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Ethical aspects of the preimplantatory genetic daignosis
Hájek Žůrková, Barbora ; Fošum, Jan (advisor) ; Štica, Petr (referee)
This thesis explores the ethical aspects associated with preimplantation genetic diagnosis (PGD) in the context of reproductive medicine. In addition to significant advancements in medical care, the continuous technological progress in medicine also brings forth increasing opportunities for manipulating the fragility of human individuality at the genetic level. Alongside preimplantation diagnosis, a growing number of ethical questions arise concerning potential risks associated with this method, which will be the focus of this work. The ethics of PGD will be examined primarily from the perspectives of bioethics and Christian ethics. Emphasis is placed on discussing human dignity, rights, and responsibilities within the realm of reproductive technologies. The aim of the thesis is to provide a deeper understanding of the ethical dimensions of PGD and to contribute to the discussion on ethical challenges in the field of reproductive medicine. At the same time, the thesis will attempt to propose solutions that would lead to an increase in the ethical acceptability of this technique. Keywords Bioethics, reproductive medicine, preimplantation diagnosis, artificial insemination, in vitro fertilization
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Current knowledge and challenges associated with embryo transfer in assisted reproduction in humans and selected mammals.
Hrdová, Lucie ; Komrsková, Kateřina (advisor) ; Cozlová, Nina (referee)
The embryo transfer represents the final and pivotal step of in vitro fertilization, which leads to a successful implantation of the embryo into the uterus and subsequent birth of a healthy offspring if executed correctly. This bachelor thesis focuses on the technique of transfer using a catheter and the potential complications associated with it, including the optimal timing for the procedure. Furthermore, differences in forms of embryo transfer are discussed, assessing advantages and risks, comparing single and multiple, as well as fresh and frozen embryo transfer. The thesis introduces the related topic of cryopreservation and the possibilities in terms of preserving embryos for future use. This thesis also covers hormonal stimulation and uterine response, addressing specifically the role of gonadotropins, steroid hormones, prostaglandins, and the potential positive influence of human growth hormone on optimizing successful outcomes in assisted reproduction. Additionally, possible complications associated with embryo transfer in the early stages of pregnancy, as well as complications that may arise before the actual embryo implantation occurs are covered. Lastly, the issues related to embryo transfer in the context of controlled breeding of selected domesticated animals and endangered mammalian...
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The effect of microfluidic sperm separation on the success of IVF therapy
NOVÁKOVÁ, Pavla
More and more couples are coming to assisted reproduction centres to solve conception problems. Despite initial efforts to improve lifestyle and reduce daily stress, problems in conceiving and delivering a healthy baby can be caused by one or a combination of multiple factors, and in such cases infertile couples opt for assisted reproductive treatment. In earlier times, the focus in the field of reproductive medicine was mainly on female fertility. In recent years, assisted reproductive medicine has largely focused on the field of andrology. In this regard, the development of enhanced spermiogram methods and sperm processing techniques has been developed. The current trend in reproductive embryology and andrology methods is to mimic the in vivo environment as much as possible. The aim of this bachelor's thesis was to determine whether the method of microfluidic sperm separation has an effect on sperm quality and whether the use of sperm obtained in this way influences the success of IVF treatment. In order to achieve the objectives of this study, data from 129 couples who underwent treatment in our IVF centre by donated oocytes and at the same time sperm from fresh ejaculate were used. The sperm samples were divided into two groups, namely for processing by gradient centrifugation and separation by microfluidic chip. The sperm were then used for in vitro fertilization using intracytoplasmic sperm injection method. Cycles with donated oocytes were selected to minimize the influence of female factor. The results of this work indicate that sperm processing by microfluidic chip method has a positive impact on the success of IVF treatment.
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Molecular aspects of mammalian oocyte and embryo quality
Chyská, Anna ; Vaškovičová, Michaela (advisor) ; Jansová, Denisa (referee)
According to statistics in the Czech Republic, up to 20 % of couples experience infertility, which is still rising. One of the infertility treatment options is to undergo one of the assisted reproduction methods. In vitro fertilization (IVF) is among the most commonly used methods. In order to increase the success rate of fertilization, it is preferable to have a quality oocyte with specific characteristics. Such an oocyte is then a prerequisite for a good quality embryo, a correct course of pregnancy, and proper fetal development. Meiosis, a key step in oocyte formation, is regulated by complex signalling pathways. If these pathways are dysfunctional, the chances of the oocyte developing into a competent embryo are reduced. For example, errors in segregation during meiosis lead to aneuploidy, which is a major cause of miscarriages and birth defects. Therefore, understanding the signaling pathways can help identify the origin of the errors that result in aneuploidy and thus contribute to improving women's reproductive health. Key words: aneuploidy, spindle, in vitro fertilization, spindle assembly checkpoint, oocyte quality, chromosome segregation
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Czechia as a target country for cross-border reproductive care
Volejníková, Adéla ; Šťastná, Anna (advisor) ; Fait, Tomáš (referee)
Czechia as a target country for cross-border reproductive care Abstract Since the 1970s, economically developed countries have been experiencing a change in the reproductive behavior of their populations, with one of the main trends being the postponement of fertility to a later age. However, this trend is associated with an increasing risk of infertility, as the chances of natural conception decrease as women age. In this context, there is a growing interest in the treatment of infertility through Assisted Reproductive Technologies (ART), which are regulated and governed by legal regulations in many countries. As a result, there is an increase in the provision of cross-border reproductive care, where infertile couples, primarily for legislative reasons, undergo assisted reproduction abroad. Since this is a relatively new and unexplored phenomenon, the aim of this study is to map the main trends in the provision of cross- border reproductive care, focusing on the perspective of Czechia as a destination country. Individual anonymized data on all initiated cycles of assisted reproduction in Czechia from 2016 to 2019 are used. It has been shown that assisted reproduction trends in Czechia are significantly influenced by the provision of cross-border reproductive care, as reproductive tourists accounted for...
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The struggle for human dignity in the era of modern eugenics. Molecular genome editing tool CRISPR/CAS9 and its use in human genome therapy from the perspective of theological ethics
Auxt, Miroslav ; Štica, Petr (advisor) ; Fošum, Jan (referee)
The recent breakthrough discovery of the molecular genome editing tool CRISPR/CAS9 represents a complete revolution in the field of molecular biology, biomedicine and other related fields. It is a highly effective biomolecular tool, derived from the bacterial immune system, with which it is possible to introduce precise changes in the genomes of all organisms. The thesis is limited to the ethical evaluation of the use of CRISPR/CAS9 exclusively in human gene therapy. Thanks to its efficiency, simplicity, accuracy and low financial costs, the CRISPR/CAS9 editing tool, in compliance with ethical parameters, already has a broad spectrum of use in therapeutic procedures on somatic or body cells in the treatment of human genetically determined diseases without introducing a change into the future offspring of the given individual. In addition to great therapeutic potential, the application of CRISPR/CAS9 raises many ethical questions related to the possibilities of its further use, possibly misuse. Ethically problematic genetic procedures include: human hereditary genome editing, i.e. the targeted alteration of the genome of sex cells, progenitor cells and cells of early embryonic development stages with the therapeutic goal of eliminating a genetically determined disease associated with the...
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Assisted reproduction in Czechia: sociodemographic context of selected treatment methods
Waldaufová, Eva ; Šťastná, Anna (advisor) ; Fait, Tomáš (referee)
Assisted reproduction in Czechia: sociodemographic context of selected treatment methods Abstract In the context of reproductive ageing, which is one of the most important trends observed since the 1990s in Czechia, there is an increase in the use of assisted reproduction technologies (ART). This brings a number of aspects that can be the subject to a study in the field of demography. Mothers who have conceived by ART and mothers who have conceived without ART are different in terms of structure, and mothers with ART have the worse birth outcomes. The aim of the thesis is to analyze the use of ART methods in Czechia and to identify differences/similarities of mothers according to the way of conception. Not only to compare mothers with or without ART, but also the method of ART (in vitro fertilization, frozen embryo transfer, and oocyte reception). Three birth outcomes are analysed in more detail, and they are low birth weight, preterm births, and caesarean section births. The research is based on individualized anonymized data on mothers who gave birth in Czechia between 2013 and 2018. It turns out that there are differences in the structure of mothers according to the way of conception from the view of sociodemographic structure, health condition, and selected birth outcomes. Using the logistic regression...
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Womenś awareness of methods of assisted reproduction in the Czech Republic
Dolejšková, Michaela ; Černý, Andrej (advisor) ; Šimják, Patrik (referee)
The theme of my thesis is women's awareness about the methods of assisted reproduction in the Czech Republic. The work is devided into a theoretical part and practical part. In the theoretical part I deal with the physiology of reproductive organs of women and men, further I describe the term infertility and its causes. In the following chapters I focus on the process of finding a specialist, subsequent examinations and possible methods of assisted reproduction. In the practical part I examine the awareness of women in this area. As a data source I use an anonymous quantitative questionnaire, shared on social networks, filled in by women of different ages. 193 women completed the questionnaire. I made several hypotheses, which I confirmed or refuted thanks to the answers. Research has confirmed the hypothesis that more than half of women know when and to which doctor to address fertility problems. Subsequently, the second hypothesis was confirmed-most women know at least some of the risk factors affecting fertility. Furthermore, I assumed that most women are aware of the importance of age in the pursuit of conception. Although I confirmed the hypothesis thanks to a questionnaire survey, but not every woman knows how low the age at which fertility reduction begins to manifest. I refute the...
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Inhibins in reproduction
Babčová, Katarína ; Ulčová-Gallová, Zdeňka (advisor) ; Kužel, David (referee) ; Crha, Igor (referee)
Inhibin A and B participate to regulation of gametogenesis. We investigated their applicability as a marker of gametogenesis of men fertility disorders. We monitored the levels of inhibins during the treatment. We interested in their paracrine activity, relationship in sera, follicular fluid and seminal plasma depending on cause of fertility failure. We studied the levels of inhibin B in serum and seminal plasma from 355 men treated for fertility failure, in the context of their andrological and immunological findings (quality of spermiogrammes and acrosome area). We monitored concentration of levels of inhibin A and B in serum and follicular fluids depending on cause of fertility failure, on course and treatment outcome. We took blood samples in the time of the oocytes collection, of the embryotransfer and early pregnancy. The follicular fluids were obtained during the oocytes collection. The levels of both of inhibins were measured by ELISA in all medium (serum, follicular fluid, seminal plasma). We confirm, that inhibin B is useful marker of spermatogenesis in men, but is necessary to examine patient in complex with determination of immunology profile or quality of acrosome. Seminal plasma is, in some indicated cases, more suitable diagnostics material. Similarly inhibin B in women seems to be...
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