MSCAGR (Animal Science) / Department of Animal Science / This study determined the effects of in vitro culture media (Ham’s F10 and TCM199) and assisted hatching techniques (laser or mechanical) on mice embryo survival following cryopreservation. Pure strain C57BL/6 (B6) female (50) and strain BALB /c (C) Male (25) mice were crossed to produce F1 generation of females which were injected for follicular growth and super ovulation at 6 weeks of age and from which embryos were produced 21 h later through in vivo fertilization. Embryos were randomly divided into Petri dishes with different culture media, and the development of embryos was assessed until the morula stage. At the morula stage, selected embryos were assisted to hatch using different techniques, and then cryopreserved in liquid nitrogen using the slow freezing method for a period of 1 week. After 1 week of cryopreservation, the embryos were thawed and cultured in the two different in vitro culture media for 72 hours. Thereafter, the numbers of embryos hatched or survived were recorded after 24 h, 48 h and 72 h. Data was analyzed using ANOVA in Minitab Software Version 16 (2010). Significant difference in embryo quality development was observed between in vitro culture media and stage of embryo development (P<0.05). In the TCM-199 in vitro culture medium, embryo quality development yielded 72, 69 and 69% from day 1 to day 3, while in Ham’s F10 embryo quality development yielded 68, 63 and 60% respectively. Relative to the control (18.1%) assisted hatching improved hatchability significantly (P<0.05) in the order laser (23.6%)>, mechanical (20.8%). There was significant (P<0.01) interaction between assisted hatching techniques and evaluation time, whereby laser assisted hatching was most successful at 48 h (42.0%) while mechanical assisted hatching was most successful at 72 h (36.8%). Cryopreservation reduced the embryo survival compared to fresh embryos. In conclusion laser was the best assisted hatching technique, while TCM-199 was the better medium for in vitro culture of embryo. / NRF

Micromotors – untethered, motile, microscopic devices – are implemented in this dissertation for two applications in the field of assisted reproductive technology. First, as synthetic motor units for individual sperm cells, representing a novel approach to counteract sperm immotility (asthenozoospermia), which is one of the most prevalent causes of male infertility. Second, as synthetic carriers of fertilized oocytes (zygotes) towards the realization of non-invasive intrafallopian transfer, representing a novel alternative to the current keyhole surgery (laparoscopy) approach to achieve early embryo transfer after in vitro fertilization. In both applications, magnetically actuated micromotors are utilized to capture, transport, and deliver individual cells in a reproducible, controllable manner. In comparison with established in vitro fertilization routines, the crucial advantage of employing micromotors for the manipulation of gametes, i.e. sperm and (fertilized) oocytes, lies in the potential transfer of decisive steps of the fertilization process back to its natural environment – the fallopian tube of the female patient – taking advantage of the untethered, non-invasive motion and manipulation capabilities of magnetic micromotors. When sperm motility can be restored with magnetic micromotors, sperm can travel to the oocyte under external actuation and control, and the oocyte does not need to be explanted for in vitro fertilization. However, if in vitro fertilization was necessary, fertilized oocytes can be transferred back to the fallopian tube by micromotors in a non-invasive manner, to undergo early embryo development in the natural environment. These novel concepts of micromotor-assisted reproduction are presented and investigated in this thesis, and their potential is analyzed on the basis of proof-of-concept experiments.:1 Introduction 6 1.1 Background and Motivation 6 1.2 Objectives and Structure of this Dissertation 9 2 Fundamentals 11 2.1 Micromotors Definition and Concept 11 2.2 Micromotors for Biomedical Applications 13 2.3 Magnetic Micropropellers 15 2.3.1 Theory 15 2.3.2 Implementation 20 2.4 Microfabrication: Direct Laser Writing 21 2.5 Assisted Reproductive Technology 23 2.5.1 In vitro Fertilization and Intracytoplasmic Sperm Injection 24 2.5.2 Embryo Transfer and Zygote Intrafallopian Transfer 25 2.5.3 The Sperm Cell and the Oocyte 26 2.6 Towards Micromotor-Assisted Reproduction 28 3 Materials and Methods 30 3.1 Fabrication of Microfluidic Channel Platforms 30 3.1.1 Tailored Parafilm Channels 30 3.1.2 Polymer Channels Cast from Micromolds 31 3.1.3 Tubular Channels to Mimic In vivo Ducts 32 3.2 Fabrication of Magnetic Micropropellers 32 3.2.1 Direct Laser Writing of Polymeric Resin 33 3.2.1.1 Design and Programming 33 3.2.1.2 Exposure and Development 35 3.2.1.3 In Situ Direct Laser Writing 35 3.2.2 Critical Point Drying 35 3.2.3 Magnetic Metal Coatings 36 3.2.4 Surface Functionalization 37 3.3 Sample Characterization 38 3.3.1 Optical Microscopy 38 3.3.2 Scanning Electron Microscopy 38 3.4 Cell Culture and Analysis 39 3.4.1 Sperm Cells 39 3.4.2 Oocytes 39 3.4.3 In vitro Fertilization 41 3.4.4 Hypoosmotic Swelling Test 44 3.4.5 Cell Viability Assays 44 3.5 Magnetic Actuation 45 3.5.1 Modified Helmholtz Coil Setup 46 3.5.2 MiniMag Setup 47 3.5.3 Experimental Procedure 48 3.5.3.1 Micromotor Performance Evaluation 48 3.5.3.2 Cell Transport Experiments 49 3.5.3.3 Cell Transfer Experiments 50 4 Micromotor-assisted Sperm Delivery 51 4.1 Micromotor Design and Fabrication 51 4.2 Actuation and Propulsion Performance 53 4.3 Capture, Transport, and Release of Sperm 56 4.4 Delivery to the Oocyte 59 4.5 Sperm Viability and the Ability to Fertilize 61 5 Micromotor-assisted Zygote Transfer 68 5.1 Micromotor Design and Fabrication 68 5.2 Actuation and Propulsion Performance 70 5.3 Capture, Transport, and Release of Zygotes 76 5.4 Transfer between Separate Environments 80 5.5 Zygote Viability and Further Development 82 6 Conclusions and Prospects 85 Appendix 87 Bibliography 93 List of Figures and Tables 108 List of Abbreviations and Terms 109 Theses 111 Selbstständigkeitserklärung 112 Acknowledgments 113 List of Publications 115 Curriculum Vitae 116

Thesis (PhD)--Stellenbosch Uni versity, 2000. / ENGLISH ABSTRACT: Intracytoplasmic sperm injection (ICSI) introduced a revolutionary way of treatment for male factor infertility. With the exception of some cases of non-obstructive azoospermia, all other male factor infertility cases have the potential to be successfully treated with ICS!. The only prerequisite seems to be the presence of a motile or viable immotile sperm cell for each oocyte. In this study we report on our own experience with the development and implementation of the ICSI method in the Reproductive Biology Unit at Tygerberg Hospita!. An analysis of 5 years of ICSI experience showed that semen parameters, sperm morphology, motility and concentration did not influence fertilization and pregnancy rates adversely. In most cases, patients who could not be treated with in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT), due to poor semen parameters or fertilization failure, were treated successfully with ICS!. Even a case of globozoospermia was treated successfully with ICS!. Testicular spermatozoa, fresh or frozen-thawed, also resulted in excellent fertilization and pregnancy rates. Cryopreservation of testicular samples facilitated the management of the infertile couple, aiding the coordination of the recovery of vital gametes from both partners and also limiting the repetition of testicular biopsies. Incubation (maturation) of testicular spermatozoa also induced an enhancement in pregnancy rates. It can be concluded that ICSI proved to be a treatment method with success similar to that of in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT), in spite of a severe male factor. The study also indicated transfer route and embryo quality (viability) to be very important factors in the success of ICS!. The tubal transfer route was shown to be a significant contributor to the pregnancy success (compared to uterine transfer) as was the transfer of embryos that showed early division to the 2-cell stage, 26 hours post injection. The transfer of early dividing embryos into the fallopian tube resulted in a pregnancy rate of almost 40%, a result similar to that of GIFT with a mild male factor. The role of the oocyte in fertilization and pregnancy success was also revealed indirectly by the introduction of ICS!. Visual observation of denuded oocytes was possible and many morphological features, normal and abnormal, can be observed. Immature oocytes can also be identified and it was shown that they could be successfully matured in vitro before injection. In this study transmission electron microscopy (TEM) was used to study abnormalities in oocyte morphology. The standard method was adapted and modified for single cell TEM. The abnormalities observed included lysosomal and non-lysosomal degeneration (yellowish or darkly coloured oocytes), degeneration and vacuole formation (vacuolated oocytes), large secondary lysosomes filled with multiple small lipid droplets - lipofuscin body (refractile body) and a fragmented oocyte. It was also possible to study at ultrastructural level, possible reasons for fertilization failure in ICS!. Different stages of oocyte activation failure, cytoplasmic immaturity, sperm cell extrusion, abnormal sperm cell decondensation, female spindle abnormalities and technique related factors were observed. TEM was also successfully implemented to elucidate the reason for infertility in a patient with a longstanding, unexplained history of infertility. TEM evaluation of two of the patient's unfertilized oocytes revealed a spindle abnormality with contributing cytoskeletal anomalies at ultrastructural level. The modified TEM technique offers a valuable tool to study this small, but important group of patients with unexplained infertility. ThisTEM study opened up a new, valuable and interesting avenue of research with both diagnostic and prognostic value for patients with unexplained infertility. ICSI is therefore a valuable method in the treatment of especially male factor infertility. It is the most advanced fertilization technique developed in the last decade in this field. Not only can almost all male factor patients be treated, but unexplained female infertility can also be exposed, studied and hopefully in future also be treated with micromanipulation methods. / AFRIKAANSE OPSOMMING: Die ontwikkeling van die mikromanipulasie tegniek "Intracytoplasmic sperm injection" (ICSI) het die behandeling van die manlike faktor in infertiliteit, revolusionêr verander. Met die uitsondering van sommige gevalle van nie-obstruktiewe asoospermia, kan potensieel alle ander manlike infertiliteits faktore suksesvol met ICSI behandel word. Die enigste voorvereiste blyk "n bewegende of "n nie-bewegende, maar bewese lewende spermsel te wees. In hierdie studie word verslag gedoen oor die ontwikkeling en toepassing van die ICSI metode in die Eenhed vir Reproduktiewe Biologie by Tygerberg Hospitaal. 'n Analise van 5 jaar se resultate na die implementering van die ICSI metode het gewys dat die semen parameters, sperm morfologie, motiliteit en konsentrasie, nie "n effek op bevrugting- en swangerskapsyfers gehad het nie. Pasiënte wat, as gevolg van ontoereikende semen parameters, nie met die klassieke metodes, in vitro bevrugting (IVB) of gameet intrafallopiusbuis terugplasing (GIFT) behandel kon word nie, kon suksesvol met ICSI behandel word. Daar was selfs "n geval van manlike infertiliteit as gevolg van globosoospermie, wat suksesvol met ICS behandel is. Die ICSI metode het dit ook moontlik gemaak om uitstekende bevrugting- en swangerskap resultate met testikulêre spermatosoa .(vars en gevries) te bereik. Die bevriesing van testisweefsel het ook bygedra tot beter hantering van sulke pasiënte. Herhaalde testisbiopsies word uitgeskakel en die koórdinasie van die verkryging van die manlike en vroulike gamete, word ook vergemaklik wanneer testisweefsel in gevriesde vorm beskikbaar is. Die studie het verder getoon dat wanneer testikulêre weefsel geïnkubeer word (om spermatosoa te laat matureer), die swangerskapsyfers verhoog was. Dit is dus duidelik dat die ICSI metode net so suksesvol soos die IVB en GIFT metodes toegepas kan word, selfs en veral in gevalle van erge manlike faktor infertiliteit. Die studie het ook verder getoon dat die plek waar embrios teruggeplaas word, asook die embriokwalitiet van teruggeplaasde embrios, belangrike bydraende faktore in die ICSI swangerskapsukses was. Embrioterugplasing in die buis van fallopius en terugplasing van embrios wat vroeë 2-sel deling, 26 uur na ICSI getoon het, is uitgewys as faktore wat ICSI swangerskap betekenisvol verbeter het. Dit was moontlik om "n swangerskapsyfer van ongeveer 40%, sootgelyk aan die van GIFT sonder "n erge manlike faktor, te bereik met die terugplasing van ten minste een vroeë deler embrio in die fallopiese buis. Die ICSI tegniek het ook indirek bygedra tot nuwe insigte met betrekking tot die rol wat die vroulike eiersel (oësief in ICSI bevrugting speel. Oósiete word gestroop van hulomringende selle vir die ICSI proses en kan dan maklik vir hul normale en abnormale morfologiese eienskappe evalueer word. Oësiete wat immatuur is kan ook so geïdentifiseer word en dit is moontlik om hulle suksesvol te matureer voor mikro-inspuiting. Transmissie-elektronmikroskopie (TEM) is in die studie gebruik om die ultrastruktuur van onbevrugde en abnormale oësiete te bestudeer. Hiervoor is "n bestaande tegniek gemodifiseer vir die hantering van "n enkele sel, in hierdie geval die oosiet. Lisasomale en nie-lisosomale degenerasie (oósiete wat geelof donker van kleur voorkom), degeneratiewe tekens en vakuole (oësiete met vakuole), groot sekondêre lisosome gevul met klein lipieddruppels ('refractile body') en 'n gefragmenteerde oosiet was van die morfologies abnormale eienskappe wat ultrastruktureel geïdentifiseer is. Moontlike faktore wat 'n rol kan speel in nie-bevrugting na ICSI kon ook op ultrastrukturele vlak met die tegniek geïdentifiseer word. Hierdie faktore het die volgende ingesluit: die onvermoë van verskillende stadiums van oosiet aktivering, sitoplasmatiese immaturiteit, uitwerping van die spermsel na die periviteliene spasie, abnormale spermsel dekondensasie, vroulike spoelvormings abnormaliteite en tegniekgekoppelde faktore. Die TEM tegniek is ook suksesvol aangewend om die infertiliteitsprobleem van 'n pasiënt wat vir etlike jare aan onverklaarbare infertiliteit gely het, te identifiseer. TEM het op die ultrastrukturele vlak gewys dat daar 'n spoel abnormaliteit in twee van haar onbevrugde oëslete was. TEM kan dus baie vrugbaar gebruik word in hierdie groep pasiënte om onverklaarbare infertiliteit, wat andersins ongeïdentifiseerd sou bly, te verklaar. Die ICSI metode is die mees revolusionêre tegniek wat die afgelope dekade vir die behandeling van veral manlike infertiliteit ontwikkel en baie suksesvol toegepas is. Die metode ook kan 'n bydraende rol speel in die hantering van onverklaarbare infertiliteit veral ten opsigte van die vroulike gameet. In die toekoms is dit moontlik dat selfs hierdie probleem met nuwe mikromanipulasietegnieke opgelos sal kan word.

Em nossa sociedade, a relação heterossexual ainda parece ser a única possibilidade legitimada para formação de um casal ou até mesmo de uma família. Porém, é cada vez maior o número de pessoas que desafia os discursos normativos presentes e busca a constituição de parcerias afetivo-sexuais com outras de seu próprio sexo, muitas vezes associando essas parcerias à experiência da parentalidade, seja com filhos biológicos ou adotivos. Com as crescentes discussões sobre os direitos sexuais reprodutivos e com o surgimento de novos arranjos familiares, entre eles o formado por casais homossexuais, começa-se a desconstruir o modelo ideal de família nuclear e abre-se caminho para discussão de temas como a maternidade lésbica. Este trabalho pretende contribuir com o debate da homoparentalidade, procurando demonstrar as especificidades existentes entre essas mulheres e suas formas de construir sua cidadania íntima dentro do contexto heteronormativo da sociedade brasileira. Para tanto, foi traçado o seguinte objetivo geral: compreender as concepções sobre a parentalidade de mulheres lésbicas que buscam a gravidez por meio de doadores de sêmen, sejam eles conhecidos ou desconhecidos. O estudo proposto baseia-se nos pressupostos da pesquisa qualitativa, como forma de privilegiar os discursos dos sujeitos como fonte de informação. Doze mulheres lésbicas aceitaram participar do estudo e foram entrevistadas entre os anos de 2009 e 2011. Os dados foram transcritos, organizados e analisados. A partir dos resultados, foi possível perceber que a vivência da maternidade por parte das mulheres lésbicas depende de fatores diversos como o histórico-cultural, o social, o jurídico-legal, o econômico e os relacionados às políticas públicas, além, é claro, da história de vida de cada uma dessas mulheres. Desta forma, para a mulher assumir a homossexualidade em uma sociedade heteronormativa e, ao mesmo tempo, optar pela maternidade, é necessário percorrer um árduo caminho, onde uma das saídas parece ser a luta pela cidadania plena e consolidação dos direitos humanos. Isto aponta para a importância de se abordar o tema em estudos e discussões acadêmicas com outras esferas da política pública e da vida social, incluindo a saúde pública / In our society, the heterosexual relationship still appears to be the only legitimate form to be a couple or to be a family. However, an increasing number of people who challenge the normative discourse are seeking for same-sex partnerships, often associating these partnerships to the experience of parenting, with biological or adoptive children. The increasing discussions about reproductive and sexual rights and the emergence of new family arrangements, including the one formed by homosexual couples, began to deconstruct the ideal model of nuclear family and its opens up the way for new discussions such as lesbian motherhood. This study intend to contribute to the homoparenthood debate, by demonstrating the specificities between these women and their ways to construct an intimate citizenship within the context of Brazilian heternormative society. To do so, the following overall aim was: to comprehend the parenthood concepts of lesbian women who seek pregnancy through known or unknown semen donor. The proposed study is based on the assumptions of qualitative research, which means that the subjects discourse was the source of information. Twelve lesbians were interviewed between the years 2009 and 2011. The data were transcribed, organized and analyzed. From the results, it was revealed that the motherhood experience by lesbians depends on several factors such as historical, cultural, social, juridical, legal, economic, public policies, and, of course, the personal history of each of these women. Thus, for women who come out as a lesbian in a heteronormative society and at the same time, opt for motherhood, they have a hard road to face. The solution seems to be to struggle for citizenship and human rights consolidation. So, its important working up this issue in academic studies and to discuss with other spheres of public policy and social life, including public health

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-12-15T11:36:47Z No. of bitstreams: 1 Isadora Urel.pdf: 4209963 bytes, checksum: be14629c19fce7828dfc6764882b24eb (MD5) / Made available in DSpace on 2017-12-15T11:36:47Z (GMT). No. of bitstreams: 1 Isadora Urel.pdf: 4209963 bytes, checksum: be14629c19fce7828dfc6764882b24eb (MD5) Previous issue date: 2017-11-30 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / The purpose of this dissertation is to demonstrate the absence of laws regarding assisted human reproduction techniques (TRHAs) and the disorders caused, especially in family law, that this legislative vacuum has provoked. The use of TRHAs and other means that also include the “surrogacy”, have been increasingly accessible to the different social strata of the Brazilian population. There seems to be a need for broad and consistent legislation on the subject in a country where the first “test-tube baby” was born more than three decades ago. Although Brazil has not legislated on the subject already exist alien legislations that will be approached / A presente dissertação tem por objetivo demonstrar a ausência de leis a respeito das Técnicas de Reprodução Humana Assistida (TRHAs) e os transtornos causados, em especial no Direito de Família, que esse vácuo legislativo tem provocado. A utilização das TRHAs e outros meios que também incluem a “barriga de aluguel”, têm sido acessíveis, cada vez mais, às diferentes camadas sociais da população brasileira. Tudo indica que se faz necessário uma legislação ampla e consistente a respeito do assunto em questão, num país em que o primeiro “bebê de proveta” nasceu há mais de três décadas. Apesar do Brasil não ter legislado sobre o tema já existem legislações alienígenas que serão abordadas

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-12-20T11:52:27Z No. of bitstreams: 1 Paola Mazzilli.pdf: 26906244 bytes, checksum: f7c79628fb3e6201bcb5c3daae7a8f58 (MD5) / Made available in DSpace on 2017-12-20T11:52:27Z (GMT). No. of bitstreams: 1 Paola Mazzilli.pdf: 26906244 bytes, checksum: f7c79628fb3e6201bcb5c3daae7a8f58 (MD5) Previous issue date: 2017-12-12 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The present work aimed at investigating and problematizing the global human sperm bank market, at the beginning of the 21st century. In view of the significant increase in sperm imports in Brazil (2,625% between 2011 and 2016) and the interest in premium donor catalogs, we carried out an exploratory study that could unravel its offer. Our purpose was to understand how the advertising strategies of this market would promote the expectation of a child ‘customization’, from the possibility of selecting an ‘ideal’ biological father. In addition, we deem it necessary to reflect on the new meanings attributed to motherhood, fatherhood and birth itself, considering progresses in the fields of biotechnology and genetics. To do so, we collected current data on the fertility market, paying special attention to the national and international commercialization of sperm. We also addressed the ‘parallel market’, where ‘independent’ donors provide their services in a paid or free basis. Finally, we conducted a case study of California Cryobank, one of the most important banks in the world. In order to understand its business dynamics, we decided to discuss it in two stages: the first one was devoted to its services offer and the second one to the catalog of its donors, which was statistically and discursively analyzed in its entirety (533 ads). We then identified what would be the main attributes that, a priori, would characterize these ‘premium’ donors. From the theoretical point of view, we preferred a transversal approach with special emphasis on contemporary authors dealing with biopower and biotechnology. We hope that the research developed may contribute to new debates, in that it articulates, in an unprecedented and representative way, empirical data and academic reflections / O presente trabalho buscou investigar e problematizar o mercado internacional de sêmen humano, no início do século XXI. Diante do expressivo aumento de importações deste produto no Brasil (2.625% entre 2011 e 2016) e o interesse por catálogos de doadores “premium”, julgamos oportuno um estudo exploratório que pudesse destrinchar sua oferta. Nosso propósito foi compreender de que modo as estratégias publicitárias desse mercado promoveriam a expectativa de “customização” de um filho, a partir da possibilidade de seleção de um pai biológico “ideal”. Além disso, julgamos necessário refletir sobre os novos significados atribuídos à maternidade, à paternidade e ao próprio nascimento, frente aos avanços nos campos da biotecnologia e genética. Para tanto, coletamos dados atuais sobre o mercado da fertilidade, atentando-nos, especialmente, à comercialização nacional e internacional de sêmen. Abordamos, ainda, o mercado paralelo, onde doadores “autônomos” prestam seus serviços de forma paga ou gratuita. Finalmente, realizamos um estudo de caso do California Cryobank, um dos bancos mais importantes do mundo. Visando a entender sua dinâmica de negócio, optamos por discuti-lo em duas etapas: a primeira dedicou- se à oferta de seus serviços e, a segunda, ao catálogo de seus doadores, que foi analisado na íntegra (533 anúncios) estatística e discursivamente. Identificamos, então, quais seriam os principais atributos que, a priori, caracterizariam esses doadores “premium”. Do ponto de vista teórico, preferimos uma abordagem transversal com especial ênfase nos autores contemporâneos que versam sobre biopoder e biotecnologia. Esperamos que a pesquisa desenvolvida possa contribuir para novos debates, na medida em que articula, de maneira inédita e representativa, dados empíricos e reflexões acadêmicas

Em nossa sociedade, a relação heterossexual ainda parece ser a única possibilidade legitimada para formação de um casal ou até mesmo de uma família. Porém, é cada vez maior o número de pessoas que desafia os discursos normativos presentes e busca a constituição de parcerias afetivo-sexuais com outras de seu próprio sexo, muitas vezes associando essas parcerias à experiência da parentalidade, seja com filhos biológicos ou adotivos. Com as crescentes discussões sobre os direitos sexuais reprodutivos e com o surgimento de novos arranjos familiares, entre eles o formado por casais homossexuais, começa-se a desconstruir o modelo ideal de família nuclear e abre-se caminho para discussão de temas como a maternidade lésbica. Este trabalho pretende contribuir com o debate da homoparentalidade, procurando demonstrar as especificidades existentes entre essas mulheres e suas formas de construir sua cidadania íntima dentro do contexto heteronormativo da sociedade brasileira. Para tanto, foi traçado o seguinte objetivo geral: compreender as concepções sobre a parentalidade de mulheres lésbicas que buscam a gravidez por meio de doadores de sêmen, sejam eles conhecidos ou desconhecidos. O estudo proposto baseia-se nos pressupostos da pesquisa qualitativa, como forma de privilegiar os discursos dos sujeitos como fonte de informação. Doze mulheres lésbicas aceitaram participar do estudo e foram entrevistadas entre os anos de 2009 e 2011. Os dados foram transcritos, organizados e analisados. A partir dos resultados, foi possível perceber que a vivência da maternidade por parte das mulheres lésbicas depende de fatores diversos como o histórico-cultural, o social, o jurídico-legal, o econômico e os relacionados às políticas públicas, além, é claro, da história de vida de cada uma dessas mulheres. Desta forma, para a mulher assumir a homossexualidade em uma sociedade heteronormativa e, ao mesmo tempo, optar pela maternidade, é necessário percorrer um árduo caminho, onde uma das saídas parece ser a luta pela cidadania plena e consolidação dos direitos humanos. Isto aponta para a importância de se abordar o tema em estudos e discussões acadêmicas com outras esferas da política pública e da vida social, incluindo a saúde pública / In our society, the heterosexual relationship still appears to be the only legitimate form to be a couple or to be a family. However, an increasing number of people who challenge the normative discourse are seeking for same-sex partnerships, often associating these partnerships to the experience of parenting, with biological or adoptive children. The increasing discussions about reproductive and sexual rights and the emergence of new family arrangements, including the one formed by homosexual couples, began to deconstruct the ideal model of nuclear family and its opens up the way for new discussions such as lesbian motherhood. This study intend to contribute to the homoparenthood debate, by demonstrating the specificities between these women and their ways to construct an intimate citizenship within the context of Brazilian heternormative society. To do so, the following overall aim was: to comprehend the parenthood concepts of lesbian women who seek pregnancy through known or unknown semen donor. The proposed study is based on the assumptions of qualitative research, which means that the subjects discourse was the source of information. Twelve lesbians were interviewed between the years 2009 and 2011. The data were transcribed, organized and analyzed. From the results, it was revealed that the motherhood experience by lesbians depends on several factors such as historical, cultural, social, juridical, legal, economic, public policies, and, of course, the personal history of each of these women. Thus, for women who come out as a lesbian in a heteronormative society and at the same time, opt for motherhood, they have a hard road to face. The solution seems to be to struggle for citizenship and human rights consolidation. So, its important working up this issue in academic studies and to discuss with other spheres of public policy and social life, including public health

In the general population, one in five couples experiences difficulty in conceiving a child. The role of obesity on women’s fecundity has become a focus of attention in recent years. Successful treatment of infertility through Assisted Reproductive Technology (ART) is also compromised by the presence of obesity, which occurs in 30 % of women seeking treatment. A negative correlation exists between increased body mass index (BMI) and the number of collected oocytes and a lower birth rate after ART. Furthermore, a number of studies have established that weight loss improves natural conception rates in overweight women. Whether weight management can improve success rates in overweight / obese women undergoing in vitro fertilisation (IVF) has not been studied. The purpose of this project was to explore the role of short–term weight loss on potential pregnancy outcomes in overweight / obese women undergoing IVF programme. However, to establish this relationship, we proposed to carry out two studies to assess the following: (I) The feasibility of very low calorie diet (VLCD) during IVF treatment with respect to duration, level of restriction and tolerability of the diet during hormonal down regulation in women (Chapter 2). (II) How energy restriction may affect the quality of an early embryo in diet - induced obese mice with respect to various body weight and caloric intake (Chapter 3). In study (I), women preferred a shorter dietary intervention with greater energy restriction (456 kcal per day) to gradual energy restriction (1200 kcal / day for the first week, and afterward, 456 kcal / day) prior to oocyte transfer. Women were able to comply with the VLCD during IVF treatment and both dietary groups achieved a significant weight loss (mean 6.3 %). In study (II), by using obese mice, the effect of rapid weight loss (mean 12 %) was observed after 5 days of energy restriction. Ovulation rate was greater in the Obese group (HFD) (55.6%) and equal in both Control (CD) and Energy Restricted (HF / ER) (44.4 %) groups. The HF / ER group showed higher fertilisation rate (80 %) than HFD and CD (55% and 45.5%, correspondingly). The blastocyst stage was reached by half of the cultured embryos in both HF / ER and HFD groups and 33 % in the CD group. The quality of embryos that completed blastocyst formation did not differ between groups. However, postfertilisation development in females fed a high fat diet was slower compared to CD and HF / ER groups. In conclusion, this work illustrated a weight management prior conception and use of VLCD during IVF treatment in clinical study needs further investigation with regard to the dietary duration, level of energy restriction and how this combination will influence IVF treatment outcomes. Furthermore, as we were unable to determine the question of how the dietary intervention affects the quality of oocytes and the animal study illustrated a promising result, thus further studies are required. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1311579 / Thesis (M.Med.Sc.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

In the general population, one in five couples experiences difficulty in conceiving a child. The role of obesity on women’s fecundity has become a focus of attention in recent years. Successful treatment of infertility through Assisted Reproductive Technology (ART) is also compromised by the presence of obesity, which occurs in 30 % of women seeking treatment. A negative correlation exists between increased body mass index (BMI) and the number of collected oocytes and a lower birth rate after ART. Furthermore, a number of studies have established that weight loss improves natural conception rates in overweight women. Whether weight management can improve success rates in overweight / obese women undergoing in vitro fertilisation (IVF) has not been studied. The purpose of this project was to explore the role of short–term weight loss on potential pregnancy outcomes in overweight / obese women undergoing IVF programme. However, to establish this relationship, we proposed to carry out two studies to assess the following: (I) The feasibility of very low calorie diet (VLCD) during IVF treatment with respect to duration, level of restriction and tolerability of the diet during hormonal down regulation in women (Chapter 2). (II) How energy restriction may affect the quality of an early embryo in diet - induced obese mice with respect to various body weight and caloric intake (Chapter 3). In study (I), women preferred a shorter dietary intervention with greater energy restriction (456 kcal per day) to gradual energy restriction (1200 kcal / day for the first week, and afterward, 456 kcal / day) prior to oocyte transfer. Women were able to comply with the VLCD during IVF treatment and both dietary groups achieved a significant weight loss (mean 6.3 %). In study (II), by using obese mice, the effect of rapid weight loss (mean 12 %) was observed after 5 days of energy restriction. Ovulation rate was greater in the Obese group (HFD) (55.6%) and equal in both Control (CD) and Energy Restricted (HF / ER) (44.4 %) groups. The HF / ER group showed higher fertilisation rate (80 %) than HFD and CD (55% and 45.5%, correspondingly). The blastocyst stage was reached by half of the cultured embryos in both HF / ER and HFD groups and 33 % in the CD group. The quality of embryos that completed blastocyst formation did not differ between groups. However, postfertilisation development in females fed a high fat diet was slower compared to CD and HF / ER groups. In conclusion, this work illustrated a weight management prior conception and use of VLCD during IVF treatment in clinical study needs further investigation with regard to the dietary duration, level of energy restriction and how this combination will influence IVF treatment outcomes. Furthermore, as we were unable to determine the question of how the dietary intervention affects the quality of oocytes and the animal study illustrated a promising result, thus further studies are required. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1311579 / Thesis (M.Med.Sc.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

Thesis (doctoral)--Uppsala University, 1991. / Includes bibliographical references (p. 201-207) and index.