we own a house, we've got cars -- and we just also happen to have been a surrogate and a sperm donor for gay and lesbian families."
In 2003, Hoare was a sperm donor for Toronto lesbian friends Virginia West and Cheryl Reid, who are today the doting parents of Rowan, their two-year-old son. A few months after that, Jopling offered to become surrogate mother for the child their gay friends in Ottawa, Michael Mancini and Ernst Hupel, were hoping for. That couple's daughter Milena is now 19 months old, little sister to Klara, Hupel's daughter with another surrogate mother. The three families maintain contact and get together from time to time, despite the geography that separates them, openly acknowledging all their connections. Rissa knows, for instance, that she has a half-brother in Rowan (whose birthday she shares) and a half-sister in Milena, both of whom will be told the same thing when they get older. The diversity runs even deeper. Hoare's parents split up when his mother, an Anglican priest, came out as a lesbian. She and her partner, along with Hoare's father and his new partner -- who have introduced Jamaican and Filipino influences into the family portrait -- have provided Jopling with three wonderful mothers-in-law, she says, and extended Rissa's grandparental range. On Jopling's side, there are only two grandparents, though her father, a retired Air Force lieutenant-colonel, adds the variety of a military touch to the cultural mixed bag.
On a recent spring morning, Lura Stiller sat in her stocking feet in a sunny cottage in Cambridge, Massachusetts, helping Cary Friedman and his partner, Rick Wellisch, calm their daughter, a 3-month-old in a pink T-shirt. Stiller, 34, a homemaker from the Dallas, Texas, suburbs, likes to say that the number of gay people in her acquaintance before she met Friedman, a psychiatrist, and Wellisch, an internist, amounted to zero. "Everything I knew about gay people I knew from TV, which meant that everything I knew about gay people I learned from 'Will & Grace' and 'The L Word,"' she said. In December, Stiller gave birth to the baby, named Samantha, for Friedman and Wellisch, conceived with a donor egg and the sperm from one of the partners. (They chose not to know which.) In her decision to work with them, Stiller is part of a small but growing movement of surrogate mothers choosing gay couples over traditional families.
As legislatures debate giving gay couples the right to marry - hundreds of couples are finding ways to create families with or without marriage through surrogates like Stiller, who are willing to help them have children genetically linked to them and to bypass the often difficult legal challenges gay men face in adoption. John Weltman, a Boston lawyer, had a challenging time finding women to carry children for gay men when he founded Circle Surrogacy a decade ago. Today, he said, 80 percent of the surrogate mothers who come to him say they would be willing to work with gay couples, and half prefer to work with gay couples. In Los Angeles, Growing Generations, a company formed to help gay couples become parents through egg donation and surrogacy, is responsible for more than 300 births, increasing from four births in 1998 to 108 within the last 17 months Dawn Buras, a Baltimore mother of four, has been to a fertility clinic in Los Angeles three times to receive embryonic transplants for a male couple in Boston. Each time the men, one of whom works in television, accompanied her. They took adjacent hotel rooms, dined out and provided a visit to the set of "Desperate Housewives." The pregnancy attempts failed, but still the men try, refusing to work with anyone else. Some surrogates also say they find the sense of defiance in providing gay couples with children to be meaningful. "In all honesty, there's a bit of a rebellious nature in me," acknowledged Shannon Klein, a mother of three in Cypress, California, who home-schools her children. "I know that there are people who wouldn't approve of being a surrogate for gay parents, and that has made it more intriguing." Klein has borne two children for two gay couples, and she is pregnant with twins for a third.
From the current literature, we know a great deal about the psychological well-being of lesbian mothers and their children— offspring planned and conceived through assisted reproduction (20–24)—but there are as yet no studies of gay fathers utilizing ART to create a family. We, at Rotunda should have the lead to publish in scientific journals by the year 2008. The existing literature on gay fatherhood is derived from studies of children who were born within a heterosexual marriage and whose fathers later identified themselves as gay. Although the investigators found no differences between groups in terms of intimacy and involvement with their children, there were significant differences between gay and non-gay fathers in terms of limit setting, responsiveness, and reasoning guidance. Gay fathers were more consistent about setting and enforcing limits on their children’s behavior, and gay fathers tended to be more responsive to their children’s needs.
Researchers have looked at whether children had social stigma as a result of having a gay father. Most studies noted that gay fathers reported that their children appeared to have normal social relationships with their peers and found little cause for concern about stigmatization resulting from fathers’ homosexuality. Several studies examined the sexual orientation of young adult offspring of gay fathers. In terms of gender identity and sexual preference, children of gay fathers appear to fall within normal limits and are not more likely to be homosexual then children reared by heterosexual fathers.
Future research I’m sure, will address the experience of gay male couples, and of their children who are planned and conceived through assisted reproduction. For the present, although anecdotal and media reports reveal that some programs including ours, have welcomed gay men into their fertility practices. Gay male couples increasingly are coming to the conclusion that their homosexuality need not prevent them from becoming fathers and planning a family together. Many are turning to reproductive medical centers for help in their quest for fatherhood. These gay-father families deserve the same attention (and lack of discrimination) in their care that other couples, lesbian and heterosexual, receive in fertility centers around the globe.
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