What can be learned from the Chinese experience in response to infertility.

OBJECTIVES: The aims of the study were to reviews the history of China's population policy since 2011, and draw lessons from the Chinese experience in response to infertility. METHODS: Data from the Chinese infertility status survey report (2009) and national statistical yearbooks (2009-2019) are used to assess the severity of infertility and reproductive centers shortage in China. Lessons from China was informed by a review of existing literature. RESULTS: The proportion of couples suffering from infertility in China increased to 12.5% (166.8 million in 2009) from just 6.89% (86.6 million in 1988) two decades earlier, while the number of reproductive centers was one for every 3.1 million citizens. The total costs per live birth for medically assisted reproduction in Chinese public fertility clinics was 30,000 yuan in 2012. Among infertile couples, unemployed patients accounted for the largest proportion (21.9% in 2014). Currently in China, health regulations permit oocyte donation only from infertility patients who have 20 or more mature oocytes, of which at least 15 must be kept for their own treatment. CONCLUSION: It is necessary to integrate the reproductive health care of infertile people into the national public health service. In addition to relieving their economic burden, national policies should guide and support enterprises to guarantee employee medical leave for infertility. Growing numbers of bereaved older women who have lost their only child make it imperative to reconsider liberalizing the regulation of oocyte donation in China.

Ex ovo omnia? A letter to members of The Ovum Club on the 50th anniversary of the beginning of IVF.

This writing presents personal reflections on issues raised by the recent publication of texts concerning the developing story of infertility treatment since the delivery of Louise Brown in 1978. It is written by a woman whose own natural conception coincided with the commencement of Steptoe and Edwards's collaboration, and who herself received, as an adult, a treatment to which their work gave rise. It addresses itself to the as yet mostly anonymous and silent female subjects-the self-styled 'Ovum Club'-without whose involvement in the original research programme in Oldham in 1969-1978 Louise would never have been born, to be followed by millions of in vitro fertilisation (IVF) babies worldwide. It ponders a few of the characteristics of the celebratory narratives of the development of IVF as have so far been told and draws attention to some of the paradoxes, inconsistencies, misunderstandings and confusions apparent in texts which have played a crucial role in shaping public awareness of this branch of medical science for 50 years. In conclusion, it points out that without hearing a range of voices of those women involved in the original experimental research who mostly lost more than they gained, a more compassionate historiography, and a balanced and comprehensive History of this branch of medicine will never be attained.

Infertility and surrogacy first mentioned on a 4000-year-old Assyrian clay tablet of marriage contract in Turkey.

Mankind has been expressing the breeding topic for thousands of years. Reproduction is the primary instinct of human beings and it is a social, cultural, medical issue. Demographic infertility is one of them, which is defined infertility as the inability to become pregnant with a live birth, within five years of regular sexual contact based upon a consistent union status in marriage maintaining a desire for a child with the lack of contraceptive use and non-lactating. A first mentions about infertility and surrogacy is discovered on a 4000-year-old clay tablet of marriage contract belonging to the Assyrian period exhibited at Istanbul Archeology Museum in Turkey. In conclusion, there are many different ways to solve infertility problems like surrogacy as mentioned even 4000 years ago in this Assyrian clay tablet of marriage contract as the first time in the literature. Medical treatments in relation to human infertility will continue to be the focus of social and cultural debates. Hence, more legislation and regulation will come in many countries to control the unauthorized exploitation of the patient.

Race, Remarital Status, and Infertility in 1910: More Evidence of Multiple Causes.

The dominant approach to studying historical race-related fertility differences has been to limit samples to first-married and younger women. We argue that studying historical race-related fertility differences in the context of remarriage is also important: remarriage and fertility patterns are both rooted in the biosocial conditions that produce racial disparities in health. We employ a multiple causes framework that attributes variation in fertility patterns to voluntary limitation and involuntary factors (infecundity/subfecundity). We use data from the 1910 Integrated Public Use Microdata Series and estimate zero-inflated negative binomial models that simultaneously distinguish those who are infecund (vs. fecund) and estimate the number of remarital births among the fecund. Our approach allows us to evaluate historical remarital (in)fertility differences, accounting for marital, socioeconomic, and geographic influences on fecundity and fertility, while empirically accounting for the influence of children "missing" from the household due to mortality and fostering/aging out. Consistent with past studies that emphasized poorer African American health as a major influence on involuntary infertility, we find that African American women were more likely than white women to be in the always-zero (infecund) group and to have fewer remarital births. Supplemental analyses nuance these findings but indicate that these results are robust. Overall, we find support for a multiple-causes perspective: while the findings are consistent with the adoption of deliberate fertility control among urban and higher-status women at higher parities, remarital fertility differences in 1910 also reflected greater infecundity/subfecundity among subgroups of women, especially African American women.

Social Perception of Infertility and Its Treatment in Late Medieval Italy: Margherita Datini, an Italian Merchant's Wife.

Because the perception of infertility in medieval Europe ranged from the extremely religious view of it as a malediction of God or the devil's work, to the reasonable medical conception of it as a sort of disease to treat, it is very difficult to determine the general attitudes of ordinary people towards infertility. This article seeks to elucidate the common social perception of infertility and its treatment in late medieval Europe by analyzing the case of Margherita Datini, an Italian merchant's wife who lived in the 1400s. It relies heavily on the documents left by her and her husband, Francesco Datini; the couple left many records, including letters of correspondence between them. Margherita and those around her regarded infertility not as the devil's curse or a punishment by God but as a disease that can be cured. Margherita and her husband, Francesco, tried hard to cure their infertility. They received treatment and prescriptions from several doctors while also relying on folk remedies, religious therapies, and even magical remedies. The comparative analysis of Datini documents, medical books, and theoretical treatises or prescriptive essays by clerics suggests that the general perception of infertility in medieval Europe was located between the extremely religious and modern medical conceptions of it.

Historical walk: the HRP Special Programme and infertility.

BACKGROUND/AIMS: The HRP Special Programme (HRP) began addressing 'reproduction' problems (infertility) at the same time as 'fertility regulation' (contraception). METHODS: This report is based upon data collected from official HRP Scientific and Technical Reports. RESULTS: In the 1970s, HRP supported research on human and nonhuman primate models to address the basic biology of reproduction. Importantly, however, it was the multicountry clinical research studies sponsored by HRP during the 1970s and 1980s which led to the identification of not only the large burden of disease but also global patterns of causation of infertility. The next decade saw the development of WHO guidelines and manuals for diagnosis, management, and treatment of infertile women and men, with HRP-sponsored operations research focused on adaptation within primary health care settings. Consensus consultations held during 2001 through 2011 resulted in recommendations to stakeholders, as well as the identification of barriers and inequities in access to infertility care services. CONCLUSION: With renewed focus on infertility through the current development of revised guidelines and manuals, and the desire to support critical clinical research protocols, including adaptation and implementation research for management and monitoring tools being developed through international partners, HRP will continue to support future success stories in family, maternal, child, and reproductive health.

Intracytoplasmic sperm injection 30 years on: too much of a good thing?

Intracytoplasmic sperm injection (ICSI) was introduced for male infertility but is now used in many other techniques in assisted reproduction. Indications for ICSI use need to be re-evaluated to ensure appropriate application in infertility management.

The African American experience in reproductive medicine: provider, patient, and pipeline perspectives.

The goal of this Views and Reviews is to let colleagues and leaders well versed in the African American experience in reproductive medicine address the problems of racism affecting our trainees and patients and, more significantly, propose solutions. The areas in reproductive medicine that will be explored from the African American perspective include the pipeline of providers, health disparities, and access to infertility treatment.

Remedial agents: missionary physicians and the depopulation of Hawai'i.

This article examines the activities and perspectives of nineteenth-century American missionary physicians in the Hawaiian Islands. The physicians' attitudes toward Hawaiian morbidity and depopulation are viewed in relation to the greater missionary community's role in the political transformation of the island nation. The article argues that missionary physicians monitored and reported on Native Hawaiian depopulation (a result of introduced western diseases) while simultaneously advertising the islands' benefits to American consumptives, imperialists, and others. Mission doctors also failed to respond effectively to the greatest epidemiological crisis Hawai'i had ever faced: a venereal scourge with a resulting blight of Native Hawaiian infertility. As a result of these and other factors, American hegemony in Hawai'i by midcentury was a foregone conclusion.

Childlessness predicts helping of nieces and nephews in United States, 1910.

The 'helpers at the nest' hypothesis suggests that individuals who are not currently reproducing often help kin by caretaking and thereby increase their inclusive fitness. Using a large scale historical dataset (Integrated Public Use Microdata Series sample of 1910; n=13,935), the hypothesis is tested that childless couples are more likely to fulfil such a role by taking care of a niece or nephew, but not a parent, than couples with children. Childless couples were significantly more likely to take care of a niece or nephew than couples with children. In contrast, couples with children and childless couples did not differ in caretaking of parents. Childless couples were also more likely to have more and younger nieces/nephews in their home than couples with children.

Ovarian hyperstimulation: past, present, and future.

The good physician treats the disease; the great physician treats the patient who has the disease. -William Osler.

Tuberculosis, bronchiectasis, and infertility: what ailed George Orwell?

In the last and most productive years of his life, George Orwell struggled with pulmonary tuberculosis, dying at the dawn of the era of chemotherapy. His case history illustrates clinical aspects of tuberculosis with contemporary relevance: the role of poverty in its spread, the limited efficacy of monotherapy, the potential toxicity of treatment, and the prominence of cachexia as a terminal symptom. Orwell's ordeals with collapse therapy may have influenced the portrayal of the tortures of Winston Smith in the novel 1984. I discuss unifying diagnoses for Orwell's respiratory problems and apparent infertility, including tuberculous epididymitis, Young syndrome, immotile cilia syndrome, and cystic fibrosis.