Papers by Joseph Schenker
Textbook of Perinatal Medicine, Second Edition, 2006
Lower limit of viability, whatever that threshold might be, is not just a medical question it is ... more Lower limit of viability, whatever that threshold might be, is not just a medical question it is also an ethical issue to be taken into account at all times. Whether intensive care should be offered to all, regardless of gestational age depends on whether one is prepared to withdraw/withhold treatment, a decision resting with the senior staff, after consultation with everyone envolved, but upon informing the parents.
Fertility and Sterility, 2001
Objective: To assess the potential involvement of the soluble endothelial cell-leukocyte adhesion... more Objective: To assess the potential involvement of the soluble endothelial cell-leukocyte adhesion molecules E-selectin and intercellular adhesion molecule-1 (ICAM-1) in the pathophysiology of capillary hyperpermeability in the ovarian hyperstimulation syndrome (OHSS). Design: Controlled clinical study. Setting: Women hospitalized for severe OHSS after ovulation induction for IVF at two tertiary medical centers. Patient(s): Eleven patients with severe OHSS undergoing IVF and 20 controls who had received a similar ovulation induction regimen and did not develop OHSS. Intervention(s): Serial serum samples were obtained from all patients with OHSS from admission until discharge. Ascitic fluid was obtained from all patients by therapeutic paracentesis. Serum was obtained from all controls 4-8 days after ET. Main Outcome Measure(s): Samples were assayed for soluble E-selectin and soluble ICAM-1 by using enzyme-linked immunosorbent assay and results were correlated with clinical and biological aspects of OHSS. Result(s): Compared with controls, patients with severe OHSS had higher levels of soluble ICAM-1 and lower levels of soluble E-selectin detected in serum and ascites. Serum levels of soluble ICAM-1 decreased, while soluble E-selectin levels increased along with clinical and biological improvement. Serum soluble ICAM-1 showed significant positive correlation and serum soluble E-selectin showed significant negative correlation with clinical and biological aspects of severe OHSS. Conclusion(s): Soluble ICAM-1 and soluble E-selectin seem to be involved in the pathophysiology of capillary hyperpermeability in severe OHSS.
The Journal of Maternal-Fetal & Neonatal Medicine, 2004
Objective: Monoamniotic twins are very uncommon and are characterized by a high perinatal mortali... more Objective: Monoamniotic twins are very uncommon and are characterized by a high perinatal mortality rate. Cord entanglement, prematurity, congenital anomalies and twin to twin transfusion are reportedly the main causes of death, which usually occurs before 24 weeks' gestation. The aim of this study was to review the newly developed methods for diagnosis and treatment and suggest a reasonable approach to the management of these rare cases. Method: We reviewed the English-language literature in the past 15 years through Medline search and subsequent examination of individual publications. Results: In the past two decades, newer technologies such as advanced ultrasonography and color flow Doppler studies have enabled early diagnosis of this condition and its complications. Furthermore, new treatment modalities such as fetoscopy with laser coagulation of vascular anastomoses and treatment with non-steroidal anti-inflammatory drugs such as sulindac, to reduce amniotic fluid volume, may have contributed to a better outcome. Also, occlusion of one umbilical cord (fetal reduction) at an early stage has been suggested to prevent late complications. Conclusion: Cumulative experience suggests that the majority of cases can be diagnosed reliably at an early gestational age. Treatment with medical amnioreduction, surgical amnioreduction or fetal reduction in selected cases may be offered before 24 weeks' gestation. Later, intensive antepartum fetal surveillance should probably be offered until 32 weeks, at which point elective preterm delivery may be considered to prevent possible fetal death.
Fertility and Sterility, 1999
Objective: To evaluate the efficacy of a newly designed round biopter as a practical and safe met... more Objective: To evaluate the efficacy of a newly designed round biopter as a practical and safe method for collecting ovarian tissue for cryopreservation in young women with cancer before chemotherapy. Design: Prospective study of young women volunteering for research (Leeds, United Kingdom) and patients with cancer (Jerusalem, Israel and Leeds, United Kingdom) undergoing laparoscopic ovarian cortical tissue biopsy and cryopreservation before administration of high-dose radiochemotherapy.
ISGE Series, 2017
Adolescent pregnancy is defined as a pregnancy in an adolescent girl, usually within the ages of ... more Adolescent pregnancy is defined as a pregnancy in an adolescent girl, usually within the ages of 13–19.
Obstetrics and Gynecology, Jun 1, 1972
Changes in the microvasculature of the retina, using the fluorescein method, were observed in wom... more Changes in the microvasculature of the retina, using the fluorescein method, were observed in women taking oral contraceptives.
Ginekologia Polska, Sep 1, 1999
Surgical voluntary sterilization has become one of the most widely used methods of contraception,... more Surgical voluntary sterilization has become one of the most widely used methods of contraception, with vasectomy and tubal sterilization being the most commonly employed techniques, associated with a low failure, morbidity, mortality, and long-term sequelae rate. As sterilization is related with the elimination of the possibility for procreation, a number of ethical, legal and religious issues have arisen, leading often to personal misjudgements, legal disputes, and failures in applying family planning. Involuntary sterilization is currently not practiced, except in cases of severely mentally retarded people, who are unable to appreciate the consequences of their acts or care for their children and who may have a high likelihood of propagating hereditary disease.
European Journal of Obstetrics Gynecology and Reproductive Biology, Mar 31, 2000
Advances in prenatal care have brought about a greater understanding as to the special status of ... more Advances in prenatal care have brought about a greater understanding as to the special status of the fetus to the point that it is considered a patient in its own regard. Pregnant women generally follow the medical recommendations of their physicians that are intended for the benefit of their baby. Any situation where maternal well-being or wishes contradict fetal benefit constitutes a maternal-fetal conflict. Such situations include a broad range of possible interventions, non-interventions, and coercive influences. In such cases, the attending physician is expected to attain an attitude that involves either the respect of the woman's autonomy and right to privacy, which precludes any approach other than to accept her decision, or to modify this absolute for the beneficence of the fetus. Current ethical viewpoints range from absolute respect for maternal autonomy with no persuasion allowed, to gentle persuasion and to others which permit intervention and overriding of the woman's autonomy. Court-ordered decisions enforcing the pregnant woman to undergo a procedure in order to improve fetal outcome have been criticized as an invasion of a woman's privacy, limitation of her autonomy, and taking away of her right to informed consent.
J Assist Reprod Genet, 1998
Human Reproduction, May 1, 1995
Science and technology in the field of human reproduction present new legal, ethical and religiou... more Science and technology in the field of human reproduction present new legal, ethical and religious questions which do not always have immediate answers. The first step in the rapidly developed field of reproductive technology was the use of sperm donation (artificial insemination by donor, AID) and the establishment of sperm banks. The state of Israel faced these problems when the regulations for sperm donation were discussed. The fact that the main holy places for the three monotheistic religions are in Israel directly influences the make-up of the population constituents. Therefore, besides a majority of secular people, a high percentage of the population of Israel is very religious: Jews, Moslems and Christians. Thus any resolution relating to AID should take this demographic combination into account. The practice of AID is opposed by the different monotheistic religions. To avoid the conflict between secular and religious people, and between the different religions' perspectives, the legal problem of AID in Israel was solved not by laws but by regulations which were published by the Ministry of Health. The main idea behind this attitude is that the state and its authorities should not and do not deal with ethical or religious questions. Thus, the decision was left to the couples and to the donors. The regulations address technical requirements, health problems and confidential issues concerning the couple, the donor and the child. In this paper we present the different views relating to these problems as perceived by the different religions, and describe the solution that was accepted by the Israeli Ministry of Health.
Religion and science have been interrelated since the beginning of human history. Nowadays, relig... more Religion and science have been interrelated since the beginning of human history. Nowadays, religious groups still exert influence on the civil authorities in matters in the field of reproduction, such as prevention of procreation or intervention in the process of fertilization. Recent developments in science and technology in the field of human reproduction present new religious questions which do not always have immediate answers.
J Assist Reprod Genet, 1994
Ethics in Reproductive Medicine, 1992
More than a decade has passed since the birth of Louise Brown (Steptoe and Edwards 1978). Since t... more More than a decade has passed since the birth of Louise Brown (Steptoe and Edwards 1978). Since then, there have been many thousands of births that resulted from successful assisted reproductive technology in clinics throughout the world. The practices of in-vitro fertilization (IVF) and embryo transfer (ET) are becoming more widely available and applied, but the ultimate success rate, as judged by live births per cycle of treatment, remains low — around 10%. There exists a considerable difference between the usual fertilization rate of 70%–80% and subsequent pregnancy rates of approximately 20% (Schenker 1991). The pregnancy rate per one pre-embryo transfer is 9.8%. Chromosomal abnormalities represent the major cause of pre-embryonic loss during the pre- and peri-implantation period; 24%–30% of pre-implantation pre-embryos resulting from IVF have a chromosomal abnormality (Plachot 1989). Induction of ovulation by different protocols in the practice of IVF has provided an increasing number of pre-ovulatory oocytes, which are fertilized, and part of them transferred into the uterine cavity in the treatment cycle or subsequent cycles.
Encyclopedia of Global Bioethics, 2014
Principles of Oocyte and Embryo Donation, 1998
Today, religious groups still exert influence on civil authorities in the field of reproduction, ... more Today, religious groups still exert influence on civil authorities in the field of reproduction, with respect to pregnancy prevention and procreation, and in issues such as abortion and infertility therapy. Recent developments in reproductive science and technology raise new religious questions that do not always have clear answers. The role of theology in bioethics is to clarify for the different religious communities attitudes regarding new developments in the new field of reproduction.
ISGE Series, 2013
Ovulation dysfunction is one of the most common causes of reproductive failure in infertile coupl... more Ovulation dysfunction is one of the most common causes of reproductive failure in infertile couples. The prevalence of this disorder in infertile women is about 30-40 %. In order to appreciate the methods of inducing ovulation, a basic understanding of the endocrinology of the menstrual cycle is essential. Failure of synthesis or release of hypothalamic LHRH or the gonadotropins FSH and LH according to the normal pattern of the menstrual cycle will result in failure of ovulation with or without cessation of menses.
American journal of reproductive immunology (New York, N.Y. : 1989), 2014
Ovarian hyperstimulation syndrome (OHSS) is one of the most important complications of ovarian st... more Ovarian hyperstimulation syndrome (OHSS) is one of the most important complications of ovarian stimulation with severe morbidity and is still a threat to every patient undergoing ovulation induction. This manuscript reviews the current evidence regarding the relationship between OHSS and thromboembolism in infertile patients undergoing ovarian stimulation published in the world literature. The PubMed Database was searched for publications on reported cases of OHSS and thromboembolic phenomenon published between 1965 and 2013. One hundred and forty cases of OHSS and thromboembolic phenomena were retrieved. The vascular accident had already occurred in the first cycle of treatment among 119 women (85%), at early stage of OHSS in 43% and late stage in 57% of cases. Venous thrombotic events were recorded mostly in unusual sites, jugular, and subclavian veins, with 69 and 38 thrombotic events, respectively. Coagulation status was found at 86 of the 140 cases (61%). Fifty-three of the pre...
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Papers by Joseph Schenker