Reproductive Rights

生殖权利
  • 文章类型: Journal Article
    本范围审查通过研究和分析全球堕胎禁令或限制的报道影响,解决了美国堕胎限制的潜在孕产妇健康结果。目的是检查由于施加的限制而无法流产具有严重医学异常的胎儿的孕妇的医学意义。EMBASE,Medline,在2022年Roev.Wade案被推翻之前,在任何国家搜索了以英文发表的关于堕胎限制的医学影响的研究和CINAHL数据库。对于使用布尔运算符的搜索条件,关键词包括术语“胎儿异常,\"\"堕胎禁令,“和”含义。“纳入标准纳入了1980年至2021年发表的研究,旨在评估干预措施的对照实验研究被排除在外。这导致了最初发现的469条记录。已删除重复的记录,并进行了两次单独的层级审查。11名审稿人独立筛选了332条记录的摘要和标题,以确定资格。资格包括被诊断为胎儿异常的孕妇,妇女被剥夺了安全堕胎的机会,以及这对产妇和胎儿的医疗影响。在第二次筛选中,三名审稿人独立阅读了36篇文章,以进一步评估资格,最终审查了14篇文章。这项研究的结果表明,世界各国的堕胎禁令导致寻求非法堕胎服务的妇女出现健康并发症,产妇心理健康下降,包括压力和抑郁,各种医疗并发症,如难产,以及出生时出现严重缺陷的高风险胎儿增加。这项审查的结果预示着在美国受更严格的堕胎法约束的妇女将经历类似的负面后果
    This scoping review addresses the potential maternal health outcomes of abortion restrictions in the U.S. by studying and analyzing the reported effects of abortion bans or limitations globally. The goal was to examine the medical implications for pregnant women who are unable to abort fetuses that have severe medical anomalies due to imposed restrictions. EMBASE, Medline, and CINAHL databases were searched for studies published in English concerning the medical implications of abortion restrictions in any country prior to the overturn of Roe v. Wade in 2022. For the search criteria using Boolean operators, keywords included the terms \"fetal anomaly,\" \"abortion ban,\" and \"implications.\" Inclusion criteria incorporated studies published between 1980 and 2021, and controlled experimental research studies aimed to evaluate interventions were excluded. This resulted in 469 records initially found. Duplicate records were removed, and two separate tier reviews were conducted. Eleven reviewers independently screened abstracts and titles of 332 records to ascertain eligibility. Eligibility included pregnant women diagnosed with fetal anomalies, women denied access to safe abortions, and the maternal and fetal medical impacts of this. Three reviewers in the second screening independently read 36 full articles to further assess eligibility, resulting in 14 articles in the final review. Findings from this study showed that abortion bans in countries around the world have led to health complications in women seeking illegal abortion services, a decline in maternal mental health, including stress and depression, various medical complications such as obstructed labor, and an increase in high-risk fetuses born with severe deficits. The findings of this review portend similar negative consequences to be experienced by women who are subject to stricter abortion laws in the U.S.
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  • 文章类型: Journal Article
    This review aims to disclose the gaps and needs for acknowledging the rights to experience motherhood of women with disabilities. To do so, we map how much is known about these women\'s experience with motherhood, shedding light on their sexual and reproductive rights. The present work followed the scoping review by the Joanna Briggs Institute (JBI). This research is structured by elaborating the question, identifying the relevant studies, selecting the studies, extracting the data, sorting, summarizing, and creating reports based on the results. Results: we found 1050 articles, of which 53 were selected for the analysis. considering the different themes, we generated three axes: (1) infantilization, dehumanization, and discredit in the experience of motherhood; (2) obstetric ableism - an expression of violence in obstetrics; (3) reproductive justice - politicize motherhood and care. The study showed the urgent need to regard women with disabilities as people having the right to make sexual and reproductive health choices. Health professionals need permanent education to acknowledge and guarantee such a need as interweaving relationships to reach decision-making and autonomy.
    Nesta revisão, buscamos identificar lacunas e necessidades para o reconhecimento do direito das mulheres com deficiência ao exercício da maternidade. Objetivamos mapear o conhecimento referente às experiências com a maternidade dessas mulheres, ressaltando a produção de conhecimento relacionada aos direitos sexuais e reprodutivos. Realizamos uma revisão de escopo conforme o Joanna Briggs Institute (JBI). A pesquisa se sustentou na: formulação da questão; identificação dos estudos relevantes; seleção dos estudos; extração de dados; separação, sumarização e relatório dos resultados. Resultados: identificamos 1.050 artigos e selecionamos 53 para análise. A separação dos temas convergentes gerou três eixos: (1) infantilização, desumanização e descrédito na experiência da maternidade; (2) capacitismo obstétrico: uma expressão da violência obstétrica; (3) justiça reprodutiva: politizar a maternidade e o cuidado. Concluímos pela urgência de considerar as mulheres com deficiência com direitos de escolhas nas questões referentes à sua saúde sexual e reprodutiva. Os profissionais de saúde precisam de educação permanente para reconhecer e garantir as necessidades como relações de interdependência para decisões e autonomia.
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  • 文章类型: Journal Article
    背景:在撒哈拉以南非洲地区,性健康和生殖健康及权利交流日益受到关注,尤其是,对于青少年。鉴于与面对面访问相关的现有障碍,使用数字媒体获取信息和服务的需求已经变得可取和势在必行,尤其是由于COVID-19大流行。然而,在撒哈拉以南非洲,为青少年提供数字媒体参与性健康和生殖健康与权利(SRHR)交流的综合证据是有限的。因此,本系统审查旨在审查和综合撒哈拉以南非洲青少年使用数字媒体进行性健康和生殖健康及权利传播的证据。
    方法:将在PubMed中进行同行评审文章的搜索,ScienceDirect,Scopus,Embase,WebofScience,PsychINFO和谷歌学者,重点是2000年至2023年之间发表的文章。仅包括观察性和定性研究。将使用JoannaBriggs研究所的标准化清单对所包含的文章进行质量评估。描述性和叙述性摘要都将用于评估纳入研究的证据。
    结论:本综述对于提供有关青少年使用数字媒体类型的信息至关重要。他们使用此平台解决的各种SRHR问题以及使用它的原因和相关挑战。它还将有助于倡导将这些技术纳入教学中,教师提供和获得SRHR信息和服务,次区域的公共卫生提供者和同伴教育者。
    背景:PROSPEROCRD42020211491。该协议遵循PRISMA-P报告系统审查的指南。
    BACKGROUND: Within the sub-Saharan African region, there is a growing concern for sexual and reproductive health and rights communication, and more particularly, for adolescents. Given the existing barriers associated with face-to-face access, the need to use digital media to access information and services has become desirable and imperative, especially so due to the COVID-19 pandemic. However, in sub-Saharan Africa, a synthesis of evidence that informs adolescents\' digital media engagements for sexual and reproductive health and rights (SRHR) communication is limited. This systematic review therefore aims to examine and synthesize evidence on use of digital media for sexual and reproductive health and rights communication by adolescents in sub-Saharan Africa.
    METHODS: A search for peer-reviewed articles will be conducted in PubMed, ScienceDirect, Scopus, Embase, Web of Science, PsychINFO and Google Scholar with emphasis on those published between 2000 and 2023. Only observational and qualitative studies will be included. Quality assessment of included articles will be done using standardized checklists from the Joanna Briggs Institute. Both descriptive and narrative summaries will be used to appraise evidence from included studies.
    CONCLUSIONS: This review will be essential in providing information on the types of digital media adolescents use, the various SRHR issues they use this platform to address and their reasons for using it and associated challenges. It will also contribute to the advocacy for the inclusion of these technologies in the teaching and learning, provision of and access to SRHR information and services by teachers, public health providers and peer educators in the subregion.
    BACKGROUND: PROSPERO CRD42020211491. This protocol follows the PRISMA-P guidelines for reporting systematic reviews.
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  • 文章类型: Systematic Review
    (1)背景:获得堕胎护理是一项至关重要的生殖健康权利。难民和移民可能限制获得和利用堕胎护理,与流离失所的历史有关,不稳定的移民和公民身份,以及在陌生的东道国医疗保健系统中导航的困难。然而,关于难民和移民的堕胎经历和观点的证据有限。此外,现有的研究尚未综合起来,以确定这一边缘化人群中获得性和生殖护理的趋势。这项系统的审查旨在解决收容国关于难民和移民经历和堕胎观点的累积证据中的这一差距。(2)方法:遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目,我们在以下数据库中搜索了关于难民和移民堕胎态度的研究,决策和经验:Embase,Medline,CINAHL,WebofScience,社会学文摘,还有Scopus.我们还搜索了同样的灰色文献。纳入标准规定了涉及移民和/或难民人口的定性研究,检查他们的堕胎经历,态度或观点,用英语写的,在2000年1月至2022年12月之间发布。两名审稿人筛选了标题,摘要和全文文章,导致27篇文章被纳入审查,在两位合著者的共识检查之后。使用关键评估技能计划工具对纳入的研究进行了方法学质量评估。(3)结果:堕胎受到污名化,通常被认为是不允许和不希望的。然而,参与者讨论了社会上确定的“例外”,假定堕胎是可以接受的情况。高收入环境中的参与者与中低收入环境中的参与者之间的经历存在显着差异。获得护理的困难无处不在,但在资源较低的环境中和公民身份不稳定的参与者中,财务和法律地位。(4)结论:调查结果强调,需要一项国际公约来指导政策和方案拟订,承认移民和难民社区的具体堕胎要求,关注他们的财务,法律和社会不稳定。
    (1) Background: Access to abortion care is a crucial reproductive health right. Refugees and migrants may have restricted access to and utilisation of abortion care, associated with histories of displacement, precarious migrant and citizenship status and difficulty navigating unfamiliar host country healthcare systems. However, there is limited evidence on the abortion experiences and perspectives of refugees and migrants. Moreover, existing research has not been synthesised to identify trends informing sexual and reproductive care access among this marginalised population. This systematic review aimed to address this gap in the cumulative evidence on refugee and migrant experiences and perspectives of abortion in host countries. (2) Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the following databases for studies on refugee and migrant abortion attitudes, decision making and experiences: Embase, Medline, CINAHL, Web of Science, Sociological Abstracts, and Scopus. We also searched the grey literature on the same. Inclusion criteria specified qualitative studies involving migrant and/or refugee populations, examining their abortion experiences, attitudes or perspectives, written in English, published between January 2000 and December 2022. Two reviewers screened titles, abstracts and full-text articles, resulting in 27 articles included in the review, following consensus checks by two co-authors. The included studies were assessed for methodological quality using the Critical Appraisal Skills Programme tool. (3) Results: Abortion was stigmatised and generally considered impermissible and undesirable. However, participants discussed socioculturally determined \'exceptions\' to this, positing circumstances where abortion was acceptable. There were striking differences in experiences between participants in higher-income settings and those in lower- and middle-income settings. Difficulties accessing care were ubiquitous but were heightened in lower-resource settings and among participants with precarious citizenship, financial and legal statuses. (4) Conclusions: The findings highlight the need for an international convention to guide policy and programming that acknowledges the specific abortion requirements of migrant and refugee communities, with attention to their financial, legal and social precarity.
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  • 文章类型: Journal Article
    法律法规为实施与性健康和生殖健康及权利有关的政策提供了框架,方案和服务。它们可以促进实现健康和人权;然而,它们也可能限制这些目标的实现。本研究使用根据可持续发展目标指标5.6.2收集的数据来分析来自153个国家的与SRHR有关的法律和限制。超越支持性法律的存在,以评估刑事定罪和多元法律制度等法律限制和矛盾的星座,可以对实现充分和平等地获得SRHR所涉及的因素有更细致的理解。法律中的限制和矛盾之间的相互作用不成比例地影响了一些人群的健康获取和结果。基于第三方授权和年龄的限制是最常见的限制类型,对年轻女性的影响不成比例。避孕,紧急避孕和堕胎面临最大的限制,表明计划生育服务的障碍明显分层。Further,多元法律制度通常与避孕服务和紧急避孕的保障相矛盾。我们的分析表明,在法律和监管框架中,受SRH服务限制影响最大的人群之一是撒哈拉以南非洲寻求堕胎或避孕服务的少女和年轻妇女。研究结果为倡导解决SRH服务的法律障碍提供了关键的起点,并为未来的政策和计划提供了证据。对于个别国家,这项研究可以作为分析其自身法律和监管框架的模型,以确定改革工作的优先领域。
    Laws and regulations provide the framework for implementing sexual and reproductive health and rights (SRHR)-related policies, programmes and services. They can promote the fulfilment of health and human rights; however, they may also limit the achievement of these goals. This study uses data collected under Sustainable Development Goal Indicator 5.6.2 to analyse SRHR-related laws and restrictions from 153 countries. Looking beyond the existence of supportive laws to assess the constellation of legal restrictions and contradictions such as criminalisation and plural legal systems provides a more nuanced understanding of factors involved in achieving full and equal access to SRHR.The interaction between restrictions and contradictions within the law disproportionately impacts some populations\' health access and outcomes. Restrictions based on third-party authorisations and age are the most common restriction types, disproportionately impacting young women. Contraception, emergency contraception and abortion face the greatest number of restrictions, indicating a significant layering of barriers to family planning services. Further, plural legal systems commonly contradict guarantees of contraceptive services and emergency contraception. Our analyses suggest that one of the populations most affected by restrictions to SRH services as they appear in legal and regulatory frameworks is adolescent girls and young women in sub-Saharan Africa seeking abortion or contraceptive services.Study findings provide a critical starting point for advocacy to address legal barriers to SRH services and evidence for future policy and programming. For individual countries, this study can serve as a model for analysis of their own legal and regulatory frameworks to identify priority areas for reform efforts.
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  • 文章类型: English Abstract
    Women with disabilities face increased precarity throughout their lives, with one of the most affected areas being their sexual and reproductive health. The aim of this study was to identify and analyze the scientific literature on obstetric violence against women with disabilities. The search was conducted from August to October 2022 in five databases: PubMed, Web of Science, Dialnet, SciELO, and Scopus. A total of 194 articles were retrieved, and after applying selection criteria, ten articles were analyzed. Through thematic analysis, the dimension \"ableist obstetric violence towards women with disabilities\" emerged. Findings suggest that women with disabilities are marginalized during obstetric care, resulting in untimely attention and cascading interventions. At present, there is scarce literature addressing this phenomenon from a rights-based perspective. Urgent measures are needed to train healthcare teams on the provision of care to people with disabilities. Additionally, it is crucial to critically examine the relationship between healthcare personnel and institutions to women with disabilities within the framework of their sexual and reproductive rights.
    Las mujeres con discapacidad se ven enfrentadas a una mayor precariedad a lo largo de sus vidas. Una de las áreas más afectadas es su salud sexual y reproductiva. El objetivo de este estudio fue identificar y analizar la literatura sobre violencia obstétrica en mujeres con discapacidad. La búsqueda se realizó durante los meses de agosto a octubre de 2022 en cinco bases de datos: PubMed; Web of Science; Dialnet; SciELO y Scopus. Se recuperaron 194 artículos y luego de aplicar los criterios de selección se analizaron diez artículos. Del análisis temático, emergió la dimensión: “violencia obstétrica capacitista hacia mujeres con discapacidad”. Los hallazgos sugieren que las mujeres con discapacidad son invisibilizadas durante la atención obstétrica, lo que genera un cuidado inoportuno e intervenciones en cascada. Existe escasa literatura que aborde el fenómeno desde una perspectiva de derechos. Es urgente contar con equipos de salud aptos para atender a personas con discapacidad, así como también, problematizar el vínculo entre el personal e instituciones de salud y las mujeres con discapacidad en el marco de sus derechos sexuales y reproductivos.
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  • 文章类型: Review
    性健康和生殖健康与权利前线工作者(SRHR)每年为数百万人提供改变生活和挽救生命的服务。从陪伴孕妇开始,分娩婴儿和照顾新生儿,以支持遭受性暴力的人;从治疗使人衰弱的感染到扩大避孕选择;从获得安全的堕胎服务到对抗同性恋恐惧症:世界各地前线的SRHR护理人员和倡导者使更多的人有可能体验到性尊严,性和繁殖。然而,他们的所作所为也受到敌意,他们为谁提供护理,他们工作的地方和他们解决的问题。从工作场所的排斥和骚扰到言语威胁和身体暴力,敌对行动甚至可以延伸到他们的私人生活。换句话说,当SRHR工人寻求实现他人的人权时,他们自己的人权受到威胁。然而,如此严重,这是一个很大程度上没有记录的现实,因此也被低估了。这项范围界定审查旨在整理有关针对前线SRHR工人的敌对行动如何表现的已知信息,针对谁,在谁的手中,在什么情况下。它基于对六个来源的回顾:同行评审和灰色文献,新闻报道,行业调查,并与部门专家进行磋商,为了对比,反对派团体发表的文献。每个源只提供部分图片,然而放在一起,它们表明,针对前线SRHR工人的敌对行动在世界各地的许多国家都在进行,上下文和设置。然而,这些来源中给出的叙述更经常将敌对行动视为“一次性”,特殊事件和/或作为日常工作中不可避免的一部分要容忍。这反过来又使这些事件与更广泛的历史分离,政治和社会背景,并使现象正常化,就好像这是角色的预期部分,而不是迫切需要解决的问题。我们的发现证实,整个SRHR部门需要以与其规模和严重性更相称的方式加强对此类报复的反应。
    Frontline workers for sexual and reproductive health and rights (SRHR) provide life-changing and life-saving services to millions of people every year. From accompanying the pregnant, delivering babies and caring for the newborn to supporting those subjected to sexual violence; from treating debilitating infections to expanding contraceptive choices; from enabling access to safe abortion services to countering homophobia: all over the world frontline SRHR carers and advocates make it possible for so many more to experience dignity in sex, sexuality and reproduction. Yet they are also subjected to hostility for what they do, for whom they provide care, for where they work and for the issues they address. From ostracistion and harassment in the workplace to verbal threats and physical violence, hostilities can extend even into their private lives. In other words, as SRHR workers seek to fulfil the human rights of others, their own human rights are put at risk. Yet, as grave as that is, it is a reality largely undocumented and thus also underestimated. This scoping review sets out to marshal what is known about how hostilities against frontline SRHR workers manifest, against whom, at whose hands and in which contexts. It is based on review of six sources: peer-reviewed and grey literature, news reports, sector surveys, and consultations with sector experts and, for contrast, literature issued by opposition groups. Each source contributes a partial picture only, yet taken together, they show that hostilities against frontline SRHR workers are committed the world over-in a range of countries, contexts and settings. Nevertheless, the narratives given in those sources more often treat hostilities as \'one-off\', exceptional events and/or as an \'inevitable\' part of daily work to be tolerated. That works in turn both to divorce such incidents from their wider historical, political and social contexts and to normalise the phenomena as if it is an expected part of a role and not a problem to be urgently addressed. Our findings confirm that the SRHR sector at large needs to step-up its response to such reprisals in ways more commensurate with their scale and gravity.
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  • 文章类型: Review
    自1960年代成立以来,伊朗目睹了人口政策的三次重大逆转。为了应对生育率迅速下降到非常低的水平,最新的政策转变导致了旨在鼓励婚姻和生育的立法的发展,特别是2021年批准的“青年人口和家庭保护”法。本研究回顾了人口政策的变化及其与生育趋势的相互关系,重点主要是自2005年以来向生殖政策的转变,以及随之而来的对生殖健康和计划生育服务的限制。结合国际和国家来源,我们将新的促发运动定位在政府试图扭转生育率下降和促进保守家庭价值观的更广泛趋势中。我们的研究有三个主要目的。(1)我们概述了生育率趋势,在过去半个世纪的伊朗社会和政治结构变化的背景下,政策话语和政策转变。(2)我们强调并讨论了新《家庭法》中最有问题的特征,特别是有关孕产妇和生殖健康的立法,堕胎和避孕,以及支持早婚和更高生育率的激励措施。(3)我们讨论了新立法对母婴健康以及性权利和生殖权利的可能后果,对于一般女性来说,和国家的社会经济差距。除了侵犯生育权,新政策不太可能实现其启动伊朗生育率持续上升的目标。
    Iran has witnessed three major reversals of population policies since their inception in the 1960s. In response to a rapid decline in fertility to very low levels, the latest policy shift has led to the development of legislation that aims to encourage marriage and fertility, particularly the \"Youthful Population and Protection of the Family\" law approved in 2021. This study reviews the changes in population policy and their interrelations with fertility trends, focusing mainly on the shift towards pronatalist policies since 2005, and accompanying restriction of reproductive health and family planning services. Combining international and national sources, we position the new pronatalist drive in the country within the broader trend of government attempts to reverse fertility decline and promote conservative family values. Our study has three main aims. (1) We provide an overview of fertility trends, policy discourses and policy shifts in the context of the changes in the societal and political structures of Iran during the last half a century. (2) We highlight and discuss the most problematic features of the new Family Law, especially the legislation pertaining to maternal and reproductive health, access to abortion and contraception, and incentives supporting earlier marriage and higher fertility. (3) We discuss the likely consequences of the new legislation for maternal and child health and sexual and reproductive rights, for women in general, and the country\'s socio-economic disparities. As well as violating reproductive rights, the new policy is unlikely to achieve its aim of initiating a sustained rise in fertility in Iran.
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  • 文章类型: Journal Article
    每天大约有231,000名妇女在美国的监狱和监狱系统中被拘留,有色人种妇女占被监禁者的近一半。这次范围审查的目的是综合有关受监禁影响的黑人妇女生殖自主性的文献,使用生殖正义的三个原则。
    我们搜索了PubMed,CINAHL,Socindex,和PsycINFO用于与生殖正义有关的研究,用英语撰写,并于1980年至2022年在美国出版。对440篇文章标题和摘要的审查产生了32篇文章,用于全文审查;纳入了9篇文章。
    八个解决了Tenet1;五个提到了Tenet2;没有一个解决了Tenet3。对监禁对黑人妇女生殖自主权的影响的认识是有限的。
    这项审查的结果表明,有必要解决(a)生殖选择,(b)支助目标,(c)支持涉及司法的黑人妇女。
    There are approximately 231,000 women detained daily within the nation\'s jail and prison systems with women of color making up nearly half of those experiencing incarceration. The purpose of this scoping review was to synthesize the literature on the reproductive autonomy of Black women influenced by incarceration, using the three tenets of reproductive justice.
    We searched PubMed, CINAHL, SocINDEX, and PsycINFO for research related to reproductive justice written in English and published in the United States from 1980 to 2022. A review of 440 article titles and abstracts yielded 32 articles for full-text review; nine articles met inclusion.
    Eight addressed Tenet 1; five mentioned Tenet 2; none addressed Tenet 3. Recognition of the influence of incarceration on the reproductive autonomy of Black women is limited.
    The findings from this review suggest a need to address (a) reproductive choice, (b) support goals, and (c) support of justice-involved Black women.
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  • 文章类型: Journal Article
    对于希望有自己的亲生孩子的癌症幸存者患者,目前的生育力保护选择有限。人类体外配子发生(IVG)具有为接受癌症治疗的个体提供独特解决方案的假设能力,从而缩短了他们的生殖寿命。通过简单的皮肤穿刺活检,患者的生育能力可以通过将真皮成纤维细胞重编程为诱导的多能干细胞来恢复,然后从原始生殖细胞样细胞转化为可用于胚胎发生的活卵母细胞和精母细胞。诱导多能干细胞也可用于形成体外环境,类似于卵巢或睾丸,卵原成熟所必需的。这将允许整个胚胎在体外产生,离体。虽然干细胞生物学研究的这一领域提供了彻底改变我们所知的生殖的潜力,有许多关键的障碍,科学和道德,需要克服的问题,有一天看到这项技术在临床上使用。
    Current fertility preservation options are limited for cancer survivor patients who wish to have their own biological children. Human in vitro gametogenesis (IVG) has the hypothetical ability to offer a unique solution to individuals receiving treatment for cancer which subsequently shortens their reproductive lifespan. Through a simple skin punch biopsy, a patient\'s fertility could be restored via reprogramming of dermal fibroblast cells to induced pluripotent stem cells, then from primordial germ cell-like cells into viable oocytes and spermatocytes which could be used for embryogenesis. Induced pluripotent stem cells could also be used to form in vitro environments, similar to the ovary or testes, necessary for the maturation of oogonia. This would allow for the entire creation of embryos outside the body, ex vivo. While this area in stem cell biology research offers the potential to revolutionize reproduction as we know it, there are many critical barriers, both scientific and ethical, that need to be overcome to one day see this technology utilized clinically.
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