In re Marriage of Witten, decided by the Iowa Supreme Court in 2003, held that neither Tamera nor Arthur (Trip) Witten could use or destroy several cryopreserved preembryos created during their marriage using in vitro fertilization (IVF), unless the former couple could reach a mutual agreement. Tamera and Trip Witten, unable to conceive conventionally during their marriage, had attempted to start a family together using IVF at the University of Nebraska Medical Center (UNMC) in Omaha, Nebraska. When Trip sought to dissolve the marriage in April 2002, following several unsuccessful IVF attempts, seventeen of their preembryos were in storage at UNMC. The former couple disagreed about what should happen to the preembryos and asked the court for a resolution as part of the marital dissolution action. The high court of Iowa’s decision to restrict both individuals from using the cryopreserved preembryos without the other person’s consent reflected a belief that Tamera and Trip shared equal decision-making authority over the preembryos.
In A.Z. v. B.Z. (2000), the Supreme Judicial Court of Massachusetts in Boston, Massachusetts, affirmed a lower courtÕs decision, ruling that contracts that require a party to become a parent against his or her will are unenforceable and contrary to public policy. The case centered around A.Z. and B.Z., a divorced couple who had previously used in vitro fertilization (IVF) to start a family together during their marriage and had several preembryos cryopreserved as part of the process. While undertaking IVF, the couple signed multiple consent forms requiring them to decide what should happen to the cryopreserved preembryos in the event of certain listed contingencies, such as death or separation of the couple. The couple indicated their preference that B.Z., A.Z.Õs now former wife, could use the cryopreserved preembryos if the couple later separated. When their relationship deteriorated, however, A.Z. objected to B.Z.Õs attempt to have additional children using the preembryos, leading to a lengthy legal battle. The court case A.Z. v. B.Z. established Massachusetts public policy that people should not be forced to become a parent against their will, even if they previously agreed to provide their genetic material for reproduction.
In 1984, human genetics and reproduction researcher and physician Joseph D. Schulman founded the Genetics and IVF Institute, an international organization that provides infertility treatment and genetic services to patients. IVF stands for in vitro fertilization, an infertility treatment in which a female egg is fertilized by male sperm outside of the female body. GIVF is headquartered in Fairfax, Virginia, in association with Inova Health System, formerly called the Fairfax Hospital Association, one of the largest regional hospital systems in the United States. GIVF offers multiple infertility and genetic services including IVF, donor egg and donor sperm programs, prenatal genetic diagnostic testing, and sex selection technology. GIVF was one of the first medical facilities in the United States to offer IVF and has innovated other infertility treatments and genetic services.
Irving Freiler Stein Sr. was a physician who studied women’s reproductive health during the twentieth century in the United States. In partnership with his colleague, Michael Leventhal, Stein identified a women’s reproductive disorder related to elevated male sex hormones, or androgens. The syndrome was originally called Stein-Leventhal syndrome and later known as polycystic ovarian syndrome. While studying the syndrome, Stein also helped establish a treatment for the condition, through the surgical removal of ovarian tissues. Stein identified the symptoms related to the condition polycystic ovarian syndrome, a hormonal imbalance estimated to be the most common female reproductive disorder as of 2017.
In 2007, Ishola Agbaje, Deirdre Rogers, Carmel McVicar, Neil McClure, Albert Atkinson, Con Mallidis, and Sheena Lewis published “Insulin Dependent Diabetes Mellitus: Implications for Male Reproductive Function,” hereby “Diabetes Mellitus: Implications,” in the journal Human Reproduction. In their article, the authors explore the effects of elevated blood sugar in the form of diabetes mellitus on the quality of male sperm. When investigating possible fertility issues, fertility specialists often study semen, the male reproductive fluid that contains sperm cells to detect changes in sperm count, movement, and structure. In “Diabetes Mellitus: Implications,” the authors use both conventional semen analysis and technical molecular methods to assess the quality of sperm from diabetic and non-diabetic men. The authors found that men with diabetes had higher levels of DNA damage within their sperm and highlighted a need for additional research on the link between diabetes and male reproductive health.
Endometriosis is a medical condition that involves abnormal growths of tissue resembling the endometrium, which is the tissue that lines the inside of the uterus. Those growths, called endometrial lesions, typically form outside the uterus, but can spread to other reproductive organs such as ovaries and fallopian tubes. Endometrial lesions swell and bleed during menstruation, which can cause painful and heavy menstruation, as well as infertility. As of 2021, there is no cure for endometriosis, although medical therapies such as birth control pills and GnRH analogues can treat the painful symptoms of endometriosis. More than eleven percent of women between the ages fifteen and forty-four in the US have endometriosis, which can often decrease a woman’s quality of life due to painful symptoms and impair her reproductive potential.
In 1904, physician William Henry Walling published Sexology, a family medicine reference book. In his book, Walling proposed that his guidance would help people who were married or single and young or old, as well as anyone who wanted to conform to, what he claims are, gender expectations. Sexology discusses issues such as masturbation, abortion, pregnancy, labor, and marriage. Despite Walling’s limited scientific explanations and evidence for his medical claims, the Puritan Publishing Company printed and distributed the book, which received many positive reviews and endorsements from other physicians, college presidents, politicians, and religious leaders. However, in the twenty-first century, people may consider many of Walling’s claims to be sexist and oppressive toward women. Sexology provides readers with examples of historical medical misconceptions of male and female anatomy and provides context for the logic of reproductive medicine at the turn of the twentieth century.
In 2017, Julie Carré, Nicolas Gatimel, Jessika Moreau, Jean Parinaud, and Roger Léandri published “Does Air Pollution Play a Role in Infertility?: a Systematic Review,” hereafter “Does Air Pollution Play a Role,” in the journal Environmental Health. The authors completed a systematic literature review to investigate the effects of air pollutants on fertility in exposed populations. Since air quality has an impact on overall health as well as on reproductive function, the authors sought to increase the awareness of the importance of environmental protection issues among the general public and the authorities. The article “Does Air Pollution Play a Role” provided the foundation for further research on how air pollution can contribute to low reproductive capacity in areas with high exposure.
In 1958, Irving Freiler Stein Sr. published “The Stein-Leventhal Syndrome: A Curable Form of Sterility” documenting his findings on the diagnosis and surgical treatment of Stein-Leventhal syndrome. Stein-Leventhal syndrome, later called polycystic ovarian syndrome (PCOS), affects the reproductive health of women. Common symptoms include excess body hair, a lack of menstrual cycle or amenorrhea, and infertility. As of 2017, polycystic ovarian syndrome is considered the most common reproductive health disorder among women in the United States. In his article, Stein argued that the means of treating infertility and menstruation issues in women with Stein-Leventhal syndrome prior to the 1950s were inferior to surgical removal of ovarian tissue. “The Stein-Leventhal Syndrome: A Curable Form of Sterility” offered a brief view of Stein’s findings over his three decades of research on the syndrome and his opinion on why surgery was the only means of treating the syndrome. The paper’s conclusions allowed later physicians to further their research on the uses of other surgical techniques and medicine to aid in treating the symptoms of the syndrome.
In Maureen Kass v. Steven Kass (1998), the Court of Appeals of New York in Albany, New York, ruled that the state should generally consider IVF consent forms signed by participants in an in vitro fertilization (IVF) program valid, binding, and enforceable in the event of a dispute. The court indicated that decisions regarding the handling of cryopreserved pre-zygotes, often called preembryos, contained within these consent forms should be upheld. Although Steven and Maureen Kass had signed IVF consent forms agreeing to donate unused preembryos to research, during their divorce Maureen argued for custody of the preembryos. The New York Court of Appeals ruled in favor of Steven Kass and concluded that the informed consent forms signed by the former couple had clearly manifested the coupleÕs mutual intent to donate any preembryos to research in the event of a dispute.