Abstract Introduction: Infertility is a disease present in the 17.5% of the adult population. COVID-19 caused overload in health centers, producing an unclear impact in the reproductive health units that perform assisted reproduction therapies. Objectives: To compare clinical characteristics and the attention times of patients subjected to in vitro fertilization in the Reproductive Medicine Unit of the Gustavo Fricke Hospital between the 2017-2019 and 2020-2022 periods. Method: Descriptive observational study in which an anonymized database of 82 patients subjected to in vitro fertilization in the Reproductive Medicine Unit of the Gustavo Fricke Hospital was used. Results: The average age was 34.2 ± 4.2 years old. The infertility time was 5.1 ± 4.3 years. The most frequent infertility factors were tuboperitoneal (59.8%) and male factors (46.3%). During the first pre-pandemic 20 months, there was a higher tendency towards early referral to the Center for Human Reproduction of the Valparaiso University (odds ratio: 3.84). Conclusions: In the course of the pandemic, there was an increase of the infertility time, the pregnancies median, prior abortions, and male factor frequency. On the other hand, there were not considerable changes when it comes to referral times to in vitro fertilization, however, early referrals decreased during the pandemic.

Resumen Introducción: La infertilidad es una enfermedad presente en el 17.5% de la población adulta. La COVID-19 provocó sobrecargas en atención de salud, generando un impacto incierto en unidades de salud reproductiva que realizan terapias de reproducción asistida. Objetivos: Comparar características clínicas y tiempos de atención de pacientes sometidas a fertilización in vitro de la Unidad de Medicina Reproductiva del Hospital Gustavo Fricke entre los periodos 2017-2019 y 2020-2022. Método: Estudio observacional descriptivo, utilizando base de datos anonimizada de la Unidad de Medicina Reproductiva del Hospital Gustavo Fricke con 82 pacientes sometidas a fertilización in vitro. Resultados: La media de edad fue de 34.2 ± 4.2 años. El tiempo de infertilidad fue de 5.1 ± 4.3 años. Los factores de infertilidad más frecuentes son el tuboperitoneal (59,8%) y masculino (46,3%). Durante los primeros 20 meses en prepandemia hubo mayor tendencia a derivación precoz al Centro de Reproducción Humana de la Universidad de Valparaíso (odds ratio: 3.84). Conclusiones: En pandemia se evidenció un aumento en el tiempo de infertilidad, mediana de gestaciones, abortos previos y frecuencia de factor masculino. No hubo cambios significativos en tiempos de derivación a fertilización in vitro, no obstante, durante la pandemia disminuyeron las derivaciones precoces.

RESUMEN: En las sociedades occidentales, la filiación se atribuye, fundamentalmente, a partir de los lazos de sangre. No obstante, las técnicas de reproducción humana asistida (TRHA) originan diversas tensiones sociales en torno a la filiación como instrumento capaz de dar cuenta de las relaciones que un individuo establece con sus parientes y con la sociedad. Los cambios en la reproducción y la filiación están dejando atrás la uniformidad que trasmitía la naturaleza para reemplazarla por la diversidad propia de las relaciones sociales. Este artículo busca explicar las tensiones sociales que las TRHA están causando en el modelo biogenético y en la bilateralidad parental como elementos constitutivos de la filiación. Cuatro tensiones sociales serán analizadas: (i) el peso simbólico de la consanguinidad; (ii) el incumplimiento del derecho de mostrarse responsivo frente a la realidad social; (iii) la primacía de la dimensión estática de la filiación a pesar de la diversidad de dinámicas familiares donde se crean los vínculos filiales y, finalmente, (iv) el reconocimiento de la socioafectividad como fuente de atribución de la filiación.

ABSTRACT: In western society, the relationship of a child to his parents is fundamentally based on filiation by blood. Assisted reproductive technologies (ART) arises a number of social tensions related to how filiation is accurately able to account for the relationships an individual establishes with his relatives and society. Advances in ART and filiation tend to abandon the natural biological perspective, replacing it with the diversity inherent to social relations. This paper seeks to explain the social tensions that ART brings about to the biogenetic and the bilateral parenthood filiation model. Four social tensions will be examined: i) the symbolic weight of consanguinity ii) the inability of regulations to respond to current social reality iii) the dimensions of filiation for the ascendency of the static dimension despite the diversity of family dynamics where affiliate links are created, and finally iv) the recognition of socioaffectivity as a source to establish filiation.

Resumen: Este estudio tuvo como objetivo analizar las concepciones de maternidad de mujeres infértiles, de diferentes niveles socioeconómicos, que se encuentran en tratamiento de reproducción asistida. Se trata de un estudio cualitativo, descriptivo, que utilizó como instrumento una entrevista semiestructurada e incluyó temas como el sentido de la familia, deseos/expectativas sobre el hijo y el embarazo y expectativas sobre la maternidad. Participaron en la investigación un total de 48 mujeres infértiles, mayores de 35 años, usuarias de tecnologías de reproducción asistida de alta complejidad en instituciones públicas y privadas. Los datos se sometieron a análisis de contenido del cual surgieron los temas: representaciones sociales familiares; representaciones sociales de la maternidad; expectativas con el embarazo y modelos maternos; hijo imaginado. Las participantes representaron a la familia de manera positiva, como sistema de apoyo, fundamento y origen del amor, configurándola como vínculo social. Por otro lado, también estuvieron presentes las concepciones familiares basadas en la consanguinidad, representando a la familia para la perpetuación de la especie y la importancia del vínculo biológico. La maternidad estuvo marcada por una importante idealización, vista como un rol gratificante y de realización de la feminidad. También se sintió el peso de la demanda social de procrear como un deber que cumplir y que, ante la imposibilidad de realizarlo, genera sentimientos de inferioridad, desvalorización, impotencia e inadecuación en la sociedad, lo que refuerza el estigma de la infertilidad. Por tanto, son necesarias reflexiones sobre el papel de la mujer en nuestra cultura, ya que la maternidad se sigue utilizando como medida del éxito o fracaso femenino. También se reflexiona sobre la posibilidad de una mayor inclusión del trabajo psicológico en la reproducción asistida dada la carga emocional y social que implica este proceso. Resumen infértiles socioeconómicos cualitativo descriptivo deseosexpectativas deseos 4 3 años privadas maternos imaginado positiva apoyo amor lado consanguinidad biológico idealización feminidad realizarlo inferioridad desvalorización sociedad infertilidad tanto cultura femenino proceso

Abstract: This study aimed to analyze the conceptions of motherhood for infertile women from different socioeconomic levels who are undergoing assisted reproduction treatment. This is a qualitative and descriptive study that used a semi-structured interview as an instrument and included topics such as the meaning of family and desires/expectations about the child, pregnancy, and motherhood. A total of 48 infertile women over 35 years of ages using high-complexity assisted reproductive technologies in private and public institutions participated in this research. The data were treated by content analysis in which the following themes emerged: family social representations; social representations of motherhood; expectations with pregnancy and maternal models; and the imagined son. Participants represented the family in a positive way as a support system and the foundation and origin of love, embracing the family as a social bond. On the other hand, the family concepts based on inbreeding were also present, representing the family by perpetuation of the species and the importance of biological bonds. Motherhood was marked by significant idealization, being seen as a gratifying role and the fulfillment of femininity. The weight of the social demand to procreate was also felt as a duty to be fulfilled that, in the impossibility of carrying it out, generates feelings of inferiority, worthlessness, impotence, and inadequacy toward society, which reinforce the stigma of infertility. Results point to the necessary reflections on the role of women and our culture since Motherhood is still used as a measure of female success or failure. They also point to a reflection on the possibility of greater inclusion of psychological work in assisted reproduction given the emotional and social burden involved in this process. Abstract treatment semistructured semi structured desiresexpectations desires child 4 3 highcomplexity high complexity research emerged models son love bond hand present bonds idealization femininity out inferiority worthlessness impotence society infertility failure process

Resumo: Este trabalho tem o objetivo de analisar as concepções de maternidade para mulheres inférteis de diferentes níveis socioeconômicos que estão em tratamento de reprodução assistida. Trata-se de um estudo qualitativo, descritivo, que utilizou como instrumento uma entrevista semiestruturada e contemplou temas como o significado de família, desejo/expectativas sobre filho e gestação e expectativas sobre a maternidade. Participaram da pesquisa 48 mulheres inférteis acima de 35 anos que usam tecnologias de reprodução assistida de alta complexidade em instituições privada e pública. Os dados foram tratados pela análise de conteúdo em que emergiram os temas: representações sociais da família; representações sociais da maternidade; expectativas com a gestação e os modelos maternos; e o filho imaginado. As participantes representaram a família de forma positiva, como um sistema de suporte, de fundação e origem de amor, configurando-a como um laço social. Por outro lado, as concepções de família com base na consanguinidade também estiveram presentes, representando a família pela perpetuação da espécie e pela importância do laço biológico. A maternidade foi marcada por significativa idealização, sendo vista como um papel gratificante e de realização da feminilidade. O peso da cobrança social para procriar também foi sentido como um dever a cumprir e que, na impossibilidade de se realizar, gera sentimentos de inferioridade, menos-valia, impotência e inadequação perante a sociedade, o que reforça o estigma da infertilidade. Tais resultados apontam a importância de reflexões sobre o papel da mulher na nossa cultura, visto que a maternidade é ainda utilizada como medida para o sucesso ou fracasso feminino. Faz-se necessário também refletir sobre a possibilidade da maior inserção do trabalho psicológico na reprodução assistida, visto a carga emocional e social envolvidas nesse processo. Resumo Tratase Trata qualitativo descritivo desejoexpectativas desejo 4 3 pública maternos imaginado positiva suporte amor configurandoa configurando lado presentes biológico idealização feminilidade realizar inferioridade menosvalia, menosvalia menos valia, valia menos-valia sociedade infertilidade cultura feminino Fazse Faz processo

SUMMARY OBJECTIVE: This study aimed to evaluate the prevalence of ovarian hyperstimulation syndrome (OHSS) and associated risk factors in patients undergoing fertilization cycles at risk of OHSS (≥15 antral follicles or ≥15 oocytes aspirated) and submitted to cryopreservation of all embryos in the Human Reproduction Service of the Pérola Byington Hospital (Referral Center for Women's Health) in São Paulo, SP, Brazil. METHODS: This cross-sectional, institutional, descriptive study of secondary data from patients’ charts enrolled in the Assisted Reproduction Service of the Pérola Byington Hospital at risk of OHSS after controlled ovarian stimulation and submitted to cryopreservation of all embryos was conducted between January 2015 and September 2017. RESULTS: OHSS occurred in 47.5% of cycles, all with mild severity, and there were no moderate or severe cases of OHSS. CONCLUSION: The cryopreservation of all embryos is associated with a reduction in moderate and severe forms of OHSS. Risk factors for OHSS should be evaluated prior to initiation of treatment, with less intense stimulation protocols accordingly. OBJECTIVE (OHSS 15 (≥1 ≥1 aspirated Referral Womens Women s Health Paulo SP Brazil METHODS crosssectional, crosssectional cross sectional, sectional cross-sectional institutional 201 2017 RESULTS 475 47 5 47.5 severity CONCLUSION treatment accordingly 1 (≥ ≥ 20 4 47. ( 2

Abstract Sperm cryopreservation is an important tool for genetic diversity management programs and the conservation of endangered breeds and species. The most widely used method of sperm conservation is slow freezing, however, during the process, sperm cells suffer from cryoinjury, which reduces their viability and fertility rates. One of the alternatives to slow freezing is vitrification, that consist on rapid freezing, in which viable cells undergo glass-like solidification. This technology requires large concentrations of permeable cryoprotectants (P- CPA’s) which increase the viscosity of the medium to prevent intracellular ice formation during cooling and warming, obtaining successful results in vitrification of oocytes and embryos. Unfortunately, this technology failed when applied to vitrification of sperm due to its higher sensitivity to increasing concentrations of P-CPAs. Alternatively, a technique termed ‘kinetic sperm vitrification’ has been used and consists in a technique of permeant cryoprotectant-free cryopreservation by direct plunging of a sperm suspension into liquid nitrogen. Some of the advantages of kinetic vitrification are the speed of execution and no rate-controlled equipment required. This technique has been used successfully and with better results for motility in human (50-70% motility recovery), dog (42%), fish (82%) and donkey (21.7%). However, more studies are required to improve sperm viability after devitrification, especially when it comes to motility recovery. The objective of this review is to present the principles of kinetic vitrification, the main findings in the literature, and the perspectives for the utilization of this technique as a cryopreservation method. species however process cryoinjury rates glasslike glass like solidification P (P CPAs CPA s CPA’s warming embryos Unfortunately PCPAs. PCPAs CPAs. P-CPAs Alternatively cryoprotectantfree cryoprotectant free nitrogen ratecontrolled rate controlled 5070% 5070 50 70% 70 (50-70 recovery, recovery , recovery) 42%, 42 42% (42%) 82% 82 (82% 21.7%. 217 21.7% . 21 7 (21.7%) However devitrification literature 507 5 (50-7 4 (42% 8 (82 21.7 2 (21.7% (50- (42 (8 21. (21.7 (50 (4 ( (21. (5 (21 (2

Abstract Currently, gonadotropin products (follicle stimulating hormone, FSH, and luteinizing hormone, LH) used in animal reproduction are produced by extraction and purification from abattoir-derived pituitary glands. This method, relying on animal-derived materials, carries the potential risk of hormone contamination and pathogen transmission. Additionally, chorionic gonadotropins are extracted from the blood of pregnant mares (equine chorionic gonadotropin; eCG) or the urine of pregnant women (human chorionic gonadotropin; hCG). However, recent advancements have introduced recombinant gonadotropins for assisted animal reproduction therapies. The traditional use of FSH for superovulation has limitations, including labor requirements and variability in superovulation response, affecting the success of in vivo (SOV) and in vitro (OPU/IVEP) embryo production. FSH treatment for superstimulation before OPU can promote the growth of a homogenous follicular population and the recovery of competent oocytes suitable for IVEP procedures. At present, a single injection of a preparation of long-acting bovine recombinant FSH (rFSH) produced similar superovulation responses resulting in the production of good-quality in vivo and in vitro embryos. Furthermore, the treatment with eCG at FTAI protocol has demonstrated its efficacy in promoting follicular growth, ovulation, and P/AI, mainly in heifers and anestrous cows. Currently, treatment with recombinant glycoproteins with eCG-like activity (r-eCG) have shown promising results in increasing follicular growth, ovulation, and P/AI in cows submitted to P4/E2 -based protocols. Bovine somatotropin (bST) is a naturally occurring hormone found in cows. Recombinant bovine somatotropin (rbST), produced through genetic engineering techniques, has shown potential in enhancing reproductive outcomes in ruminants. Treatment with rbST has been found to improve P/IA, increase donor embryo production, and enhance P/ET in recipients. The use of recombinant hormones allows to produce non-animal-derived products, offering several advantages in assisted reproductive technologies for ruminants. This advancement opens up new possibilities for improving reproductive efficiency and success rates in the field of animal reproduction. Currently follicle LH abattoirderived abattoir derived glands method animalderived materials transmission Additionally equine human hCG. hCG . hCG) However therapies limitations response SOV (SOV OPU/IVEP OPUIVEP (OPU/IVEP procedures present longacting long acting rFSH (rFSH goodquality good quality embryos Furthermore ovulation PAI P AI eCGlike like reCG r (r-eCG P4E2 PE P4 E2 E P4/E based protocols bST (bST rbST, , (rbST) techniques ruminants PIA IA P/IA PET ET recipients nonanimalderived non P4E (rbST

Abstract This study aimed to estimate the cost of implementing a center for assisted human reproduction in a public reference hospital in Rio de Janeiro. The cost analysis was carried out from the perspective of the SUS provider of assistance. The eligible population was men and women diagnosed with the most frequent causes of infertility. The cost items included in primary care and medium complexity were consultations and examinations and in high complexity were equipment, human resources and supplies. Costs were identified and quantified through consultation with assisted reproduction clinics, specialists and literature. They have been valued through public databases. Data analysis was performed using an analytical decision model that included costs of assisted reproduction and effectiveness procedures. The cost per procedure in high complexity was R$ 18,829 for in vitro fertilization with intracytoplasmic sperm injection and R$ 5,649 for artificial insemination. The initial investment required to operate the high complexity center for 480 cycles was R$ 15,903,361 in the first year, which included structuring the physical environment. Estimating the investment required for the incorporation and maintenance of services in SUS is essential for the management of available financial resources. Janeiro assistance infertility equipment supplies clinics literature databases procedures R 18829 18 829 18,82 5649 5 649 5,64 insemination 48 15903361 15 903 361 15,903,36 year environment 1882 1 82 18,8 564 64 5,6 4 1590336 90 36 15,903,3 188 8 18, 56 6 5, 159033 9 3 15,903, 15903 15,903 1590 15,90 159 15,9 15,

Resumo O objetivo do estudo foi estimar o custo da implantação de um centro de reprodução humana em um hospital público de referência nacional localizado no Rio de Janeiro. A população elegível foi a de homens e mulheres que possuem diagnóstico das causas mais frequentes de infertilidade. Os itens de custos incluídos foram consultas, exames, equipamentos, recursos humanos e insumos. Os custos foram identificados e quantificados a partir de consulta a clínicas de reprodução assistida, especialistas e literatura. Foram valorados através de bases públicas. A análise dos dados foi realizada através de um modelo de decisão analítico. A perspectiva do estudo foi do SUS provedor. O custo por procedimento na alta complexidade foi de R$ 18.829 para a fertilização in vitro com injeção intracitoplasmática de espermatozoide e de R$ 5.649 para a inseminação artificial. O investimento inicial necessário para funcionamento do centro de alta complexidade para a realização de 480 ciclos foi de R$ 15.903.361 no primeiro ano, o qual incluiu a estruturação do ambiente físico. A estimativa do investimento necessário para a incorporação e manutenção dos serviços no SUS é indispensável para a gestão financeira. Janeiro infertilidade consultas exames equipamentos insumos assistida literatura públicas analítico provedor R 18829 18 829 18.82 5649 5 649 5.64 artificial 48 15903361 15 903 361 15.903.36 ano físico financeira 1882 1 82 18.8 564 64 5.6 4 1590336 90 36 15.903.3 188 8 18. 56 6 5. 159033 9 3 15.903. 15903 15.903 1590 15.90 159 15.9 15.

RESUMEN El creciente campo de la reproducción humana asistida ha alcanzado hitos inimaginables. Su continuo desarrollo y las innovaciones que genera, en ocasiones, plantean dilemas tanto éticos como jurídicos. El presente ensayo trata de exponer los cambios progresivos que se están viviendo en el ámbito del origen de la vida debido al desarrollo de nuevas opciones y estrategias en reproducción humana asistida. En primer lugar, se realiza una reflexión interdisciplinar desde la ciencia, la ética y el derecho, sobre la naturaleza humana y los cambios a los que la sociedad se enfrenta, en particular, desde la perspectiva española. En segundo lugar, recoge una breve aproximación en torno a las técnicas biomédicas presentes o futuras en el campo de la reproducción humana. Concluye sobre la necesidad de reflexionar ante el vertiginoso avance de la ciencia en materia de reproducción humana asistida.

ABSTRACT The growing field of assisted human reproduction has achieved unimaginable milestones. Its continuous development and the innovations it generates at times pose both ethical and legal dilemmas. This essay aims to elucidate the progressive changes occurring in the realm of the origin of life due to the development of new options and strategies in assisted human reproduction. First, it constructs an interdisciplinary reflection on human nature and the changes society faces from the perspectives of science, ethics, and law, particularly from the perspective of Spain. Second, it provides a brief overview of current or future biomedical techniques in the field of human reproduction. It concludes with a discussion of the need to reflect on the rapid advancement of science in assisted human reproduction.

Abstract This study aimed to estimate the cost of implementing a center for assisted human reproduction in a public reference hospital in Rio de Janeiro. The cost analysis was carried out from the perspective of the SUS provider of assistance. The eligible population was men and women diagnosed with the most frequent causes of infertility. The cost items included in primary care and medium complexity were consultations and examinations and in high complexity were equipment, human resources and supplies. Costs were identified and quantified through consultation with assisted reproduction clinics, specialists and literature. They have been valued through public databases. Data analysis was performed using an analytical decision model that included costs of assisted reproduction and effectiveness procedures. The cost per procedure in high complexity was R$ 18,829 for in vitro fertilization with intracytoplasmic sperm injection and R$ 5,649 for artificial insemination. The initial investment required to operate the high complexity center for 480 cycles was R$ 15,903,361 in the first year, which included structuring the physical environment. Estimating the investment required for the incorporation and maintenance of services in SUS is essential for the management of available financial resources.

Resumo O objetivo do estudo foi estimar o custo da implantação de um centro de reprodução humana em um hospital público de referência nacional localizado no Rio de Janeiro. A população elegível foi a de homens e mulheres que possuem diagnóstico das causas mais frequentes de infertilidade. Os itens de custos incluídos foram consultas, exames, equipamentos, recursos humanos e insumos. Os custos foram identificados e quantificados a partir de consulta a clínicas de reprodução assistida, especialistas e literatura. Foram valorados através de bases públicas. A análise dos dados foi realizada através de um modelo de decisão analítico. A perspectiva do estudo foi do SUS provedor. O custo por procedimento na alta complexidade foi de R$ 18.829 para a fertilização in vitro com injeção intracitoplasmática de espermatozoide e de R$ 5.649 para a inseminação artificial. O investimento inicial necessário para funcionamento do centro de alta complexidade para a realização de 480 ciclos foi de R$ 15.903.361 no primeiro ano, o qual incluiu a estruturação do ambiente físico. A estimativa do investimento necessário para a incorporação e manutenção dos serviços no SUS é indispensável para a gestão financeira.

RESUMEN El creciente campo de la reproducción humana asistida ha alcanzado hitos inimaginables. Su continuo desarrollo y las innovaciones que genera, en ocasiones, plantean dilemas tanto éticos como jurídicos. El presente ensayo trata de exponer los cambios progresivos que se están viviendo en el ámbito del origen de la vida debido al desarrollo de nuevas opciones y estrategias en reproducción humana asistida. En primer lugar, se realiza una reflexión interdisciplinar desde la ciencia, la ética y el derecho, sobre la naturaleza humana y los cambios a los que la sociedad se enfrenta, en particular, desde la perspectiva española. En segundo lugar, recoge una breve aproximación en torno a las técnicas biomédicas presentes o futuras en el campo de la reproducción humana. Concluye sobre la necesidad de reflexionar ante el vertiginoso avance de la ciencia en materia de reproducción humana asistida.

ABSTRACT The growing field of assisted human reproduction has achieved unimaginable milestones. Its continuous development and the innovations it generates at times pose both ethical and legal dilemmas. This essay aims to elucidate the progressive changes occurring in the realm of the origin of life due to the development of new options and strategies in assisted human reproduction. First, it constructs an interdisciplinary reflection on human nature and the changes society faces from the perspectives of science, ethics, and law, particularly from the perspective of Spain. Second, it provides a brief overview of current or future biomedical techniques in the field of human reproduction. It concludes with a discussion of the need to reflect on the rapid advancement of science in assisted human reproduction.

RESUMEN El creciente campo de la reproducción humana asistida ha alcanzado hitos inimaginables. Su continuo desarrollo y las innovaciones que genera, en ocasiones, plantean dilemas tanto éticos como jurídicos. El presente ensayo trata de exponer los cambios progresivos que se están viviendo en el ámbito del origen de la vida debido al desarrollo de nuevas opciones y estrategias en reproducción humana asistida. En primer lugar, se realiza una reflexión interdisciplinar desde la ciencia, la ética y el derecho, sobre la naturaleza humana y los cambios a los que la sociedad se enfrenta, en particular, desde la perspectiva española. En segundo lugar, recoge una breve aproximación en torno a las técnicas biomédicas presentes o futuras en el campo de la reproducción humana. Concluye sobre la necesidad de reflexionar ante el vertiginoso avance de la ciencia en materia de reproducción humana asistida.

ABSTRACT The growing field of assisted human reproduction has achieved unimaginable milestones. Its continuous development and the innovations it generates at times pose both ethical and legal dilemmas. This essay aims to elucidate the progressive changes occurring in the realm of the origin of life due to the development of new options and strategies in assisted human reproduction. First, it constructs an interdisciplinary reflection on human nature and the changes society faces from the perspectives of science, ethics, and law, particularly from the perspective of Spain. Second, it provides a brief overview of current or future biomedical techniques in the field of human reproduction. It concludes with a discussion of the need to reflect on the rapid advancement of science in assisted human reproduction.

Abstract Human reproduction goes through many challenges to its success and in many cases it fails. Cases of pregnancy loss are common outcomes for pregnancies, and implantation failures (IF) are common in assisted reproduction attempts. Although several risk factors have already been linked to adverse outcomes in reproduction, many cases remain without a definitive cause. Genetics of female reproduction is a field that may bring some pieces of this puzzle; however, there are no well-defined genes that might be related to the risk for recurrent pregnancy loss (RPL) and IF. Here, we present a literature review of the studies of genetic association in RPL and IF carried out in the Brazilian population and complemented with a database search to explore genes previously related to RPL and IF, where a search for genes previously involved in these conditions was performed in OMIM, HuGE, and CTD databases. Finally, we present the next steps for reproductive genetics investigation, through genomic sequencing analyses and discuss future plans in the study of RPL genetics. The combined strategy of looking for literature and databases is useful to raise hypotheses and to identify underexplored genes related to RPL and IF. fails pregnancies (IF attempts cause puzzle however welldefined well defined (RPL Here OMIM HuGE Finally investigation

Abstract Scientific knowledge and reproductive technologies are a recent field that transform the biological foundations of the creation of new human beings. They are modifying the role of women in reproduction and changing the understandings and forms of association in modern societies. In previous works we have analyzed the development of reproductive technologies in the 21st century, through the monitoring and study of biomedical advances and from the framework of feminist theory. We have also studied the positive and unexpected effects of these advances, as well as the debate on the reproductive rights of women, the questioning of central concepts such as consanguinity, motherhood, contemporary parenting and how these can facilitate new forms of social organization. In this study, we review the feminist perspective in literature regarding the debates surrounding assisted reproduction from its origin to this day. We present a panoramic analysis throughout the vision of institutions, social organizations, networks, users, and feminist collectives and conclude with new questions and perspectives on the future.

Resumen El conocimiento científico y en particular las tecnologías reproductivas son un campo reciente que transforma los fundamentos biológicos de la creación de nuevos seres humanos, modifican el papel de las mujeres en la reproducción, así como las concepciones y formas de asociación. Mediante el seguimiento y estudio de los avances biomédicos y desde el marco de la teoría feminista, en trabajos anteriores hemos analizado el desarrollo de las tecnologías reproductivas en el siglo XXI, sus efectos positivos e inesperados, así como el debate sobre los derechos reproductivos de las mujeres, el cuestionamiento de conceptos centrales como consanguinidad, maternidad y parentalidades contemporáneas que posibilitan nuevas modalidades de organización social. En este trabajo, hacemos una revisión de la literatura sobre los debates y posiciones feministas en torno a la reproducción asistida desde sus inicios a la actualidad, dando un panorama del camino recorrido a partir de las primeras manifestaciones académicas, hasta llegar al presente con la mirada de las instituciones, las organizaciones sociales, redes, usuarias y colectivas feministas, para compartir algunas preguntas y perspectivas que apuntan hacia el futuro.

Abstract This article explores the context of the non regulation of gestational surrogacy in Mexico in the last three years. Through the legislative initiatives presented at the Congress of the Union and the rulings of the Supreme Court of Justice of the Nation during 2021, this work asks whether they contribute to the strengthening of state secularism and to what extent the recent visibility evangelical associations and confessional based parties contribute to this regard. Based on the review of the content of the proposals to modify the Federal Health Law by Senator Olga Sánchez Cordero of the party in power, the National Regeneration Movement (Morena), as well as the main educational document of the federal government, the Cartilla moral, the three main features of the religious perspective are discussed: 1) affirmation of the fertilized egg as a person; 2) rejection of “gender ideology” and 3) the notion of natural family. Given the fact that the twenty initiatives presented since 2011 before the chambers of deputies and senators are in ‘pending’ status, it is concluded together with medical specialists (Canales de la Fuente 2019, 13) and feminist civil associations (GIRE A. C. 2021, 332) that, despite the fact that medically assisted human reproduction techniques have been performed in Mexico for more than four decades in public and private clinics and hospitals, until now there is no regulatory framework that allows guaranteeing access to this technique, type of care, producing uncertainty, risks for those involved and opening the door to possible acts of discrimination.

Resumen Este artículo explora el contexto de la no regulación de la gestación por sustitución o gestación subrogada en México en los últimos tres años. A través de las iniciativas legislativas presentadas ante el Congreso de la Unión y las sentencias de la Suprema Corte de Justicia de la Nación durante 2021, este trabajo se pregunta si estas abonan o no al fortalecimiento del laicismo del Estado y en qué medida la visibilidad reciente de las asociaciones evangélicas y de los partidos de base confesional aportan en este sentido. Con base en la revisión del contenido de las propuestas de modificación a la Ley Federal de Salud por parte de la senadora Olga Sánchez Cordero del partido en el poder, Movimiento de Regeneración Nacional (Morena), tanto como en el principal documento pedagógico del gobierno federal la Cartilla moral, se discuten los tres principales rasgos de la perspectiva religiosa: 1) afirmación del óvulo fertilizado como persona; 2) rechazo a la “ideología de género”, y 3) la noción de familia natural. Ante el hecho de que la veintena de inicitativas presentadas desde 2011 ante las cámaras de diputados y senadores se encuentre en estatus ‘pendiente’, se concluye junto con especialistas médicos (Canales de la Fuente 2019, 13) y asociaciones civiles feministas (GIRE A. C. 2021, 332) que, a pesar de que desde hace más de cuatro décadas en México se realizan técnicas de reproducción humana médicamente asistida en clínicas y hospitales públicos y privados, hasta este momento no existe un marco normativo que permita garantizar el acceso a este tipo de atención, produciendo incertidumbre, riesgos para los involucrados y abriendo la puerta a posibles actos de discriminación.

Abstract In the last years, the improvement of the assisted reproduction techniques and different laws between countries has propitiated an important flow and exchange of patients and reproductive biological material between nationals and internationals clinics. Spain has one of the better assisted reproduction techniques laws regarding the obtaining, handling, storing and distributing cells and tissues for reproduction, although these laws are submitted to the European laws. These laws and the recommendations of scientific societies regulate the transport of human embryos, oocytes and semen. So, they establish technical conditions and everybody’s documents (patients, home clinic, destination clinic and carrier) of these kinds of transports. Thus, it guarantee the sample’s viability and, very important, its traceability.

Resumen En los últimos años, la mejora de las técnicas de criopreservación y la diferencia de legislación entre distintos países en materia de reproducción asistida, ha propiciado que se produzca un importante flujo e intercambio de pacientes y de material biológico reproductivo entre clínicas nacionales e internacionales. España es uno de los países mejor legislados en materia de obtención, manejo, almacenaje y distribución de células y tejidos con carácter reproductivo, aunque estén bajo el paraguas de las normativas marcadas por la Unión Europea, de rango superior a las nacionales. Estas leyes, junto con las recomendaciones de las distintas sociedades científicas regulan el traslado de prembriones humanos, ovocitos o semen. Se establecen así, las condiciones técnicas para estos traslados y la documentación que cada parte del proceso (pacientes, clínica de origen, clínica de destino y empresa de transporte) está obligada a aportar con el fin de garantizar la correcta viabilidad de las muestras y, muy importante, la trazabilidad de estas desde su obtención hasta el laboratorio de destino.