Mais les résultats doivent être attendus longtemps et il n'y a généralement pas de temps metronidazole prix L'autre cas, c'est que l'achat d'un ou d'un autre antibiotique dans une pharmacie classique nécessite des dépenses matérielles considérables et pas toutes les personnes ne peuvent acheter des produits pharmaceutiques aussi coûteux.
ON REPRODUCTIVE TECHNOLOGIES
In British Columbia 275,000 workers are in unions affiliated to the B.C. Federation of Labour. More than one quarter of these members are women. They work in grocery stores, hotels and restaurants, in hospitals, child care centres, post offices, newspapers, laboratories, factories, telecommunications centres and government offices across the province.
Although the range of their work is great, there are similarities in their experiences as women and workers. They share an interest in social progress and in the betterment of society for working people.
As workers we have had bitter experience with technological innovation. Engineered to resolve production "problems", as identified exclusively by the owners, these technologies have rarely benefited the production workers. We have learned from our experience that technologies are not neutral - they reflect and reinforce the values and power structure of the society in which they are developed.
It may seem inappropriate to borrow from the language and history of industrial production for discussions of new reproductive technologies. But in periodicals and news reports of developments in diagnostic and fertilization techniques or genetic research, journalists and scientists employ the metaphors of mining, big game expeditions and heroic exertion to describe their progress. The language of the workshop is no more jarring, and there are parallels between the transformation of production and reproduction that are evident to working people.
The introduction of computer-integrated manufacturing and the subdivision of production processes into distinct disconnected events marginalized workers, alienated the production worker from the product and enhanced the power of industrial engineers, managers and owners.
The new reproductive technologies similarly threaten to redefine and limit the role of women in reproduction, if not ultimately remove them from direct involvement should experiments in genetic manipulation, cloning, parthenogenesis and extra-uterine development be taken to their "logical" conclusion. New reproductive technologies like in-vitro fertilization (IVF) promise women more choices and more control over their reproductive destinies. There is a glaring contradiction, however, between the potential of such reproductive technologies to improve the health and quality of life for women and their children, and the actual experiences of women in treatment programs. During treatment like IVF in particular their short-term and long-term physical health and emotional and psychological well-being, are jeopardized by drugs and procedures which fail 80-95 percent of the time.
These experiences do not simply reflect the primitive state of these technologies. We are not just making a few mistakes on the way to a perfect world. As with the technologies that transformed industrial production, the new reproductive technologies are authoritarian in their nature and application. In the absence of control and direction they institutionalize, rather than resolve, the contradictory and negative attitudes our society displays concerning sexuality, and reproduction, women, and children themselves.
In popular culture, sexuality is divorced from reproduction. To take one example, public depiction of breasts as sexual attributes is common, and the commercial distribution of such images is identified with the exercise of rights of free speech. Yet the minimal public display of breasts while feeding an infant was socially unacceptable until quite recently and is still regarded as something properly hidden in a toilet area. The value our society really places on children is evident by the alarming incidence of child abuse, in the fact that it has required Court orders to open housing to women with children, and in the absence of a national child care program.
Social attitudes toward women are ambivalent. While our society appears to affirm women's sexuality, this occurs in a way that objectifies and dehumanizes women, denigrates their reproductive functions and belittles their contribution to society as a whole. The social and economic inferiority of women, the incidence of public violence and the tolerance of domestic violence (which interestingly enough often coincides with pregnancy), provide more evidence of a society that does not recognize or serve the interests of women.
Little value is placed on the work women do in connection with reproduction - pregnancy, labour or the raising and care of children. This is clear in the low wages earned by child care workers, and also from the struggle that was required by women to gain the right to remain in the workplace when pregnant and the right to return to their jobs after giving birth. It is also evident in the unwillingness of both private and governmental employers to accommodate the workplace and work regimes to the needs of women who are bearing children.
Our society does place a high value on material success and the acquisition of consumer goods. This is characterized by a tendency to transform every facet of human experience into a marketable commodity. Even children become products that every successful person should own. We are hypnotized by technology and convinced that technology, combined with individual will, can overcome all natural obstacles. In some respects our culture is narcissistic and self-absorbed, preoccupied by the achievement of individual goals to the exclusion of community concerns.
These negative features unhappily appear to be faithfully recreated in the new reproductive technologies and in the justifications surrounding their application, like the assertion of the bewildering new right "to parent". In-vitro fertilization effectively separates reproduction from sexual intercourse. New diagnostic techniques medically and conceptually separate the foetus from the mother as an entity that can be medically treated apart from (or despite the wishes of) the mother. Developments in IVF,
combined with surrogacy, reinforce the notion emerging in legal assumptions of foetal rights that a woman is "potting soil" or an empty vessel, secondary to the entire reproductive process, as she is secondary in the social order.
We question whether technologies developed indiscriminately in this context respect and enhance the rights and power of women.
The technologies certainly enhance the power of the medical profession, as the "medicalization" of birth and the definition of pregnancy as an illness and disability did in an earlier era. In the absence of regulation or social consensus, doctors are deciding who is and who is not a suitable candidate for reproductive procedures like IVF and artificial insemination. Lesbians, single women and couples judged to be "unstable" by the physician need not apply. Married women require the authorization of their husbands.
Reports and studies from the B.C. Royal Commission on Family and Children's Law (1975) to the Ontario Law Reform Commission have proposed to enshrine in law or regulation presumptions about the personal reproductive choices of women, and to legislate who in society is fit to parent and who is not. Ironically, this is exactly the kind of decision that women are prevented from making because of lack of access to reliable contraception or abortion services. When a woman believes she is unprepared to have a child, there are few jurisdictions where her decision on the matter is sufficiently respected that she can act upon it.
Therefore, the promise of more reproductive choice extended by the proponents of new reproductive technologies seems rather thin. The testimony of many women who have undergone IVF suggests that women experience a loss of control and a diminishing will to contradict medical decisions and to alter or suspend treatment.
Here is the story of one woman in B.C. (who asked to remain anonymous) who was treated for infertility over a four-year period by three different gynecologists:
"I felt like a piece of meat when I visited the gynecologist."
One day she began to feel a sharp pain in her left side. Her doctor suggested she was ovulating. His advice: "Go home and give the old man hell."
The pain continued for eleven days. Finally she was referred to a gynecologist for an ultrasound. "At the hospital, I knew something was going on but nobody would tell me." After being sent out to have lunch, a doctor confirmed that she had an ectopic pregnancy. A life-saving operation was delayed for 12 hours because she had just eaten. The next day she learned that one fallopian tube had been removed. The surgeon also told her she would have died from internal bleeding in another day or two.
Now with only one fallopian tube left, she was given fertility drugs for two years. When one set did not work, she was given another type - a single pill - and told to take one-half in the evening and one-half in the morning. "When I went to pick up the prescription, there were three pages of typewritten notes about the possible side effects.
Yet my doctor had not said anything about side effects. These were serious side effects like amnesia, cramps in the legs, and headaches. I took half the pill and the next morning I could not stand up, I was nauseous and I could not even make it to the bathroom. I thought if this is what half does, then they can take them and stick them ."
"I decided after four years I had had enough. Also, my marriage was on the rocks." Now she has a new partner. She wonders if she should try again to have children. "Today I still do not know if I can have a baby. It was a very degrading experience. I never received any literature about infertility. I was never given any options. This was all done to me, not with me."
There are also concerns that the refinement of foetal screening techniques and the development of procedures to isolate and alter genes will increase pressure on women to submit to the screening techniques and to then abort foetuses that show abnormalities or do not match expectations regarding sex, attributes or health. The opinion that life for the disabled is "nasty, brutish and short" and that the disabled "are a burden to themselves and others" underlies the pressure to abort. This may simply reflect the way our society fails to provide support and assistance for people with disabilities. Capability may invent a new responsibility to produce perfect children, and this may further limit a woman's choice.
We are concerned that women and men may be made more vulnerable economically because of the growth in diagnostic technologies. In the U.S., 80 percent of companies already use the medical records of individuals to make personnel decisions. The ability to screen for genetic disposition to conditions or illnesses will provide a tool that many employers, in their search for the perfect workforce, are eager to use. Legislation has already been introduced in American jurisdictions permitting employers to demand and use the results of tests showing genetic disposition.
Many critics of new reproductive technologies have expressed concern that women involved in treatment programs, or who utilize diagnostic processes, are not fully informed about the nature and possible risks of treatment. Ultrasound, sampling of chorionic villi and amniocentesis can be dangerous to both the mother and child, yet such diagnostic techniques are being routinely applied to healthy, risk-free women. The IVF procedures and associated diagnostic techniques can be harmful in themselves. Some examination procedures, like the one used to detect fallopian tube blockages (uterotubal insufflation) and endometrial biopsies, are reported to be very painful. Egg extraction is reportedly painful and carries risks to the woman, ranging from hemorrhage and puncture of organs to recurrences of pelvic inflammatory disease. The side effects of drug treatments are debilitating and the long-term effects on women (and their children, should they conceive) are unknown.
It is disturbing that women are enrolled in such drastically experimental programs after a very short period of counselling and attempts to conceive naturally. Couples are declared infertile after only one year of attempts - a defining period that is half that used in other countries. Consequently, a large number of women are undergoing radical treatment who may well be able to conceive naturally.
Critics, like Linda Williams of Trent University, have pointed out that the research and medical procedures have subdivided the process of conception (which is a biological continuum) into a series of steps and hurdles from ovulation to the implanting of fertilized ovum into the uterus. The establishment of the measurable steps in itself appears to inhibit the ability of women to discontinue unsuccessful treatment programs.
"Since they were aware of the outcome of each step, positive outcomes such as the collection of a large number of eggs or their subsequent fertilization were interpreted by these women as signs that they were getting closer to becoming pregnant and would probably be pregnant next time. Consequently, they were very reluctant to stop trying."
Treatment by the medical profession, the lack of social and financial supports and the confusing legal context have been criticized by women on artificial insemination programs. One woman in B.C. (who prefers to remain anonymous) expressed these frustrations about her experience during artificial insemination:
"The whole process was difficult for me, juggling the demands of work and having to be at the clinic at specific times, wanting to protect my privacy and my partner. I didn't want anyone, let alone my employer, to know we were infertile. But I had to take lots of time off because my cycle is so irregular. It took eight months of treatment to conceive our first child, and eleven months for the second. None of my time away from work was covered and the drugs weren't covered either. They cost about $200 every time. I'm worried about what happens to my medical records, about whether the children will know or will have a legal right to know.
There was a long waiting list for the gynecologist who specializes in these treatments and I'm not aware of any outside the Lower Mainland.
But what really got me was the doctors. They should change their attitudes and not just tell women who are trying to conceive to "relax". Why don't they explain or investigate the causes of the problem? I had to try for a year before they did anything at all."
In the existing health care model in our society, information is not fully shared between doctor and patient, nor are patients involved as partners in decision-making about procedures initiated or rejected. So far, reproductive treatment programs have been no different, and the physician who is an enthusiastic advocate of IVF, for example, may not be the best advocate or counsellor for a patient who is driven by a complex of individual and social expectations to adopt desperate measures in her efforts to conceive. Changes in the structure of treatment programs may be required to ensure that patients consent to procedures with a thorough knowledge of the implications, possible outcomes and attempts. Changes might also help ensure that the best interests of the patient take precedence throughout.
We maintain that in the development and application of new reproductive technologies, women as a group are not the clear beneficiaries. The women who are likely to be most exploited by the new technologies will be the poor - the Third World women who are reported to be already aborting foetuses for cash settlements to satisfy the demand for
foetal tissue. The "patients" in IVF treatment programs are also vulnerable since their sustained participation in unsuccessful treatment programs guarantees a supply of "subjects" and healthy eggs for use in perfecting the techniques.
Poor women, lured by fees into surrogacy arrangements, are not necessarily beneficiaries. The growing practice of surrogacy raises a number of questions about motherhood, contract law, custody rights and the role of women. In some instances, motivations of the couple looking for a "surrogate mother" may seem noble - for example, a desire to avoid passing on a hereditary disease.
In practice and with few exceptions, poor women are the surrogate mothers bearing children for others for money. The surrogacy contracts are disturbing, since they transform the child into a commercial product and restrict the liberty of the "surrogate mother" in an extraordinary and unjustifiable way. Surrogacy appears to many to be a new sanitized form of concubinage. Where no money for the service is exchanged, as in instances where friends or family members bear children for others, it is a practice that appears to be more acceptable because sexual intercourse has been divorced from reproduction. The implications for the status of women and the implications for the children themselves have not been explored.
It is difficult to believe that the development of many of the new reproductive technologies is a response to wide-spread public demand, or even the demands of women alone. A shortage of world population has not been identified as a "problem". According to the 1989 United Nations Population Report, there are now 5.3 billion people in the world, and we are likely to add 90-100 million people every year for the next decade. Birth rates in Canada are falling but there is no shortage of children, and the low birth rate is most likely related to socio-economic factors, rather than sterility or infertility. In fact, according to studies done by organizations like the Canadian Advisory Council on the Status of Women, the incidence of infertility and sterility is quite low.
The major reproductive health demands of women in Canada over the past twenty years have been access to reliable, harmless and more efficient methods of contraception, access to abortion and the development of contraceptive methods for men. Instead, millions are spent on artificial reproductive technologies to increase fertility. While it seems impossible to perfect technologies as basic as the manufacture of reliable condoms, in tests conducted this spring by the federal Health Protection Branch, of 62 different brands of condoms, nearly a third of those tested failed.
There is always a public demand for healthy babies, but this does not necessarily require genetic manipulation, invasive surgical techniques or research to isolate elements of the human genetic code. A reduction in infant mortality and birth defects and a reduction in sterility and infertility levels, might be more effectively accomplished through public health programs, pre-natal and post-natal care, stiff regulatory frameworks and more research on the use of industrial chemicals, environmental pollution and agricultural pesticides, and food additives.
While $3.5 million was spent on new reproductive technologies by Canadian governmental funding agencies in 1987, only $400,000 was allocated to fund public research related to reproductive disorders.
Governments and employers have shown a cavalier attitude toward occupational hazards. Chemicals common in many workplaces, such as mercury, lead, benzene, carbon disulfide and vinyl chloride, are recognized as having the potential to affect the reproductive capacity of men and women, foetal development and to cause miscarriage, stillbirths and birth defects.
The system for identifying chemical substances to workers, and educating them about their effects on reproduction (where that is known), is in its infancy. Workers have very little power to refuse to work in conditions or with materials likely to affect reproduction. Workers have no means to oblige employers to find alternate safe chemicals or production methods.
Some researchers, like Weinstein of the University of Columbia, have estimated that as many as 60,000 chemicals are in use in industrialized countries, and that another 1,000 new or reformulated chemicals are introduced annually. Only a handful are tested for effects on growth and development of the foetus, or reproductive capacity of males and females.
Where reproductive hazards are recognized, employers have been more energetic in excluding workers "at risk" from the worksite than they have been in reducing the hazards. "Workers at risk" has meant women of childbearing age, not just pregnant women. It has been the practice of employers to either exclude women of childbearing age from the work area, or demand that women produce medical certificates of sterilization before admitting them to hazardous areas.
The effect of chemicals, radiation, heat, etc. on male reproductive capacity has been ignored. The early legislation, which selectively "protected" women from the reproductive hazards of radiation and lead in the workplace, was struck down either because of human rights complaints or because labour shortages made it impracticable to exclude women from the workplace. But companies, particularly in the U.S., have revived the practice and these personnel practices have been upheld by the Courts acting to protect the foetus.
Industrial hazards that threaten reproductive capacity and foetal development, and cause birth defects are not confined to the workplace. Members of the community are exposed, generally without their knowledge, to toxic wastes, lead and hazardous levels of ionizing and non-ionizing radiation. Pesticides that have created reproductive problems for agricultural workers and birth defects in their children are present in foods we consume. Hormones are present in our meats and other chemical substances in our foods, and their long-term effects are unknown.
The links between reproduction and prolonged exposure to this complexity of substances in the workplace, household and community has not been well-researched. Little public money is expended on prevention - diagnosis and intervention hold more fascination. The new technologies are all focused on early identification and reversal or elimination of defects, or elimination of foetuses with defects. Little effort is put into identifying and containing the elements or substances responsible for the defects, or the conditions.
Sexually transmitted diseases, particularly gonorrhea, and chlamydia and pelvic inflammatory disease are responsible for a significant percentage of reproductive problems, but few public health initiatives or research monies are aimed at treating, eliminating or preventing these diseases. In the absence of any national consensus about public health policy, moralists like Bill Vander Zalm, the Premier of British Columbia, can delay and confuse public health campaigns designed to prevent the spread of disease among sexually active teenagers.
Research into factors contributing to low sperm counts, the causes of abnormal cervical mucus, or immunologic factors, the causes of hormonal imbalance that underlies infrequent ovulation, and causes of infertility in couples could be more effective than development of invasive technologies in addressing infertility. Expenditures on these kinds of initiatives, research and preventative actions would be more in keeping with the aims of a national public health policy than with the expense of vast sums of money on questionable procedures and treatment programs. We need to reaffirm the goals of a national health care strategy as pressure grows to include costly experimental technologies in the public health care budget.
We are concerned that reproductive technology is developing under its own impetus, according to its own internal logic and in the absence of public demand or consensus. The consequences are already astonishing. The refinement of foetal surgical interventions and research on the applications of foetal tissue, have already resulted in the "production" of foetuses for tissue and organ donations. Members of the medical community are already discussing the "routine" artificial fertilization and implantation of anencephali (foetuses without brains) to be carried to term for organ donation.
Although the techniques were ostensibly developed to correct infertility and to detect and correct foetal abnormalities, the same techniques are already being applied to create and sustain foetuses outside the womb. Experiments in extra-uterine development, cloning and parthenogenesis are being financed and conducted in the absence of any public consensus on whether such investigations are necessary, beneficial or ethical. "Ground rules" have been adopted in some jurisdictions governing medical practices, like the 14-day limit on the use of foetal tissue, but it is unclear which social groups participated in establishing that guideline. In some Canadian provinces there has been public outcry about the medical use of foetuses after abortions, without the knowledge or consent of the women who had undergone the procedure.
Given the biological and ethical implications, development of reproductive technologies has proceeded at an astonishing rate, particularly when compared with the caution that has surrounded the provision of access to abortion services. It is a revealing contrast. Since the early 1970s, a majority of the women of Canada have demanded abortion services to expand their reproductive choices. Their demand has been postponed for
20 years as uneasy governments have attempted to forge a national consensus or reach some compromise between constituencies who hold diametrically-opposed views on the ethics of providing such services. No similar caution has prevailed with regard to reproductive technologies.
We are concerned about the role of corporations, foundations and the pharmaceutical industry in financing research and controlling technology and products. Experimental implantation of foetal brain tissue to halt the onset of Parkinson's disease was conducted recently in the United States, despite a ban on the use of federal funds for such procedures - a ban indicating lack of public support. The surgery was financed by a private foundation.
Commercial enterprises have intruded into collection and storage of sperm, ova and foetal tissue, as well as the provision of fertility and diagnostic services. Their involvement in this particular aspect of medical services is, if anything, even more inappropriate than commercial involvement in any other aspect of medicine and public health. The prospect of commercial traffic in genetic material and foetal tissue is offensive. In gauging the potential effect of the close involvement of the pharmaceutical industry in these technologies, we have an example of the profound and negative world-wide effects of the domination of post-war agriculture by the agro-chemical industry and bio-engineering enterprises.
The commoditization of children and the commercialization of the reproductive process is reflected in attempts to apply the laws of commercial transaction to surrogacy agreements, in assertions regarding the status and rights of clients, and in the ownership, both individual and corporate, of genetic and foetal materials, ova and sperm.
The technological innovations in reproduction have been accompanied by disturbing legal developments that exalt the rights of the foetus and further reduce the role and value of women in reproduction and in society. Canadian and U.S. Courts have intervened to impose medical procedures on unwilling mothers in the name of foetal health. The Courts have apprehended children in-utero and confined mothers for the safety of the foetus. In several U.S. cases, mothers have been apprehended and charged for ignoring medical orders regarding drug or alcohol use. The Courts seem determined to establish the rights of the foetus at the expense of the mother.
Although to date in Canadian jurisprudence the foetus so far has no legal status (even granting that it did acquire "personhood"), there are still no other situations in which individuals are required to undergo medical treatment for another "person".
Many critics have noted the contradiction revealed by the cases referred to above. One week specific behavior that affects foetal development is grounds for criminal prosecution. In another week, abortion is a legally-sanctioned medical procedure. Unfortunately, many fear that the contradiction is likely to be resolved in a way that further limits women.
We view the work of the Royal Commission on New Reproductive Technologies as an important first step in developing a national consensus on the limits of research on new technologies and on public health priorities in the area of reproductive health.
The B.C. Federation of Labour will present recommendations on each of the issues raised in the position paper. As one writer said in speaking of new production technologies, "authoritarian technology and democratic society are incompatible" . We believe that many of the new reproductive technologies are also authoritarian in nature and inimical to the best interests of society. A redirection of public health resources and medical research is needed to both sustain a healthy population and advance the rights of women and children.
Public Health Policy
1. The federal government must articulate a coherent public health policy that
emphasizes preventzative health care, not medical intervention;
2. Establish a regulatory body, representative of a variety of groups beyond the
medical profession, to recommend a regulatory framework for New Reproductive Technologies, and this body should make annual reports to the Legislature, but their recommendations should not be implemented without public hearings.
Artificial Insemination by Donor
There should be no requirements for medical supervision for this process; and
There should be no restrictions on access to this technique apart from medical reasons, i.e. no criteria or requirement that married women have "permission of spouses", and no exclusion of women for sociological reasons.
All clinics providing fertility treatment should be administratively associated with hospitals;
There should be no criteria for entry into these programs apart from medical criteria, but the eligibility period should be extended to two years;
Publicly fund only diagnosis and counselling;
Require hospitals offering clinics to establish medical and psychological counselling teams outside the clinic, and require patients enrolled in in-vitro programs to be referred to these teams for independent medical and psychological counselling, funded through health funds; and
Implement improved hospital quality assurance programs to prevent random and unnecessary testing.
Federal funds must support an aggressive research campaign to identify links between industrial and agricultural chemicals and reproductive hazards;
Public health dollars must be increased for programs to reduce infant mortality and improve pre-natal and post-natal; care.
Research money must be dedicated to identifying hazards in foods and consumer products;
Increased research money must be redirected towards the development of new, safe contraceptive methods for men and women;
Direct money for research into the study and prevention of sexually-transmitted diseases, pelvic inflammatory diseases and chlamydia, and the side effects of some birth control methods which contribute to infertility and sterility;
Increase public health money for campaigns to prevent sexually-transmitted diseases, including AIDS;
Publicly fund all diagnostic procedures used to determine the nature of fertility problems. Fund artificial insemination programs and their associated costs, but there should be no public funding of in-vitro fertilization at this point; and
Increase financial support and housing for the disabled, and undertake a program to make our society accessible.
Establish tough legislation to oblige industrial and agricultural concerns to eliminate chemical hazards from their production processes;
Prohibit research into human cloning, ectogenesis, parthenogenisis and deliberate growth of foetuses for tissue or organ transplants;
Clearly establish that there can be no ownership of genetic materials, no patents issued except on equipment and drugs, and that drug patents be very short-lived to permit development and sale of generic drugs;
Prohibit the import of ova, sperm, and foetal tissue;
Prohibit commercial involvement in sperm and ova banks and in the provision of fertility or infertility treatment and diagnosis;
Clearly establish that no woman can be obliged to undergo medical treatment ag her will;
Clearly establish that the foetus has no status in law;
The Royal Commission on New Reproductive Technologies should condemn the American practice of charging women with "foetal neglect", reject the concept that pregnant women have a "duty of care", and condemn the practice of seizing children "in-utero";
Clearly establish that individuals own ova and sperm, and that no use of these materials can be made without their explicit consent, that the disposition of any fertilized egg, once outside body, requires the consent of both donors (unless the requirement is explicitly waived by the party), and that fertilized eggs should be maintained for the length of a treatment program and then destroyed;
This Commission should reject the concept of the "right to parent";
Surrogacy contracts should have no status in law and should remain unenforceable - the payment of money to a "surrogate" must be prohibited and no "agencies" should be permitted to arrange surrogacy; and
The legal parent should be recognized as the birth mother, regardless of the origin of sperm or ova and any arrangement to give the child to other parents should be made after birth, following ordinary procedures for adoption. As in adoption, a grace period should be built in to allow the birth mother to reconsider and any biological parent may sue for custody, with the best interests of the child to determine the outcome of the case.
Change the federal and provincial Labour Codes to provide leave for medical reasons related to reproduction;
Prohibit employers from requiring and using information from genetic screening tests; and
Prohibit employers from excluding individuals from the workplace on the basis of gender or reproductive capacity.
GLOSSARY OF NEW REPRODUCTIVE TECHNOLOGY TERMS
A test used to diagnose genetic problems which may cause disease
or disability in the foetus. In amniocentesis, ultrasound is used to guide a needle
through the mother's abdomen into the amniotic sac which surrounds the foetus. A
small amount of the fluid in the amniotic sac is removed and the cells in it are checked
for abnormalities. Amniocentesis can also show the sex of the foetus. Amniocentesis is
usually done in the second trimester between the 14th and 16th weeks of pregnancy.
The results are not known until the 18th to 20th week. Amniocentesis has a small - less
than one percent - chance of causing a miscarriage.
A way of becoming pregnant without having sexual
intercourse. Sperm is placed in a woman's vagina when she is ovulating. There are
three kinds of artificial insemination:
AID (artificial insemination/donor), in which the sperm comes from a donor;
AIH (artificial insemination/husband), in which the sperm comes from the woman's husband; and
AIC (artificial insemination/combination), in which a combination of husband and donor sperm is used.
Most artificial insemination in North America is done with sperm from paid, anonymous donors. Because the identities of these donors are unknown to the children, it is nearly impossible for them to trace their biological father. Despite routine screening of donors, the risk of being infected with HIV (the virus which causes AIDS) is higher during artificial insemination than during intercourse with a known partner.
Chorionic Biopsy or Chorionic Villi Sampling (CVS):
A test in which a catheter
(small tube) is inserted through the mother's vagina and cervix, and a sample of the
membrane surrounding the foetus is taken. Like amniocentesis, CVS is a test used to
detect metabolic disorders and chromosomal problems. CVS can also show the sex of
the foetus. CVS can be done during the 8th or 9th week of pregnancy and the results
are usually known within a week. CVS has about a one percent chance of causing a
Chromosomes, DNA, Genes and Genome:
Genome is the word used to describe the
complete set of instructions for making a human being. These instructions are
contained in the 46 chromosomes which human beings normally have. Twenty-three
chromosomes come from a mother's egg, 23 from a father's sperm. Contained in each
of these chromosomes is a long, twisted ribbon of DNA (deoxyribonucleic acid). Genes,
the basic biological units of heredity, are located at specific points along this ribbon of
DNA. Each gene contributes a specific bit of the information that makes each human
being different. The human genome contains about 100,000 genes.
A drug used to induce ovulation so that eggs can be collected for use during in
vitro fertilization. Clomid is chemically similar to DES (di-ethyl stilbestrol), a drug that
has been linked to higher rates of some kinds of cancer in the daughters and sons of
women who were given it. To date, there have been no animal studies or good clinical
analyses of the long-term effects of clomid.
A form of asexual reproduction in which the nucleus of a single cell is used to
produce an exact copy of the original organism.
Conceptus, Embryo and Foetus:
After the egg has been fertilized, the cells begin to
divide. Some of these cells will become the "embryo", the term applied to the first eight
weeks of development. Other cells will become part of the membranes that nourish the
developing embryo. "Conceptus" is the term used to describe the product of conception
and includes both the embryo and the membranes. After eight weeks, the "embryo" is
referred to as the "foetus".
Describes the production of a real "test-tube baby". Ectogenesis means
developing a human foetus completely outside the womb, using an artificial womb or life
support technology. So far, this has not been done and is still only a theoretical
A pregnancy that develops outside the uterus, for example in the
fallopian tubes. Ectopic pregnancy occurs in one of four in vitro fertilization
pregnancies, compared to one in 100 to 300 naturally occurring pregnancies. Most
ectopic pregnancies end in miscarriage because tissues other than the uterus cannot
support a foetus. A medical emergency, like bleeding, can result when an ectopic
A surgical procedure in which a fertilized egg is removed from one
woman's uterus and placed in another woman's uterus.
The term applied to efforts to "improve" the human race, either through
selective breeding or genetic manipulation.
Foetal Heart Monitoring:
Used during labour to detect foetal stress so that, if needed,
a rapid delivery can be performed. Foetal monitoring can be done externally, by placing
electrodes on the mother's abdomen or internally, by attaching electrodes to the foetus.
Making changes in the genetic code to correct imperfections or
introduce a new genetic characteristic.
Genetic or Biological Father:
The man whose sperm fertilizes an egg.
Genetic or Biological Mother:
The woman whose egg is fertilized.
Gestational or Uterine Mother:
The woman who carries the pregnancy to term.
Inability to become pregnant as readily as most women or couples. In North
America, a couple that has been having intercourse for one year, is not using any form
of birth control, and has not conceived, is considered by medical experts to be infertile.
In-Vitro Fertilization (IVF):
The fertilization of a human egg outside of the womb. The
eggs are removed from a woman's ovaries, fertilized with sperm in a laboratory and
then placed in a woman's uterus. The fertilized eggs may either be placed in the uterus
of the woman who produced the eggs or in the uterus of another woman.
A type of asexual reproduction in which the female egg is
duplicated without being fertilized by sperm. Parthenogenesis produces only female
offspring. The process has been used in laboratory experiments, but has not been
done with humans.
Pelvic Inflammatory Disease (PID):
An infection of the uterus and fallopian tubes.
PID is often caused by untreated, sexually-transmitted diseases like chlamydia and
gonorrhea. PID can cause scarring and blocking of the fallopian tubes, and can lead to
infertility, ectopic pregnancy or pelvic pain.
The contract a woman signs when she agrees to act as a
"surrogate mother" and carry a child for someone else. Under the terms of the contract,
the woman - who besides being the uterine mother, may also be the genetic mother -
agrees to give up all rights to the child she carries.
Choosing the sex of a child before birth. Sex selection can be done
before conception, by separating male and female sperm. The woman is then artificially
inseminated with sperm that are likely to produce a baby of the desired sex. The most
effective and commonly used form of sex selection is done after conception. Screening
techniques like amniocentesis are used to determine the sex of the foetus, and if the
foetus is not of the "right" sex, it is aborted.
Inability to conceive. Sterility may be primary, meaning that no conception
has ever been possible, or secondary, which means that the sterility has been caused
by surgery or disease.
A term used to describe a woman who is artificially inseminated
with the sperm of a man whose wife is unable or unwilling to bear a child, and who has
agreed to give the baby to the couple after it is born. She is usually paid for this service.
The term "surrogate mother" is misleading in this case, because the "surrogate" is in
fact the true biological mother of the child.
Sends high frequency sound waves through the mother's abdomen.
These sound waves bounce off the foetus and are converted into a picture on a video
screen. Ultrasound is useful for detecting pelvic tumors or ectopic pregnancy, and for
confirming a multiple pregnancy or an abnormal foetal presentation ( a foetus that is in
some position other than head downward in the uterus). Ultrasound is also used as part
of the in vitro fertilization process to locate and determine the size of egg follicles on the
Adopted in Convention 1990
B.C. Federation of Labour
archive/BCFL Policies:/PP-Reproductive Technologies 1990
Diário da República, 2.ª série — N.º 114 — 15 de Junho de 2007do disposto no artigo 241.º da Constituição da República Portuguesa,do artigo 64.º, n.º 7, alínea a) da Lei n.º 169/99, de 18 de Setembroe do artigo 55.º da Lei n.º 2/2007, de 15 de Janeiro. O RTEDUL tem por objectivo o ordenamento da utilização da viapública, quer na circulação, quer no parqueamento de veíc
Ten guidelines for creating and using hypotheses Here is how to make a useful research hypothesis: STEP 1: THE QUESTION Our example starts with a small article in a journal for chemists. Scientists at the Technical University of Copenhagen had a test done with plastic pipes for drinking water. They had filled tubes with water in their laboratory and left it there for a couple of days. The