Macer, D.R.J. (1994) "Perception of risks and benefits of in vitro fertilization, genetic engineering and biotechnology", Social Science and Medicine 38: 23-33.
Kurian, K.J. Female Infanticide in India EEIN 3 (1993), 3.
Shirai, Y. What Future for Surrogacy in Japan? EEIN 3 (1993), 3.
Daniels, K. New Zealand Assisted Human Reproduction EEIN 4 (1994), 58. Database of Information on Infertility and Assisted Reproduction EJAIB 5 (1995), 130.
A Sperm bank
Short History of Reproductive Medical Problems in Japan - Shinryo N. Shinagawa , , EJAIB 6 (1996), 158-60.
Commentary on Shinagawa - Yutaka Tejima , EJAIB 6 (1996), 160.
Ethics and the regulation of preimplantation diagnosis in Germany - Stefan Mueller , EJAIB 7 (1997), 5.
Commentary on Mueller - Les S. Rothenberg , EJAIB 7 (1997), 6.
Health professionals' attitudes toward preimplantation diagnosis in Japan - Yasuko Shirai , EJAIB 7 (1997), 49-52.
Commentary on Shirai - Masahiro Morioka , EJAIB 7 (1997), 52.
Case of the first test tube baby in India - K.K. Verma / Commentary on Verma: Thoughts About India - Frank J. Leavitt EJAIB 7 (1997), 67.
Assisted human reproduction in New Zealand: The contribution of ethics - Ken R. Daniels EJAIB 8 (1998), 79-81.
An examination of the "best interests of children" in the field of assisted human reproduction - Ken R. Daniels EJAIB 8 (1998), 146-8.
Commentary on Daniels - Masahiro Morioka EJAIB 8 (1998), 148.
Reproductive Technology, Screening and Genetics in Taiwan: Centennial Profile (1902-1997) - Yu Shi Ang EJAIB 9 (1999), 99-101.
Surrogate Motherhood as a Life-Saving Measure in Jewish Law - W. F. Silverman & E.D. Clark EJAIB 9 (1999), 101-104.
Genes and Judaism: Commentary on Silverman and Clark - Yeruham Frank Leavitt EJAIB 9 (1999), 104-5.
New Reproductive Biotechnology, Values and Society - Siti Nurani Mohd Nor EJAIB 9 (1999), 166-9.
Commentary on Siti Nurani Mohd Nor - Masahiro Morioka EJAIB 9 (1999), 169.
Commentary on Nudeshima - Masahiro Morioka > , EJAIB 11 (Jan 2001), 2-3.

. An on-line site with issues of reproductive biotechnology
Cloning Bibliography updated March 1997

Amara: The Colour of Difference EJAIB 12 (July 2002), 149-150.
Commentary on Amara - Masahiro Morioka EJAIB 12 (July 2002), 151.

EJAIB 13 (2003), 59-61 Assisted Reproduction - Islamic Views on the Science of Procreation - Norhayati Haji Ahmad

EJAIB 13 (2003), 61-63 Clinical Ethics Discussion 2: The Family and Assisted Reproductive Technology - Yukari Take and Atsushi Asai

EJAIB 14 (2004), 48-49 Artificial Insemination and happiness - Yali Cong
M. Cristina Rosamond Pinto, Some Ethical Issues Concerning Medical Reproduction in PortugalEJAIB 15 (January 2005), 12-13.
Frida Simonstein, Artificial Reproduction Technologies and Ectogenesis EJAIB 15 (January 2005), 13-15.
James A. Rice, What's Morality Got to Do With it? The Need for Principle in Reproductive Technology and Embryo ResearchEJAIB 15 (January 2005), 16-21.
Mohammad Ali Khalili, Mete Isikoglu, Mojdeh Ghasemi, Attitudes of Christians and Muslims to an Oocyte Donation Program in Iran EJAIB 16 (May 2006), 66-71.
Maria Cristina Rosamond Pinto, Medically Assisted Procreation: Legal Framework in Portugal, EJAIB 16 (Sept. 2006), 158-61.

The reports from Washington of scientists who conducted experiments on embryo splitting has generated a range of opinions and comments. The European Parliament has unanimously adopted a resolution (B3-1519/93) to ban cloning. They say that any cloning for whatever purpose is "unethical, morally repugnant, contrary to respect for the person, and a grave violation of fundamental human rights which cannot under any circumstances be justified or accepted". They also note concern about eugenics and commercialisation of human genetics. They would like to call for a world conference to bring about an international agreement to ban the cloning of human beings. The resolution has a number of implications for bioethical debate, for example, why is the splitting of a human embryo (which happens in nature with twins) and the implantation of two embryos into a women to increase her chance of having a baby a violation of human rights?

It is apparent that we will see more discussion of this issue! A cover page article in Newsweek (8 Nov), 42-7, also looks at the topic, with a more mixed discussion. More comments are in BME 92 (Oct 1993), 1; (Nov), 2; Science 262 (1993), 652-3; New Scientist (30 Oct, 1993), 7. As I said in the last issue; EEIN 3: , this making of twins is not something so novel, and it is interesting to see all the attention. However, if it makes people think about these issues than that is good, but they should be more considered. If you want to see the abstract, it is number o-001 and a general prize paper in the abstracts in a November issue of Fertility & Sterility.

The UK has seen three topics come to broad press attention over the New Year, with much media attention. One is the issue of a black woman using a white egg donor; Times (1 Jan 1994), 1, 15; Washington Post (1 Jan 1994), A15, 24. This was claimed to be racial engineering, however, clinically it is indicated as no other donor is possible and the couple do not mind the colour. Another case was the birth of twins to a 59 year old English woman, given fertility treatment by Italian doctors. However, we should note that births of children to woman of this age do occur naturally, and were more common in the past. They are not to be generally recommended, or supported however. There is much less ethical support for the use of spare eggs from aborted fetuses, though it also needs discussion. In the UK Parliament it was called "womb robbing", Guardian (3 Jan 1994), 1, 16; Times (3 Jan), 1.

In the UK the Human Fertilisation and Embryology Act of 1990 states that embryos should not be stored frozen for more than 5 years, and the potential problems are discussed in Despatches 4(1), 8-9. In the UK there was also a recent case of an implantation of 9 embryos, Lancet 342 (1993), 1231; see also BMJ 307 (1993), 1281-2. On the risks of new approaches to IVF see New Scientist (27 Nov, 1993), 13-4.

Reviews of interest include: H.W. Jones & J.P. Toner, "The infertile couple", NEJM 329 (1993), 1710-5; C. Mastroyannis, "Gamete intrafallopian transfer: ethical considerations, historical development of the procedure, and comparison with other advanced reproductive technologies", F&S 60 (1994), 389-402. The difficulties and need for accurate record keeping and data on assisted reproductive technology are made in F&S 60 (1994), 403-5, 759-63. The possibility of increased ovarian cancer being associated with use of fertility drugs is raised in F&S 60 (1994), 406-8.

An extensive discussion of the secrecy/openness debate in donor insemination is in Politics & Life Sciences 12 (1993), 155-203. It includes papers by authors from New Zealand, Canada, Poland, U.K., France, USA, following a leading article, K.R. Daniels & K. Taylor, "Secrecy and openness in donor insemination", p. 155-70. It calls for governments to make donors lists more open, and that this would be to the advantage of everybody involves. The views that secrecy is best for some are not supported by the data. A recent study in New Zealand found that 51% of parents were definitely, and 32% probably, going to tell their child of their status. In France a study on the families that used artificial insemination has been stopped, BMJ 307 (1993), 1026. In the UK changes in the adoption law will make the opinions of the child more important, BMJ 307 (1993), 1231. The psychological similarity of adoption and IVF is discussed in book reviews in JAMA 270 (1993), 2383-4.

The technology for sperm separation is progressing, and success for sex selection in animals is steadily increasing, BMJ 307 (1993), 1303. Letters reporting fertilisation using testicular sperm are in Lancet 342 (1993), 1237-8. A new book on the technical side is S.J. Behrman et al., Progress in Infertility, 4th edition (640 pp., £110, Churchill Livingstone 1993).

A discussion of recent uses of reproductive technology and the ethical issues they raise is in Newsweek (17 Jan 1994), 38-43; Nature 367 (1994), 2, 99-100; Lancet 343 (1994), 165-6; SSM 38 (1994), v-viii. A discussion document from the UK HFEA, Donated Ovarian Tissue in Embryo Research and Assisted Conception is summarised in BME (Dec 93), 5; BMJ 308 (1994), 153. Comments are requested before 1 June, 1994. A discussion of "clones" is is in JAMA 271 (1994), 331-2. A general discussion of advances in technology is in Scientific American (Feb 1994), 13-5. Sex selection and UK law = is discussed inDispatches 4(2), 1-4.

The final report of the Canadian Royal Commission on New Reproductive Technologies, titled Proceed with Care, is available for sale. They recommend prohibition of techniques which are against "Canadian ethical and social values", and the establishment of a Commission to examine whether reproductive technologies are being performed in the public interest. They also look at genetic screening by preimplantation diagnosis and gene therapy, and use of fetal tissue. For a report see BMJ 308 (1994), 154.

A paper on the social counseling desirable for infertile couples is K. Daniels, "Infertility counselling: The need for a psychosocial perspective", Br. J. Social Work 23 (1993), 501-15. A paper on how to develop selection policies for use of assisted reproduction is in SSM 37 (1993), 1473-80. A study of what factors lead people to withdraw from a donor insemination program in New Zealand is reported in H.V. Danesh-Meyer et al., "Withdrawal from a donor insemination programme", Aust NZ J. Obstet. Gynaecol. 33 (1993), 187-90. The major reasons were natural conception, adoption or medical and social reasons.

A survey on the use of fertility drugs in the USA from 1973 - 1991 is in F&S 60 (1993), 1096-8. The effect of such drugs and in vitro methods on 106 triplet pregnancies is reported in F&S 60 (1993), 1031-4.

The UK Human Embryology and Fertilisation Act does permit the offering or preferential service to women who agree to donate eggs to other parents at the clinic, despite recent controversy about this; BME 95 (Feb 1994),6. However, the donor of gametes should only receive £15 plus reasonable expenses. Also on the ethical issues of sex selection see Galton Institute Newsletter (March 1994), 6-8.

The UK Parliament has passed a ban on the use of embryos from aborted fetuses being used in fertility treatments, Nature 368 (1994), 674-6; New Scientist (15 Jan 1994), 7. At first a committee and the HFEA had been asked to consider it, and was going to seek public opinion, BMJ 308 (1994), 153-4; Lancet 343 (1994), 165; but politicians decided to enact a law quickly, within 4 months of the controversy being raised (see earlier issues). The idea of politicians adding on issues to other bills, has upset many observers. The development of universal guidelines for experiments using eggs from aborted fetuses is called for in GEN (15 March 1994), 4, 22.

Another research result which may raise eyebrows is the success of growing sperm from germ cells in vitro, BMJ 308 (1994), 156; Cell 75 (1993), 997-1006... As discussed in the section above, the embryo research debate is also hot in the USA, with both the US and Canada deciding to slow down human reproduction research, Hospital Ethics (Jan), 10-12; BMJ 308 (1994), 154-5. The Swedish regulations are discussed in J. Assisted Reproduction & Genetics 10 (1993), 243-5.

A new book is Gwynne Basen, Margrit Eichler & Abby Lippman, eds., Misconceptions: The Social Construction of Choice and the New Reproductive and Genetic Technologies, (C$14.95, Voyageur Publishing, 82 Frontenac Street, Hull, Quebec J8X 1Z5, Canada; Toll free 1-800-268-2946). Any profits will go to the National Action Committee on the Status of Women in Canada to support their work for the women. Volume 2 is expected soon. The final report of the Canadian Royal Commission on New Reproductive Technologies, Proceed with Care, is available for C$52, or US$67.60 overseas, for two volumes.

A paper reporting attitudes is S.J. Genuis et al., "Public attitudes in Edmonton toward assisted reproductive technology", CMAJ 149 (1993), 153-61. The study found two thirds would donate an egg or sperm to a sibling, and 40% would donate to a stranger. 74% agreed with surrogacy for medical reasons, but 85% opposed it for convenience only. 72% thought that assisted reproductive technology should be regulated. Australian attitudes are reported in M.C. Bowman & D.M. Saunders, "Community attitudes to maternal age and pregnancy after assisted reproductive technology: too old at 50 years?", Human Reproduction 9 (1994), 167-71. 64% accepted oocyte donation (very similar to Canada, above), 55% accepted use of own gametes after menopause, and 38% accepted donated gametes being used after menopause. These suggest reasonable public support, which is interesting given the cases debated earlier in the year (see earlier issues) for older mothers, New Scientist (8 Jan 1994), 3, (15 Jan), 3. In France, the health minister has said fertility treatment should not be available to postmenopausal women, BMJ 308 (1994), 154; Lancet 343 (1994), 166. Italy has also said it will control their use, BMJ 308 (1994), 155.

Psychological aspects of donor insemination are discussed in J.R. Moreno et al., "Personality characteristics analysis in couples undergoing artificial insemination", Human Reproduction 9 (1994), 172-5. L.R. Schover et al., "Psychological screening and the success of donor insemination", Human Reproduction 9 (1994), 176-8. The ethical and social impact of reproductive technology is debated in Search 25: 53-6, 60-2; F&S 61 (1994), 236-8. A kit for DIY sperm testing will be on sale in the Netherlands soon, New Scientist (8 Jan 1994), 9. Book reviews of interest for reproductive technology are in Bioethics 8 (1994), 171-7.

An interesting figure is that in 1991 there were more than 13000 human embryos in frozen storage in Australia; Australian Doctor (4 Feb), 29. Many states do not impose a limit time on storage, though the 1993 Western Australian law puts a 3 year limit on storage and a maximum of three embryos at any time per couple; while South Australia is 10 years and Queensland 15 years.

The new French law on bioethics includes tough restrictions on embryo research, which will halt some research. IVF is limited to heterosexual couples of child-bearing age. It forbids mixing sperm. An exception for families with a history of genetic disease to use embryo biopsy was included however, Science 264 (1994), 1655; BMJ 308 (1994), 1186. Preimplantation diagnosis is discussed in Lancet 343 (1994), 972-3. The survival of a human embryo after two micromanipulations is reported in F&S 170: 1199-203. Also in France, a judge has ordered the destruction of two frozen embryos from a widow, BMJ 308 (1994), 1319-20. The case may be appealed, as it is strange that the embryos are not the property of the woman!

In the UK, the legal moves to ban egg implants from fetuses for infertility treatment are discussed in New Scientist (23 April 1994), 8; Nature 369 (1994), 598. Two reports from a group of Japanese scholars seeking legal regulations for assisted reproductive technology have been published (largely in Japanese - but English summary is available). Contact: Prof. Kunihiko Shoji, Faculty of Law, Hokkaido University, Kita-ku, kita 9, Nishi 6, Sapporo 060, JAPAN. The 1992 Brazilian general Medical Council's statement on death and artificial procreation is in IDHL 45: 100-2.

The question of the ethics of human cloning is debated is two papers, J.A. Robertson, "The question of human cloning", HCR 24(2): 6-14; R.A. McCormick, "Blastomere separation: some concerns", HCR 24(2): 14-6. Robertson argues it should be acceptable, as he sees no great risks from it. McCormack argues against it from the view of individuality being natural.

A discussion of ethical issues in post-menopausal pregnancy and birth is in IN/FIRE Ethics 3(1), 1-8; Monash Bioethics Review 13(2) (1994), 1-4. An editorial on oocyte donation to older women is in MJA 160 (1994), 244-5. Letters on age-related decline in fecundity are in F&S 170: 792-3. Another more general paper on the ethical issues of viewing the body as objects from a feminist outlook is R. Mykitiuk, "Fragmenting the body", Australian Feminist Law J. 2: 63-98. General letters on the infertile couple are in NEJM 330 (1994), 1154-5.

Papers on the counseling of couples receiving infertility treatment include K. Daniels & I. Stjerna, "Infertility: The Social Work Contribution", Socionomen 6 (1993), 41-6; K. Daniels, "Adoption and Donor Insemination: factors influencing couples' choices", Child Welfare LXXIII: 5-14. In a New Zealand study of insemination it was found that most couples had considered adoption. However, this may depend on the country, for example in Japan adoption is less common than in the West. An interesting topic. In a major long-term US study of adopted children released in June, it was found that parents of adopted children are less likely to divorce, and no negative factors were found in the children. A related book review is JAMA 271 (1994), 1212. Children of single parent families may be most affected by socioeconomic factors than parent number, BMJ 308 (1994), 114-5. Let us hope economic conditions are getting better, as in 1992 in the UK one out of three babies were born to unmarried women (31%; compared to 14% in 1982).

The Vatican has condemned artificial insemination of lesbians, following an Italian doctors report (Reuter News, 24 June). A review of the book, John Boswell, Same-Sex Unions in Premodern Europe, (Villard Books, 412pp., US$25), is in Newsweek (20 June), 47. He has studied the evidence that homosexual marriages have long been performed, and had church blessing in Medieval times.

A study of the techniques claimed to separate sperm by sex chromosome finds that they do not work as claimed; F&S 61 (1994), 720-6; New Scientist (4 June 1994), 8. The crystal structure of human chorionic gonadotropin is reported in Nature 369 (1994), 455+.

A third Indian state has banned the use of amniocentesis to chose fetal sex, now Rajasthan, Maharashtra and Gujurat ban the use; Reproductive Freedom News (10 June 1994), 8. The proposed national law has been held up for 3 years in Parliament.

There has been a claim at the annual meeting of the American College of Neuropsychopharmacology that estrogen given to postmenopausal women increases their thinking ability and memory, to add to the current data suggesting benefits from osteoporosis and cardiopulmonary disease; Japan Times (2 July 1994), 12. The use of thyroid hormone and estrogen, and positive effects on bone density are discussed in JAMA 271 (1994), 1245-9, 1283-4. Also on estrogen, JAMA 271 (1994), 1670-1.

A full review of the New Zealand Government Report into Assisted Human Reproduction, by Ken Daniels, is at the front of this issue. The committee only had two persons for financial reasons. New Zealand did not have the C$20 million to spend on a Commission as in Canada, but their report is built on submissions and the work of people in New Zealand like Ken Daniels, and there has been strong interest in reproductive technology since the beginning of its use.

An English language Report on Medically Assisted Procreation from the Portugese National Council of Ethics for the Life Sciences can be obtained from the Council, Rua Prof. Gomes Teixeira, 1300 Lisboa, Portugal. One of their conclusions is that only the number of oocytes that can be realistically implanted, e.g. 3 or 4, should be inseminated at each time. This avoids the need to have surplus embryos, like the German law.

There was debate on the 14 June in the Norwegian Storting (Parliament) on the bill "Biotechnology in relation to human beings". It was passed, and repealed the existing Act No. 68 of 12 June 1987, since the provisions are included in the new act. The act will be reviewed in 1999. It continues a ban on embryo research. Preimplantation Diagnosis is permitted, and prenatal diagnosis, but not for sex selection. It includes guidelines on genetic testing after birth, and on somatic cell gene therapy. Germline gene therapy is prohibited. A Norwegian Biotechnology Advisory Board can be appointed by the King. The penalties for infringement are imprisonment up to 3 months, and fines. A copy is in BME 99 (July 1994), 8-11.

The Human Fertilisation and Embryology Authority (HFEA) has issued a report stating its views on ovarian tissue donation, BME 99 (July 1994), 4-6, 13-18. There were 8,946 responses to the HFEA document, that were not petitions or surveys. They were generally negative, and some analysis of ideas has been reported. The report is Donated Ovarian Tissue in Embryo Research & Assisted Conception, and it and the latest annual report are available from HFEA, Paxton House, 30 Artillery Lane, London E1 7LS, U.K. The text of the law amendment in the UK, clause 69 inserted into the Criminal Justice and Public Order Bill, which bans the use of human germ cells from females, is in BME 98 (May 1994),8-9. Fetal tissue can be used for research but not for treatment, a position supported by the BMA, BMJ 309 (1994), 200, 289-90; Nature 370 (1994), 236, 241; Lancet 344 (1994), 142; Science 265 (1994), 608. Public opinion is presented in Lancet 344 (1994), 204; and ethical issues are in Brit. J. O&G 101: 567-70.

The NIH Advisory panel on embryo research is likely to conclude that research should be permitted up to 14 days, Nature 370 (1994), 8. This is in contrast to the recent French law to ban embryo research, Science 264 (1994), 1655. UK attitudes to fetal tissue research were found to be very supportive (94%) in F. Anderson et al., "Attitudes of women to fetal tissue research", JME 20 (1994), 36-40.

A paper discussing sex selection in the UK, and the HFEA document on it, is in Dispatches 4(3), 1-4. Australian researchers claim they have disproved that sperm selection works, but the London Gender clinic is defending their method, New Scientist (4 June 1994), 8. Letters on the subject are in F&S 61 (1994), 1181-2. Babies for older woman using IVF are discussed in BME 98 (May 1994),19-24. A general book review is Lancet 343 (1994), 1416; also see O&G 84 (1994), 307-10.

A series of papers on interpretation of infertility in different cultures are in SSM 39 (1994), 459-518, 671-86. A call for examination of whether people are suitable as parents, as made in the book, Too Many People, is discussed in New Scientist (13 Aug 1994), 3; see also,Lancet 343 (1994), 1373-4; 344: 132-3. A survey on preferences towards being a genetic or social mother in the UK is JME 20 (1994), 87-92.

The French IVF program, FIVNAT, has released statistics for 1989-93, showing there were 8721 deliveries, 27% of these multiple; Lancet 343 (1994), 1421. Among the 11283 newborn babies, 1.07% had major deformities and 1.73% had minor deformities. Microinjection of oocytes was used 200 times last year in France. There were 7569 frozen embryos transferred. On Canada, Ikonomidis S & Lowy F. "Access to in Vitro Fertilization in Canada," Journal SOGC. (June 1994) 1831-1837.

A US paper on the costs of IVF found a range between US$44,000 to $211,940, per delivery, P.J. Neumann et al., "The cost of a successful delivery with in vitro fertilisation", NEJM 331 (1994), 239-43, 270-1. There are extra costs also posed by the incidence of multiple births, and efforts to reduce them could safe much money, T.L. Callahan et al., "The economic impact of multiple-gestation pregnancies and the contribution of assisted-reproduction techniques to their incidence", NEJM 331 (1994), 244-9; see also O&G (July); Science 265 (1994), 477. Transferring extra embryos increases the chances of heterotopic pregnancy also, F&S 61 (1994), 1065-7.

Preimplantation diagnosis of Tay Sachs and hemophilia A at the same time is reported in M.C. Snabes et al., "Preimplantation single-cell analysis of multiple genetic loci by whole-genome amplification", PNAS 91 (1994),, 6181-5. See also Lancet 343 (1994), 1569-70.

Declining sperm counts are rejected in BMJ 309 (1994), 1-2, 19-22, 131. A high sperm count was reported in members of the UK organic farmers association, Lancet 343 (1994), 1498. Male infertility treatment using sperm injection is discussed in Lancet 344 (1994), 191-2; see also Lancet 343 (1994), 1473-9; MJA 160 (1994), 545-52. A review of female infertility is in Lancet 343 (1994), 1539-44. Antisperm antibodies are discussed in F&S 61 (1994), 1001-13.

An advertisement in the UK Times newspaper for donor eggs is discussed in BME 100 (Aug 1994), 4. The advert read "Donor Egg - Immediate Availability". The Genetics and IVF Institute, an internationally respected center for infertility treatments using advanced reproductive technologies, has a large selection of donors available now for patients requiring donor oocytes. No waiting list. Suburban Washington D.C. location. We have extensive experience working with patients from throughout the world, and would welcome your enquiries." The address in Fairfax, Virginia was given. The use of oocytes from aborted fetuses as donors is debated in F&S 62 (1994), 449-51. Views on donated ovarian tissue in the UK are in Lancet 344 (1994), 824-5.

A further comment on the New Zealand report on assisted reproduction (see EEIN 4 (1994), 58-9) is in Otago Bioethics Report 3(3), 4-7; Lancet 344 (1994), 674. In France there is controversy over a report on assisted reproduction there, Lancet 344 (1994), 606. The question of payment for IVF is in Brit.J. O&G 101 (1994), 759-61. Israel is expected to legislate on surrogate motherhood following a report, BMJ 309 (1994), 359. Human cloning is discussed in Ethics & Medicine 19(6), (1995), 3-4.

A study suggesting only 2 embryos should be transferred each time is Vauthier-Brouzes, D. et al., "How many embryos should be transferred in in vitro fertilisation. A prospective randomized study", F&S 62 (1994), 339-42. The number for GIFT is discussed in a UK study, BMJ 309 (1994), 510-1.

Infertility linked to moderate alcohol consumption in women is reported in AJPH 84 (1994), 1429-32; and on frequency of intercourse and infertility in men, F&S 62 (1994), 370-5; Lancet 344 (1994), 766. Falling sperm counts are seen in sperm donor data from 1940-1969, BMJ 309 (1994), 476. A study finds some sub-fertility in men is familial, BMJ 309 (1994), 570-3. There is some possibility for ovarian cancer risk in long term use of the infertility drug clomiphene, NEJM 331 (1994), 771-6, 805-6. On breast cancer risk, Lancet 344 (1994), 610-1.

Laws against prenatal sex selection by abortion in India were reported last issue, see also, Lancet 344 (1994), 399; BMJ 309 (1994), 428. Female genital mutilation is called a child abuse in NEJM 331 (1994), 712-6, 739-40. On male circumcision, BMJ 309 (1994), 660-1.

A new report is from The Ethics Committee of the American Fertility Society, Ethical Considerations of Assisted Reproductive Technologies, Fertility & Sterility ++ Supplement 1, 125pp. It is available for US$20 from the American Fertility Society, Att: Ethics, 1209 Montgomery Highway, Birmingham, Alabama 35216-2809, USA. It goes through the general issues involved in an organised, but sometimes brief manner, then considers the various permutations of technology. They recommended continual monitoring and study to look at new technology, and widened discussion of the issues. A review of Florida's law on ART is O&G 84 (1994), 889-93.

A discussion of donated eggs and playing God is Stoffell, B. "Playing god?", Monash Bioethics Review 13(4) (1994), 14-9. Studies finding no difference between 30-50 years of age in capacity of women to implant oocytes, and there is no higher rate of aneuploidy, are Human Reproduction 9 (1994), 1981-2, 2160-3; Lancet 344 (1994), 1089-90, 1437; F&S 62 (1994), 1092-4. A report from a US court case were a child conceived with the late father's sperm seeks recognition as legal daughter and heir, Reproductive Freedom News (16 Dec 1994), 3. On posthumous reproduction, Human Reproduction 9 (1994), 2182-5. In Italy a man used a surrogate mother to carry a frozen embryo from him and his wife who deceased 2 years before: the surrogate was his sister-in-law and the baby was recently born.

A discussion on artificial insemination of single women or lesbian couples is Human Reproduction 9 (1994), 1969-77. Social studies on people seeking infertility treatment include, CJPH 85: 28+. Family values are discussed in a future prediction in New Scientist (15 Oct 1994), Supplement 29-31. Age limits are discussed in BMJ 309 (1994), 1515-6.

A cheaper method for IVF has been developed in Australia, Time (14 Nov), 59. Letters on the economics of IVF are in NEJM 331 (1994), 1588-9; and Vekemans, M. et al. "Infertility treatment: luxury, desire or necessity", Reproductive Health Matters 4 (1994) 93-8. The number of centers could also be regulated to improve quality, CQHE 3 (1994), 383-90.

A debate on the techniques and ability to perform sex selection, including Ericsson, R.J. "Sex selection via albumin columns: 20 years of results", Human Reproduction 9 (1994), 1787-90. A debate over the risks and benefits of using immature oocytes for IVF is Human Reproduction 9 (1994) 1585-8.

A book in French on the ethics, law and religious views and implications of new reproductive technologies written by an Italian is Ventura, Marco, Procreer Hors la Loi. Loi civile, loi morale et loi canonique face a la nouvelle procreation (Cerdic Publications, Strasbourg, 380pp., ISBN 2-85097-052-2, 200FF). A summary of the Italian National Committee on Bioethics recommendations on infertility treatment is HCR 24(6), 3-4. In Italy it is estimated that an extra 500-600 multiple births have occurred because of IVF technology, Human Reproduction 9 (1994), 9. A review of the UK HFEA is in Human Reproduction 9 (1994), 1779-82. Also on the ethics of ARTs, NEJM 331 (1994), 1032--4; F&S 62 (1994), 893-5.

Reviews of the progress of ART include Chen, S.H. & Wallach, E.E. "Five decades of progress in management of the infertile couple", F&S 62 (1994), 665-85, 686-9. Also on technical aspects, Science 266 (1994), 1459; F&S 62 (1994), 781-5. Caution on the use of interferon to promote male fertility is voiced in Lancet 344 (1994), 1027. The reduction in male reproductive system this century is becoming clear, BMJ 309 (1994), 1316-7.

A special issue of the Kennedy Institute of Ethics Journal 4 (Sept 94), 187-289 is on ethics and the cloning of human embryos. It includes 8 papers of interest in the debate about using embryo splitting to clone human embryos, from the clinical, ethical and legal sides. See also the paper by Anees in this issue of EJAIB. Discussion of the NIH embryo research guidelines, previously discussed in the last few issues, is also in HCR 25: 36-46. The cloning experiments in George Washington University, were actually done without approval of the university, Science 266 (1994), 1949. There has also been a controversy in France about embryo freezing research, Nature 373 (1995), 553.

A New York Court has ruled that a divorced woman can have sole custody of 5 frozen embryos, Reproductive Freedom News (27 Jan 1995), 2. She wants to implant them, but the former husband wants to donate them to research. The Supreme Court judge rejected the Tennessee 1992 ruling in the Davis case.

A Jewish view of ART is Grazi, Richard V. Be Fruitful and Multiply: Fertility Therapy and the Jewish Tradition (Israel: Genesis Jerusalem Press, 1994, US$20). A general book is Dyson, Anthony, The Ethics of IVF (London: Mowbray, 1995, 132pp., £10), reviewed in BME 104 (Jan 1995), 24. The UK monitoring of IVF success is being more standardised, Lancet 345 (1995), 246. Male infertility is discussed in NEJM 332 (1995), 312-7; and falling sperm quality in Auger, J. et al. "Decline in sperm quality among fertile men in Paris during the past 20 years", NEJM 332 (1995), 281-5, 327-8.

The Pope has released another statement on life, Evangelium Vitae, The Gospel of Life. The responses of various bishops on the issues since 1991 are taken into account, and he says he is concerned about the "culture of death". It is 189 pages long, and reviewed in Time (10 April 1995), 46; Nature 374 (1995), 489. As expected he is against abortion and use of human embryos, assisted procreation, and prenatal diagnosis for eugenic purposes.

A Human Embryo and Fetus protection working group has been set up by the European Commission in Brussels, BME 105 (Feb), 7. The issue of embryo research is dividing Germany and several conservative countries from others, as also seen in the divisions over the Council of Europe Bioethics Convention. The Netherlands Health Council set up a committee to discuss the latest advances in assisted reproduction, which should report within 12 months; Network 9 (Feb), 3-5.

A review of different countries' guidelines on embryo research is Nature Medicine 1 (1995), 2, 5-6. Papers on cloning are Robertson, J.A. "The question of human cloning", Monash Bioethics Review 14 (1995), 15-29; McCormick, R.A., Blastomere separation:some concerns", Monash Bioethics Review 14 (1995), 29-33.

A letter on freezing of porcine embryos is Nature 374 (1995), 416; and on problems in mice embryos, Dulioust, E. et al. "Long-term effects of embryo freezing in mice", PNAS 92 (1995), 589-93; Science 267 (1995), 618-9; New Scientist (4 Feb, 1995), 14-5. These results suggest a reassessment of the use of freezing, and of the length of time frozen human embryos are kept is timely. Studies of embryos have found the centrosome is derived from the father's chromosomes, Nature Medicine 1 (1995), 19-20, 47-52.

In April, Israel's Supreme Court in a 4 to one decision reversed and earlier decision, ruling that the husband has a right to refuse the use of embryos fertilised with his sperm. The wife had previously been awarded the embryos, arguing that her husband's consent should not be revokable, and that this was her last chance to have genetic offspring. The husband's "right not to be a father" has been recognised, and the embryos' will be destroyed.

Philosophical papers include, Robertson, J. (1994), "Posthumous Reproduction", 76 Indiana Law Journal 1027-65; Kuhse, H. "New reproductive technologies: ethical conflict and the problem of consensus", Monash Bioethics Review 13(4) (1994), (Ethics Committee Supplement), 4-19; New Scientist (18 Feb, 1995), 43. Donor insemination is discused in Shenfield, F. & Steele, S.J. "Why gamete donors should not be paid", Human Reproduction 10 (1995), 253-5; Lui, S.C. et al. "A survey of semen donor attitudes", Human Reproduction 10 (1995), 234-8. In the UK study of potential donors, 82% did not mind giving non-identifying information to the recipients and offspring, but 89% of potential donors required confidentiality and anonymity.

The performance of a Canadian clinic over 5209 IVF cycles in 2391 couples at University Hospital, London, Ontario, found a 20% pregnancy rate per embryo transfer, and no higher incidence of abnormalities; Human Reproduction 10 (1995), 470-4.

In New Zealand, the public is against general free access to assisted reproductive technologies, despite what the recent law reform commission report recommended, NZ Listener survey 1995. Among the sample (N=1000), 86% agreed to use by infertile couples, but only 24% say so for lesbian couples, 17% for postmenopausal women, and 31% for single women.

A legal review of the progress in Australia since the 1991 decision to try to make uniform guidelines on surrogacy is Stuhmcke, A. "Surrogate motherhood: The legal position in Australia", J. Law & Med. 2 (1994), 116-24. The recent decisions of the UK HFEA on fetal oocytes are in Human Reproduction 10 (1995), 239-44.

Papers on information sharing in AID include Daniels, K. "Information sharing in donor insemination: A conflict of rights and needs", CQHE 4 (1995), 217-24; Daniels, K.R. et al. "Telling donor insemination offspring about their conception: The nature of couples' decision-making", SSM 40 (1995), 1213-20. The second paper is based on a study of 58 children and follow-up questionnaires in New Zealand. New Zealand is in the middle of a dispute following the privatisation of an Auckland fertility service which will mean the possible closure of the unit in the National Women's Hospital, which would also raise questions over patient services, and the fate of embryos, etc., Lancet 345 (1995), 1298. The move is challenged as the change was made without consultation which is required by the law. It should also be noted that a patient death for a women undergoing IVF was confirmed at the private clinic, Lancet 345 (1995), 849.

India is planning laws to regulate sperm donor banks, BMJ 310 (1995), 1224. On the safety and secrecy of AID, JAMA 273 (1995), 890-1. An administrative law judge in New Orleans ruled at the beginning of June that a girl who was conceived after her father's death is entitled to her father's Social Security benefits,The Dallas Morning News (3 June, 1995). About 65,000 artificial inseminations take place annually in the United States, but no one knows many occur after the death of a father. Under current policy, Social Security benefits go to only those dependent children conceived while their parents were alive. Lawyers for the Social Security Administration argue that the decision in favour of Judith Hart might force the government to change not only its definition of dependent but also the word conception.

Australia is considering law reform in ART, MJA 162 (1995), 501. A second volume of the book, Basen, G., Eichler, M. & Lippman, A. eds., Misconceptions. The Social Construction of Choice and the New Reproductive and Genetic Technologies, (ISBN 0-921842-37-6, C$15, 247pp., Voyageur Publishing 1995 (fax: +1-613-925-0029 ). It includes several papers assessing the Canadian Royal Commission on reproductive technologies. The English translation of the Norwegian law on biotechnology in humans is in IDHL 46 (1995), 51-5. The legal limbo on surrogacy in South Africa is debated in SAMJ 85 (1995), 29-30. Portugese advice on ethics of ART is reviewed in IJB 6 (1995), 76-8. In general on ART, BMJ 310 (1995), 1066-7; NEJM 332 (1995), 966-8; F&S 63 (1995), 701-2. On the regulation of IVF, Modern Law Review 58 (1995), 454-5.

Dutch police have begun an international investigation following allegations that young Polish women are being lured to Holland, Belgium and Germany to act as surrogate mothers for childless couples (The Independent, 4 June, 1995). According to police in the eastern Dutch town of Adeldoorn, the women are recruited through advertisements in Polish newspapers which promise "discretion" and "good fees" in return for their services as surrogate mothers. Fees are believed to be as high as 35,000 guilders (about pounds 14,000), the equivalent of around two years' salary for most Poles. Surrogate motherhood for commercial gain was banned in the Netherlands two years ago and carries a prison sentence of up to one year.

Applicants are told to contact an agent in the Polish harbour city of Szczecin who arranges for the women to undergo medical tests before organising their journey to the clients' homes. The operation was first revealed by two Dutch journalists who found that at least 12 Polish women (most under 25), had been brought to Holland as "au pairs". The women lived with a couple who wanted children, usually sleeping with the man to become pregnant, although in some cases it is believed that artificial insemination was used. Once the baby was born, the biological mother was expected to return to Poland, leaving the baby with her hosts. The organiser said he did not know it was illegal. He is believed to have made around a thousand guilders per transaction.

The Association of Italian Medical and Dental Surgeons has approved a new code of ethics to regulate ART until a future national law is implemented, Reproductive Freedom News (5 May 1995), 8; Lancet 345 (1995), 974-5. It would exclude physicians who broke the code. It forbids insemination for lesbians and post-menopausal women. A series of articles in the BMJ has challenged the idea that older women should not be helped to conceive. In the UK all hospitals have their own ethics committees, and most ban IVF treatment for women of 50 (The Independent, 3 June, 1995). In the Netherlands, a couple found a mistake in their twins, one was balack and one was white, The Daily Telegraph (20 June, 1995).

The total number of babies born in Japan by IVF is over 10,000, Japan Times (28 May 1995), 3. There are 237 hospitals offering services and the success rate is up to 15.7% live birth rate. A report on the preimplantation diagnosis research at Kagoshima University in Japan, discussed last issue, is Science 268 (1995), 1586.

Comments on cloning in the USA are in KIEJ 5 (1995), 57-60. The major conclusions of the NIH report on embryo research are in Ethics & Medicine 11 (1995), 20-3. There are allegations of improper conduct against personnel in the Fertility Clinic at UC-Irvine, American Medical News (l9 June l995). On the background to the German embryo protection law, Science & Engineering Ethics 1 (1995), 145-50.

A new method for IVF using sperm injection developed in Japan is discussed in Nature Medicine 1 (1995), 289; and another method is in F&S 63 (1995), 1231-40. On male infertility, Lancet 345 (1995), 1231. A fish study suggesting vitamin C improves sperm quality is Biol. Reproduction 52 (1995), 982-8. The risk of ovarian cancer after infertility treatment is discussed in NEJM 332 (1995), 1300-2. The production of fetuses from cryopreserved mouse gametes is reported in Mouse Genome (1995) 164-6. Circumcision is discussed in Lancet 345 (1995), 927.

Several papers on the subject of use of ART and cloning are in a special issue of Cambridge Quarterly of Healthcare Ethics 4 (1995), 263-366. They include papers on genetics, as listed below. Also on ARTs, Nelson, H.L. "Dethroning choice: analogy, personhood, and the new reproductive technologies", JLME 23 (1995), 129-35.

The English summary of the Health Council of the Netherlands report on sex-selection for non-medical reasons is in BME 109 (1995), 8-10. The Dutch sex selection clinic that was planned has faced much opposition, BMJ 311 (1995), 10-1. A letter on China's missing girls is Science 269 (1995), 147-8. On reproductive technologies in developing countries, see Bioethics 9 (1995), 276-82. On the Israel surrogacy law, BMJ 311 (1995), 347-8; and on the unusual decision in Israel to reconsider a law case in the Supreme Court on the ownership of eggs, Lancet 345 (1995), 1498. The health minister of Canada has called for a moratorium on new IVF technologies, Lancet 346 (1995), 367.

In the UK a woman was compensated £35000 for removing her ovaries without consent, BMJ 311 (1995), 212-3. Fortunately she has 3 children, but as a 36 year old, she was disturbed that the hysterectomy was expanded. As reported last issue a fertility clinic at UC Irvine is facing misconduct charges, Nature 376 (1995), 456. There appear to be misappropriations of eggs and embryos. An administrator who was fired last year, said that she was fired because she opposed the taking of eggs for donation without consent of the donor. The problem of twins being black and white due to a Dutch fertility clinic error, is in Newsweek (3 July, 1995), 33.

In general on social aspects of ARTs, SSM 41 (1995), 287-8; F&S 64 (1995), 10-2, 252-4; BMJ 310 (1995), 1476. On adoption across races, Time (4 August, 1995), 32-3. On complications of IVF, Br.J.O&G 102 (1995), 520-4.

A study showing similar pregnancy rates in older women as younger is Sauer, M.V. et al. "Pregnancy in women 50 or more years of age: outcomes of 22 consecutively established pregnancies from oocyte donation", F&S 64 (1995), 111-5. The ethics of offering older women IVF are debated in BMJ 310 (1995), 1455-8. However, there are limits on the number of oocytes that can be retrieved from older patients, which limits GIFT, F&S 64 (1995), 107-10. On freezing embryos from women who want to have children later, MJA 163 (1995), 623-4. A British study found Indian women had lower success than white women in IVF programs, Mahmud, G. et al. "A controlled assessment of the in vitro fertilisation performance of British women of Indian origin compared with white women", F&S 64 (1995), 103-6. The 1993 results of IVF in the USA and Canada are reviewed in F&S 64 (1995), 13-21. They include data from 267 programs, with overall results for IVF of 18% deliveries per retrieval. The results of Mt. Sinai clinic, NY for 100 women who had successful pregnancies are in F&S 64 (1995), 88-92. A study calling for special care in obstetrics for singleton pregnancies from IVF patients is O&G 86 (1995), 188-92.

An editorial looking at deletions of the Y chromosome which can cause infertility is Reijo, R. et al. "Diverse spermatogenic defects in humans caused by Y chromosome deletions encompassing a novel RNA-binding protein gene", Nature Genetics 10 (1995), 383-93, 367-8. On falling sperm counts, BMJ 311 (1995), 347; and on male infertility, NEJM 332 (1995), 1790-1. There are claims that the reduction in male fertility is linked to the insecticide DDT, BMJ 311 (1995), 11-2; Nature 376 (1995), 522.

The 1995 Victorian, Australia, Infertility Treatment Act ensures children identifying information about sperm donors, following the New Zealand and Swedish laws; The Bulletin (Newsweek Australia, 11 July, 1995), 30-1. On the Swedish law, Daniels, K. "The Swedish Insemination Act and its impact", Aust. NZ. J. Ob. & Gyn. 34 (1995), 437-9. A paper on ARTs in New Zealand is Daniels, K. "Assisted reproductive technology policy in New Zealand: Needs, rights and responsibilities", Public Sector 17 (No. 3, 1995), 22-5.

A review of interest for dreams of cloning is Surani, M.A. "Parthenogenesis in man", Nature Genetics 11 (1995), 111-3; and the paper reporting a parthenogenic chimeric boy, Strain, L. et al. "A human parthenogenetic chimera", Nature Genetics 11 (1995), 164-9. The boy had some facial abnormalities on one side of his face, but not the other - and the maternal X chromosome in the XX/XY genotype is the same in all cells, suggesting mosacism. Should the boy be fertile, they predict normal children.

Ethical issues of sex selection are discussed in Arda, B. "Ethics and the commercial use of gametes", BME 111 (Sept 1995), 19-22. Secrecy in AID is used in Cameroon, Politics & Life Sciences 14 (1995), 87-8. The issue of harvesting sperm is debated in Murphy, T.F. "Sperm harvesting and postmortem fatherhood", Bioethics 9 (1995), 380-98. On falling sperm counts, Lancet 346 (1995), 635.

Recent law cases in surrogacy are discussed in HCR 25 (5, 1995), 30-31. A paper looking at the marriage system is MacDonald, K. "The establishment and maintenance of socially imposed monogamy in Western Europe", Politics & Life Sciences 14 (1995), 3-23; which is followed by a series of commentaries, pp. 24-46. Infertility counseling is discussed in JAMA 274 (1995), 1159-64.

In Denmark there are concerns about the rapidity of development of assisted reproduction, Lancet 346 (1995), 629. A review is Levinson, G. et al. "Recent advances in reproductive genetic technologies", Biotechnology 13 (1995), 968-73. The case of misconduct in the USA is discussed in Biotechnology 13 (1995), 925; and variations in infertility clinics, BMJ 311 (1995), 1041. Also on IVF, Lancet 346 (1995), 901.

Cases of sex chromosome abnormalities have been suggested following intracytoplasmic sperm injection, Lancet 346 (1995), 773, 1095-7. The technique is causing controversy in France, a country with much use of ART, Nature 377 (1995), 277; BMJ 311 (1995), 896. It has been used on about 13500 ova, with 6065 embryos, 4030 were implanted, with 21% resulting in pregnancy.

On July 27, 1995 the federal Health Minister, Diane Marleau, announced her government's response to the report of the Royal Commission on the New Reproductive Technologies, which was released in November 1993 (Canadian Bioethics Report, Humane Medicine 10 (1994), 136-137). The Minister called for a voluntary moratorium on nine reproductive and genetic technologies and practices: sex selection for non-medical purposes; commercial pre-conception ("surrogacy") arrangements; buying and selling of eggs, sperm and embryos; egg donation in exchange for in vitro fertilization services; germ-line genetic alteration; ectogenesis (creation of an artificial womb); the cloning of human embryos; formation of animal-human hybrids by combining animal and human gametes; and the retrieval of eggs from cadavers and fetuses for donation, fertilization or research. The Minister established a panel to advise her department on whether and how the moratorium is being respected, how it should evolve and what issues are emerging in the field. Her long-term goal is to have a permanent management regime as part of a comprehensive approach to the health and safety issues associated with genetic and reproductive technologies.

There does not appear to be increased ovarian cancer in women who enrolled in IVF programs that stimulae egg production, nor breast cancer, Lancet 346 (1995), 995-1000.

A paper exploring feminism from a sociobiological perspective is Liesen, L.T. "Feminism and the politics of reproductive strategies", Politics & Life Sciences 14 (1995),145-62. A series of 12 commentaries exploring feminism, sociobiology, and reproduction follow, pp. 163-193. A cost estimate is made in Collins, J.A. et al. "An estimate of the cost of in vitro fertilization services in the United States in 1995", F&S 64 (1995), 538-45. In 1993 there were 31,718 IVF cycles with an average charge of US$6,233, making a total of US$198 million. If IVF services were added to health insurance schemes it would add less than $3 per annum for each employer, at that rate of use. See also, F&S 64 (1995), 470-3. Infertility and the NHS is discussed in BMJ 311 (1995), 1586-7.

The results of a survey on IVF to the general public in the Kinki region of Japan (Kansai area), with a 24% response rate of which only 26% answered all the questions (N=345), is Kozaki, N. et al. "Application of reproductive techniques in Japan and Japanese views on surrogate motherhood", F&S 64 (1995), 686-8. It suggested low familiarity with the terms, and they found 51% approved of surrogate motherhood. The reasoning was examined. A philosophical paper on motherhood is Apple, R.D. "Constructing mothers: Scientific motherhood in the nineteenth and twentieth centuries", Social History of Medicine 8 (1995), 161-78. A philosophical paper is Gibson, S. "Reasons for having children: Ends, means and "family values", J. Appl. Philosophy 12 (1995), 231-9. On older mothers, BMJ 311 (1995), 1585-6.

The UK Human Fertilization and Embryology Authority published their annual report together with a patients' guide to fertility treatment clinics. The live birth rates for IVF overall were 14.1%, but for donor insemination, 6.9%. A list of work loads and success rates was published allowing people and the Press to make comparisons, BME 112 (1995), 3-5. They also report on ethical issues. A study of couples undergoing their second or third pregnancy with IVF found increased success rates than the first attempt, F&S 64 (1995), 546-51. A general review of infertility treatment is F&S 64 (1995), 459-69.

The number of cases of switched embryos and gametes in infertility treatment is causing people to have doubts about the clinics, J.A. Robertson, "The case of the switched embryos", HCR 25 (6, 1995), 13-9. A discussion of the ethics of embryos for research is D. Davis, "Embryos created for research purposes", KIEJ 5 (1995),343-54; Robertson, J.A. "Ethical and legal issues in human embryo donation", F&S 64 (1995), 885-94; JAMA 274 (1995), 1344-5. The US Board on Ethics in Reproduction statements on embryo splitting and embryo research are in IJB 6 (1995), 263-65. The lessons for public policy bioethics are discussed in Green, R.M. "The human embryo research panel: lessons for public ethics", CQHE 4 (1995), 502-15. Counseling in reproductive medicine is being developed. F&S 64 (1995), 895-7.

A dismissal of European postcoital tests for infertility tests is Br.J.O&G 102 (1995), 621-4. Environmental effects on human reproduction are seen in the toxic compounds in Eastern Europe, and the WHO is supporting the research, SSM 41 (1995), 1479-86. Papers reporting the success of embryo freezing for IVF include: F&S 64 (1995), 647-50, 987-90. Intracytoplasmic sperm injection can also aid female-related infertility, F&S 64 (1995), 977-81, 982-6. An on-line site with issues of reproductive biotechnology is: http://Numbat.murdoch.edu.au/spermatology/spermhp.html

A discussion of where childbirth should occur is NEJM 333 (1995), 1635-7. Pregnancies attended by certified nurse midwives are 50% less likely to end in cesarean sections in the USA, BMJ 311 (1995), 1387.

A paper reporting a 2% annual fall in sperm quality in the UK is Irvine S et al. "Evidence of deteriorating semen quality in the United Kingdom: birth cohort study in 577 men in Scotland over 11 years", BMJ 312 (1996), 467-70; but a smaller French study with no change is Bujan L, Mansart A, Ponteonnier F, Mieusset, "A Time series analysis of sperm in concentration in fertile men in Toulouse, France, between 1977 and 1992", BMJ 312 (1996), 471-2; see also pp. 457-8, 506; which discusses possible causes and reviews the debate over pollutants as a cause. Adverse effects of chemicals are also discussed in AJHG 57 (1996), 245. Techniques to overcome male infertility are discussed in O&G 87 (1996), 22-6; and sex chromosomal abnormalities and intracytoplasmic sperm injection may be related to a compound used, PVP, Lancet 347 (1996), 1566. Fertilization without sperm is discussed Nature 379 (1996), 493-5.

A new law is being submitted to the Danish parliament to cover ART, EBN 215 (1996), 2-3. It will allow insemination of single women, will allow fertile women to undergo IVF, and allow preimplantation diagnosis for "serious diseases", and embryo storage for three years instead of the current one year is suggested. A comment against laws forbidding ARTs is Dickens B. "Do Not Criminalize New Reproductive Technologies," Policy Options 17(1996), 11-14; also 15-7. On legal issues in ART, F&S 65 (1996), 11-2; and microinjection of nuclei in France is being criticized for alleged avoidance of guidelines, Nature Medicine 2 (1996), 16.

A 48pp summary in English of the Health Council of the Netherlands Report, Sex selection for non-medical reasons, 1995/11E, is a good review of the issues involved (ISBN 90-5549-102-0). Sex determination and informing the sex of a fetus are criminal in India, since 1 January, Nature 379 (1996), 201. On reproductive technology, AJHG 57 (1996), 245-7. Israel no longer has a ban on surrogacy, Lancet 347 (1996), 113. Oocyte donation success in older women is reported in F&S 65 (1996), 94-7, 103-8.

A paper advising that IVF is cost effective if it avoids multiple pregnancies is Goldfarb JM et al. "Cost effectiveness of in vitro fertilization", O&G 87 (1996), 18-21. They calculate costs of US$39,000 per pregnancy for single or twin pregnancies. A paper which examines whether infertile couples should adopt children given an overpopulated world is Munthie, C. "The argument from transfer", Bioethics 10 (1996), 27-42. Letters on evaluation of the infertile couple are in JAMA 275 (1996), 185-6.

The second revision of the UK HFEA Code of Practice for storage of gametes or embryos for cancer patients is in BME 115 (1996), 8-10. The BMA has changed its opinions on surrogacy to one of cautious acceptance, see the text excerpt from BMA, Changing Conceptions of Motherhood: The practice of surrogacy in Britain, London, 1996; in BME 115 (1996), 10-11. A discussion of contracts in surrogacy is Watson, B. "Linguistic analysis of pre-conception contracts: Towards a model for Canada", Health Law Review 4 (2, 1995/1996), 26-31. Israel has legalized surrogacy by a new law, provided it is not commercial and the ovum is donated, Nature Medicine 2 (1996), 372-3; BMJ 312 (1996), 729-30. A survey of attitudes towards artificial insemination among lesbian, heterosexual couples and single women in the USA is F&S 65 (1996), 764-70.

On April 2, 1996 the B.C. Supreme Court rendered its judgment on the appeal of Dr. Gerald Korn against a decision of the B.C. Council of Human Rights that he had wrongfully discriminated against Tracy Potter and Sandra Benson because of their sexual orientation, Canadian Bioethics Report (April 1996). Dr. Korn had refused to provide artificial insemination to the couple, who are lesbians. The Court found that the Member Designate of the Council of Human Rights who heard the case had not erred in law in finding that Dr. Korn denied A.I. to the couple, that the Member Designate did have jurisdiction to consider questions relating to the matters complained of, and that he did not err in law by finding that Dr. Korn did not have a reasonable justification for refusing to accept the couple as patients. The Court therefore dismissed the appeal and awarded costs to the respondents, Potter and Benson.

In general, McCall, M. "Pursuing conception: a physician's experience with in-vitro fertilization", CMAJ 154 (1996), 1075-1079. Parks, JA. "A closer look at reproductive technology and postmenopausal motherhood", CMAJ 154 (1996), 1189-1191.

In mid-1996 an Infertility Treatment Authority will be set up in Victoria, Australia as the committee established by the new Infertility Treatment Act, Lancet 347 (1996), 684. There has been debate in Denmark over whether infertility treatment should be included under health insurance, Lancet 347 (1996), 462. In general on infertility and ethics, JAMA 275 (1996), 566-7; JME 22 (1996), 57. A survey of attitudes of persons in IVF programs found them willing to have multiple pregnancies but also more willing than general to use multiple pregnancy reduction, Goldfarb, J. et al. "Attitudes of in vitro fertilization and intrauterine insemination couples toward multiple gestation pregnancy and multifetal pregnancy reduction", F&S 65 (1996), 815-20.

Researchers in Wisconsin say they were using embryos for experiments given from a University of California at Irvine clinic, only because they thought consent had been given, in fact it had not, Nature 380 (1996), 756. A survey of costs of IVF in the UK is in Brit. J. O&G 103 (1996), 198-201. The incidence of multiple pregnancies after IVF is dependent upon maternal age and number of embryos, F&S 65 (1996), 561-5. Antisperm antibodies in infertile men are discussed in JAMA 275 (1996), 885-6. On the safety of cryopreservation of embryos, following the extension to ten years of the period in the UK that embryos may be preserved, Nature 380 (1996), 194. A study suggesting that average pregnancy rates per natural menstrual cycle are 30% is F&S 65 (1996), 503-9.

The 1995 report of the Danish Council of Ethics includes a report, Assisted Reproduction - A Report, translated into English 82pp. Available from the Danish Council of Ethics, 2-4 Ravnsborggade, DK 2200, Copenhagen N, DENMARK (also available on Internet . In most of the conclusions a majority supports the techniques, with a minority view also expressed. They all recommend a general law be introduced to clarify the legal situation. A general review on the demand for children and ART is HCR 26 (March/April 1996), 19-29.

An English summary of the Health Council of the Netherlands June 1995 report on sex selection for non-medical criteria is Network 10 (March 1996), 12-3. The Dutch Medical Association has opened the way for IVF in older women in a report, IVF in Later Life, BMJ 312 (1996), 1319. A call for allowing more embryos to be implanted in older women due to lower implantation rate is Lancet 347 (1996), 1032. Canada is going to limit some ARTs, Lancet 347 (1996), 1110. A call for guidelines and surveillance on ART in the USA is F&S 65 (1996), 1090-2. A debate on whether ART are playing God is in J.Med.&Phil. 21 (1996), 419-438.

A letter on safeguards for embryo donation is F&S 65 (1996), 1262-3; and discussion, NEJM 334 (1996), 1329-32; Freeman, JS. "Arguing along the slippery slope of human embryo research", J.Med.&Phil. 21 (1996), 61-81. Research on spare embryos is discussed in Lancet 347 (1996), 983, 1488-9. Economics of infertility are reviewed in AJO&G 174 (1996), 1200-7.

A study of giving sperm is Daniels, KR. & Lewis, GM. "Donor insemination: The gifting and selling of semen", SSM 42 (1996), 1521-36. On the ethics of surrogacy and labour, JME 21 (1995), 345-9.

A call for monitoring of the safety and harm to babies born from ART is AJO&G 174 (1996), 1208-17; Lancet 347 (1996), 1277. Most cases of male infertility appear to result from absence of a protein that allows sperm to grip on the egg, Biology of Reproduction 54 (1996), 1018+; NS (8 June 1996), 16; in general, Lancet 347 (1996), 1028. A US study suggests that there may be no decline in sperm counts, Lancet 347 (1996), 1319; NS (11 May 1996), 10; see also Disease Risks section above on environmental estrogens. There is lower fertility in the UK compared to Finland, Lancet 347 (1996), 1519-22. One possibility is to bank spermatogonial stem Cells, Nature Medicine 2 (1996), 638-9.

The Health Council of the Netherlands has released its interim report (in English) on Assisted Fertilization: Intracytoplasmic sperm injection (ICSI) (No. 1996/06E, The Hague, 19 June 1996), 45pp. They recommend that some conditions be required for the continued practice of ICSI, and that 20 year follow up studies be conducted. There are some doubts about the technique which may introduce microdeletions into the sons DNA, see Lancet 348 (1996), 59, 332; JAMA 275 (1996), 1829-30; NS (17 August 1996), 18. In studies of sperm quality, diet appears not to have effect, but tight-fitting underwear does decrease sperm, Lancet 347 (1996), 1844-5. Also on sperm insemination, O&G 88 (1996), 93-8; Biology of Reproduction 55 (1996), 709-14; and on transplants of spermatogonia, SA (Aug. 1996), 26-8.

Canada is criminalising some ARTs (e.g. commercial surrogacy and commerce in gametes) in the new law, Lancet 347 (1996), 1758; Science 273 (1996), 191. The embryo research ban would be after 14 days.

A perspective from New Zealand on ARTs is Nicholas, B. "Community and justice: The challenges of bicultural partnership to policy on assisted reproductive technology", Bioethics 10 (1996), 212-21. A discussion on the topic of access by older women to IVF is in Monash Bioethics Review 15 (1996), 13-9. A book review of Marsh, M. & Ronner, W. The Empty Cradle: Infertility in America from Colonial Times to the Present (John Hopkins University Press 1996) is in NEJM 335 (1996), 441. On ethics of ARTs, NS (31 August 1996), 43; Baird, PA "Ethical issues of fertility and reproduction", Ann. Rev. Med. 47 (1996), 107-16; J. Assisted Reproduction & Genetics 12 (1995), 473-6, 477-83, 484-90, 509-16, 531-6, 543-51.

An opinion survey conducted by Kyodo News Service in Japan in 1996 (N+1995) finds that in response to the question what people think about IVF, 1.7% said it should be actively encouraged, 60.1% approved its use for a married couple, 24.6% said we should avoid it, 10.5% said we should not do at all, and 3.1% said don't know (Nikkei Kasei Shimbun). Since 1991 when a US surrogacy agency was established in Tokyo, there have been over 50 babies born from surrogacy arrangements in the USA, with average costs over 10 million Yen.

4000 frozen embryos that had expired 5 year time limits under UK law were destroyed, BMJ 313 (1996), 1-2, 189; Lancet 348 (1996), 399; NS (13 July 1996), 3. Attitudes are reported in Corrigan, E. et al. "Posthumous storage and use of sperm and embryos: survey of opinion of treatment centres," BMJ 313 (1996), 24. Debate on manipulation of embryos has been occurring in the Italian Bioethics Committee, Science 273 (1996), 177. On the issues of embryos, Lancet 348 (1996), 198.

The executive summary of the Health Council of the Netherlands report on Sex Selection is in BME 119 (1996), 8-10; and there is controversy over use of preimplantation diagnosis for sex selection in disease, in Japan, Lancet 348 (1996), 198-9.

Two papers on adoption ethics are in CQHE 5 (1996), 430-9. On single mothers in Australia, Lancet 348 (1996), 531. In general on infertility treatment, BMJ 313 (1996), 444; F&S 66 (1996), 202-4, 205-9. Infertility patients have a high drop out rate, O&G 88 (1996), 289-93; and on insurance protection in the USA, Harvard Law Review 109 (1996), 2092-2109.

On 11 Sept, 1996, the US Court of Appeals for the Eighth Circuit upheld a finding that a woman whose health plan does not cover costs for fertility treatment can not sue for discrimination under the US Americans with Disabilities Act, Reproductive Freedom News (16 Oct 1996), 2. The case, Krauel v. Iowa Methodist Medical Center. A paper examining the issue is Millsap, D. "Sex, lies, and health insurance: Employer-provider health insurance coverage of abortion and infertility services and the ADA", AJLM XXII (1996), 51-84.

A discussion of the ethical issues raised by the business nature of obstetrics and gynecology is AJO&G 175 (1996), 523-7; and Human Reproduction 11 (1996), Natl. Supplement 71-7. A guide to IVF and AID is in Human Reproduction 11 (1996), 1363-70; and on 1996 guidelines of the ESHRE following a Capri meeting, Human Reproduction 11 (1996), 1775-807.

In the UK so far about 3,300 stored embryos from 30 clinics have been destroyed as the time period expired, causing controversy, Nature Genetics 14 (1996), 13. A discussion of various ethical debates in the UK regarding the use of embryos, and abortion, is BME 120 (1996), 3-5; and the 1996 regulations on embryo storage in the UK are in BME 120 (1996), 8-10. The On storage of sperm and embryos, BMJ 313 (1996), 1078-9. The chance of pregnancy after preimplantation appears to increase if the embryos are grown in groups, F&S 66 (1996), 394-7. A paper looking at experiments is Heyd, D. "Experimenting with embryos: Can philosophy help?", Bioethics 10 (1996), 292-309.

A widow's fight for her husband's sperm is discussed in BMJ 313 (1996), 837, 899. The summary of the Dutch Health Council report on ICSI (see last issue), is reproduced in BME 121 (1996), 8-9. Several papers on giving semen are by one of our new editorial board members, Daniels, KR & Lewis, GM, "Donor insemination: The gifting and selling of semen", SSM 42 (1996), 1521-36; Daniels, KR et al. "Semen donor recruitment: a study of donors in two clinics", Human Reproduction 11 (1996), 746-51; Daniels, KR et al. "Families formed as a result of donor insemination: the views of semen donors", Child & Family Social Work 1 (1996), 97-106; Daniels, KR & Lewis, GM, "Openness of information in the use of donor gametes: developments in New Zealand", J. Reproductive & Infant Psychology 14 (1996), 57-68. Canadian guidelines on semen distribution are in IDHL 47 (1996), 342-5. Comparisons between fertility in the UK and Finland are Lancet 348 (1996), 616.

A survey suggesting that the pregnancy outcome of women after 45 years of age is generally good, but that there were more complications, is AJO&G 175 (1996), 668-74. On infertility counseling, some abstracts of papers from the American Fertility Society meeting are in F&S 66 (1996), Supplement, S215-8. On ovulation induction and ovarian cancer, F&S 66 (1996), 499-507. Letters on the health care needs of transgendered patients are in JAMA 276 (1996), 874.

A review is Reubinoff, BE & Schenker, JG., "New advances in sex preselection", F&S 66 (1996), 343-50. The only reliable methods they report are preimplantation diagnosis or sperm separation by flow cytometry and IVF. The sequential use of PCR and FISH on the same blastomere can be used as a check for sex determination, F&S 66 (1996), 490-2. On sperm selection in lizards, Nature 383 (1996), 585. Data on human male-female ratios in Denmark since 1851 are in Lancet 348 (1996), 828-9; and a review across the world is Human Reproduction 11 (1996), Supplement, p. 5+. A review of environmental estrogens is American Scientist 84 (1996), 452-62; and on US guidelines, EST 30 (1996), 385A, 429-30A; NS (14 Sept. 1996), 7.

In the UK there have been a list three requests from women for sperm removal from dead husband's, or boyfriends, for them to use to become pregnant, Guardian (24 Oct 1996). The Dianne Blood case which the High Court rejected the end of October, has been called the widow's fight for her husband's sperm, BMJ 313 (1996), 1477; Lancet 348 (1996), 1164. The UK HFEA is also rejected the export of the sperm to other countries for her to use, despite its discretionary powers to do so. Lord Winston, a well-known clinician has suggested to UK doctors that export of testicular tissue is not regulated and could be conducted. In a US survey of 300 fertility clinics it was found that more than a dozen clinics have admitted harvesting sperm from cadavers and storing it for later use, NS (30 Nov 1996), 5. Three times more said they had been asked to do so.

On the social aspects of AID, Gillett, WR et al. "Feelings of couples who have had a child by donor insemination: the degree of congruence", J. Psychosom. Obstet. Gynecol. 17 (1996), 135-42; which found that the man and women's feelings did not correlate with their perceived view of their partner's feelings. However the relationships usually improved, Daniels, KR et al. "Successful donor insemination and its impact on recipients", J. Psychosom. Obstet. Gynecol. 17 (1996), 129-34. In the UK there is a shortage of eggs donated by ethnic minority groups, BMJ 313 (1996), 1145. Donation of frozen embryos after IVF is uncommon in the USA, with four times more couples destroying embryos after a successful birth than donating, F&S 66 (1996), 837-8. In general on ethics of assisted reproduction, Otago Bioethics Report 5 (1996), 3-9,

The Israeli High Court has ruled after a long case that a woman can use her embryo's to get pregnant despite the ex-husband's objection, Nature Medicine 2 (1996), 1164-5; Lancet 348 (1996), 1024. There is still some doubt whether she may need permission if she uses them in surrogacy arrangements. A book review of Crouch, M. & Manderson, L. New Motherhood: Cultural and Personal Transitions in the 1980s (Gordon & Breach Science, 1993, 214pp.) is in SSM 43 (1996), 1427-8. The Council of Europe Bioethics Convention on Human Rights and Biomedicine allows use of embryos for research but not there specific creation for it, Nature 384 (1996), 298; and on views against this, BME 122 (1996), 9-11. A report on the Visible Embryo project on the Internet is in NS (26 Oct 1996), 6. A report on Hong Kong's Gender Choice Centre that opened in November 1993 is Chinese Bioethics Newsletter (Winter 1995), 3. It charges HK$28,000 for couples who want to choose the sex of their offspring using sperm separation, with a claimed 75% success rate.

A call for papers on new reproductive technologies: social, clinical and ethical issues is being made by the Journal of Community and Applied Social Psychology, by 1 May 1997; contact Dr Robert J. Edelmann (Email: R.Edelmann@surrey.ac.uk), Dept of Psychology, University of Surrey, Guildford, GU7 1UF, UK. On the technique of IVF an analysis of the UK data since 1991 found live birth rate was 13.9%, Templeton, A. et al. "Factors that affect outcome of in vitro fertilization treatment", Lancet 348 (1996), 1402-6, 1394. The North American registry data for USA in 1994 are in F&S 66 (1996), 697-705.

A discussion of surrogacy in Australia is Krohn, A. "Surrogacy arrangements in the Australian Capital Territory: What happened to uniform Australian policy?", Bioethics Research Notes 8 (1996), 37-8. It reviews the varying policy in different states. On surrogacy, Watson Janu, P. "The case for discouragement of surrogacy arrangements", J. Law & Med. 4 (1996), 72-81. The Supreme Court of Tasmania gave inheritance rights to embryos which were conceived in vitro before the death of the biological father although implanted in the mother after the father's death, Australian Law J. 70 (1996), 972-3. In the UK a 29 year old surrogate decided to keep the child, BMJ 314 (1997), 250. On the growing number of single women in Europe, Newsweek (20 Jan 1997), 41-5.

A US scientist Mark R. Hughes, who has been researching preimplantation diagnosis has been forced to resign from Georgetown Medical Center, and fired from the NIH, Probe V (No.10, 1997), 3, 8; Washington Post (15 Jan 1997); Nature 385 (1997), 190, 570. The reason for this is claimed to be religious groups opposing his work and research on embryos. More on preimplantation diagnosis in Germany (see Mueller in EJAIB 7 (1997)), is NatMed 3 (1997), 13.

The annual number of triplets and higher number multiple births in the USA rose from 1337 in 1980 to 4594 in 1994, Vital Health Statistics Series 1997; 21(55). About one-third of the increase in the triplet births can be explained by more women bearing children at a later age. The use of fertility-enhancing drugs and techniques may be responsible for the rest of the increase. On infertility treatment in general, FDA Consumer (Jan/Feb 1997), 18-21; and costs, F&S 66 (1996), 885-6, 896-903. Ring chromosome 14 has been detected after intracytoplasmic sperm injection, F&S 67 (1997), 164-5.

Dutch have tightened up embryo storage rules, BMJ 314 (1997), 537. An Israeli court has overturned the IVF regulations, BMJ 314 (1997), 538. A widow has won the battle over her husband's sperm, to allow her to go to Belgium to be inseminated with it, BMJ 314 (1997), 143, 461; Nature 385 (1997), 563; F&S 66 (1996), 889-95. On information sharing in semen donation, SSM 44 (1997), 673-80. On the discovery of sperm, F&S 67 (1997), 16-7. Criticism of the UK HFEA: Lancet 348 (1996), 1739.

Bill C-47, an Act respecting human reproductive technologies and commercial transactions relating to human reproduction, was introduced into the Canadian Parliament on June 14, 1996 (Canadian Bioethics Report, July 1996) and received its second reading in November 1996. It was then referred to the Standing Committee on Health for detailed study. For further information contact Pierre Rodrique, Clerk of the Sub-Committee on Bill C-47, Room 604, Wellington Bldg., House of Commons, Ottawa, ON K1A 0A6, Canada.

A number of reports on cloning continue: Geneletter 1(5) (March 1997); Nature Biotechnology 15 (1997), 293-4, 306; Nature 385 (1997), 769, 771; 386 (1997), 1, 8-9, 97-8, 119, 204; Science 275 (1997), 1271, 1733; Nature Medicine 3 (1997), 370-1; Nature Genetics 15 (1997), 323; Economist (1 March 1997), 16; Lancet 349 (1997), 705, 785; BMJ 314 (1997), 697; GEN (1 April 1997), 4, 35; Science and Engineering Ethics 3 (1997), 106-8; BME 126 (1997), 4-6, 8; NS (1 March 1997), 3, 4-5; (15 March 1997), 3, 4; (22 March 1997), 49; Time (10 March 1997), 28-41. (see also newspaper reports in section on Biotechnology and the Public). On philosophical issues, Roberts, M.A. "Human Cloning: A Case of No Harm Done? J. Med. Phil 21 (1996), 537-554. An editorial asking why the UK Ministry of Agriculture or Animal procedures Committee did not start discussion of the issues of cloning earlier, since they knew the state of the research, is BME 125 (1997), 1. A case study on cloning for education is on the Access Excellence site . A discussion of how science reporters also become moralizers is Probe V (11, April 1997), 1, 4. On 26 March The Japanese Ministry of Education issued a statement to stop human cloning research in its facilities, in case anyone was doing such research, following a statement of 21 March by the Science Council.

The best approach may be a moratorium rather than a ban on human cloning, but there will be much discussion. The European Parliament has called for a world ban on cloning, BMJ 314 (1997), 847; and the issue may get specifically included in the UNESCO Genome Declaration, to be discussed and adopted later this year. See also papers by Morioka, and Anees in EJAIB 7 ( May 1997), and the editorial.

Background on how the Council of Europe may regulate embryos is Byk, C. "A proposed draft protocol for the European Convention on Biomedicine relating to research on the human embryo and fetus", JME 23 (1997), 32-7. The European Bioethics Convention has been signed, see Medical law section below. On philosophical status of the human embryo, Howsepian, AA. "Lockwood on human identity and the primitive streak", JME 23 (1997), 38-41.

The UK lady, Mrs. Blood, who sought to take her dead husband's sperm to Belgium so she could implant it was awarded the sperm and is undergoing infertility treatment there, BME 125 (1997), 5. On the issue in general, Peng, FC. "Post-mortem insemination: Taking sperm from the dead", Health Law Review 5 (3) (1997), 18-24; Capen, K. "Lesbians, artificial insemination and human-rights laws: Can doctors place limits on their medical practices?", CMAJ 156 (1997), 839-40. In Australian three women in a defacto relationship have won a case against Victorian IVF legislation on the grounds it is discrimination, Lancet 349 (1997), 860. A book review is JME 23 (1997), 61-2. On the psychology of infertility, Lloyd, M. "Condemned to be meaningful: Non-response in studies of men and infertility", Sociol. Health & Illness 18 (1996), 433-54; Gillet, WR et al. "Feelings of couples who have had a child by donor insemination: the degree of congruence", J. Psychosom. Obstet. Gynecol. 17 (1996), 135-42; Daniels, KR. et al. "Families and donor insemination: the views of semen donors", Scand. J. Soc. Welfare 5 (1996), 229-37.

The Canadian Bill C-47 on reproduction has been scrapped since the government has called for an election (see EJAIB 7 (1997), 59. A Canadian study found single mothers were significantly more likely than the mothers in 2-parent families to be poor, to be 25 years of age or less, to have mental health problems (dissatisfaction with multiple aspects of life, affective disorder ever and 1 or more psychiatric disorders in the past year or ever) and to use mental health services; Lipman, EL. et al. "Single mothers in Ontario: sociodemographic, physical and mental health characteristics", CMAJ 156 (1997), 639-45; Avison, WR. "Single motherhood and mental health: implications for primary prevention", CMAJ 156 (1997), 661-3.

A change in male proportion among newborn infants in Europe is debated in Lancet 349 (1997), 804-6. A study showing the great increase in multiple birth pregnancies for a small group of women using ARTs is BMJ 314 (1997), 775-9. The letter by Verma in EJAIB 7 (1997), 67, explains the fate of the doctor who conducted the first Indian case of IVF, Hindustan Times (20 Feb 1997).

New members of the UK HFEA are listed in BME 125 (1997), 7. A method for injecting ooplasmic round spermatids is reported in J. Assisted Reprod. & Genetics 14 (1997), 55+; F&S 67 (1997), 559-61; and on male infertility, Lancet 349 (1997), 787-90; NEJM 336 (1997), 994+; JAMA 277 (1997), 963-4. There is continued debate in South Africa over cross-racial adoption, Newsweek (14 April 1997), 20-1.

A number of reports on cloning continue: Geneletter 1(5) (March 1997); Nature Biotechnology 15 (1997), 293-4, 306; Nature 385 (1997), 769, 771; 386 (1997), 1, 8-9, 97-8, 119, 204; Science 275 (1997), 1271, 1733; Nature Medicine 3 (1997), 370-1; Nature Genetics 15 (1997), 323; Economist (1 March 1997), 16; Lancet 349 (1997), 705, 785; BMJ 314 (1997), 697; GEN (1 April 1997), 4, 35; Science and Engineering Ethics 3 (1997), 106-8; BME 126 (1997), 4-6, 8; NS (1 March 1997), 3, 4-5; (15 March 1997), 3, 4; (22 March 1997), 49; Time (10 March 1997), 28-41. (see also newspaper reports in section on Biotechnology and the Public). On philosophical issues, Roberts, M.A. "Human Cloning: A Case of No Harm Done? J. Med. Phil 21 (1996), 537-554. An editorial asking why the UK Ministry of Agriculture or Animal procedures Committee did not start discussion of the issues of cloning earlier, since they knew the state of the research, is BME 125 (1997), 1. A case study on cloning for education is on the Access Excellence site . A discussion of how science reporters also become moralizers is Probe V (11, April 1997), 1, 4. On 26 March The Japanese Ministry of Education issued a statement to stop human cloning research in its facilities, in case anyone was doing such research, following a statement of 21 March by the Science Council.

The best approach may be a moratorium rather than a ban on human cloning, but there will be much discussion. The European Parliament has called for a world ban on cloning, BMJ 314 (1997), 847; and the issue may get specifically included in the UNESCO Genome Declaration, to be discussed and adopted later this year. See also papers by Morioka, and Anees in EJAIB 7 ( May 1997), and the editorial.

Background on how the Council of Europe may regulate embryos is Byk, C. "A proposed draft protocol for the European Convention on Biomedicine relating to research on the human embryo and fetus", JME 23 (1997), 32-7. The European Bioethics Convention has been signed, see Medical law section below. On philosophical status of the human embryo, Howsepian, AA. "Lockwood on human identity and the primitive streak", JME 23 (1997), 38-41.

The UK lady, Mrs. Blood, who sought to take her dead husband's sperm to Belgium so she could implant it was awarded the sperm and is undergoing infertility treatment there, BME 125 (1997), 5. On the issue in general, Peng, FC. "Post-mortem insemination: Taking sperm from the dead", Health Law Review 5 (3) (1997), 18-24; Capen, K. "Lesbians, artificial insemination and human-rights laws: Can doctors place limits on their medical practices?", CMAJ 156 (1997), 839-40. In Australian three women in a defacto relationship have won a case against Victorian IVF legislation on the grounds it is discrimination, Lancet 349 (1997), 860. A book review is JME 23 (1997), 61-2. On the psychology of infertility, Lloyd, M. "Condemned to be meaningful: Non-response in studies of men and infertility", Sociol. Health & Illness 18 (1996), 433-54; Gillet, WR et al. "Feelings of couples who have had a child by donor insemination: the degree of congruence", J. Psychosom. Obstet. Gynecol. 17 (1996), 135-42; Daniels, KR. et al. "Families and donor insemination: the views of semen donors", Scand. J. Soc. Welfare 5 (1996), 229-37.

The Canadian Bill C-47 on reproduction has been scrapped since the government has called for an election (see EJAIB 7 (1997), 59. A Canadian study found single mothers were significantly more likely than the mothers in 2-parent families to be poor, to be 25 years of age or less, to have mental health problems (dissatisfaction with multiple aspects of life, affective disorder ever and 1 or more psychiatric disorders in the past year or ever) and to use mental health services; Lipman, EL. et al. "Single mothers in Ontario: sociodemographic, physical and mental health characteristics", CMAJ 156 (1997), 639-45; Avison, WR. "Single motherhood and mental health: implications for primary prevention", CMAJ 156 (1997), 661-3.

A change in male proportion among newborn infants in Europe is debated in Lancet 349 (1997), 804-6. A study showing the great increase in multiple birth pregnancies for a small group of women using ARTs is BMJ 314 (1997), 775-9. The letter by Verma in EJAIB 7 (1997), 67, explains the fate of the doctor who conducted the first Indian case of IVF, Hindustan Times (20 Feb 1997).

New members of the UK HFEA are listed in BME 125 (1997), 7. A method for injecting ooplasmic round spermatids is reported in J. Assisted Reprod. & Genetics 14 (1997), 55+; F&S 67 (1997), 559-61; and on male infertility, Lancet 349 (1997), 787-90; NEJM 336 (1997), 994+; JAMA 277 (1997), 963-4. There is continued debate in South Africa over cross-racial adoption, Newsweek (14 April 1997), 20-1.

The ethics of cloning is discussed in numerous papers and letters, Lancet 349 (1997), 1401; NS (31 May 1997), 3, 12; SA (May 1997), 15-6; JAMA 277 (1997), 1023-6, 1102-3; Nature 388 (1997), 15; Dispatches 7 (2, Spring 1997), 1-6; Monash Bioethics Review 16 (2, April 1997), 1-5; Biomedical Ethics 2 (1, 1997); CSTPE Newsletter 6 (6, May/June 1997), 1-3; SRT Bulletin 13 (May 1997); The Sciences 37 (3, May/June 1997), 10-1; Univ. Pennsylvania Center for Bioethics Newsletter 2 (3, Spring 1997), 1, 5. the EU Group of Advisors on the Ethical Implications of Biotechnology has said in a statement of 28 May 1997, that the cloning of humans is ethically unacceptable, but animal cloning is acceptable if welfare is considered, Nature 387 (1997), 536. The 12 March 1997 resolution of the European Parliament is in BME 128 (May 1997), 10-11. The UK House of Commons Science and Technology Committee has called to modify the UK law to ban cloning, GenEthics News 17 (April/May 1997), 1-2. RAFI made a statement on 8 May against cloning and the patents that have been applied for, NS (26 April 1997), 25. The International Publication Numbers on the patents are WO 97/07668 and 97/07669, and include the method for nuclear transfer cloning. President Clinton announced on 6 June that he would send legislation to Congress to outlaw the use of cloning techniques to make a human child, following recommendations of the National Bioethics Advisory Commission, Lancet 349 (1997), 1752; Science 276 (1997), 1185-6, 1640; NatGen 15 (1997), 323-4; Nature 387 (1997), 217, 323, 644, 748, 754; USA Today (6 June 1997), 1. The Director of WHO has also called it unacceptable, JAMA 277 (1997), 1105.

In Japan a survey by Yomiuri Shimbun found 54% want to have some type of law to prevent cloned humans, Yomiuri Shimbun (9 May 1997), 2. In the USA in June there was debate over how a researcher conducted embryo research inspite of a US law against it using federal funds, Nature 387 (1997), 833. Some animals (18 species) use polyembrony for reproduction, such as Armedillo. A group of scientists from the International Academy of Humanism signed a letter in Defense of Cloning and the Integrity of Scientific Research, rejecting those who are attempting to outlaw it, Science 276 (1997), 1341. Other scientists defend cloning in animals only, Nature 387 (1997), 324; 388 (1997), 6.

On the decrease in sperm levels see papers in Environment & Health News 2 (No.3, March 1997), 12. Chemotherapy induces transient aneuploidy in human sperm, NatGen 16 (1997), 74-8. The UK GMC has issued guidelines on male circumcision, BMJ 314 (1997), 1573; and a study suggests it has little affect on health, JAMA 277 (1997), 1052-7. Others suggest it has bad psychological affects, Lancet 349 (1997), 1257-8. The ethics are discussed in Denniston, GC. "Circumcision: An ethical and human rights impact assessment", CQHE 6 (1997), 89-92; Price, C. "Male circumcision: an ethical and legal affront", BME 128 (May 1997), 13-9.. On analgesia for it, NEJM 336 (1997), 1197-201, 1244-5. Ritual female circumcision is reported in Asali, A. et al. "Ritual female genital surgery among Bedouin in Israel", Archives Sexual Behaviour 24 (1995), 573-7. A study on European noble families suggests daughters of older fathers may die earlier, Science 276 (1997), 1503. Cattle breeders can now buy sex-specific sperm from XY Inc, Fort Collins, Colorado, Science 276 (1997), 1503.

A special report is Ethics Committee, American Society for Reproductive Medicine, Ethical Considerations of Assisted Reproductive Technologies (May 1997), F&S Supplement 9S. The duties of ethical committees are discussed in J. Assisted Reproduction & Genetics 13 (1996), 689-97. Also on the ethics, Baird, P. "Individual interests, societal interests, and reproductive technologies", Persp. Biol. & Med. 40 (1997), 440-51. A number of abstracts from the 16th World Congress on IVF and Assisted Reproduction are in J. Assisted Reproduction & Genetics 14 (1997), 7S, 38-9S, 46-9S. Also on ethics, CQHE 6 (1997), 148-56; Humane Health Care International 13 (1997), 6-7, 29-31.

On IVF in Singapore, J. Assisted Reproduction & Genetics 14 (1997), 527-35; in Victoria, Australia, J. Assisted Reproduction & Genetics 13 (1996), 5-8; Western Australia, pp. 197-200; Germany, pp. 193-5; Czech, pp. 195-6; and an overview, J. Assisted Reproduction & Genetics 14 (1997), 69-72. On the ethics in Islam see, Begum, H. "Issues related to implementation of reproduction technology in Islamic societies", Bioethics 11 (1997), 341-7. A report on the Hong Kong bill is Becker, GK. "Hong Kong's human reproductive technology bill", Ethics and Society Newsletter (Centre for Applied Ethics, Hong Kong Baptist University), 5 (May 1997), 2-7. A survey of the world found 29 jurisdictions have relevant statutory legislation on IVF, IAB News 5 (Spring 1997), 2-4.

A debate on whether egg donors should be paid is in BMJ 314 (1997), 1400-3; and on surrogacy, Lancet 349 (1997), 1487. Oocyte donation can have increased rates of conception for some infertile couples, F&S 67 (1997), 717-23; but sisters may not be ideal donors, F&S 67 (1997), 912-6. A review on guidelines for sperm donation is Meirow, D. & Schenker, JG. "The current status of sperm donation in assisted reproduction technology: Ethical and legal considerations", J. Assisted Reproduction & Genetics 14 (1997), 133-8; and on anonymity, Bioethics 11 (1997), 336-40. A 63 year old first time mother gave birth to a baby transferred after IVF, Paulson, RJ. et al. "Successful pregnancy in a 63-year old woman", F&S 67 (1997), 949-51; Newsweek (5 May 1997), 37; Guardian (5 June 1997), 4. Age effects are discussed in F&S 67 (1997), 702-10. The question whether infertility treatment should be offered to couples at high genetic risk is in Biomedical Ethics 2 (1, 1997). On the need for counseling, J. Assisted Reproduction & Genetics 14 (1997), 181-91. The success rate of IVF and safety seem similar to natural conception, F&S 67 (1997), 1077-83. The auditing of success rate is discussed in F&S 67 (1997), 830-6; J. Assisted Reproduction & Genetics 13 (1996), 1-5. A paper on the results for women is Purdy, LM. "What can progress in reproductive technology mean for women", J. Med. & Phil. 21 (1996), 499-514. On the relationship between fetus and mother, J. Med. & Phil. 21 (1996),515-35.

UK doctors can not use law to force cesarean sections on unwilling mothers, Lancet 349 (1997), 1006;and the details of Re "MB" on 18 Feb. 1997 are in BME 127 (April 1997), 21-4. Delivery after one cesarean is successful 50-60% of the time, AJOG 176 (1997), 741-4. Letters on the right number of cesarean sections are in Lancet 349 (1997), 1557.

Reappraisal of postmenopausal hormone therapy is called for in NEJM 336 (1997), 1821-2. On sexual dysfunction, BMJ 314 (1997), 1432; NEJM 336 (1997), 1766. The most important factor for success for cryoimplantation was embryo quality, J. Assisted Reproduction & Genetics 14 (1997), 201+; and on ethical issues, J. Assisted Reproduction & Genetics 13 (1996), 755-61.

The Committee of government experts to UNESCO met in 22-25 July, 1997, in Paris and added several items to the UNESCO IBC Declaration on the Human Genome. A revised draft has been released. Perhaps the most talked about addition is Article 11 is modified to read "Practices which are contrary to human dignity, such as reproductive cloning of human beings, shall not be permitted. States and competent international organizations are invited to cooperate in identifying such practices and in determining, nationally or internationally, appropriate measures to be taken to ensure that the principles set out in this Declaration are respected". This has been criticized, Nature 388 (1997), 501, 508; as it has by some members of the IBC who had tried to make the Declaration not to mention any techniques. It is difficult to see how splitting an embryo into to, as a twin clone, to help the chances of a successful pregnancy for infertility treatment is contrary to human dignity. However strong pressure from Germany and Canada pushed the inclusion of the phrase. The Declaration is to be adopted in Oct/Nov at the General Assembly of UNESCO, and we can hope that there will be more discussion of the consequences of inclusion of a ban which is not universally seen as logical.

On the five year ban on human cloning in the USA, Shapiro, HT, "Ethical and policy issues of human cloning", Science 277 (1997), 195-6; NS (14 June 1997), 7; JAMA 278 (1997), 13-4; GenEthics News 18 (June/July 1997), 3. Also on ethics of cloning (see previous issue), Nature 388 (1997), 505, 611; NatMed 3 (1997), 710; BioScience 47 (1997), 340; HCR 27 (1997), 5; KIEJ 7 (1997), 171-80; Otago Bioethics Report 6 (2, 1997), 11-5; CSTPE Newsletter 7 (1, 1997), 2-3; GEN 17 (August 1997), 1, 6, 50; NatBio 15 (1997), 406, 488, 600, 609, 705. The French Bioethics Committee report on the cloning is in Les Cahiers 12 (July 1997), 17-39. Human stem cells from embryos can be grown, and have been used for research for some time, NS (19 July 1997), 3, 4. However to prove that they are ES cells requires mixing into embryos which is outlawed in many countries. On animal models see the section on animal genetic engineering above, for example nuclear transfer in cows (Biology of Reproduction 57 (1997), 204-13) and sheep is known to work.

The ethics and policy of surrogacy in New Zealand is discussed in Otago Bioethics Report 6 (2, 1997), 1-4. There are also several other papers on embryos and regulation of research in the same issue. A call to think rationally about surrogacy is NS (12 July 1997), 46; and the UK policy is being reviewed, BMJ 314 (1997), 1782. The Victorian (Australia) Infertility Treatment Act 1995 is in IDHL 48 (1997), 24-33. The director of the NIH in the USA faced tough questions over the embryo experiments of Mark Hughes in 1996, and said that they would be more careful in the future, Science 276 (1997), 1963.

In Japan the MHW has attempted to gather public opinions on sibling egg and sperm donation, Japan Times (14 Jan. 2003). A case of a sperm donor who suffered from an inherited disease in Holland is discussed in JME 28 (2002), 213-4. Use of older gametes may present some risks, Lancet 359 (2002), 1670-1. Designer children are discussed in BMJ 325 (2002), 771-3; NatMed. 8 (2002), Fertility Supplement s29s23-8. The views of the UK HFEA on sex selection are reported in BME 182 (Oct. 2002), 3-4; NS (14 Sept., 2002), 42-5. In general on sex selection in the USA, F&S 78 (2002), 460-3. Gender and health in China is discussed in SSM 55 (2002), 1039-54. Legal protection of posthumous children is discussed in HCR 32 (Nov. 2002), 8-9. Two UK women asked to be allowed to use embryos without the former partner7s consent, BMJ 325 (2002), 617. Papers on the Canadian Assisted Human Reproduction Act are in Health Law Review 11 (2002), 3-71. ART in Israel is reviewed in SSM 55 (2002), 511-3. Pregnancy in the 50s is reported in JAMA 288 (2002), 2320-3.

The economic impact of ART is discussed in NatMed. 8 (2002), Fertility Supplement s29-32.  Some clinics implant too many embryos to boost their success rates, NS (13 July., 2002), 4. The coding of procedures in ART is discussed in F&S 78 (2002), 1344-6.  Micromanipulation of gametes and embryos may be a risk for human germ-line gene transfer, F&S 78 (2002), 455-9. A review on the science of ART is Science 296 (2002), 2188-90.

           Outcomes of reproductive technology in Australia are reviewed in Bioethics Research Notes 15 (2003), 1-3. Legal status after adoption is discussed in Family Law Quarterly 36 (Fall 2002), 449-71. The barriers to adoption in India are discussed in SSM 56 (2003), 1867-80.  Suicide in intercountry adoptees in Sweden is reported in Lancet 360 (2002), 423, 443-8. Insurance and outcomes after IVF in USA are compared in NEJM 348 (2003), 958-9.

           New reproductive technology in Egypt is reviewed in SSM 56 (2003), 1837-51. In general on ART policy, Ethics and Medicine 18 (2002), 145-54; NEJM 348 (2003), 1507-8; Nature 422 (2003), 647, 656-8; SSM 56 (2003), 1831-6; BMJ 326 (2003), 518; in Brazil, Developing World Bioethics 2 (2002), 144-58; Greece, SSM 56 (2003), 1853-66; and on Spain, Law and the Human Genome Review 17 (July 2002), 205-14. Design of children is discussed in RSA J. (April 2003), 34-7. Changes to the UK HFEA are discussed in BME 186 (2003), 1, 2, 13-5. Reproductive tourism is discussed in JME 28 (2002), 337-41.

           The case of when a sperm donor suffers years later from an inherited disease is debated in JME 28 (2002), 213-4. On posthumous semen retrieval, JME 28 (2002), 299-303.  Polygamy among Malian migrants to France is reported in SSM 56 (2003), 1961-72. On sperm size, Current Biology 13 (2003), R355-6.

A survey of the situation of US fertility clinics in 2002 is reported in F&S 79 (2003), 1060+. A book review of IVF Children is JAMA 289 (2003), 2288-9. Zygotic splitting rates after single embryo transfers are discussed in NEJM 348 (2003), 2366-7. Use of ART and association with rare congenital disorders is discussed in Lancet 361 (2003), 1975-7. The question whether infertility medicatioNS affect breast cancer risk is debated in F&S 79 (2003), 844-55. Use of recombinant chorionic gonadotropin in induction of ovulation is reported in F&S 79 (2003), 1051-9; also, F&S 79 (2003), 1037+..

Ethics of intersex changes is discussed in HCR 33 (July 2003), 12-3. A special supplement is Parens E. & Knowles LP., "Reprogenetics and public policy: Reflections and Recommendations" is HCR 33 (July 2003), S1-24. Surrogacy and adoption are compared in National Catholic Bioethics Quarterly 3 (2003), 309-30. On surrogacy in Israel, Med. Anthropology Quarterly 17 (2003), 78-98. Cases in the UK on choice of babies are discussed in BME 188 (May 2003), 7-8. Egg donation is discussed in Lancet 362 (2003), 413; BMJ 327 (2003), 250.

The definition of infertility is discussed in Bioethics Research Notes 15 (Dec 2003), 45-7. Research using mice suggests adult females may produce eggs, Science 303 (2004), 1593. Mouse eggs have been fertilized by artificial sperm, NS (13 Dec. 2003), 19.

Sex selection is discussed in Indian J. Medical Ethics 1 (2004), 53; GeneWatch 17 (Jan. 2004), 3-5; BMJ 327 (2003), 1007. The UK HFEA has recommended a ban on it, BMJ 327 (2003), 1123. Gamete donor anonymity is discussed in Health Law Review 12 (2003), 39-45; F&S 81 (2004),527-30. On family members as gamete donors or surrogates, F&S 81 (2004), 1124-9. The UK is expected to remove anonymity for sperm donors, BMJ 328 (2004), 244. Israel is allowing the removal of sperm from dead men at the request of their wives, BMJ 327 (2003), 1187. Genetic paternity testing is discussed in CQHE 13 (2004), 49-60. On use of ARTs for HIV infection, JME 29 (2003), 313-29. Scandinavian recommendatioNS on sperm donation and women as research subjects are in BME 191 (2004), 8-11. On suggested legal changes to the regulation of ART in New Zealand, New Zealand Bioethics J. 4 (2003), 4-7. On human chimeras, NS (15 Nov. 2003), 34-6.

Surrogacy is discussed in Formosan J. Medical Humanities 5 (2004), 48-62. Ovarian function may be preserved in cancer patients, F&S 81 (2004), 243-57. Papers on the safety of ISCI are in F&S 80 (2003), 508-12, 526-30, 646-48, 851-9, 930-5, 1077-85. On the disposition of frozen reproductive tissue, F&S 80 (2003), 584-9. Rules in Victoria, Australia to govern import of gametes are debated in J. Law, Medicine and Ethics 31 (Fall 2003), 239-56. Guidelines on posthumous reproduction in Israel allow it under some cases, HCR 34 (March 2004), 6-7. Also on posthumous fatherhood, F&S 81 (2004), 223-4. Conception for donation is debated in JAMA 291 (2004), 2079, 2125-6. Also on sperm donation and banking, BMJ 327 (2003), 1354.
Trends in embryo transfer practice and outcomes in ART in USA are reviewed in NEJM 350 (2004), 1639-45, 1603-4. US politics and the president's Bioethics Council report on ART are discussed in Science 304 (2004), 188. On ART psychosocial concerns, F&S 81 (2004), 271-8, 532-8, 982-8; SSM 57 (2003), 2325-41. Individual physiciaNS vary in success even in the same clinic, F&S 81 (2004), 944-6. Epigenetics and ART should be examined more, AJHG 74 (2004), 599-609; and on the safety, F&S 81 (2004), 512-3. Multiple births are still a problem, F&S 81 (2004), 517-22.
The infertility of George Washington is discussed in F&S 81 (2004), 495-9. Selective abortion against girls in India is discussed in Lancet 362 (2003), 1553; BMJ 327 (2003), 1297-8.

           The UK ART laws are under discussion, BME 196 (2004), 3-4. The secrecy of DI is discussed in Rushbrooke, R. "Donor insemination: the secret experiment", BME 196 (2004), 13-22. In Japan the offering of preimplantation diagnosis for nondisease conditions is a matter of much debate, Mainichi Shimbun and Asahi Shimbun (27 May 2004), 1. The question of designer babies is discussed in Newsweek (2 Feb. 2004), 44-9; JAMA 291 (2004), 2306-8. The US President's Bioethics Council has called for more studies of ART, Nature 428 (2004), 590.

           A reduction in the number of twin pregnancies after IVF will save money, F&S 81 (2004), 1240-6. A report from international studies of IVF and ART is Supplement 4, F&S 81 (May 2004),  S1-50. The 2000 year US results from ART at 383 programs is summarized in F&S 81 (2004),  1207-20. The delivery rate per retrieval of eggs was 30%.  Emotional adaptation following successful IVF is discussed in F&S 81 (2004), 1254-64. Research on mice suggests extension of reproductive age may be possible, Newsweek (22 March 2004), 46-7. The perinatal outcomes of singleton births after ART is worse than from normal fertilization, BMJ 328 (2004), 261-4.

Papers on ethics of ART regulation include HCR 34 (July 2004), 14-7. A new law in Italy bans freezing and destroying embryos and limits the number of oocytes to be fertilized to 3, BMJ 329 (2004), 71, 1334. It also forbids preimplantation diagnosis. On ethics of preimplantation diagnosis, NS (12 June 2004), 6-7. Papers on artificial procreation in Italian are in Alpha Omega VII (April 2004), 91-114; VII (July 2004), 301-26. A survey suggesting 30% of couples would donate embryos is Burton, PJ. & Sanders, K. "Patient attitudes to donation of embryos for research in Western Australia", MJA 180 (2004), 559-61. In general on ethics of IVF, Sexuality, Reproduction & Menopause 2 (June 2004), 61-3. Sex selection is discussed in NS (12 June 2004), 3, 7; Bioethics 18 (2004), 205-20. China plans to ban sex-selection abortions in order to balance gender of births, Japan Times (16 July 2004), 4. Selection for tissue typing is discussed in NS (24 July 2004), 3; Current Biology 14 (2004), R594.

A discussion of how many eggs to use in ART is BMJ 329 (2004), 302-3, 311-4. There are no extra neurological risks of children after ICSI and IVF according to a Danish study, BMJ 329 (2004), 311-4. However children born from IVF were found 9 times more likely to have a rare disorder Beckwith-Wiedemann syndrome, NS (14 Aug. 2004), 11. A paper on procreative liberty versus harm to offspring in ART is AJLM 30 (2004), 7-40. Ovarian transplants can restore fertility in cancer patients, NatMed. 10 (2004), 764; NS (3 July 2004), 4. Ovaries may make eggs throughout life, NS (10 July 2004), 8. The lesbian baby boom using IVF is discussed in Sexuality, Reproduction & Menopause 2 (June 2004), 83-8. Disclosure decisions among oocyte donation recipients in the USA were the same whether using known or anonymous oocytes, F&S 81 (2004), 1565-71. Egg sharing is discussed in F&S 82 (2004), 74-9. Disclosure after DI is discussed in F&S 82 (2004), 172-9; Modern Law Review 67 (2004), 658-69. 

On masculinity and infertility and the media, SSM 59 (2004), 1169-75. Some possible infertility increase was reported in Gulf war veterans in the UK, BMJ 329 (2004), 196-200. The terminology used in reproductive medicine is discussed in F&S 82 (2004), 36-40.