Hot Topics: Reproductive Medicine

Blog Posts (79)

September 14, 2016

Pregnancy, stigma, and moral responsibility in the Zika epidemic

by Kelly McBride Folkers, BS

Pregnancy comes with great moral responsibility from mother to future child. A healthy pregnancy requires that pregnant women abstain from certain behaviors, like eating unpasteurized foods and drinking excessive amounts of alcohol.…

August 25, 2016

More on the Male Pill: Social Reasons Why It Is Good for Women and Men

In my previous blog , I discussed how the lack of male contraception reduces men’s reproductive autonomy and burdens women with the health-related and financial consequences of being the one responsible for contraception. In this blog, I want to explore some of the social burdens women face when contracepting, especially those that men do not and would not face when using contraception.

Women face the social burdens of contraception, which include medicalization of one’s reproductive health, the stress and worry about the possibility of an unintended pregnancy, social repercussions of one’s contraceptive decisions, and possible moral reproach for contraceptive failures. While men could potentially face some of these social burdens, several of them are specific to women. For example, since pregnancy occurs in a woman’s body, she will physically embody the stigma and shame of an unintended pregnancy whereas the man will not carry any physical reminder of it.

Another burden unique to women is the double-bind they face regarding contraceptive use. Women who use contraceptive may be seen as violating the feminine norm of chastity. Yet, if single women do not use contraception, they risk an unintended pregnancy, which is associated with irresponsibility and trying to “trap” a man.

Since men are not held to the norm of chastity, but rather are frequently lauded for sexual promiscuity, they are not socially penalized for engaging in sexual activity and using contraception. Thus, the development of male contraceptives could help women avoid this no-win situation while empowering men to control their reproduction.

The need for male contraceptives is often looked overlooked because contraception is often conflated with women, thereby marginalizing and even ignoring men. For instance, unmet need for contraception is generally calculated using only women’s information: their fertility intentions and their contraceptive use. Excluding men from questions about unmet contraceptive needs fails to recognize their role in and responsibility for contraception both in their personal relationships and on the social level. It moreover fails to acknowledge that men may also have unmet contraceptive needs.

One study in Western Africa that interviewed both women and men regarding unmet contraceptive need found that between 15 – 23% of husbands had unmet contraceptive need even though their wives did not. These men were not interested in having children, at least at that time, but the dearth of reversible male contraceptives limited their options for controlling their reproduction since their partner did not have unmet contraceptive need and was consequently not using female or shared methods (and the male condom is frequently considered a shared method).

One of the benefits of female LARCs is that the woman’s partner does not need to be involved in or even know about their use. This is a good option for women if they and their partner disagree about contraceptive use. Unfortunately, men have no alternative available to them that they can use without their partner’s involvement or knowledge, which raises justice concerns and highlights men’s diminished reproductive autonomy.

 

 


 [LC1]Hyperlink to my previous blog.

August 25, 2016

More on the Male Pill: Social Reasons Why It Is Good for Women and Men

In my previous blog , I discussed how the lack of male contraception reduces men’s reproductive autonomy and burdens women with the health-related and financial consequences of being the one responsible for contraception. In this blog, I want to explore some of the social burdens women face when contracepting, especially those that men do not and would not face when using contraception.

Women face the social burdens of contraception, which include medicalization of one’s reproductive health, the stress and worry about the possibility of an unintended pregnancy, social repercussions of one’s contraceptive decisions, and possible moral reproach for contraceptive failures. While men could potentially face some of these social burdens, several of them are specific to women. For example, since pregnancy occurs in a woman’s body, she will physically embody the stigma and shame of an unintended pregnancy whereas the man will not carry any physical reminder of it.

Another burden unique to women is the double-bind they face regarding contraceptive use. Women who use contraceptive may be seen as violating the feminine norm of chastity. Yet, if single women do not use contraception, they risk an unintended pregnancy, which is associated with irresponsibility and trying to “trap” a man.

Since men are not held to the norm of chastity, but rather are frequently lauded for sexual promiscuity, they are not socially penalized for engaging in sexual activity and using contraception. Thus, the development of male contraceptives could help women avoid this no-win situation while empowering men to control their reproduction.

The need for male contraceptives is often looked overlooked because contraception is often conflated with women, thereby marginalizing and even ignoring men. For instance, unmet need for contraception is generally calculated using only women’s information: their fertility intentions and their contraceptive use. Excluding men from questions about unmet contraceptive needs fails to recognize their role in and responsibility for contraception both in their personal relationships and on the social level. It moreover fails to acknowledge that men may also have unmet contraceptive needs.

One study in Western Africa that interviewed both women and men regarding unmet contraceptive need found that between 15 – 23% of husbands had unmet contraceptive need even though their wives did not. These men were not interested in having children, at least at that time, but the dearth of reversible male contraceptives limited their options for controlling their reproduction since their partner did not have unmet contraceptive need and was consequently not using female or shared methods (and the male condom is frequently considered a shared method).

One of the benefits of female LARCs is that the woman’s partner does not need to be involved in or even know about their use. This is a good option for women if they and their partner disagree about contraceptive use. Unfortunately, men have no alternative available to them that they can use without their partner’s involvement or knowledge, which raises justice concerns and highlights men’s diminished reproductive autonomy.

 

 


 [LC1]Hyperlink to my previous blog.

August 15, 2016

Why We Need a Male Pill: Enhancing Men’s Reproductive Autonomy and Unburdening Women’s Contraceptive Responsibility

One of the key tenets of reproductive autonomy is being able to control if, when, and with whom one reproduces. Men’s reproductive autonomy is inhibited by the lack of good contraceptive options available to them. Whereas women have 11 types of contraceptives—including barrier, hormonal, permanent, and long-acting reversible—men only have two types—the male condom, a barrier method, and vasectomy, a permanent method. It is not just the number of methods that is problematic; it is also the lack of long-acting reversible contraceptives (LARCs). Many men want to maintain their future fertility, thus ruling out vasectomy, but do not want to rely on condoms, especially if they are in a long-term monogamous relationship. While part of the reason some men do not like condoms is because they can decrease sexual sensation, another reason is that the failure rate for actual use is so high: 17%. Female LARCs, in contrast, have much lower failure rates for actual use, which enhances their reproductive autonomy because they are equipped with effective methods to enact their reproductive desires (i.e. avoiding pregnancy).

The lack of male LARCS causes some men to rely upon their female partner to contraceptive since she has more and better contraceptive options. Yet this dependence on his partner may also comprise his reproductive autonomy because he has to trust that she is consistently and correctly using female methods. If she does become pregnant, he has no recourse and, in many settings, is legally responsible for any offspring, including financial and even social obligations to the child.

Placing the majority of contraceptive responsibility on women due to the lack of male methods is not just bad for men; it is also bad for women. Women have to shoulder the health-related side effects of contraception, which tend to have more serious side effects than male methods because they include hormonal methods. Not surprisingly then, the most common reason for nonuse of modern contraceptives among women with an unmet need is health concerns and side effects. Additionally, side effects are the most cited reason why women discontinue contraceptives and most forms of contraception have discontinuation rates near 50% after one year of use. The fact that women continue to use a particular method does not mean she is happy with it; she (and her partner) may simply see it as their best option among poor choices.

In addition to the health related side effects of contraception, there are also the financial burdens of contraception. In the US, although the Affordable Care Act requires health insurance companies to cover female contraceptives, not all women are aware of this and very few women realize that certain forms of contraceptive, such as IUDs and tubal ligation, are covered. Even if the cost of contraception is covered, women still have to invest the time to acquire contraception: all methods except the female condom and the sponge require at least one health care provider visit and hormonal methods require an ongoing prescription. In the global South, women may face difficulty affording contraception, especially if their government does not prioritize reproductive health services.

June 20, 2016

The Politics of Fetal Pain: Why This Is Not A Legislative Issue

I read with interest the recent blog by my colleagues Paul Burcher and Claire Horner entitled “The Politics of Fetal Pain”. In their blog they discuss the recent fetal pain bill passed in Utah, which “requires the use of general anesthesia on women seeking abortions at 20 weeks gestation or later.” At stake is the concern that fetuses may be capable of experiencing pain by 20 weeks, which has prompted 12 states to restrict or prohibit abortions from that point on, instead of 24 weeks, which is the current standard.

Burcher and Horner remind us that the issue of fetal pain has been a source of contention for some time, which has led to “several states restricting or prohibiting abortions 20 weeks or later on the basis of potential fetal pain.” The authors are very much aware of the possibility that anti-abortion advocates may be using this issue as a convenient means by which to place additional limits on abortion rights of women. Which is to say, anti-abortion advocates supporting these restrictions on women’s reproductive rights may be using the fetal pain issue as a means to restrict abortion rights. Even if they do have a bias in creating this law, Burcher and Horner still believe that the law itself is justified.

Though I would share a concern about the possibility of fetal pain, if I had reason to believe there were evidence to support it, I disagree that the appropriate next move ethically is to join forces with a legislative agenda of politicians whose interests go far beyond the issue of fetal pain. My worry is that such legislative actions in fact usurp the professional role of physicians as medical experts of scientific data to set appropriate standards for medical care.

I accept that the possibility of fetal pain at 20 weeks is a theoretical possibility. But to the extent I find such a claim plausible I would do so by placing my confidence in scientific evidence, which to date is questionable. The paper from which Burcher and Horner take their evidence about fetal pain comes from an author who makes it clear in his writing that he believes abortion is an act of unjust killing. This is not an unreasonable moral position nor does it mean that he is not accurate in his assessment of the medical and scientific evidence regarding fetal pain. But it does raise concerns about his ability to assess and write about data of fetal pain without bias. Is he following the evidence or is he interpreting the evidence to support his preexisting moral views? The answer is we just don’t know, in the same way we don’t know if the Utah state legislature is really concerned about the possibility of fetal pain beginning at 20 weeks or is their real goal to place additional restrictions on abortions?

I want to make it clear that people, including bioethicists, legislators, and the public at large, have every right to advocate, based on their understanding of the evidence, to ensure that fetuses do not suffer during abortions from 20 weeks and beyond. My only point is that such advocacy should not be expressed in laws that impose standards of care on how physicians practice medicine. Such advocates may retort, but why should I think that the medical profession or the scientific community is unbiased? Could it be the case that these professional bodies are abdicating their professional, moral obligations to reduce the possibility of human suffering? Of course that is a theoretical possibility. But in an era where the role of science is grossly misunderstood and under attack by many advocacy groups, those of us in bioethics must champion the standards of scientific research and judgment by medical professionals to produce evidence that is unbiased and reflects the best available understanding of important empirical questions, such as, can fetuses feel pain? This is not an ethical question, i.e. it has nothing to do with whether or not fetuses have moral standing as human beings—rather the question is purely a matter of getting the facts as clear as possible in determining at what point in the development of a human fetus is there a physiological basis for experiencing pain. This is exclusively the scientific issue about which scientific and medical experts must decide based on the best available evidence.

So where should we look for such an understanding of the data on fetal pain? The answer is we should rely on the experts on such matters as reflected in the opinion from the American Congress of Obstetricians and Gynecologists (ACOG), which concluded “fetal perception of pain is unlikely before the third trimester. Although ultrasound monitoring can show intrauterine fetal movement, no studies since 2005 demonstrate fetal recognition of pain.”

I hasten to make it clear that it is always possible current scientific opinions will need to be revised based on new data. There are many examples that bear out this point. But we should realize just how procedurally disruptive and even iconoclastic it is to impose standards legislatively onto medicine because, in effect, we don’t trust or have faith in the integrity of medical experts to be fair or unbiased themselves. For doing so indicts the institution within our democratic system whose defined role and responsibility is to be the arbiters of empirical disputes. The process, i.e. the scientific method they use is by definition one that has the least chance of bias. And without robust confidence in the scientific enterprise and the knowledge that is generated, bioethics loses its footing to make moral assessments and judgments. Thus I agree with the view of ACOG:

“Sound health policy is best based on scientific fact and evidence-based medicine. The best health care is provided free of governmental interference in the patient-physician relationship. Personal decision making by women and their doctors should not be replaced by political ideology.”

Committing ourselves to make decisions based on scientific evidence, both in individual cases and at the policy level, requires us to always stipulate that our knowledge today may not be getting things exactly right. Advocates for the possibility of fetal pain, and I may be one of them, should not be quiet. They have every right and perhaps an obligation to express their concerns. But to conclude that ACOG refuses to accept the possibility of fetal pain because of politics—the fear of having to possibly create new standards about which they may fear a backlash from prochoice advocates or that they really do not believe a fetus has full moral standing—is to lose trust and confidence in an essential democratic institution, and indeed risks becoming cynical and riding roughshod over the role of professional medical expertise.

Thus, I conclude the Utah bill was not an appropriate action for the legislature to take, even if there is eventually scientific evidence that supports their concerns. I understand that there are some medical concerns about which a state legislature may appropriately pass laws—assisted suicide or narcotics—if there is a clear and compelling public interest. But I submit, since there is no clear and compelling evidence, the issue of fetal pain is not one of them.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

May 27, 2016

Support New York State’s Oncofertility Legislation

As I have discussed in previous blogs, fertility preservation for cancer patients is very expensive and it is rarely covered by insurance. Cost is the primary barrier for why cancer patients do not preserve their fertility before undergoing lifesaving, yet potentially sterilizing, treatments. One cycle of IVF is on average $12,400 and estimates for ovarian tissue cryopreservation range from $5,000-$30,000. Furthermore, annual storage fees for frozen gametes and embryos can run up to hundreds of dollars a year. For many, especially while in the midst of a life-threatening health emergency, these costs are prohibitive, and future fertility is left to chance.

Legislation, however, is currently being considered in New York State that could change this situation. SB7219, authored by State Senator Diane Savino, would alter the current infertility mandate in New York to include coverage for standard fertility preservation services needed by those facing possible iatrogenic (medically-induced) infertility due to treatments such as chemotherapy, radiation, and surgery.

If you are a resident of New York and care about this issue, please contact your state representative to let them know how important this is for you! By bringing together voices of patients, professionals, and families we can help make this change.

How You Can Get Involved:

If you are a cancer patient, survivor or family member who has been touched by this issue, please submit your email here:

Coalition to Help Families Struggling with Infertility - Link for Individuals

If you are a healthcare provider serving patients in New York who would be positively impacted by this coverage, please submit your email here:

Coalition to Help Families Struggling with Infertility - Link for Family Building Professionals

If your institution or nonprofit organization is interested in joining the Coalition to Help Families Struggling with Infertility, email advocacy@helpfamilieswithinfertility.net.

Time is of the essence! All communications should be submitted by June 2nd if possible; the last day of the NY legislative session is June 16th.

References:

  1. To read the entire Bill: http://legislation.nysenate.gov/pdf/bills/2015/S7219
  2. To learn more about the Bill or the Coalition: Coalition to Help Families Struggling with Infertility Website

 

- See more at: http://www.allianceforfertilitypreservation.org/blog/support-pending-fertility-preservation-legislation-in-new-york#sthash.EjwhZ7wP.dpuf

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

May 16, 2016

Taking a ride down the slippery slope

Did you know: we can now make sperm from embryonic stem cells (in mice).  Not only can we create this sperm, but we can use it to successfully fertilize an egg and develop into a fully grown mouse.  And what is the role of bioethics in this scientific discovery, according to the article?  A brief mention of theoretical ethical issues relegated to the end of the news article that no one reads far enough to see, anyway.

 

Scientific advancements in reproduction have occurred at an unbelievable rate.  We not only have the ability to create sperm, but we can also create an embryo using three genetic donors, choose or reject embryos based on their genetic traits, such as sex, and correct genetic defects by essentially cutting and pasting healthy DNA sequences over defective ones.  Conversely, using such technology, we also have the potential to clone human beings, choose or reject embryos based on traits such as hair color or athletic ability, and irreversibly alter a germ cell line, potentially leading to unknown negative effects in later generations.

 

While breakthroughs in reproductive technologies have the potential to address issues as important and varied as male infertility, uterine factor infertility, mitochondrial disease, genetic defects and disease, and even artificial gestation, one wonders whether anyone is stopping to ask: to what end?  How will we use this technology?  What are the short- and long-term effects?  How might this technology be misused?  And, my personal favorite, when will we start to regulate how and when we tinker with biology at a genetic level?

 

Despite the promise of treatment or eradication of genetic diseases using this technology, there is still a persistent and very realistic fear that this technology will be misused.  Even worse, the misuse may become so common as to be considered acceptable, particularly in our profit-driven fertility industry.  Will the desire to prevent Huntington’s disease also lead to the desire to enhance intelligence?  Can we really resist the urge to create so-called designer babies, and should we accept that while some may win the genetic lottery, others will be able to afford to stack the deck?

 

Bioethicists are sometimes viewed as obstructionists on the path of progress, unnecessarily blocking scientists from discovering all that can be accomplished through science and medicine. (For an excellent rebuttal, read here).  But the very purpose of the vast and diverse field of bioethics is to identify and acknowledge the normative implications of scientific advances and engage in a dialogue that directly addresses the “should” in a world of “could.”  Hence, the age-old question that is often asked but rarely answered: just because we can do it, does it mean we should?

 

In the world of reproductive technologies and germline manipulation, perhaps the answer, sometimes, is no.

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

May 9, 2016

Bad Moms, Blameless Dads: Examining How the Media Portrays Age-Related Preconception Harm

As I discussed in a previous blog, the blame for fetal harm is generally directed at women. Some of my colleagues and I, including AMBI faculty member Zubin Master, were interested in examining how fetal harm, and more specifically age-related preconception harm, is portrayed in the media. Our findings were published earlier this year in the American Journal of Bioethics Empirical Bioethics.

Given the significant social change that many people today are delaying childbearing in comparison to previous generations, it is relevant to examine the media portrayal of older parental age and risk to future offspring. Furthermore, there is clear evidence that older parental age carries certain risks to offspring: older age in women and men leads to an increased risk of having children with autism and Down syndrome and older paternal age has also been linked to higher rates of children with schizophrenia. Many people get most of their scientific news from the media, so it is important to examine the accuracy and biases of the information.

Our results indicate that reproduction is still largely seen as the domain of women, rather than of couples or of men. We rarely found articles discussing reproduction as it relates to both women and men as the majority of articles were maternally focused. Even among the articles that were paternally focused, they almost always discussed maternal harm as well. However, the reverse – maternally focused articles containing discussions of paternal harm – were almost nonexistent. This pattern suggests that men alone are never seen as solely responsible for fetal harms, but rather that this responsibility is always shared with women.

Responsibility and blame typically go hand-in-hand and not surprisingly articles were four times more likely to blame women for fetal harms than men. The infrequency of paternal blame suggests that authors either do not recognize men’s contribution to harm due to ignorance or denial, or do not want to hold men responsible for harm. Even when men’s contribution to harm was acknowledged, the authors were more likely to absolve men from responsibility for harm by presenting reassuring information, such as the overall risk of fetal harm is quite low, in conjunction with factual information stating that older paternal age can increase risks to future children. The same sort of reassurance was not seen for women.

Although reproductive blame and responsibility is still typically assigned to women, newspapers are increasingly discussing the relationship between paternal age and preconception harm: no articles discussed this relationship in the 1970s or 1980s, 20% discussed it in the 1990s, and nearly 40% discussed it between 2000 and 2012. The increase in articles on paternal harm in the 2000s may be due to the increase in scientific data showing the connection between paternal age and harm, the growing body of social science literature on male reproduction, the rising medicalization of men’s sexuality and reproduction, as well as changes in social norms that make discussions of paternal role and responsibility in reproduction more commonplace.

However, despite the fact that newspapers are actually acknowledging and discussing paternal age and preconception harm, the primary focus of newspaper articles regarding preconception harm remains concentrated on women and articles are more likely to blame women than men for any harm. In short, our analysis of age-related preconception harm reflects the broader gendered social patterns regarding reproduction that tend to minimize, and even ignore, men’s role in and responsibility for reproduction.

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

April 27, 2016

The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic

by Lisa H. Harris, Neil S. Silverman, and Mary Faith Marshall

The inequalities of outcome are, by and large, biological reflections of social fault lines (Paul Farmer)

Three paradoxes characterize the Zika virus pandemic and clinical and policy responses to it:

  1. Zika virus has been shown to cause severe developmental anomalies in the fetuses of infected women.
April 26, 2016

BioEthicsTV: A night of consent issues on ChicagoMed

by Craig Klugman, Ph.D.

On this week’s episode of ChicagoMed (Season 1; Episode 15) issues of consent was the main focus.…

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Published Articles (25)

American Journal of Bioethics: Volume 16 Issue 5 - May 2016

The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic Lisa H. Harris, Neil S. Silverman & Mary Faith Marshall

American Journal of Bioethics: Volume 16 Issue 2 - Feb 2016

Fetal Risks, Relative Risks, and Relatives' Risks Howard Minkoff & Mary Faith Marshall

American Journal of Bioethics: Volume 16 Issue 2 - Feb 2016

Restricting Choices of Childbearing Women Bela Fishbeyn

American Journal of Bioethics: Volume 15 Issue 11 - Nov 2015

Sleepwalking Into Infertility: The Need for a Public Health Approach Toward Advanced Maternal Age Marie-Eve Lemoine & Vardit Ravitsky

American Journal of Bioethics: Volume 15 Issue 2 - Feb 2015

Ritual Male Infant Circumcision and Human Rights Allan J. Jacobs & Kavita Shah Arora

American Journal of Bioethics: Volume 14 Issue 7 - Jul 2014

Therapeutic, Prophylactic, Untoward, and Contraceptive Effects of Combined Oral Contraceptives: Catholic Teaching, Natural Law, and the Principle of Double Effect When Deciding to Prescribe and Use Murray Joseph Casey & Todd A. Salzman

American Journal of Bioethics: Volume 14 Issue 5 - May 2014

Transnational Gestational Surrogacy: Does It Have to Be Exploitative? Jeffrey Kirby

American Journal of Bioethics: Volume 13 Issue 10 - Oct 2013

Gender Eugenics? The Ethics of PGD for Intersex Conditions Robert Sparrow

American Journal of Bioethics: Volume 13 Issue 10 - Oct 2013

Critically Appraising Prenatal Genetic Diagnosis to Prevent Disorders of Sexual Development: An Opportunity Missed Laurence B. McCullough

American Journal of Bioethics: Volume 13 Issue 5 - May 2013

The Right to Know Your Genetic Parents: From Open-Identity Gamete Donation to Routine Paternity Testing An Ravelingien & Guido Pennings

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News (707)

September 8, 2016 8:00 am

Cesarean Birth Linked to Risk of Obesity in Childhood (U.S. News)

Infants delivered by cesarean section may face a higher risk of becoming obese, a new study suggests.

September 1, 2016 8:00 am

Study: Ohio’s Abortion Pill Law Led to Worse Health Outcomes (Washington Post)

Ohio’s restrictions on the so-called abortion pill led to a higher rate of side effects, more doctor visits and additional medical treatment for patients, according to a new study.

August 16, 2016 8:00 am

How Big A Risk Is Acetaminophen During Pregnancy? (NPR)

One study now caught in that eddy is a report reporting behavioral problems in children born to women who took acetaminophen (popular brand name: Tylenol) during pregnancy. Evie Stergiakouli and George Davey Smith at the University of Bristol published it Monday in JAMA Pediatrics. They studied about 7,800 women and their children over the course of more than seven years.

July 29, 2016 8:13 am

Dolly the Sheep’s Fellow Clones, Enjoying Their Golden Years (New York Times)

Dolly the Sheep started her life in a test tube in 1996 and died just six years later. When she was only a year old, there was evidence that she might have been physically older. At five, she was diagnosed with osteoarthritis. And at six, a CT scan revealed tumors growing in her lungs, likely the result of an incurable infectious disease. Rather than let Dolly suffer, the vets put her to rest.

July 25, 2016 5:04 am

The HIV Trap: A Woman's Lack Of Control (NPR)

When you’re pregnant, going to the doctors can be exciting. You get to find out if you’re having a boy or a girl. Maybe hear the baby’s heart beat. But in southern Africa, many women find out something else.

July 21, 2016 8:41 am

I.V.F. Does Not Raise Breast Cancer Risk, Study Shows (New York Tmes)

Women undergoing in vitro fertilization have long worried that the procedure could raise their risk for breast cancer.

July 20, 2016 8:36 am

Florida is checking possible local case of Zika (Washington Post)

The Florida health department said late Tuesday that it is investigating what could be the first case of locally spread Zika virus in the continental United States.

July 5, 2016 8:52 am

Sex May Spread Zika Virus More Often Than Researchers Suspected (New York Times)

An outbreak of the Zika virus in the continental United States could begin any day now. But while there is plenty of discussion about mosquito bites, some researchers are beginning to worry more about the other known transmission route: sex.

June 23, 2016 8:47 am

Birth Control via App Finds Footing Under Political Radar (New York Times)

A quiet shift is taking place in how women obtain birth control. A growing assortment of new apps and websites now make it possible to get prescription contraceptives without going to the doctor.

May 9, 2016 8:54 am

Why this lab-grown human embryo has reignited an old ethical debate (Science)

It’s easy to obey a rule when you don’t have the means to break it. For decades, many countries have permitted human embryos to be studied in the laboratory only up to 14 days after their creation by in vitro fertilization. But—as far as anyone knows—no researcher has ever come close to the limit. The point of implantation, when the embryo attaches to the uterus about 7 days after fertilization, has been an almost insurmountable barrier for researchers culturing human embryos.

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