New freedoms, new dependencies : new reproductive technologies, women's health and autonomy

Gupta, Jyotsna Agnihotri Rijksuniversiteit te Leiden 1996 국내박사

Making Up Mosquitoes: Gene Drives, Malaria, and Reproductive Transformation in the Field

O'Connor, Anne University of California, Davis ProQuest Dissertat 2022 해외박사(DDOD)

This dissertation is based on five years of fieldwork with the UC Davis Vector Genetics Laboratory in Davis California. Following particularly their collaboration with a University of California consortium project led by UC Irvine, it is focused on the laboratory’s contribution to the project of creating the first open-field trial of genetically modified organisms bearing gene drives, a genetic element which alters patterns of genetic inheritance. These organisms are a version of the Anopheles gambiae mosquito, which is the main African vector of malaria. That disease continues to kill nearly half a million people on that continent every year, most of them children. Even with the very recent introduction of a possible vaccine, with only about 30% effectiveness, the project is premised on the conclusion that existing prevention and treatment efforts are, and will continue to be, inadequate. The research team believes that this project, if it progresses to implementation on continental Africa, has the potential to eliminate malaria. The Vector Genetics Laboratory has been tasked with undertaking the fieldwork portion of this project, or bringing organisms and phenomena demonstrated in the laboratory to fruition in the world. This text highlights a simple point which has nevertheless been neglected in most conversations around gene drives and similar genetic engineering projects. The trial, like some others using similar technologies, depends on the manipulation of existing populations and their reproductive networks. This new mode of controlling living organisms is offered as a more elegant and effective way to change other living beings in the world. Rather than doing things to them, we have them do them to each other. Gene drives are perhaps the clearest example of this strategy, and it is widely recognized that this opens up new possibilities for the manipulation of living beings. I argue here, however, that this strategy also re-theorizes ideas of control in practice, and scrambles existing discourses about novelty and change through what it does to sexual reproduction. While we tend to think of the new mosquito as the novel element of the equation, my fieldwork shows that it does not figure centrally in the planning of an open field trial. That is because it is not very likely to do a new or unexpected thing all on its own. The crux of this new technology is that it intervenes at the point of reproduction—the space where the researchers anticipate they may be surprised, where something unpredictable may happen, is at this sexual interface between laboratory mosquito and wild-type. Because they know a great deal about the former, but very little about the latter, it is in the wild half of this equation that attention is centered. This matters for the kinds of stories we are building around this and other projects using gene drives. Because this is likely to be the first use of the technology outside the laboratory, its outcome carries tremendous consequences for future uses, both planned and as-yet unimagined. I argue that implementation, far from being after-the-fact, is actually the main event. The project is not the mosquito; it is what the mosquito can do with the world. Investigations of mosquito worlds, thus, take on a new and greater significance: they are not the passive ground upon which change is enacted, but active doers catalyzed in a particular way by sex.

출산테크놀로지에 대한 여성학적 접근 : 시험관 아기 기술을 중심으로

조영미 이화여자대학교 대학원 1994 국내석사

(The) impact of health insurance coverage for assisted reproductive technology on multiple pregnancy and birth in South Korea

차원태 Graduate School, Yonsei University 2023 국내박사

ABSTRACT The Impact of Health Insurance Coverage for Assisted Reproductive Technology on Multiple Pregnancy and Birth in South Korea Background: Since 2002, Korea has experienced an ultra-low birth rate with a total fertility rate <1.3. Recognizing the problem of low fertility due to late marriage and low birth rate as a societal responsibility rather than an individual responsibility, the government initiated a large-scale support project for infertile couples with low income in 2006, in which the government subsidized part of the cost of assisted reproductive technology in response to the low birth rate. Since October 2017, health insurance has been used to provide universal cost support regardless of income level, and infertility treatment is being expanded to all couples with infertility who desire children. The number of births due to the national assisted reproductive technology (ART) support program for couples with infertility has also increased. In this background, this study aimed to evaluate the effect of ART health insurance mandate on multiple pregnancies and births in Korea. Methods: In this population-based cohort study, we used two data sources: Data from the National Health Insurance Service (NHIS)-delivery cohort database (July 2015 to December 2019) were used in the individual-level analysis, and publicly released data from the Statistics Korea were also used in the aggregate-level analysis. A total of 1,474,484 individuals were included in the study after excluding individuals with no birth records at Korean medical institutions and those with missing data. Since the NHIS had begun covering ART on October 1, 2017, and the last follow-up date for the data was December 31, 2019, we determined the follow-up period before and after the intervention to be 27 months each (pre-intervention period: July 2015 to September 2017; post-intervention period: October 2017 to December 2019). Multiple pregnancies and multiple births were identified by diagnosis codes according to the International Classification of Diseases, 10th revision. Total births were defined as the total number of babies born to each pregnant woman during the follow-up period. In aggregate-level analysis, an average of 12,524,214 women of childbearing age per month, and an average of 29,701 live births per month were included in the analysis. An interrupted time series with segmented regression was performed to analyze the time trend and its change in outcomes. Results: After covering ART treatment, the likelihood of multiple pregnancies and multiple births was estimated to increase by 0.7% (p<.0001) and 1.2% (p<.0001), compared to before coverage. The probability of an increase in the number of total births per pregnant woman after the intervention was estimated to be 0.5% (p<.0001). The relatively high-income class above the median income showed a decreasing trend in multiple births and total births before the intervention, but after the intervention, it turned to a significant increase. On the other hand, the implementation of ART coverage policy had no significant impact on the marriage and pregnancy rates. However, it did affect multiple pregnancy and multiple birth rates, which increased by 1.0% (p=0.0001) and 1.4% (p<.0001), respectively, compared to the pre-intervention period. Although the effect of covering ART treatment on the total birth rate was not confirmed, a slightly slower decline was observed after the intervention (Exp(β1)=0.993, p<0.0001, Exp(β1+β3)=0.996, p= 0.012). Conclusions: This population-based cohort study found that the possibility of multiple pregnancies and births in Korea significantly increased after the implementation of an ART health insurance coverage policy. This policy increased the fertility rate of couples who wanted to have children, but did not contribute to raising the overall fertility rate. Nonetheless, our findings suggest that ART health insurance coverage policies that can support infertile couples should be further developed to urgently solve the problem of Korea’s low fertility rate.

한국 생명의료기술의 전환에 관한 연구 : 재생산기술로부터 생명공학기술로

하정옥 서울대학교 대학원 2006 국내박사

Fortpflanzungsmedizin als Gegenstand des Strafrechts? : eine Untersuchung verschiedenartiger Regelungsansa@tze aus rechtsvergleichender und rechtspolitischer Perspektive

Jungfleisch, Frank Max-Planck-Institut fu@r ausla@ndisches und intern 2005 국내박사

Development of basic assisted reproductive technologies for Selachimorpha

김상화 서울대학교 대학원 2022 국내박사

Shark is a generic term for fish species belonging to the Class Chondrichthyes Superorder Selachimorpha and is a representative animal group that has successfully survived to date among early vertebrates. As they appeared in the early stages of vertebrate formation and thus contain the history of evolution, sharks are important subject of evolutionary biological studies in various aspects such as immunology, reproductive biology, and cancer biology. In addition, sharks play an important role in ecological point of view because they are the apex predators of the marine food chain and are contributing to maintain a balanced and stable ecosystem. It has already been revealed through several previous studies that if the number of sharks become seriously reduced, the entire food chain of the relevant area can collapse. Sharks are thus also called as keystone species because of their high importance. The problem is that sharks are currently in critical danger of extinction. According to the IUCN Red List, about 37% of chondrocytes are classified into “vulnerable (VU),” “endangered (EN),” and “critically endangered (CR)” groups, facing serious extinction. Decline of population had been perceived since the 1970s, and the biggest contributing factor has been pointed out as fishing, led by the shark's fin industry. Accordingly, conservational efforts have been carried out worldwide to reduce shark fishing, but their endangered status has not been easily improved due to their uniquely slow breeding rate. Artificial intervention by human is indispensable for the conservation of critically endangered animal species. Assisted reproductive technology has already been developed and applied to conservational works for various endangered species such as white cranes, Przewalski’s horses, elephants, and northern white rhinos. However, in the case of sharks, access to the animals is not easy, so few studies have been conducted thus far. Therefore, in this paper, a series of studies on assisted reproductive technology were conducted to contribute to the shark conservation. First, basic imaging atlas was established, and then shark semen cryopreservation protocol, hormone induced ovulation protocol, and hormone induced semen sampling protocol were developed. 1. As imaging analysis techniques are the basis of veterinary approaches, this study established detailed imaging atlas in sharks using computed tomography (CT) and magnetic resonance imaging (MRI) methods for the first time. Whole-body CT and MRI scans were performed with three young banded houndsharks (Triakis scyllium) of around 1 m in total body length, and each individual was cryosectioned into transverse, sagittal, and dorsal planes to compare and analyze with the images from CT and MRI scans. Atlas was established by classifying various organs and tissues in detail. However, it was impossible to confirm the reproductive system as the study was conducted on immature individuals. 2. Experiments were conducted on five male banded houndsharks (Triakis scyllium). One hour after 0.2 mL/kg of Ovaprim® administration, the shark's abdomen was gently massaged and the secondary cloudy portion of semen was sampled through urogenital papilla. The composition of an activating extender capable of maximizing the motility of stationary spermatozoa was established, which was designated as SSAE-1. To establish a cryopreservation protocol optimized for banded houndshark semen, a total of 8 extender solutions, 3 extension ratios, 15 cryoprotectants, 4 equilibration periods, 3 cooling rates, and 3 thawing temperatures were tested. The optimized protocol (Kim’s protocol) was as follows: extender, filtered seawater; extension ratio, 1:3; cryoprotectant, egg yolk 10% + ethylene glycol 10%; equilibration period, 10 min; cooling rate, 3 cm, 3 min; thawing temperature, 30℃, 10 s. The resulting post-thaw spermatozoa motility was 2.03%. 3. Experiments were conducted on the ovoviviparous shark banded houndshark (Triakis scyllium) and the placental shark (Triaenodon obesus) to confirm the applicability of salmon-derived gonadotropin-releasing hormone analogue (sGnRHa, Ovaprim®) throughout shark species with various breeding strategies. Prior to the experiment, normal blood sex hormone concentrations of females and males were identified in each of the species, and used as the base line for further experimental analysis. In both species, it was confirmed that Ovaprim® successfully induced changes in concentration of estradiol, progesterone, and testosterone in the blood, follicular maturation and ovulation in females, and semen release in males. The optimized injection protocols of Ovaprim® for future application to artificial insemination were as follows: male banded houndshark: 0.2 mL/kg administration and semen sampling 1 hour after administration; female banded houndshark: 0.2 mL/kg first administration and 0.5 mL/kg second administration with 24 hours of gap time; male whitetip reef shark: 0.2 mL/kg administration and semen sampling right after administration; female whitetip reef shark: 0.2 mL/kg first administration and 0.2 mL/kg or 0.3 mL/kg second administration with 24 hours of gap time. 상어는 판새아강 상어상목에 속하는 어종들의 총칭으로, 초기 척추동물 중 현재까지 성공적으로 생존해 있는 대표적인 동물군이다. 척추동물 형성 초기에 나타나 진화의 역사를 고스란히 담고 있는 만큼, 상어는 면역체계, 번식 전략, 암 저항성 등 다양한 측면에서 중요한 진화생물학적 연구의 대상이다. 뿐만 아니라 상어는 생태학적으로도 중요한 역할을 하는데, 해양 생태계 먹이사슬의 최상위 포식자로서 해당 생태계가 균형 있고 안정적으로 유지될 수 있도록 기여하고 있기 때문이다. 상어 개체 수에 이상이 생기면 먹이사슬 전체가 무너질 수 있다는 점은 이미 여러 선행연구를 통해 밝혀진 바, 그 중요성이 높기 때문에 핵심종이라고도 불린다. 문제는 이들이 현재 심각한 멸종위기에 처해있다는 점이다. IUCN Red List에 따르면, 연골어류의 37%가량이 취약 (VU), 절멸 위기 (EN), 절멸 위급 (CR)군으로 분류되고 있어 심각한 멸종위기 상태를 마주하고 있다. 이러한 양상은 이미 1970년대부터 확인되어 왔으며, 그 가장 큰 요인으로는 샥스핀 산업을 필두로 하는 어업이 지적되어 왔다. 이에 전세계적으로 상어 어획량을 줄이고자 하는 환경운동이 수행되어 왔으나, 상어 특유의 느린 번식속도에 기인하여 이들의 멸종위기 상태가 쉽게 개선되지는 않고 있는 실정이다. 심각한 멸종위기 상태의 동물 종 보전을 위해서는 사람의 인위적인 개입이 필수불가결하다. 이미 재두루미, 몽고말, 코끼리, 북부흰코뿔소 등 다양한 멸종위기 동물종에서 종 구제 및 보호를 위하여 보조생식기술이 개발 적용되고 있다. 그러나 상어의 경우 동물 자체에 대한 접근이 쉽지 않아 사실상 연구 되어있는 바가 거의 없다. 이에 본 논문에서는 상어 종 보전에 기여하고자 일련의 연구들을 수행하였다. 우선적으로 기초적인 영상의학 아틀라스를 확립하였으며, 이후 보조생식기술 개발을 위하여 상어 정액 동결보존 프로토콜 및 호르몬 유도 배란 프로토콜, 호르몬 유도 정액 샘플링 프로토콜을 개발하였다. 1. 영상의학적 분석 기반 확립은 모든 수의학적 접근 방식의 기본이 되는 만큼, 본 연구는 최초로 컴퓨터 단층촬영 (CT) 및 자기공명영상진단 (MRI) 방식을 이용하여 상어에서의 세밀한 영상의학 아틀라스를 확립하였다. 체장 1 m 안팎의 어린 까치상어 (Triakis scyllium) 세 마리의 전신 CT 및 MRI 스캔을 수행했으며, 각 개체들을 냉동 후 transverse, sagittal, dorsal 단면으로 잘라 실제 단면 모습과 CT, MRI상의 단면을 비교분석 하였다. 다양한 장기 및 조직들을 세밀하게 구분하여 아틀라스를 확립하였다. 다만 미성숙 개체들을 대상으로 연구를 수행하였던 만큼 생식계통에 대한 확인은 불가하였다. 2. 까치상어 (Triakis scyllium) 수컷 다섯 마리를 대상으로 실험을 수행하였다. Ovaprim®을 0.2 mL/kg 투여 후 1시간 뒤, 상어의 복부를 부드럽게 마사지하여 urogenital papilla를 통해 나오는 정액의 secondary cloudy portion을 샘플링 하여 실험에 이용하였다. 정지상태 정자의 motility를 최대로 만들 수 있는 활성화 용액 조성을 확립하였으며 이를 SSAE-1로 명명하였다. 까치상어 정자에 최적화된 동결보존 프로토콜을 확립하기 위하여 총 8종의 extender solution, 3종류의 extension ratio, 15종의 cryoprotectants, 4종의 equilibration periods, 3종의 cooling rates, 3종의 thawing temperature를 테스트 하였다. 결과적으로 정립된 Kim’s protocol은 다음과 같다: extender, filtered seawater; extension ratio, 1:3; cryoprotectant, egg yolk 10% + ethylene glycol 10%; equilibration period, 10 min; cooling rate, 3 cm, 3 min; thawing temperature, 30℃, 10 s. 프로토콜을 이용했을 때 최종적으로 확인된 정자의 해동 후 운동능은 2.03%로 확인되었다. 3. 난태생 상어인 까치상어 (Triakis scyllium)와 태반성 태생 상어인 화이트팁 상어 (Triaenodon obesus)에서 실험을 수행하여 다양한 번식전략을 지닌 상어 종 전반에 걸쳐 연어 유래 gonadotropin-releasing hormone (GnRH, Ovaprim®) 적용 가능성을 확인하였다. 실험에 앞서 두 상어종에서 암컷과 수컷의 정상 혈중 성호르몬 농도를 각각 확인하여 추후 실험 분석의 base line으로 이용하였다. 두 종 모두에서 Ovaprim®이 혈중 에스트로겐, 프로게스테론, 테스토스테론의 농도 변화를 성공적으로 유도하였으며, 암컷에서는 난포 성숙 및 배란을, 수컷에서는 정액 사출을 유도함을 확인하였다. 추후 인공수정에 적용할 수 있도록 Ovaprim®의 농도 및 투여 주기를 최적화한 결과는 다음과 같았다: 까치상어 수컷: 0.2 mL/kg 투여 1시간 뒤 정액 샘플링; 까치상어 암컷: 0.2 mL/kg 투여 24시간 뒤 0.5 mL/kg 2차 투여; 화이트팁 상어 수컷: 0.2 mL/kg 투여 직후 정액 샘플링; 화이트팁 상어 암컷: 0.2 mL/kg 투여 24시간 뒤 0.2 mL/kg 또는 0.3 mL/kg 2차 투여.

Predictive value of ultrasound markers measured on 3-dimensional ultrasound for pregnancy in fresh and frozen-thawed embryo-transfer cycles

Saemi Park 고려대학교 대학원 2024 국내석사

Purpose: To evaluate endometrial markers on ultrasound (US) to predict clinical pregnancy (CP) in fresh and frozen-thawed embryo transfer (ET) cycles. Materials and methods: A total of 170 ET cycles (80 fresh and 90 frozen-thawed) were performed. All patients underwent controlled ovarian stimulation and in vitro fertilization (IVF). Endometrial parameters, including endometrial thickness (EMT), endometrial and subendometrial volumes, and vascular indices, were measured on the day of ET using two-dimensional (2D-) and three-dimensional (3D-) US with power Doppler. Results: Endometrial volume was significantly higher in the CP group than in the non-CP group in all ET cycles. In multiple regression models for the prediction of CP, the odds ratio (OR) of endometrial volume was 1.36 (95% confidence interval [CI]: 1.08-1.69) (P = 0.008) and the OR for subendometrial volume was 1.91 (95% CI: 0.99 – 3.67) (P = 0.053) after adjusting for the transferred embryo stages and number of transferred embryos. In the fresh ET cycle subgroup, both endometrial and sub-endometrial volumes were significantly higher in the CP group than in the non-CP group. In contrast, the endometrial and subendometrial volumes were not significantly different between the CP and non-CP groups in frozen-thawed ET cycles. None of the vascular indices were associated with positive CP in any of the ET cycles. Conclusion: Endometrial and subendometrial volumes are associated with the probability of CP in fresh ET cycles, whereas vascularization indices do not predict CP. Keywords: Assisted reproductive technology, endometrium, implantation, ultrasound, power Doppler 목적: 신선 및 냉동-해동 배아 이식 주기에서 임상적 임신 예측을 위해 초음파의 자궁내막 마커를 조사함. 재료 및 방법: 총 170회의 배아 이식 주기(신선 80회, 냉동-해동 90회)를 대상으로 함. 모든 환자는 난소 자극과 체외 수정을 받았음. 자궁내막 두께, 자궁내막 및 자궁내막 하 부피, 혈관 지수를 포함한 자궁내막 매개변수는 배아 이식 당일 2차원(2D) 및 파워도플러를 이용한 3차원(3D) 초음파를 사용하여 측정하였음. 결과: 모든 배아이식 주기에서 자궁내막 및 자궁내막 하 부피는 비임신 그룹에 비해 임신 그룹에서 유의하게 높았음. 임신 예측을 위한 다중 회귀 모델에서 이식된 배아 단계와 이식된 배아 수를 조정한 자궁내막 부피의 승산비는 1.36(95% 신뢰 구간: 1.08-1.69) (P = 0.008)이고 자궁내막 하 부피에 대한 승산비는 1.91(95% CI: 0.99 – 3.67) (P = 0.053)임. 신선한 배아 이식 주기의 하위 그룹에서 자궁내막 부피와 자궁내막 하 부피는 비임신 그룹에 비해 임신 그룹에서 통계적으로 더 높았음. 대조적으로, 자궁내막 및 자궁내막 하 부피는 냉동-해동 배아 이식 주기에서 CP 그룹과 비CP 그룹 사이에 통계적으로 차이를 나타내지 않았음. 모든 ET 주기에서 혈관 지수 중 어느 것도 임신과 연관되지 않았음. 결론: 자궁내막 및 자궁내막 하 부피는 신선 배아 이식 주기에서 임상적 임신 확률과 연관되어 있는 반면 혈관 지수는 임상적 임신에 대한 예측 가치가 없다는 것을 알 수 있음. 키워드: 보조생식술, 자궁내막, 이식, 초음파, 파워 도플러

A survey of porcine respiratory disease complex (PRDC) associated pathogens among commercial pig farms of Korea via oral fluid method : 돼지구강액을 이용한 한국내 양돈장에서 PRDC와 연관된 병원체에 대한 조사

정여택 건국대학교 대학원 2017 국내석사

Oral fluid analysis for monitoring herd is an interest in commercial pig farms in Korea. The aim of this study was to investigate the positive rates and correlation of eight pathogens associated with porcine respiratory disease complex (PRDC) by analyzing oral fluid samples from 214 pig groups from 56 commercial farms. The samples collected by rope-chewing method were analyzed with reverse-transcription polymerase chain reaction (RT-PCR) or standard PCR depending on microorganisms. The pathogens were divided into virus group and bacteria group. The former consisted of porcine reproductive and respiratory syndrome virus (PRRSV) and porcine circovirus type 2 (PCV2), and the latter Pasteurella multocida (PM), Haemophilus parasuis (HPS), Actinobacillus pleuropneumoniae (APP), Mycoplasma hyopneumoniae (MHP), Mycoplasma hyorhinis (MHR), and Streptococcus suis (SS). All pathogens were detected more than once in the PCR reaction. Analysis based on age distribution showed increasing PCR positive rates for PCV2 and MHP with increasing age. SS was inverse proportion. Correlations between pathogens were assessed in 36 different combination pairs. Seven pairs showed statistically significant correlations. In conclusion, the oral fluid method could be a feasible way to detect various swine respiratory disease pathogens and therefore, could complement current monitoring systems for respiratory diseases in the swine industry. 돈군 모니터링을 위한 구강액 분석은 국내 양돈장에서 관심을 끌고 있다. 본 연구의 목적은 56개 돼지 농장, 214개 돈군에서 채취한 구강액을 분석하여 돼지호흡기복합증후군(porcine respiratory disease complex, PRDC)과 관련된 8개 병원체의 양성율과 연관성을 조사하는데 있다. 로프를 씹음으로 인해 얻은 샘플은 병원체의 특성에 따라 역전사 중합효소 연쇄반응(reverse-transcription polymerase chain reaction, RT-PCR) 혹은 중합효소 연쇄반응(polymerase chain reaction, PCR)을 수행하였다. 병원체는 바이러스 그룹과 박테리아 그룹으로 나누었다. 바이러스 그룹은 돼지호흡기생식기증후군 바이러스(porcine reproductive and respiratory syndrome virus, PRRSV)와 돼지써코바이러스(porcine circovirus type 2, PCV2)로 구성이 되었고, 박테리아 그룹은 파스튜렐라 멀토시다(Pasteurella multocida, PM), 해모필러스 파라스위스(Haemophilus parasuis, HPS), 액티노바실러스 플루오르뉴모니애(Actinobacillus pleuropneumoniae, APP), 마이코플라즈마 하이오뉴모니애(Mycoplasma hyopneumoniae, MHP), 마이코플라즈마 하이오라이니스(Mycoplasma hyorhinis, MHR) 및 스트렙토코커스 스위스(Streptococcus suis, SS)로 구성이 되었다. 모든 병원체는 PCR 반응에서 한 번 이상 검출되었다. 나이 분포에 기반한 분석은 주령이 증가할 때 PCV2와 MHP 양성율은 상승하는 반면에, SS는 감소하였다. 병원체간 연관성은 36개의 서로 다른 조합쌍을 조사하였다. 7개 조합쌍에서 통계적으로 유의성이 있었다. 결론적으로 구강액 방법은 다양한 돼지 호흡기 병원체의 탐색에 있어서 접목 가능한 방법일 수 있으며, 양돈산업에 있어서 현재의 호흡기 질병 모니터링 방법을 보완할 수 있을 것이다.

한국 생식의료의 전개과정에 관한 연구 : 소극적 정책보조자에서 산업개척자로 : from passive policy assistant to industrial pioneer

박종헌 서울대학교 대학원 2008 국내박사