Medical research and reproductive medicine in an ethical context: a critical commentary on the paper dealing with uterin
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COMMENTARY
Medical research and reproductive medicine in an ethical context: a critical commentary on the paper dealing with uterine lavage published by Munné et al. Maximilian Murtinger 1 & Barbara Wirleitner 1 & Libor Hradecký 2 & Giorgio Comploj 3 & Jasmin Okhowat 1 & Dietmar Spitzer 4 & Jürgen Stadler 4 & Robert Haidbauer 4 & Maximilian Schuff 1 & Selma Yildirim 5 & Therese Soepenberg 6 & Kerstin Eibner 7 & Friedrich Gagsteiger 7 Received: 17 June 2020 / Accepted: 22 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract A recent study published in Human Reproduction claimed that uterine lavage offers a non-surgical, minimally invasive strategy for the recovery of human embryos from fertile women who do not want or need IVF for medical reasons but who desire preimplantation genetic testing (PGT) for embryos. To prove this hypothesis, the researchers recruited dozens of young Mexican women. The prospective oocyte donors underwent ovarian stimulation to induce the production of multiple mature oocytes. Subsequently, these women were inseminated by donor semen. A few days later, the developing embryos were collected by uterine lavage (uterine flushing) and subjected to genetic testing for aneuploidies (PGT-A). Oocyte donors with persistently elevated hCG levels, indicating the implantation of one or more embryos after uterine lavage, had to undergo uterine curettage and/or treatment with methotrexate. A critical opinion paper discussing the aforementioned study was published by De Santis and colleagues and has raised critical issues that are largely technical in nature. However, this opinion paper neglects—from our point of view—critical issues of the Mexican study regarding ethical principles and moral standards in human research. These aspects are summarized below. Keywords Uterine lavage . Oocyte donors . PGT-A . Ethics . Publication standards
Introduction The rapid pace of development in assisted reproductive techniques (ART) prompts the question whether all studies in this Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10815-020-01954-9) contains supplementary material, which is available to authorized users. * Maximilian Murtinger [email protected] 1
NEXTCLINIC IVF Zentren Prof. Zech–Bregenz, Bregenz, Austria
2
IVF Zentren Prof. Zech-Pilsen, Pilsen, Czech Republic
3
EuBios Centri Fivet Prof. Zech, Merano, Italy
4
IVF Zentren Prof. Zech-Salzburg, Salzburg, Austria
5
MVZ Kinderwunsch Münsterland, Bocholt, Germany
6
MVZ NEXTCLINICS Kinderwunschzentrum Köln, Cologne, Germany
7
Medical Department, Kinderwunsch-MVZ Ulm, Ulm, Germany
field performed in the name of science are ethically and morally acceptable, especially with regard to the CRISPR-based human genome editing experiments by He Jiankui. In January 2020, Human Reproduction published a study with the aim of comparing the chromosomal constitution of in vivo derived embryos with PGT-A findings of in vitro derived embryos [1]. The study protocol i
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