First-trimester fetal limb biometry in Chinese population

OBJECTIVES: To establish reference ranges for fetal limb biometry obtained by transabdominal ultrasound examination at 12-14 weeks of gestation in Chinese women. METHODS: A total of 1489 normal singleton fetuses between 12(+0) and 14(+6) weeks of gestation were examined transabdominally by two experienced observers. The gestation was ascertained by measurement of fetal crown-rump length (CRL) or biparietal diameter (BPD) and head circumference (HC). The lengths of the humerus and femur were prospectively worked out. RESULTS: Gestation-specific reference ranges for limb measurements were calculated. The femur length (FL) (mean +/- SD) was 9.15 +/- 1.44 mm at 12-12(+6) weeks, 11.45 +/- 1.35 mm at 13-13(+6) weeks, and 13.64 +/- 1.60 mm at 14-14(+6) weeks; the corresponding humerus length (HL) (mean +/- SD) was 9.63 +/- 1.44 mm, 12.01 +/- 1.41 mm, 14.29 +/- 1.48 mm, respectively. CONCLUSIONS: There was a general increase in fetal limb biometry with gestation. Fetal limb length can be an early marker of early growth restriction as well as fetal skeletal dysplasia among women in the local population.     

Legal and ethical issues in the international transaction of donor sperm and eggs

Pertinent ethical and legal issues in the international transaction of donor sperm and eggs are discussed. Firstly, there may be legislative and ethical “contradiction” by the local health authority in permitting import of donor gametes, due to varying policies on donor reimbursement in different countries. This is particularly significant in countries where the underlying principle of gamete donation is altruistic motivation, and where reimbursement is given only for direct “out-of-pocket” expenses i.e. traveling costs. Secondly, there is a lack of clear and coherent internationally-binding legislation and regulatory guidelines overseeing the exchange of donor gametes across international borders. In particular, provisions should be made for donor traceability if gametes are sourced from abroad. Thirdly, in the case of “frozen-egg donation” from abroad, patients must rightfully be informed that current cryopreservation technology is still sub-optimal, and all studies have consistently shown that the chances of conception are always lower with “frozen-eggs” compared to freshly-retrieved eggs. Finally, regulatory safeguards should be put in place to prevent fertility clinics and medical professionals from “re-selling” imported donor gametes at a profit to the patient, since it would be thoroughly unprofessional for them to earn a profit simply through the ‘brokerage’ of donated human material.     

Is it ethically justifiable to cryopreserve oocytes and ovarian tissues of healthy women not facing premature ovarian failure, but seeking to extend their biological clocks?

Recent advances in oocyte and ovarian tissue cryopreservation technology have not only brought hope to women facing premature loss of ovarian function; it can also be utilized for healthy women seeking to extend their biological clocks. This is a major issue of contention in healthcare ethics. Proponents of this new technology argue that this enables women to fully pursue educational and career goals in their youth, whilst upon reaching middle age they would have more financial resources for their offspring. Nevertheless, this argument is flawed by the reality that even if the cryopreservation of oocytes and ovarian tissue were optimized, this would in no way be a guaranteed route for women to have biological children later in life. Moreover, because only a limited amount of autologous reproductive material can be cryopreserved and stored for a single healthy woman, there is a risk of material depletion before reproductive success is attained. Another prime consideration is the increased morbidity and mortality associated with clinical assisted reproduction in older women. Hence, it is suggested that the cryopreservation and storage of oocytes and ovarian tissues be restricted only to women facing the prospect of premature ovarian failure.     

大鼠生后锰接触对黑质多巴胺能神经元发育的毒性影响

目的　研究大鼠出生后锰接触对黑质多巴胺 (DA)神经元发育的毒性影响。方法　采用Morris水迷宫试验检测仔鼠的肌力变化 ;荧光分光度计法检测仔鼠尾状核脑匀浆DA含量的变化 ;酪氨酸氢氧化酶(TH)免疫细胞化学 (ABC法 )与图象分析相结合法检测黑质DA神经元和尾状核DA纤维的免疫反应强度和平均相对密度。结果　 (1)随着染锰浓度的增高 ,仔鼠的肌力呈现明显的衰退 ;(2 )尾状核脑匀浆的DA含量 ,随染锰浓度的升高而降低 ;(3)黑质TH免疫反应阳性神经元和尾状核TH免疫反应阳性纤维的反应强度、以及相应的TH阳性产物的平均相对密度 ,均随着染锰浓度的升高而显著下降。结论　大鼠生后锰接触 ,对黑质多巴胺神经元的发育有明显的毒性损害 ,其损害程度随染锰的剂量升高而增加