Reproductive technologies essay


Original Articles

The histories of imperialisms and colonialisms not only intersected with but have also been constitutive of the situated histories of reproductive technologies e. There are several pertinent concerns. First, in recent scholarship, heretofore conventional assumptions about late nineteenth and twentieth century European colonialisms as adequately representative of forms of imperialism are being actively destabilized e.

For example, the significance of Japanese imperialism for much of Asia and the Pacific is beginning to be elaborated e. Very recent work takes up Chinese imperialism in Tibet Stoler et al. Second, theories reliant upon one-way metropole to colony frameworks, including modernization and development theories, have been widely challenged e. In terms of the sciences, EASTS offered a special issue on colonial sciences in former Japanese imperial universities Tsukahara ; see also Fan a.

In terms of medicine and often inspired by Arnold , , there has been a spate of recent work that opens up broader questions of colonialism e. Liu offers a revisionist history of the spread of modern medicine from Japan to its colonies, arguing that it was not so much or not only a planned colonial project as it was the result of academic rivalries within Japan.

Others have studied medical practices in colonial Taiwan e. Looking at biomedicine in Chinese East Asia, Anderson Forthcoming troubles the categories of colonial per se. Perhaps most important here among recent studies is Rogaski's project on how hygiene became a crucial element in the formulation of Chinese modernity in the nineteenth and twentieth centuries. For much of the nineteenth century, weisheng was associated with diverse regimens of diet, meditation, and self-medication from Chinese cosmology.

With the arrival of imperialism, its meanings shifted to encompass such ideas as national sovereignty, laboratory knowledge, the cleanliness of bodies, and the fitness of races. Significantly, her work demonstrates a different modernity in East Asia. Using her lens on reproductive technoscience might easily broaden the possibilities of seeing how such modernity might be gendered.

Such expanding conceptualizations of imperialism and colonialism are already complicating studies of reproductive sciences and technologies by demanding research on nonwestern colonial situations such as Korea or Taiwan under the Japanese c— Work such as Yoo's on The Politics of Gender in Colonial Korea greatly facilitates research directly on gender and reproductive technologies.

What relation did this have to reproductive technologies? Hodges counters conventional colonial framings by elucidating how South India's engagement with birth control before WWI not only remade South India but also refashioned the international birth control movement. Anderson's work on settler colonies provokes different questions about relations between reproductive technologies and indigenous populations and their health. Issues of postcolonial and nationalist embeddedness pose yet other problems in considering reproductive technologies in East Asia.

The term postcolonial is itself challenging. Today, we often see the terms neocolonial and neoliberal expansions used to refer to the varied forms of maintenance of colonial regimes and practices. For example, looking at Chinese East Asia, Anderson Forthcoming argues that, in some sites, medicine was better conceptualized as semicolonial, troubling the boundary with postcolonial yet further.

Looking at Taiwan, Chin directly links the practices of colonial medical police with postcolonial medical surveillance systems. Whether and how these medical issues link to access to or practices around reproductive technologies are interesting questions we hope will be pursued. It can be argued that issues of nationalism somehow inform the conceptualization and consideration of almost if not all reproductive technologies and policies relating to them in East Asia today.

Moreover, because reproductive technologies actively intervene in reproduction, so important to the nation-state, issues of nationalism become central to their very framing. Even a cursory review of the bibliography of works in English on reproductive technologies in East Asia in this volume reveals the pressing questions of salience of cultural and geopolitical histories and boundaries. Issues of postcolonialism and nationalism in relation to reproductive technologies after WWII also link to international health and development programs, and more recently to global health e.

For example, Dimoia this volume and Kuo , although not centered on gender politics, provide case studies for South Korea and Taiwan respectively of how contraception and population control linked to the Cold War, nation-building, and development. The activities of major Western foundations in East Asia must be considered within this framework e. One East Asian biotechnological exemplar here is the major Korean investment in stem cell research that culminated in the Hwang controversy see, e. As Ong points out, national patterns of biotech investment vary tremendously in East Asia.

Assisted Reproductive Technology - Part 1

Another example is the reproductive tourism business in East Asia e. Sites for such tourism are multiplying and the networks among them densify rapidly. An interesting project would be tracing how these projects stimulate each other—become coconstitutive. Of particular pertinence to studying gender and reproductive technologies in East Asia is feminist attention to and theorization of transnational issues sustained over at least the past two decades.

Reproductive technologies travel widely, sliding along biomedical and development project infrastructures into new settings. As already demonstrated by much of the literature on reproductive technologies in East Asia, the salience of nation states and nationalisms for gendered issues is not dissipating, but perhaps even increasing Kim-Puri There are also stratifications of reproduction within nation states e. Hopefully the next generation of studies of reproductive technologies in East Asia will pursue such complexities. Forms of biological citizenship emerged in the late twentieth century as rights of citizens to protection and promotion of their health and well-being, however rhetorical rather than in concrete practice.

The development of biological citizenship in locations with colonial histories is, of course, worthy of study on its own terms as well as in relation to reproductive technologies. Key questions for us are whether and how forms of biological citizenship are emergent in different national policies and practices related to reproductive technologies. Such questions likely need to be asked regarding one nation state at a time and one reproductive technology at a time.

That is, a particular nation may or may not offer state-supported use of a particular reproductive technology. State-supported health services typically cover contraception, sterilization, prenatal care and birthing but not assisted reproductive technologies for infertility. Moon's work on gendered citizenship in South Korea, for example, included explicit concern with and policies around women and reproduction formulated by the state itself.

I. The Puzzle and Its Stakes

In terms of gender and reproductive technologies, it will be interesting to see whether and how biological citizenship is taken up. Through case studies of stem cell related technologies and banks in the Taiwanese biotech industry, she suggests that notions of peoplehood not personhood are configured in newly biosocialized modes. In sum, we anticipate that future scholarship will articulate layered consequences of imperialisms, colonialisms and postcolonialisms, and begin to tease these apart. Biological citizenship and emergent forms of biosociality in both their localizing and transnationalizing dimensions will also be linked to reproductive technologies in newly elaborated ways.

The topics of the papers in this special issue range from reproductive science in China to birth control, family planning and population policy in colonial South Korea and in the new republic's early years, and lived experiences of infertility and its treatment in contemporary Japan. The first paper, by Howard Hsueh-Hao Chiang, centers on aspects of the uptake of Western reproductive science in China in the first half of the twentieth century. Analyzing both the scientific and more popular writings of embryologist Zhu Xi — , Chiang shows how the discourse of ci biological femaleness and xiong biological maleness was linked to the capacity to see sexual differences.


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Not surprisingly, given the historical importance of sex and gender as binaries in Chinese culture e. The next two papers take up dynamics of birth control, family planning and population policy in Korea. Sonja Kim examines how birth control issues emerged in colonial Korea as they were being hotly debated and more or less regulated in imperial Japan.

In terms of the circulation of information about birth control and advertisement of birth control products, the situation seems to have been ambiguous in both Japan and Korea. While providing scientific information about birth control processes and products was legitimate, direct advertising was not. After World War I, links between overpopulation, poverty and failures of industrialization began to be articulated. Korean reformers and Korean feminists alike found birth control advocacy and use appropriate, as did many women.

In contrast, various Japanese anti-birth control articles appeared. By the early s, eugenic concerns dominated Japanese rhetoric, dimming by the late s as colonial needs for increased population escalated. He argues that while considerable attention has been paid in scholarship on postwar Korea to the role of the military in modernization, not enough has been devoted to corresponding mobilizations of biomedicine of which reproductive technologies are a significant manifestation.

This program was exemplary among the transnational population control efforts of this era. DiMoia's paper enriches this history. DiMoia concludes that birth control technologies as biomedical innovations were embraced enthusiastically by an array of local actors in republican South Korea as a new means of exerting control over their own people, and have left behind an ambiguous legacy of state control that is only beginning to be re-examined. On population science and Asia, see also Greenhalgh , and Sharpless See also Connelly Our last paper in this special issue focuses on infertility in contemporary Japan.

Here Azumi Tsuge explores how women often feel torn—on the horns of a dilemma—about whether to continue or discontinue pursuit of a child through infertility treatment. Tsuge uses feminist narrative analysis to elucidate stories of women well into prolonged treatment trajectories, and by then well aware that success was unlikely. The women, who she studied over many years, clearly situated their decisions about continuing to use technoscience deeply within highly gendered familial and cultural expectations of motherhood as properly feminine.

For these women, ceasing pursuit of a child through the use of reproductive technologies meant reconstructing their identities and subjectivities, and sometimes redirecting their careers as well, in ways that echo studies of people coming to terms with severe illness and disability e. One woman, herself a scientist, went forward with treatment multiple times and discussed having done this altruistically—on behalf of other patients as well as herself. This echoes recent work on scientists taking personal risks for their science Herzig In sum, a second wave of research on gender and reproductive technologies is gaining momentum, marked by studies of such technologies in their transnational travels of which works on East Asia now constitute a growing contribution.

These works emphasize the diversity of situations in East Asia wherein reproductive technologies are taken up and often counter traditional gender stereotypes of suffering and patriarchy. The often complicated new biosocialities—familial, community, and national—in which they are embedded are revealed. At the same time, these projects increasingly attend to and reveal the imbrications of reproduction per se in the historically dense and nuanced histories of imperialisms and colonialisms, postcolonialisms and especially nationalisms.

We anticipate that these areas of focus, along with new and emergent framings of biological citizenship, biosocialities and the turn to affect, subjectivity and technoscience will become of increasing concern in the next decade. More broadly, scholars may explore whether reproductive technologies are constitutive of the biomedicalization not only of individuals but also of societies—transformations of societies induced by biomedicine Burri and Dumit This would be going pretty far indeed.

Sign In or Create an Account. Advanced Search. User Tools. Sign In. Article Navigation. Introduction September 01 Clarke Adele E. Clarke ucsf. This Site. East Asian Science, Technology and Society 2 3 : Article history Received:. Google Scholar. Search ADS. New creation stories of eggs, sperm and embryos: An ethnographic study of creations at sperm banks and fertility clinics. Selling genes, selling genders: egg agencies, sperm banks and the medical market in genetic material. The colonial medicine of settler states: comparing histories of indigenous health.

Colonizing the body: State medicine and epidemic disease in nineteenth-century India. Population Control for National Development: From world discourse to national policies. Constructing world culture: International Nongovernmental Organizations since Consuming cultures, global perspectives: Historical trajectories, transnational exchanges.

Biomedicine as culture: Instrumental practices, technoscientific knowledge, and new modes of life. Locality in the history of science: Colonial science, technoscience, and indigenous knowledge. Colonial medical police and postcolonial medical surveillance systems in Taiwan, —s.

Maverick reproductive scientists and the production of contraceptives c— Biomedicalization: Technoscientific transformations of health, illness, and U. Biomedicalization: Technoscience and transformations of health and illness in the U. The logic of eugenics and American National Family Planning. Revisioning women, health, and healing: Feminist, cultural, and technoscience perspectives. Ontological choreography: agency through objectification in infertility clinics.

De Grazia. In India, outsourcing has reached the womb: Infertile couples can hire low-cost surrogates in growing industry. Science in cultural borderlands: methodological reflections on the study of science, European imperialism, and cultural encounter. The social construction of population science: an intellectual, institutional and political history of 20th century demography. Riddled with secrecy and unethical practices: Assisted reproduction in India. Reproductive rights and wrongs: The global politics of population control and contraceptive choice. Philanthropy and cultural context: Western philanthropy in South, East, and Southeast Asia in the twentieth century.

Contraception, colonialism and commerce: Birth control in South India, — Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine and psychiatry. Pedagogy of democracy: Feminism and the Cold War in the U. The family, medical decision-making, and biotechnology: Critical reflections on Asian moral perspectives. Situating reproduction, procreation and motherhood within a cross-cultural perspective: An introduction.

Paper presented at the annual meetings of the American Anthropological Association. The ripples of rivalry: the spread of modern medicine from Japan to its colonies. Building a modern Japan: Science, technology, and medicine in the Meiji era and beyond. Maternal mortality in Egypt: Selective health strategy and the medicalization of population control. Global assemblages: Technology, politics, and ethics as anthropological problems. Scales of exception: Experiments with knowledge and sheer life in tropical Southeast Asia. The decline of the one-size-fits-all paradigm, or how reproductive scientists try to cope with postmodernity.

Between monsters, goddesses and cyborgs: Feminist confrontations with science, medicine and cyberspace.

Assisted Reproductive Technologies | Year 11 WACE - Human Biology | Thinkswap

Framing women, framing fetuses: how Britain regulates arrangements for the collection and use of aborted fetuses in stem cell research and therapies. Biosocialities, genetics and the social sciences: Making biologies and identities. Relocating modern science: Circulation and the construction of scientific knowledge in South Asia and Europe. Ramirez de Arellano. Colonialism, Catholicism and contraception: A history of birth control in Puerto Rico. Crossing the border for abortions: California activists; Mexican clinics, and the creation of a feminist health agency in the s.

Reproductive Health Matters. In one meta-analysis, individual patient data were used [ 37 ]. Five meta-analyses compared double embryo transfer DET to elective single embryo transfer eSET , and one also assessed higher order multiple embryo transfers and limited analyses to fresh embryos only. Three excluded blastocyst-stage embryos, and one excluded donor oocytes or embryos, although the use of donors was not explicitly stated in any of the pooled studies. The safety and effectiveness of FETs compared to fresh embryo transfers was assessed in 5 reviews of 83 unique primary studies published between and [ 42 — 46 ].

Four also presented meta-analyses. However, one was based on a single study and another focused exclusively on the incidence of ectopic pregnancy [ 42 ]. The remaining two assessed the effect of FET on pregnancy and miscarriage 3 RCTs , and maternal and infant safety in singleton pregnancies 11 cohorts [ 45 , 46 ].

The fifth review, which did not perform a meta-analysis, assessed 67 studies, 25 comparing the transfer of frozen cleavage-stage embryos to fresh cleavage-stage embryos or SC 1 RCT, 12 retrospective cohorts, and 12 registry reports [ 44 ].

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The remaining 42 were non-comparative and evaluated the transfer of frozen blastocyst-stage embryos or the fertilization and transfer of frozen oocytes. In most, details of clinical protocols used were not reported. No reviews or additional primary studies reporting the effect of fresh versus frozen embryo transfer on the incidence of multiples were found.

Four meta-analyses focused on the effect of developmental stage of the embryo during transfer, comparing cleavage-stage embryo transfer, where embryos were transferred 2—3 days after fertilization, to blastocyst-stage embryo transfer, where embryos were transferred 5—6 days after fertilization [ 47 — 51 ]. Three limited inclusion to RCTs. The fourth incorporated any comparative study reporting on sex ratio and monozygotic twinning MZT , regardless of its design. All 4 meta-analyses considered fresh cycles only, and in 2, autologous oocytes only.

Collectively, they involved a total of 38 distinct primary studies 18 RCTs published between and Where reported, numbers varied across studies. In 9, only women deemed likely to succeed with blastocyst transfers were included, and in 2, only women with a poor prognosis were included. Safety data were limited. However, 2 primary studies retrospective cohorts published in and which assessed the impact of embryo stage on obstetric and perinatal complications after IVF provided such information [ 52 , 53 ]. Details of the 79 primary studies covered in the review were not provided.

No reviews or additional primary studies assessing the impact of donor embryo transfer on cycle cancellation or multiple births were found. In general, most of the systematic reviews were of high quality, regardless of whether meta-analyses had been performed. All provided details of their search strategy, which was comprehensive, and nearly all clearly described their study inclusion criteria. However, where validity was assessed, appropriate criteria were used.

Comparing studies that pooled data with those that did not, there was variation in the degree of clinical heterogeneity deemed too much to pool. Conclusions drawn in all reviews were consistent with the data they collected and reported. Quality of systematic reviews: Oxman and Guyatt index of scientific quality for systematic reviews.

For most of the procedural comparisons addressed in the reviews and additional primary studies, data from experimental trials were available and supplemented with data from prospective and retrospective cohorts. Therefore, it was difficult to rule out the use of less invasive ARTs treatments in control groups, as well as the potential influence of infertility and other population differences. Within each review, patient populations and treatments varied across included studies.

Among reviews of the same comparisons, there was overlap in selected studies multiple reports on the same studies or patients published by different investigators. The majority of reviews did not identify or discuss such overlap. These risks remained even after studies with spontaneous pregnancies in infertile couples had been excluded through sensitivity analyses. Across the studies that controlled for basic maternal characteristics e. Those adjusting for at least maternal age indicated that singletons born to infertile women without the use of assisted conception had a significantly higher risk of PTB and low birth weight LBW than singletons born to fertile women [ 32 ].

When ART singletons and multiples had been considered separately, congenital malformation rates were significantly higher in both groups OR:singletons This difference held for singletons, while no significant differences between twins were observed. Similar growth patterns between ART-conceived and spontaneously conceived children, adolescents, and adults were observed [ 21 , 34 ].

Assisted Reproductive Technologies and Culture Change

However, where analyses had controlled for maternal age, gestational age and parity, the odds of experiencing GD, PIH, and caesarean delivery were found to be significantly higher not only after IVF but also after IUI in comparison to SC [ 36 ]. The results of one meta-analysis indicated that compared to SET, DET was associated with higher rates of preterm rupture of membranes 8. With respect to the incidence of GD, findings were inconsistent.

However, those from a meta-analysis of cohort studies showed no significant difference [ 30 , 37 ]. In two reviews, no significant differences in the number of ectopic pregnancies or women admitted to the hospital during their pregnancy after fresh versus FETs were observed [ 42 , 43 ]. One review included a study in which slightly more women developed OHSS after fresh versus FET, but differences did not reach statistical significance.

Further, pooled data in one review showed no significant differences in congenital malformations between fresh and FET [ 45 ]. One of 9 comparative studies comprising a review showed significantly higher rates of MZT after blastocyst transfers compared to cleavage transfers [ 47 ]. Other than this finding, no review discussed differences in safety between blastocyst- and cleavage-stage embryo transfers. Two recent primary studies, one on over 12, singleton IVF births from a Canadian ART registry and one on over 4, singleton IVF births in Australia, performed analyses of obstetric and perinatal complications, adjusting for several maternal and procedural characteristics [ 52 , 53 ].

In the two primary studies reporting infant outcomes, no significant differences in LBW, size for gestational age, congenital anomalies, stillbirth, or neonatal death blastocyst- and cleavage-stage embryo transfers were found [ 52 , 53 ]. No significant differences between donor cycles and PTD were observed [ 54 ].

The same review found no significant differences in LBW rates, proportion of infants small for their gestational age, or congenital malformation rates between infants conceived through donor IVF versus those conceived through autologous IVF [ 54 ]. Results from one meta-analysis indicated no significant differences in pregnancy or live birth rates after IVF and stimulated IUI sIUI in couples with unexplained infertility.

However, multiple pregnancies in the IVF group were found to occur only in couples who received more than 1 embryo [ 31 ]. Both reviews examining the relationship between number of embryos transferred and number successfully implanted found that success rates were similar, regardless of whether 1 or 2 had been transferred [ 38 , 39 ]. In another review, significantly higher pregnancy rates were seen in women who received more than two embryos in comparison those who received one or two embryos [ 41 ]. Based on the results of meta-analyses, while cumulative live birth rates per couple were found to be comparable between DET and SET, live birth rates per cycle after DET were significantly higher than those after SET, with odds ratios ranging from 1.

While these differences were significant in one OR Further, subgroup analyses revealed no differences when an equal number of cleavage and blastocyst stage embryos were transferred, or when more cleavage stage embryos than blastocyst stage embryos were transferred. No variation in the proportion of women experiencing miscarriages after blastocyst transfers versus cleavage transfers was found [ 50 ]. When only women expected to have a good prognosis with blastocyst transfer were considered, differences were even greater, and, conversely, when unselected women or women with a poor prognosis were considered, no significant differences were shown.

No significant difference in the multiple pregnancy rates between blastocyst- and cleavage-stage embryo transfers were seen [ 48 , 50 ]. No reviews discussed differences in effectiveness between donor and non-donor IVF. This study was conducted to support policy development by the provincial government of Alberta.

As public policy is usually context-dependent, the comparators chosen for this study were based on the ARTs interventions under consideration for funding in the province and the corresponding policy questions around the funding of these interventions. It may also have adverse effects throughout infancy, childhood and adulthood. Studies with longer follow-up are needed to confirm these findings. However, embryo stage blastocyst versus cleavage does not appear to impact safety. Similarly, the health of infants born after donor cycles appears to be at least as good as that of infants born after autologous cycles.

However, donor IVF is often associated with anovulation and advanced maternal and studies of donor cycles should take both of these factors into account. In comparison to fresh embryo transfer, the findings suggest that FET has fewer adverse events throughout pregnancy and delivery, and is least as safe as fresh embryo transfer in terms of infant outcomes. Overall, IVF shows a clear benefit over no treatment and IUI for certain types of infertility with respect to pregnancy and live birth.

In fact, most of the studies comprising the review did not specifically address this point. The findings suggest that clinical pregnancy rates and live birth rates are similar or better after FET compared to fresh embryo transfer, and after blastocyst-stage embryo transfer compared to cleavage-stage embryo transfer, particularly in women considered to have a good prognosis. There appears to be little if any difference in the rate of multiple pregnancies between the two groups.

However, these choices may reduce its effectiveness. Therefore, clinical and policy guidance need to ensure that the trade-offs involved are carefully considered by both patients and providers. Fertil Steril. Draft Guidance for Stakeholder Consultation. Hum Reprod Update. Parliamentary Research Branch. Fertility: Assessment and Management update. Am Fam Physician. Homan GF, Davies M, Norman R: The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review. American Society for Reproductive Medicine: Smoking and infertility: a committee opinion.

Hum Reprod. Infertility FAQs. PLoS Med. Health Policy. Cohen J: A coefficient of agreement for nominal scales. Educ Psychol Meas.

II. Mapping Reproductive Wrongs

J Clin Epidemiol. Bandolier Professional. Rating the quality of evidence. J Perinat Med. Hvidtjorn D, Schieve L, Schendel D, Jacobsson B, Svaerke C, Thorsen P: Cerebral palsy, autism spectrum disorders, and developmental delay in children born after assisted conception: a systematic review and meta-analysis.

Arch Pediatr Adolesc Med. Dtsch Arztebl Int. Farhi J, Fisch B: Risk of major congenital malformations associated with infertility and its treatment by extent of iatrogenic intervention.

Pediatr Endocrinol Rev. Cochrane Database Syst Rev. Systematic review and meta-analysis.


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