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Preterm birth, defined as delivery before 37 completed weeks of pregnancy, affects roughly one in ten pregnancies worldwide and remains the leading cause of neonatal mortality. Beyond the immediate risks to newborn survival, babies born too early face higher rates of long-term health challenges, including respiratory disease, neurodevelopmental delays, and chronic conditions that can persist into adulthood.
Advances in reproductive medicine are opening doors that were unimaginable just a generation ago, particularly for women concerned about inherited disease and fertility loss. Emerging technologies such as mitochondrial replacement therapy, gene editing, and the development of artificial gametes promise new ways to prevent severe genetic disorders and expand reproductive options. For women who carry known genetic mutations or who have lost fertility due to age, cancer treatment, or medical conditions, these innovations offer the possibility of having healthy, genetically related children; an outcome that until recently was often out of reach.
Mitochondria are inherited almost exclusively from the mother through the egg cell. During fertilization, the sperm contributes mainly its nuclear DNA, while its mitochondria, located in the sperm’s tail, either fail to enter the egg or are actively destroyed after entry. As a result, all the mitochondria in an embryo come from the mother’s egg, making mitochondrial DNA (mtDNA) maternally inherited.
Debates over the right to reproduce in the United States sit at the intersection of constitutional law, ethics, economics, and healthcare policy. Although the Supreme Court has historically recognized procreation as a fundamental liberty interest, questions remain about what this right means in practice—particularly as reproductive technologies such as IVF, donor gametes, surrogacy, and preimplantation genetic testing become more common and more expensive.
Infertility is defined by the American College of Obstetricians and Gynecologists as the inability to become pregnant after 12 months or more of unprotected intercourse for women under 35 and after six months for women over 35.
Infertility in women can stem from a variety of root causes, often involving complex interactions between hormonal, structural, and physiological factors.
Non-IVF fertility treatments include lifestyle changes, medications to stimulate ovulation (like Clomid), intrauterine insemination (IUI), and less common approaches like restorative reproductive medicine. Treatment choices depend on the cause of infertility, with methods like ovulation induction or IUI being less invasive and costly than IVF but having lower success rates.
In vitro fertilization (IVF) is an assisted reproductive technology (ART) designed to help individuals and couples achieve pregnancy. The process involves several meticulously coordinated steps to facilitate fertilization outside the body. It begins with ovarian stimulation, where fertility medications such as FSH are administered to encourage the ovaries to produce multiple mature eggs instead of the usual single egg per cycle.
The timing of sexual intercourse in relation to ovulation strongly influences the chance of conception. In the days leading up to ovulation, rising estrogen levels cause the cervix to produce thin, watery, and highly permeable mucus that facilitates sperm passage, creating an optimal environment for fertilization. During ovulation, progesterone plays a crucial role in transforming cervical mucus from a receptive, fertile state to a less hospitable one.
Oral contraceptives are highly effective in preventing pregnancy when taken consistently and correctly, boasting a success rate of over 99%. These contraceptives typically combine synthetic forms of estrogen and progestin, which work synergistically to inhibit ovulation by suppressing the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. Additionally, oral contraceptives thicken cervical mucus, creating a barrier to sperm entry, and alter the endometrial lining, making it less receptive to a fertilized egg.
Pregnant women are more vulnerable to infections and tend to experience more severe symptoms due to several physiological and immunological changes that occur during pregnancy. The immune system undergoes modifications to accommodate and protect the developing fetus, which is genetically distinct from the mother.