Embryo Project Encyclopedia Articles

Fetal programming, or prenatal programming, is a concept that suggests certain events occurring during critical points of pregnancy may cause permanent effects on the fetus and the infant long after birth. The concept of fetal programming stemmed from the fetal origins hypothesis, also known as Barker’s hypothesis, that David Barker proposed in 1995 at the University of Southampton in Southampton, England. The fetal origins hypothesis states that undernutrition in the womb during middle to late pregnancy causes improper fetal growth, which in turn, causes a predisposition to certain diseases in adulthood. In addition to nutritional impacts, researchers have studied the fetal programming effects of many factors, such as maternal anxiety or violence during pregnancy. Researchers proposing the concept of fetal programming established a new area of research into the developmental causes of disease, pointing towards the in utero environment and its critical role in healthy human development.

Isotretinoin is a molecule and a byproduct (metabolite) of vitamin A, and in greater than normal amounts in pregnant women, it can cause fetal abnormalities including cleft lips, ear and eye defects, and mental retardation. Isotretinoin is commonly called by its trade name Accutane, and it's a chemical compound derived from vitamin A, or retinoic acid. Doctors prescribe isotretinoin to treat severe acne. For pregnant women, too much vitamin A or isotretinoin can also cause greater than normal rates of stillbirths and fetal disintegrations after the ninth week of gestation. Women who use isotretinoin during the first trimester of their pregnancies, even in small amounts, risk defects to their fetuses such as external ear malformations, cleft palates, undersized jaws (micrognathia), a variety of heart defects, buildups of fluids inside the skulls that leads to brain swelling (hydrocephalus), small heads and brains (microcephaly), and mental retardation.

Orchiopexy, also known as orchidopexy, is a surgical technique that can correct cryptorchidism and was successfully performed for one of the first times in 1877 in Scotland. Cryptorchidism, a condition where one or both of the testicles fail to descend before birth, is one of the most common male genital birth defects, affecting approximately 2 to 8 percent of full-term male infants, and around 33 percent of premature infants. Typically in the womb, male testes form within the abdomen, then descend into the scrotal area between twenty-five to thirty-five weeks’ gestation. If one or both testicles fail to descend before birth, physicians use orchiopexy to surgically relocate the undescended testes to their normal position in the scrotum. According to many researchers, most cases of cryptorchidism do not resolve on their own, and therefore, orchiopexy surgery is often necessary. Orchiopexy, when performed before puberty, can decrease the risk of testicular cancer and infertility associated with cryptorchidism.

Henrietta Lacks, born Loretta Pleasant, had terminal cervical cancer in 1951, and was diagnosed at The Johns Hopkins University in Baltimore, Maryland, where researchers collected and stored her cancer cells. Those cells went on to become the first immortal human cell line, which the researchers named HeLa. An immortal cell line is an atypical cluster of cells that continuously multiply on their own outside of the organism from which they came, often due to a mutation. Lacks’s cancer cells enabled scientists to study human cells outside of the human body, though that was controversial since she did not voluntarily donate her cells for such research. Science writer Rebecca Skloot chronicled Lacks’s life in her book, The Immortal Life of Henrietta Lacks, which became a movie in 2017. Lacks’s HeLa cell line has contributed to numerous biomedical research advancements and discoveries and her story has prompted legal and ethical debates over the rights that an individual has to their genetic material and tissue.

First manufactured in 1988 by Serono laboratories, recombinant gonadotropins are synthetic hormones that can stimulate egg production in women for use in fertility treatments. Recombinant gonadotropins are artificially created using recombinant DNA technology, a technology that joins together DNA from different organisms. In vertebrates, naturally-occurring gonadotropins regulate the growth and function of the gonads, known as testes in males and ovaries in females. Medical professionals can derive female gonadotropins from the urine of pregnant and post-menopausal women, often using it to facilitate in vitro fertilization, or IVF. With the rapid development of assisted reproductive technologies like IVF, demand for human-derived gonadotropins rose to a global yearly demand of 120 million liters of urine by the beginning of the twenty-first century, which resulted in a demand that could not be met by traditional technologies at that time. Therefore, researchers created recombinant gonadotropins to establish a safer and more consistent method of human gonadotropin collection that met the high demand for its use in fertility treatments.

On 23 April 2008, the US Government Accountability Office, or GAO, released a report titled, “Abstinence Education: Assessing the Accuracy and Effectiveness of Federally Funded Programs,” hereafter “Abstinence Education,” in which it investigated the scientific accuracy and effectiveness of abstinence-only education programs sanctioned by individual states and the US Department of Health and Human Services, or HHS. GAO is a government agency whose role is to examine the use of public funds, evaluate federal programs and activities, and provide nonpartisan support to the US Congress. In “Abstinence Education,” GAO found that as of August 2006, a variety of factors in such programs, such as inaccurate medical information, contributed to overall conclusions that abstinence-until-marriage programs were unsuccessful at reducing the rates of adolescent pregnancy. In “Abstinence Education,” GAO recommends that HHS implement procedures to better assure the accuracy of educational materials used in abstinence programs and to set standards that measure the effectiveness of those programs.

Josef Warkany studied the environmental causes of birth defects in the United States in the twentieth century. Warkany was one of the first researchers to show that factors in the environment could cause birth defects, and he helped to develop guidelines for the field of teratology, the study of birth defects. Prior to Warkany’s work, scientists struggled to explain if or how environmental agents could cause birth defects. Warkany demonstrated that a deficiency or excess of vitamin A in maternal nutrition could cause birth defects. He also established that mercury in teething powders increased infant mortality rates. Warkany showed how substances outside the human body could adversely affect conception, growth, and development of the human fetus in utero.

Between 1925 and 1961, a Roman Catholic order of nuns called the Bon Secours Sisters operated the Bon Secours Mother and Baby Home, or the Home, an institution where unmarried pregnant women gave birth in Tuam, Ireland. Pregnant women who delivered their infants at the Home were required to work at the Home for no less than one year without pay. The Irish government and the Catholic Church endorsed the Mother and Baby Home as a means to limit the number of children born out of wedlock by discouraging women from getting pregnant before marriage. During the Home’s thirty-six years of operation, the nuns reported that almost 800 children died in their care. In 2015, researchers discovered a tomb of 796 infant and child skeletons in a septic tank underneath where the Home once stood. The acceptance and use of Mother and Baby Homes revealed the way Ireland treated pregnant women in the twentieth century.

In the late-twentieth century in the United States, Catherine DeAngelis was a pediatric physician, researcher, and editor of multiple medical journals. During her time with the Journal of the American Medical Association, DeAngelis became the journal’s first female editor. At Johns Hopkins University in Baltimore, Maryland, she studied how physician-nurse interactions affected patient care, how immunizations and adolescent pregnancy affected children, and how medications affected men and women differently. She also worked to reduce gender inequality in the practice of medicine by publishing articles that addressed the pay gap between men and women at Johns Hopkins. Throughout her career, DeAngelis advocated for equality between men and women in the medical field and supported equal treatment of women as patients and as practitioners of medicine. By doing so, she helped women become more central participants in medicine and therefore helped increase the focus on women's health in medicine.

Polycystic ovarian syndrome or PCOS is one of the most common reproductive conditions in women, and its symptoms include cystic ovaries, menstrual irregularities, and elevated androgen or male sex hormone levels. During the 1930s, Irving Freiler Stein and Michael Leventhal identified the syndrome and its symptoms. Women who experience symptoms of PCOS may also experience secondary symptoms, including infertility and diabetes. Though estimates vary and the causes of the syndrome are not clear as of 2017, PCOS affects approximately ten percent of women of reproductive age. Women who suspect they have symptoms of PCOS should see a doctor, as early treatment may help prevent long-term implications such as infertility, diabetes, and some types of cancers.