Overview of the current situation of embryo donation in Belgian fertility centers.

OBJECTIVES: The aim of this study is to survey the current situation in Belgium regarding embryo donation (ED) practices and to explore the potential reasons for not offering this treatment option. STUDY DESIGN: A questionnaire was sent to all fertility centers in Belgium that are allowed to perform IVF regarding whether or not they perform ED for third parties, their overall experience with ED and the possible reasons for not doing it. The questionnaire was divided into three different sections, depending on whether the center currently performs ED for third parties, has never performed it or once performed it but no longer does. All respondents were anonymized. RESULTS: The questionnaire was returned by 16 out of 18 centers. Only three out of 16 centers currently perform ED. All these centers require additional actions before ED can be performed. Sometimes ED is not performed although it was indicated in the contract; the most important reasons are the need for additional investigations, the administrative obstacles and the non-eligibility of the embryos. Between 2017 and 2021, few ED were performed in these centers (n = 2, 38 and 6). Eight out of 16 centers previously offered ED but ceased. In two centers, patients who want to donate their supernumerary embryos are referred for treatment to a center where ED is performed, but none of these centers transfer embryos to a center performing ED. The main reasons for discontinuing ED were the additional investigations required and the unprofitable investment in time and personnel. Five out of 16 centers never offered ED. At one center, patients who still indicate ED for their supernumerary embryos are referred to a center performing ED. The reduction of the administrative burden and avoiding additional testing are the most indicated measures that could facilitate the introduction of an ED program. CONCLUSIONS: Embryo donation, although legally allowed, is currently hardly performed in Belgium. The reasons for this are mainly associated to additional mandatory post-hoc testing and the extra administrative burden which is not financially covered. Poor transparency and communication between Belgian centers may be an additional factor explaining the country's low embryo donation rate.

Potentiality switches and epistemic uncertainty: the Argument from Potential in times of human embryo-like structures.

Recent advancements in developmental biology enable the creation of embryo-like structures from human stem cells, which we refer to as human embryo-like structures (hELS). These structures provide promising tools to complement-and perhaps ultimately replace-the use of human embryos in clinical and fundamental research. But what if these hELS-when further improved-also have a claim to moral status? What would that imply for their research use? In this paper, we explore these questions in relation to the traditional answer as to why human embryos should be given greater protection than other (non-)human cells: the so-called Argument from Potential (AfP). According to the AfP, human embryos deserve special moral status because they have the unique potential to develop into persons. While some take the development of hELS to challenge the very foundations of the AfP, the ongoing debate suggests that its dismissal would be premature. Since the AfP is a spectrum of views with different moral implications, it does not need to imply that research with human embryos or hELS that (may) have 'active' potential should be completely off-limits. However, the problem with determining active potential in hELS is that this depends on development passing through 'potentiality switches' about the precise coordinates of which we are still in the dark. As long as this epistemic uncertainty persists, extending embryo research regulations to research with specific types of hELS would amount to a form of regulative precaution that as such would require further justification.

Transparency in controversial research: A review of human embryo research publication ethical disclosure statements.

In 2021, the International Society for Stem Cell Research (ISSCR) released updated guidelines that included human embryo research guidance. Requiring ethics statements in publications using human embryos is one way to verify adherence to these guidelines. A review of top-tier biomedical journal requirements identified only one publisher that requires a human embryo statement. A review of articles using human embryos from top-tier biomedical journals found that all contain some form of ethics statement, but they differ in content and location. Requiring ethics statements with specific elements could improve transparency and adherence to research guidelines.

El embrioide y sus leyes. Una breve aproximación al contexto internacional / L’embrioide i les seves lleis. Una breu aproximació al context internacional / The embryoid and its laws. A brief approach to the international context

En los últimos años el desarrollo de modelos in vitro con células madre humanas que simulan el desarrollo embrionario temprano ha vivido un gran progreso. Las dificultades para acceder a embriones humanos, la escasez de material embrionario y los desafíos técnicos, legales y éticos existentes sobre la investigación y experimentación con embriones humanos in vitro siguen siendo una barrera para avanzar en el conocimiento de la embriogénesis tras la gastrulación. Por ello distintos mecanismos celulares subyacentes a la formación de las líneas celulares en los seres humanos siguen siendo desconocidos. En el presente trabajo intentaremos reflejar varios de los aspectos que son motivo de incertidumbres jurídicas internacionales en relación con la investigación con embrioides como modelo experimental.(AU)

En els últims anys el desenvolupament de models in vitroamb cèl·lules mare humanes que simulen el desenvolupament embrionari primerenc ha viscut un gran progrés. Les dificultats per a accedir a embrions humans, l'escassetat de material embrionari i els desafiaments tècnics, legals i ètics existents sobre la recerca i experimentació amb embrions humans in vitrocontinuen sent una barrera per a avançar en el coneixement de la embriogènesi després de la gastrulació. Per això diferents mecanismes cel·lulars subjacents a la formació de les línies cel·lulars en els éssers humans continuen sent desconeguts. En el present treball intentaré reflectir diversos dels aspectes que són motiu d'incerteses jurídiques internacionals en relació amb la recerca amb embrioides com a model experimental.(AU)

In recent years, the development of in vitromodels with human stem cells that simulate early embryonic development has experienced great progress. The difficulties in accessing human embryos, the scarcity of embryonic material, and the existing technical, legal, and ethical challenges regarding research and experimentation with in vitrohuman embryos still represents a barrier to advancing in the knowledge of post-gastrulation embryogenesis. Therefore, different cellular mechanisms underlying the formation of cell lines in humans remain unknown. In the present work Iwill try to reflect several of the aspects that are the cause of internationallegal uncertainties in relation to research with embryoids as an experimental model.(AU)

The Ethics of Cellular Reprogramming.

Louise Brown's birth in 1978 heralded a new era not just in reproductive technology, but in the relationship between science, cells, and society. For the first time, human embryos could be created, selected, studied, manipulated, frozen, altered, or destroyed, outside the human body. But with this possibility came a plethora of ethical questions. Is it acceptable to destroy a human embryo for the purpose of research? Or to create an embryo with the specific purpose of destroying it for research? In an attempt to construct ethical and legal frameworks for the new era of cellular reprogramming, legislators and ethicists have tried to distinguish between different kinds of biological entity. We treat cells differently depending on whether they are human or animal, somatic cells or gametes, and on whether they are embryos or not. But this approach to the ethics of cellular reprogramming is doomed to failure for the simple reason that cellular reprogramming in itself destroys the distinctions that the law requires to function. In this article, we explore the historical trajectory of cellular reprogramming and its relationship with ethics and society. We suggest that the early hype of embryo research has not obviously fulfilled expectations, but since new avenues of research are continuously opening, it is hard to say definitely that these promises have been broken. We explore the forthcoming challenges posed by the creation of DNA from scratch in the laboratory, and the implications of this for understandings of identity, privacy, and reproduction. We conclude that while ethics used to seek answers in biological facts, this is no longer possible, and a new approach is required.

An ethical framework for human embryology with embryo models.

A human embryo's legal definition and its entitlement to protection vary greatly worldwide. Recently, human pluripotent stem cells have been used to form in vitro models of early embryos that have challenged legal definitions and raised questions regarding their usage. In this light, we propose a refined legal definition of an embryo, suggest "tipping points" for when human embryo models could eventually be afforded similar protection to that of embryos, and then revisit basic ethical principles that might help to draft a roadmap for the gradual, justified usage of embryo models in a manner that aims to maximize benefits to society.

Human stem cells turned into detailed lab replicas of embryos.

Mock embryos created by multiple groups recapitulate developmental events beyond implantation.

Perspectiva legal del manejo de embriones supernumerarios en Italia. Soluciones prácticas de Derecho comparado / [Legal perspective of the management of supernumerary embryos in Italy. Practical Comparative Law Solutions]

Los avances en el ámbito de la medicina reproductiva han situado en un lugar destacado una nueva entidad: el embrión humano. La reconstrucción de su identidad jurídica reviste una importancia primordial en aras de encontrar soluciones a una de las cuestiones más sensibles que actualmente impulsan el debate en el contexto italiano, a saber, el destino de los embriones supernumerarios. La presente contribución realiza una sucinta revisión de las aportaciones efectuadas por la doctrina y la jurisprudencia tanto a nivel nacional como europeo en relación con este asunto, para posteriormente ahondar en algunas propuestas de carácter práctico, analizando sus potencialidades y aspectos críticos. (AU)

The advances in the field of reproductive medicine have placed a new entity at the forefront: the human embryo. The reconstruction of its legal identity assumes paramount importance in the pursuit of finding solutions to one of the most sensitive issues currently driving the debate in the Italian context, namely, the fate of supernumerary embryos. This contribution provides a concise review of the contributions made by doctrine and jurisprudence, both at the national and European levels, concerning this matter. Subsequently, it delves into some practical proposals, analyzing their potentialities and critical aspects. (AU)

The Warnock report and partial ectogestation: retracing the past to step into the future.

Partial ectogestation continues to move towards human clinical trials. This article draws upon the Report of the Committee of Inquiry into Human Fertilisation and Embryology (Warnock Report) to provide guidance as to what may need to be considered for the future regulation of this technology. While the Warnock Report dates back to 1984, its significance and legacy continue to influence the current regulation of reproductive practices in the UK. By drawing upon specific elements within the report, many of the decisions and recommendations within it could provide direction for the future regulation of partial ectogestation. The role of the public, the social and political context at the time of the Warnock report, the determination of the status of the embryo, and arguments pitted against in vitro fertilisation (IVF) at the time, are all examined. As a result, this article suggests that the inclusion of the general public in the development and implementation of partial ectogestation prior to another Warnock-style inquiry will increase the success of long-standing regulatory and legislative provisions.

Chapitre 6. Révisions des lois de bioéthique et recherche sur l'embryon humain : une analyse psychosociale des États Généraux de la Bioéthique.

Bioethics are widely used in the course of biomedical science’s evolution. It allows to question ethical aspects underlying the setting of new research and clinical intervention techniques. This ethical thinking reflects norms and values socially admitted and question the way new scientific information are integrated to individuals’ system of knowing. Human embryo research, subject to bioethics laws revisions, represents an almost prototypical object of these issues, both lay and scientific. This study aims to study these issues through the context of bioethics revision laws, from users’ comments on Estates-General of Bioethics website, using the social representations theorical frame. A thematic content analysis has been performed. Results shows that embryo status is a structural argument of the debate, and that the opinion on human embryo research results from a set of ethical concerns that come from socially anchored values, accounting for the way individuals define science, biotechnologies and research on the living, that we also find in the bioethics legislation.

Shadowed by past, gene-editing summit looks to future.

London meeting touts sickle cell success, but questions about embryo editing linger.

Chapitre 6. Révisions des lois de bioéthique et recherche sur l'embryon humain : une analyse psychosociale des États Généraux de la Bioéthique.

Bioethics are widely used in the course of biomedical science’s evolution. It allows to question ethical aspects underlying the setting of new research and clinical intervention techniques. This ethical thinking reflects norms and values socially admitted and question the way new scientific information are integrated to individuals’ system of knowing. Human embryo research, subject to bioethics laws revisions, represents an almost prototypical object of these issues, both lay and scientific. This study aims to study these issues through the context of bioethics revision laws, from users’ comments on Estates-General of Bioethics website, using the social representations theorical frame. A thematic content analysis has been performed. Results shows that embryo status is a structural argument of the debate, and that the opinion on human embryo research results from a set of ethical concerns that come from socially anchored values, accounting for the way individuals define science, biotechnologies and research on the living, that we also find in the bioethics legislation.