Embryo Project Encyclopedia

The US 2nd Circuit Court of Appeals' 1984 decision United States v. University Hospital, State University Hospital of New York at Stony Brook set a significant precedent for affirming parental privilege to make medical decisions for handicapped newborns, while limiting the ability of the federal government to intervene. The ruling stemmed from the 1983 case involving an infant born with severe physical and mental congenital defects; the infant was only identified as Baby Jane Doe. After her parents opted against corrective surgery for some of her deformities, Baby Jane Doe became the epicenter of a national right-to-life debate that had been previously sparked one year prior with the case of Baby Doe, an Indiana infant born with similarly severe handicaps.

In 2017, Julie Carré, Nicolas Gatimel, Jessika Moreau, Jean Parinaud, and Roger Léandri published “Does Air Pollution Play a Role in Infertility?: a Systematic Review,” hereafter “Does Air Pollution Play a Role,” in the journal Environmental Health. The authors completed a systematic literature review to investigate the effects of air pollutants on fertility in exposed populations. Since air quality has an impact on overall health as well as on reproductive function, the authors sought to increase the awareness of the importance of environmental protection issues among the general public and the authorities. The article “Does Air Pollution Play a Role” provided the foundation for further research on how air pollution can contribute to low reproductive capacity in areas with high exposure.

In September 2003, Robert L. Goldenberg and Cortney Thompson published the article “The Infectious Origins of Stillbirth” in the American Journal of Obstetrics and Gynecology. In the article, the authors conducted a literature review of articles from the US National Library of Medicine database to review the relationship between perinatal infections, which are infections around the time of birth, and the occurrence of stillbirth. Stillbirth is the death of a fetus in the uterus after at least twenty weeks of pregnancy. Infectious disease can cause or increase the risk of stillbirth in several ways, by causing illness in the pregnant person, damaging the placenta, or directly infecting the fetus. Infectious agents can be viruses, bacteria, or protozoa. Rates of infectious disease and stillbirth are both higher in developing than in developed countries, and the authors state that stillbirth due to infectious disease is also higher. “The Infectious Origins of Stillbirth” provides a comprehensive review of the information available on how infections can lead to stillbirth, providing a foundation for further research.

The Baby Doe Rules represent the first attempt by the US government to directly intervene in treatment options for neonates born with congenital defects. The name of the rule comes from the controversial 1982 case of a Bloomington, Indiana infant Baby Doe, a name coined by the media. The Baby Doe Rules mandate that, as a requirement for federal funding, hospitals and physicians must provide maximal care to any impaired infant, unless select exceptions are met. If a physician or parent chooses to withhold full treatment when the exceptions are not met, they are liable for medical neglect. After a prolonged legal battle, President Ronald Reagan signed the law on 9 October 1984 as an amendment to the Child Abuse Prevention and Treatment Act (CAPTA) of 1974. Since then, the Baby Doe Rules have influenced both the parents' right to make medical decisions for their child and the way laws can affect treatment options in the US.

The French flag model represents how embryonic cells receive and respond to genetic information and subsequently differentiate into patterns. Created by Lewis Wolpert in the late 1960s, the model uses the French tricolor flag as visual representation to explain how embryonic cells can interpret genetic code to create the same pattern even when certain pieces of the embryo are removed. Wolpert's model has provided crucial theoretical framework for investigating universal mechanisms of pattern formation during development.

In 2017, Laura Geer and colleagues published the results of a study investigating the effects of parabens and antimicrobial compounds on birth outcomes in the article “Association of Birth Outcomes with Fetal Exposure to Parabens, Triclosan and Triclocarban in an Immigrant Population in Brooklyn, New York” in the Journal of Hazardous Materials. Parabens are a class of preservatives found in cosmetic and pharmaceutical products and antimicrobial compounds are compounds that kill microorganisms such as bacteria. In the University Hospital of Brooklyn’s Prenatal Clinic in New York City, New York, the authors tested the concentration of parabens and certain antimicrobial substances in pregnant women’s urine and umbilical cord blood plasma, finding that the concentration of one of the substances, triclocarban, may affect many health outcomes for the developing fetus. The authors’ results demonstrate how some common consumer products, in large quantities, may have harmful reproductive effects and birth outcomes.

In 1994, the Eastern Virginia District court case Bailey v. Blue Cross Blue Shield of Virginia established that insurance companies could not deny coverage for experimental stem cell therapy treatments. The plaintiff, Mary Bailey, was diagnosed with advanced stage breast cancer and sought treatment involving high-dose chemotherapy and an advanced stem cell treatment, which was a novelty at the time. Stem cells are cells that have the potential to develop into several different types of cells in the body. The defendant was the health insurance company Blue Cross Blue Shield, which denied coverage for Bailey’s treatment. The district court sided with Bailey and ordered that BCBS could not deny coverage for her specific treatment. While Bailey v. Blue Cross Blue Shield of Virginia resulted in Bailey receiving compensation for her treatment, it also increased national awareness of stem cell therapy with chemotherapy.

In the early 2000s, Richard S. Legro, Mark V. Sauer, Gilbert L. Mottla, Kevin S. Richter, William C. Dodson, and Duanping Liao studied the relationship between air pollution and reproductive complications. In the United States, Legro’s team tracked thousands of women undergoing in vitro fertilization, or IVF, along with the air quality of both the IVF clinics and patients’ home locations. IVF is a reproductive technology during which a physician obtains mature eggs from a patient’s ovaries and fertilizes them with sperm in a lab setting outside of the body, after which the physician transfers the fertilized eggs into the patient’s uterus. As stated in Legro’s publication, Legro suspected that poor air quality would adversely affect live birth rates during IVF, so he compiled and analyzed the various types of pollutants that IVF patients were naturally exposed to in their homes and clinics. Legro’s experiment led to an increased awareness among patients about the dangers of conceiving via IVF in highly polluted areas.

In December 2011, the Stillbirth Collaborative Research Network, or SCRN, published the article “Causes of Death Among Stillbirths” in The Journal of the American Medical Association. The authors of the article investigate the causes of stillbirth and possible reasons for the racial, ethnic, and geographic disparities in stillbirth rates. According to the Centers for Disease Control and Prevention, or CDC, stillbirth is the death of a fetus at twenty or more weeks during pregnancy. “Causes of Death Among Stillbirths” explores the common causes of stillbirth in different racial and ethnic groups, and provides a framework for future research into medical interventions to help reduce racial and ethnic stillbirth disparity.

In April 1994, Elizabeth Raymond, Sven Cnattingius, and John Kiely published “Effects of Maternal Age, Parity, and Smoking on the Risk of Stillbirth” in the British Journal of Obstetrics and Gynecology, now known as BJOG: An International Journal of Obstetrics and Gynecology. The article examines how advanced maternal age, defined as delivery at thirty-five years old or older, cigarette smoking, and nulliparity, or the state of never having given birth, can negatively impact pregnancy. At the time of publication, according to Raymond and colleagues, stillbirths comprised over half of all perinatal, or close to birth, deaths and more than one-third of total fetal and infant deaths in Europe and North America. In the article, Raymond and her coauthors demonstrate how certain risk factors may increase the risk of stillbirth at different stages of pregnancy, which helped set a foundation for future research in interventions to prevent stillbirth.