Embryo Project Encyclopedia Articles

In Maureen Kass v. Steven Kass (1998), the Court of Appeals of New York in Albany, New York, ruled that the state should generally consider IVF consent forms signed by participants in an in vitro fertilization (IVF) program valid, binding, and enforceable in the event of a dispute. The court indicated that decisions regarding the handling of cryopreserved pre-zygotes, often called preembryos, contained within these consent forms should be upheld. Although Steven and Maureen Kass had signed IVF consent forms agreeing to donate unused preembryos to research, during their divorce Maureen argued for custody of the preembryos. The New York Court of Appeals ruled in favor of Steven Kass and concluded that the informed consent forms signed by the former couple had clearly manifested the coupleÕs mutual intent to donate any preembryos to research in the event of a dispute.

In Gonzales v. Carhart (2007), the US Supreme Court held in a five-to-four decision that the 2003 Partial-Birth Abortion Ban Act passed by the US Congress was constitutional. Although the Court previously ruled in Stenberg v. Carhart (2000) that a Nebraska law that prohibited partial-birth abortions was unconstitutional, Gonzales reversed this decision. Gonzales created the precedent that anyone who delivers and kills a living fetus could be subject to legal consequences, unless he or she performed the procedure to save the life of the mother.

Howard Wilber Jones Jr. and his wife, Georgeanna Seegar Jones, developed a method of in vitro fertilization and helped create the first baby in the US using that method. Though the first in vitro baby was born in England in 1978, Jones and his wife's contribution allowed for the birth of Elizabeth Carr on 28 December 1981. Jones, a gynecologist and an obstetrician, researched human reproduction for most of his life.

Fetal surgeries are a range of medical interventions performed in utero on the developing fetus of a pregnant woman to treat a number of congenital abnormalities. The first documented fetal surgical procedure occurred in 1963 in Auckland, New Zealand when A. William Liley treated fetal hemolytic anemia, or Rh disease, with a blood transfusion. Three surgical techniques comprise many fetal surgeries: hysterotomy, or open abdominal surgery performed on the woman; fetoscopy, for which doctors use a fiber-optic endoscope to view and make repairs to abnormalities in the fetus; and percutaneous fetal theray, for which doctors use a catheter to drain excess fluid. As the sophistication of surgical and neonatal technology advanced in the late twentieth century, so too did the number of congenital disorders fetal surgeons treated, such as mylomeningeocele, blocked urinary tracts, twin-to-twin transfusion syndrome, polyhydramnios, diaphragmatic hernia, tracheal occlusion, and other anomalies. Many discuss the ethics of fetal surgery, as many consider it contentious, as fetal surgery risks both the developing fetus and the pregnant woman, and at times it only marginally improves patient outcomes. Some argue, however, that as more advanced diagnostic equipment and surgical methods improve, advanced clinical trials in a few conditions may demonstrate more benefits than risks to both pregnant women and fetuses.

Dell Publishing in New York City, New York, published Lennart Nilsson's A Child Is Born in 1966. The book was a translation of the Swedish version called Ett barn blir till, published in 1965. It sold over a million copies in its first edition, and has translations in twelve languages. Nilsson, a photojournalist, documented a nine-month human pregnancy using pictures and accompanying text written by doctors Axel Ingelman-Sundberg, Claes Wirsen and translated by Britt and Claes Wirsen and Annabelle MacMillian. Critics lauded A Child Is Born for its photographs taken in utero of a developing fetus. Furthermore, the work received additional praise for what many described as simple and scientifically accurate explanations of complicated processes during development.

In Stenberg v. Carhart, the US Supreme Court ruled on 28 June 2000 that a Nebraska law banning partial birth abortions was unconstitutional. Though the US Supreme Court case Roe v. Wade in 1973 had set a precedent that constitutionally protected abortions, some states established limitations on certain types of abortion procedures. When NebraskaÕs state government criminalized partial birth abortions, physician LeRoy Carhart challenged the constitutionality of the case. Don Stenberg, an Attorney General located in Lincoln, Nebraska, represented the state of Nebraska. Stenberg determined that states could not create undue burden on womenÕs right to terminate their pregnancies, and that specific restrictions on abortion procedures must include an exception to protect a womanÕs health and life.

Surgeons sometimes operate on the developing fetuses in utero of pregnant women as a medical intervention to treat a number of congential abnormalities, operations that have ethical aspects. A. William Liley performed the first successful fetal surgery, a blood transfusion, in New Zealand in 1963 to counteract the effects of hemolytic anemia, or Rh disease. The ethical discussions surrounding fetal surgery are complex and are still being defined, as fetal surgery represents an emerging field of in utero medical interventions that impact the quality of life for both pregnant women and fetuses. Such discussions involve the ethical relationships between parents, fetuses, doctors, and health care organizations like hospitals. What may benefit the fetus may harm the pregnant woman, and what may benefit the pregnant woman could negatively impact the viability of the pregnancy. Risks to the pregnant woman include preterm membrane rupture, preterm labor, wound infection, hemorrhage, loss of uterus, damage to the organs near the uterus, and possibly death. Fetal surgery does not always improve the quality of life for the developing fetus, and the risks and benefits of fetal surgery must be carefully weighed and discussed between the medical team, the pregnant woman, and her partner to customize the most ethical plan of action

In a clinical trial from 1969 to 1972, Sir Graham Collingwood Liggins and Ross Howie showed that if doctors treat pregnant women with corticosteroids before those women deliver prematurely, then those women's infants have fewer cases of respiratory distress syndrome than do similarly premature infants of women not treated with corticosteroids. Prior to the study, premature infants born before 32 weeks of gestation often died of respiratory distress syndrome, or the inability to inflate immature lungs. Liggins and Howie, then both at the University of Auckland in Auckland, New Zealand, published their results in A Controlled Trial of Antepartum Glucorticoid Treatment for Prevention of the Respiratory Distress Syndrome in Premature Infants in 1972. The study built on experiments Liggins had earlier conducted with sheep. Liggins' corticosteroid experiments changed the way doctors treated pregnant women experiencing preterm labors, and they improved the life expectancy of prematurely born infants.

In Davis v. Davis (1992), the Supreme Court of Tennessee decided a dispute over cryopreserved preembryos in favor of Junior Lewis Davis, who sought to have the preembryos destroyed over the objections of his former wife, Mary Sue Davis. The decision in Davis, although not binding in other states, suggested a framework for resolving similar disputes in the US. That framework established that courts should follow the wishes of those who contribute their sperm and egg cells, or gamete providers, to create preembryos. In the event of a dispute, courts should enforce any prior agreement between the gamete providers and in the absence of such an agreement, the court should weigh the interests of the parties, ordinarily ruling in favor of the party who wishes to avoid procreation.

Cocaine use by pregnant women has a variety of effects on the embryo and fetus, ranging from various gastro-intestinal and cardiac defects to tissue death from insufficient blood supply. Thus, cocaine has been termed a teratogen, or an agent that causes defects in fetuses during prenatal development. Cocaine is one of the most commonly used drugs in the US and it has a history of both medical and illegal recreational use. It is a drug capable of a wide array of effects on physical and mental health. Research on the teratogenic effects of cocaine began in the early 1980s, and in 1985 research on the effects of cocaine on prenatal development gained widespread attention. Since then, numerous studies have contributed to information about the detrimental impacts of maternal cocaine use on embryonic and fetal development.