A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Doctor of Philosophy July, 2015 / Introduction: Anastrozole is clinically effective in ovulation induction, but it has not been well researched. The aim of this study was to determine the optimal dose for anastrozole as a superovulator and ascertain its effects on implantation in Wistar rats; also to determine its effects on uterine morphology during early pregnancy using light microscopy and scanning electron microscopy (SEM). [Abbreviated Abstract. Open document to view full version] / AC2016

The aim of the thesis is twofold: the first aim is to identify a number of reproductive logics that are used to construct Swedish regulation of embryo donation for reproductive use as either ethical or unethical in the governmental – and medical discussions – and to examine how these logics are interconnected with notions of gender and parenthood. The second aim is to identify a number of tensions that arise in the application of the governmental ethical logic on the embryo and embryo donation and discuss how these tensions can be solved with a feminist material approach. I argue that the terminology used to distinguish between genetic, biological, social and legal parenthood in my material is insufficient for understanding the value of the embryo outside its pre-human status. I therefore argue for an embryonic feminist bioethics that is attentive to the embryos post-human status, and for a reformulation of the parenthood terminology in line with what I call „reproductive ties‟.

Anthropological research on the sociocultural outcomes from applications of Assisted Reproductive Technologies (ARTs) for infertility, particularly in sub-Saharan Africa, is greatly lacking and much needed. Narratives from individuals, couples, families, community leaders and members are particularly germane to medical anthropological studies on the intersection of science and technology in the new millennium. With ART applications still in their infancy in sub-Saharan Africa, research of this nature may be of benefit in determining how best to apply ARTs within important cultural frameworks and allow infertile couples and other recipients the opportunity to minimize adverse results. This paper draws upon theoretical perspectives from anthropology, science and technology studies, ethnographic data from my field study in Uganda, and reviews of literature, to construct theories about how for the Baganda, the proliferation of ARTs could potentially change or disrupt cultural notions of power and identity and unseat core notions of kinship.

Denmark is a major exporter of both anonymous and identity-release donor sperm worldwide, and is home to one the world's largest sperm bank networks. The country's legal framework allows for sperm donors to make the choice whether to be anonymous or to release their identity to potential offspring, in contrast to the majority of European countries which require either anonymity or identity-release donation. As such, it represents a chance for researchers to draw comparisons between donors who have explicitly made these different choices. This thesis draws on data from thirteen in-depth semi-structured interviews carried out with donors at a major Danish sperm bank. I suggest that neither the traditional ‘beer money for the weekend’ nor the currently-popular ‘wanting to help’ narrative of sperm donation tells the full story; the experiences of these donors cannot be expressed fully using an altruistic gifting model, but neither are they fully captured in terms of the capitalist exchange of labour; as ‘help’ or as ‘work’. Donor virility, and by extension masculinity, is represented through sperm quality and the discourse of “good sperm”, which then explicitly informs donor payment, complicating the relationship between donors’ embodied experience, their pride in their ‘product’ and the various ways in which semen as a substance is understood: “good sperm” could make a donor into a ‘good guy’ who could help with the falling national birth count, whereas sperm that was “bad” could be reframed as the product of donors’ lifestyles or as ‘good soldiers’ fighting against the freezing process. Donor accounts of sperm donation were also informed by the wider web of connections that are formed through the process of sperm donation: real, potential, or imagined connections between donor and offspring, donor and their imagined ‘good’ recipient, offspring and donor families, and donors and the wider Danish nation in terms of the production of so-called ‘Viking sperm’ and the extension of the ‘help’ discourse through the falling Danish sperm count.

Thesis advisor: Lisa S. Cahill / Weaving qualitative interview analysis together with ethical inquiry, this project traces the trajectories of Catholic women and couples who hope to form families but contend with infertility and consider whether and how to treat it. Motivating this study is the challenge of balancing individual agency with the role of powerful social forces that shape agency. Examining and critiquing the social forces that shape the circumstances in which Catholic women and couples in the U.S. contend with infertility, this dissertation demonstrates how agential freedom is conditioned by familial, clinical, and ecclesial cultures and structures. It harnesses sociological tools and theological resources to argue for an account of agency that prioritizes critical engagement of contextual factors and suggests that the Church as a moral teacher ought to support the cultivation of this agency. Chapter one challenges the model of moral agency found in magisterial teachings that oppose the use of contraception and reproductive technologies, which suggests that lay Catholics ought to obey magisterially prescribed norms regardless of context. The chapter argues that the magisterial model of moral agency does not adequately account for the role of context in shaping agency, and it instead proposes an account of contextually situated agency that resonates with Pope Francis’ prioritization of contextual realties in his apostolic exhortation Amoris Laetitia. The second chapter demonstrates how various social forces, including structures supporting heterosexual marriage, cultural ideals related to biological childbearing, and ecclesial structures of marital formation all contribute to U.S. Catholic couples’ family formation choices and can intensify burdens of infertility. The chapter proposes a reorientation of Catholic support for families centered on justice in relationships and Christian discipleship instead of family structure. The third chapter examines how cultural ideals related to childbearing, the medicalization of infertility, and social location all contribute to shaping how Catholic women in the U.S. make sense of infertility. Contesting the cultural notion that women are responsible for infertility with reference to a criterion of justice, it describes infertility as a kind of biological bad luck also shaped by systemic forces. Structural injustices related to sexism and racism in healthcare function to distribute the bad luck of infertility unjustly based on societal vulnerabilities, which constitutes a kind of social sin. The fourth chapter considers how two different understandings of Catholic identity shape treatment trajectories of Catholics contending with infertility toward either secular fertility clinics or Catholic clinics. It then examines these two clinical settings, demonstrating how contextual pressures shape how Catholics make treatment choices and underscoring how Catholic moral commitments can support moral agents’ resistance to these pressures. Its final section considers the social forces at work in adoption and fostering. The final chapter turns to the role of the Church in supporting the moral agency of Catholics making decisions regarding family formation and infertility treatment. After analyzing and critiquing the dominant ideals found in Catholic and secular support group settings, it suggests that synodal commitments of mutual listening and inclusive dialogue can support the development of new structures of moral discernment in the Church. It concludes by considering how the social witness of the Church can contribute to the transformation of sinful social forces that constrain the freedom of women and couples contending with infertility. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Theology.

The Royal Commission on New Reproductive Technologies developed rapidly in Canada after the birth of world’s first “test tube baby,” Louise Brown, in 1978. Canadian feminists, propelled by the women’s health movement, perceived these technologies as a threat to women’s control over their bodies, the gains made to redefine the identity “woman” against the biological tradition of “mother,” and against the safety and freedom of women based on race, disability and class. In response to the lobby efforts of the women’s movement under the Canadian Coalition for a Royal Commission on New Reproductive Technologies, the Mulroney government established a commission in 1989 to study the medical, legal, and social implications these technologies would have on Canadian society. Through a qualitative analysis of manuscript and printed sources, this thesis explores the debate surrounding new reproductive technologies (NRTs) before and after the mandate of the Royal Commission (1989 to 1993). It discusses the views and positions of some of the key stakeholders such as the National Action Committee on the Status of Women, the Canadian Medical Association, the DisAbled Women’s Network, as well as adds the voice of infertile women through the Infertility Awareness Association of Canada. This thesis also examines the controversy and discontent created by the Commission’s dismissal of several members, by the management’s style of its Chair, and by the final report’s narrow scope. In the end, the reaction to the report was one of considerable disappointment amongst all major stakeholders, starting with NAC, which claimed that its voice had not been heard. At the same time, the debate over NRTs illustrates NAC’s ongoing internal problems as it faced the challenge of “identity politics.”

The Royal Commission on New Reproductive Technologies developed rapidly in Canada after the birth of world’s first “test tube baby,” Louise Brown, in 1978. Canadian feminists, propelled by the women’s health movement, perceived these technologies as a threat to women’s control over their bodies, the gains made to redefine the identity “woman” against the biological tradition of “mother,” and against the safety and freedom of women based on race, disability and class. In response to the lobby efforts of the women’s movement under the Canadian Coalition for a Royal Commission on New Reproductive Technologies, the Mulroney government established a commission in 1989 to study the medical, legal, and social implications these technologies would have on Canadian society. Through a qualitative analysis of manuscript and printed sources, this thesis explores the debate surrounding new reproductive technologies (NRTs) before and after the mandate of the Royal Commission (1989 to 1993). It discusses the views and positions of some of the key stakeholders such as the National Action Committee on the Status of Women, the Canadian Medical Association, the DisAbled Women’s Network, as well as adds the voice of infertile women through the Infertility Awareness Association of Canada. This thesis also examines the controversy and discontent created by the Commission’s dismissal of several members, by the management’s style of its Chair, and by the final report’s narrow scope. In the end, the reaction to the report was one of considerable disappointment amongst all major stakeholders, starting with NAC, which claimed that its voice had not been heard. At the same time, the debate over NRTs illustrates NAC’s ongoing internal problems as it faced the challenge of “identity politics.”

The Royal Commission on New Reproductive Technologies developed rapidly in Canada after the birth of world’s first “test tube baby,” Louise Brown, in 1978. Canadian feminists, propelled by the women’s health movement, perceived these technologies as a threat to women’s control over their bodies, the gains made to redefine the identity “woman” against the biological tradition of “mother,” and against the safety and freedom of women based on race, disability and class. In response to the lobby efforts of the women’s movement under the Canadian Coalition for a Royal Commission on New Reproductive Technologies, the Mulroney government established a commission in 1989 to study the medical, legal, and social implications these technologies would have on Canadian society. Through a qualitative analysis of manuscript and printed sources, this thesis explores the debate surrounding new reproductive technologies (NRTs) before and after the mandate of the Royal Commission (1989 to 1993). It discusses the views and positions of some of the key stakeholders such as the National Action Committee on the Status of Women, the Canadian Medical Association, the DisAbled Women’s Network, as well as adds the voice of infertile women through the Infertility Awareness Association of Canada. This thesis also examines the controversy and discontent created by the Commission’s dismissal of several members, by the management’s style of its Chair, and by the final report’s narrow scope. In the end, the reaction to the report was one of considerable disappointment amongst all major stakeholders, starting with NAC, which claimed that its voice had not been heard. At the same time, the debate over NRTs illustrates NAC’s ongoing internal problems as it faced the challenge of “identity politics.”

The Royal Commission on New Reproductive Technologies developed rapidly in Canada after the birth of world’s first “test tube baby,” Louise Brown, in 1978. Canadian feminists, propelled by the women’s health movement, perceived these technologies as a threat to women’s control over their bodies, the gains made to redefine the identity “woman” against the biological tradition of “mother,” and against the safety and freedom of women based on race, disability and class. In response to the lobby efforts of the women’s movement under the Canadian Coalition for a Royal Commission on New Reproductive Technologies, the Mulroney government established a commission in 1989 to study the medical, legal, and social implications these technologies would have on Canadian society. Through a qualitative analysis of manuscript and printed sources, this thesis explores the debate surrounding new reproductive technologies (NRTs) before and after the mandate of the Royal Commission (1989 to 1993). It discusses the views and positions of some of the key stakeholders such as the National Action Committee on the Status of Women, the Canadian Medical Association, the DisAbled Women’s Network, as well as adds the voice of infertile women through the Infertility Awareness Association of Canada. This thesis also examines the controversy and discontent created by the Commission’s dismissal of several members, by the management’s style of its Chair, and by the final report’s narrow scope. In the end, the reaction to the report was one of considerable disappointment amongst all major stakeholders, starting with NAC, which claimed that its voice had not been heard. At the same time, the debate over NRTs illustrates NAC’s ongoing internal problems as it faced the challenge of “identity politics.”

Successful fertilization depends upon the activation of metaphase II arrested oocytes by sperm-borne oocyte activating factor (SOAF). Failure of oocyte activation is considered as the cause of treatment failure in a proportion of infertile couples. SOAF induces the release of intracellular calcium in oocyte which leads to meiotic resumption and pronuclear formation. Calcium release is either in the form of single calcium transient in echinoderm and amphibian oocytes or several calcium oscillations in ascidian and mammalian oocytes. Although the SOAF attributes are established, it is not clear which sperm protein(s) play such role. Sperm postacrosomal WW binding protein (PAWP) satisfies a developmental criteria set for a candidate SOAF. This study shows that recombinant human PAWP protein or its transcript acts upstream of calcium release and fully activates the amphibian and mammalian oocytes. Interference trials provided evidence for the first time that PAWP mediates sperm-induced intracellular calcium release through a PPXY/WWI domain module in Xenopus, mouse and human oocytes. Clinical applications of PAWP were further investigated by prospective study on the sperm samples from patients undergoing intracytoplasmic sperm injection (ICSI). PAWP expression level, analyzed by flow cytometry, was correlated to ICSI success rate and embryonic development. This study also explored the developmental expression of the other SOAF candidate, PLCζ in male reproductive system and its function during fertilization. Our findings showed for the first time that PLCζ most likely binds to the sperm head surface during epididymal passage and is expressed in epididymis. We demonstrated that PLCζ is also compartmentalized early in spermiogenesis and thus could play an important role during spermiogenesis. Detailed analysis of in vitro fertilization revealed that PLCζ disappears from sperm head during acrosome reaction and is not detectable during sperm incorporation into the oocyte cytoplasm. In conclusion, this dissertation provides evidence for the essential non-redundant role of sperm PAWP in amphibian and mammalian fertilization; recommends PAWP as a biomarker for prediction of ICSI outcomes in infertile couples; and proposes that sperm PLCζ may have functions other than inducing oocyte activation during fertilization. / Thesis (Ph.D, Anatomy & Cell Biology) -- Queen's University, 2013-09-29 23:45:35.395