Writing Assignment 1
Dr. Jaroslav Marik
Information can be found at:
In an attempt to interact with Dr. Marik’s view of science, I have created a series of questions drawing heavily from the first assigned reading. Answers represent Dr. Marik’s theoretical answers as distorted through the lense of my own personal biases.
Q: Is science limited to rolling balls down ramps, or putting chemicals in test tubes?
A: As someone who works with test tubes in a laboratory setting, Dr. Marik would admit to that being a large part of science, as it is perceived by our contemporary culture.
Q: Are scientists responsible for what they “accomplish”
A: One of Dr. Marik’s accomplishments is the procedure of allowing a parents to choose their baby’s sex by sorting the father’s sperm. The technique originated 30 years ago, as an effort to prevent families from having children with sex-linked congenital problems, such as hemophilia or Duchenne's muscular dystrophy. However, due to the modestly high success rates, the technique began to be used in a more “consumer” fashion. By performing this technique for couples that simply want to choose their baby’s sex, many say he is pushing humans one step closer to being able to truly “play god”. Officially Dr. Marik declines assertions that what he is doing is unethical, he does claim that the service is there, and if people wish to fund his future work by buying this service in this manner, he has no objections.
Q: how would he help children get interested in science?
A: Although having a hands on Gynecological exam for science lab in junior high might peak the interests of some kids, Dr. Marik would probably help kids understand the ubiquitous nature of science, leading kids to discover that science is connected to all areas of their daily life. Additionally, He might appeal to their sense of compassion by talking about how a knowledge and practice of science can be used to help other people find family and happiness, which is a fundamental principal behind his work.
Q: is “scientific method” a set thing?
A: maybe he would argue that because he has to work on these things with other people, there is a common syntax and procedure which is sometimes called the “scientific method”. Perhaps he would refer to it as the “scientific procedure,” or “scientific Syntax”. I would imagine that working in a field where one projects undesired results are an other project’s scientific breakthrough, it’s important not to blind oneself with rules and conventions. When it comes to useable results, scientific research is no more or less valid when done in the lab, or at home in the bathroom.
Q: would he call himself a presuppositionalist? Or a falseifactionist?
A: Dr. Marik works in a rather in a field of tangible elements, and thus is more interested in making things happen than, trying to prove theories true or false.
Q: is there a relation between society and science? If so, to what degree?
A: Dr. Marik’s work with genetic manipulation and fertility treatment is the poster boy of the contemporary science vs. society argument. Many of the methods that Dr, Marik incorporates are a result of Societies desire for perfect bodies, as well as being able to control every element of life juxtaposed with the current consciousness of Human, fetus and animal rights. In fact, you could say that Dr. Marik’s entire field of study is a response to the desires for power and control of the same culture and society which condemn it.
Q: is there a good use of science, and a bad use of science?
A: throughout history, science, especially truly remarkable science, has been contested by one group or another. If we label science good and bad now, we would be missing out on all the possible research, and positive benefits that the scientific revelations could present in the future. For example, the assertion that the earth was not flat would defiantly be considered a “bad” science when the notion was first introduced. However today, it is one of the principle truths which lets us put faith in this reality.
Every scientific discovery has the potential for constructive and destructive applications. The study of viruses for example yields both the ability to make viral biological weapons, as well as making vaccines for common viruses. All scientific discoveries move Humankind away from where the were prior to the discovery, even though the application and relevance of the discovery might not be visible for hundreds of years.
With regard to Dr. Marik’s current research, there are many groups which contest the “goodness” of “messing with genetics”. Because of that, Dr. Marik is forced to deal with not only the difficulties of his research, but also with fitting his goals and findings within the morals and constraints placed upon his field of research by society; much of which has an imperfect understanding of what his research is about.
Because Dr. Marik’s research has direct, tangible benefit to humans, it is easier for him to rationalize that his efforts are for the betterment of humans. Few people would argue that his work in curing ailments constitutes a scientific threat to the forces of good. His work in genetic manipulation (I.e. sperm selection) and stem cell research receive greater amounts of criticism, due to fact that they more actively change previously uncontrollable, fundamental elements of human beings. Are people reacting to his work due to humans innate fear or change? Are they reacting because now they have one more thing to potentially be responsible for, and feel guilty about if they botch the decision? Or are the reasons purely moral or religious?
One reason for the amount of concern this field of study has been receiving, is thanks to the fact that Dr. Marik’s work has a strong humanitarian application, which separates it from a more removed area of study, such as astronomy. This creates instance relevance between Dr. Marik’s work and every person alive today; allowing even the most grizzled prospector in the Appalachians to have an opinion to, “should humans be able to pick the sex of their babies” as opposed to, “should NASA spend more money on Rocket propulsion, or long range communications Security routines?”
Dr. Jaroslav Marik
Dr. Jaroslav J. Marik is the Medical Director of the Institute for Reproductive Medicine and Genetic Testing, an affiliate of the The Tyler Medical Clinic. He joined the Tyler Medical Clinic in 1971, and prior to that, he completed his training in obstetrics and gynecology and worked in various research institutions. He also undertook specialized training in abdominal surgery. His association with the Tyler Medical Clinic became the fulfillment of his professional expectations and was enhanced by a warm and friendly relationship with Dr. Tyler. The early 1970's impacted deeply on Dr. Marik's understanding of the problems connected with establishing a family.
Using previous training and experience, he was one of the first physicians in Southern California to perform diagnostic and therapeutic laparoscopy.
In 1972, he became a founding member of the American Association of Gynecological Laparoscopists. He was one of the first physicians in the world to perform hysteroscopic examination of the uterus. In the early 70's, he also benefited by preceptorship in microscopical infertility surgery under the guidance of Dr Kurt Swolin from Sweden who is "the father" of gynecological microsurgery.
In the mid-1980's, he became a charter member of the Society of Reproductive Surgeons, a branch of the American Fertility Society. He quickly established himself as an expert in the surgical treatment of infertility. He became a Director and Board Member of the International Human Society for Photoscopy, the International Society of Human Reproduction, the Fallopius International Society and a member of various other professional associations.
In the early 1970's, he joined the teaching staff of the UCLA School of Medicine,
Department of Obstetrics and Gynecology and became actively involved in training of the residents and fellows. For these activities, he repeatedly received the prestigious award for "Excellence in Teaching Infertility Surgery". He organized numerous symposia, teaching other doctors the newest diagnostic and therapeutic advances in the field of infertility diagnosis, surgery and treatment. He has been a frequent speaker at scientific meetings and international congresses, presenting in excess of 200 scientific papers in this country and 15 other countries. He has published more than three dozen scientific publications, inclusive of Congress proceedings, and has been an editor of the Newsletter of the International Society of Reproductive Medicine and the Fallopius International Society.
In the early 1970's, he became personally interested in the work of Dr. Patrick Steptoe who later accomplished the first conception through In Vitro Fertilization. He established the In Vitro Fertilization program at Tyler Medical Clinic in 1983, which was the second such program in the western United States. In the mid-1980's he achieved one of the first successful conceptions through the then new G.I.F.T. procedure and later expanded these advanced reproductive techniques to include egg donation to sterile women and gestational surrogacy. Successful conception of a patient without ovarian function was the third of its kind reported in this country, and the Tyler Medical Clinic was also the third institution to produce a pregnancy through the use of a gestational surrogacy. The services provided through Tyler Medical Clinic have included conventional surrogacy arrangements since the mid-70's.
Dr. Marik has received a dozen awards and honors from various national, as well international societies including several for his efforts in the perfection of surgical treatment of pathological changes of the female genital system.
The Institute for Reproductive Medicine and Genetic Testing, a Los Angeles-based company, is focused on the combination of reproductive medicine and genetic testing. Our primary goal is to prevent the transmission of genetic conditions, that cause severe disease in children of parents that are either afflicted with the disease or are carriers, using a breakthrough technology called Preimplantation Genetic Diagnosis - PGD.
Preimplantation Genetic Diagnosis signals the beginning of an end for many genetic diseases. Using PGD we now have the means to remove a single cell from a developing embryo and test it for a genetic abnormality, implanting only healthy embryos. The result will be the significant reduction and possibly the eradication of a genetic disease from affected families.
Our Institute was founded in January 2001 by Jaroslav J. Marik, MD, the medical director since 1971 of The Tyler Medical Clinic, one of the most noted and respected infertility clinics in the nation; and Jerry L. Hall, PhD, director of the Center for Reproductive Research and Testing in Maryland, an institution that has been involved in the research of human and animal husbandry.
We also count with the partnership of the Genetic Resources Medical Group, formerly DNA Dynamics, a Los Angeles-based company providing patients with genetic counseling; the UCLA Department of Medical Genetics and Molecular Pathology that has contributed immensely to the development of the technology in our Institute; and the Department of Pathology's specialty laboratory at UCLA that performs the laboratory testing using fluorescence in site hybridization.
What is Preimplantation Genetic Diagnosis - PGD?
Preimplantation Genetic Diagnosis - PGD allows people with serious genetic disorders the chance to decrease the risk of passing the disorder to their child. PGD is a technique used during in vitro fertilization (IVF) to test embryos for genetic disorders prior to the embryos being implanted in the uterus.
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How is a diagnosis made using Preimplantation Genetic Diagnosis - PGD?
During IVF, sperm and eggs are combined in the laboratory to form embryos. Embryos are grown for a period of about two to three days. Or, the third day, an embryologist uses microscopic instruments to carefully extract one cell from each embryo. A geneticist analyzes the cell and determines genetic abnormalities and the clinician then transfers healthy embryos to the uterus.
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Why is Preimplantation Genetic Diagnosis - PGD performed?
Genetic disorders are devastating to the child and the family. Most parents who are carriers of genetic disorders don't want to pass their disorder on to their children. Prior to PGD, parents were limited in their options and either took the risks of passing on the gene or chose adoption, embryo donation or surrogacy.
PGD is also tremendously helpful in increasing the success rate of the IVF process. Studies have shown that in couples having trouble conceiving, over half of the embryos are genetically defective. PGD will be a significant boon to routine IVF patients because the implantation of abnormal embryos will be eliminated, thus giving every embryo transferred a good chance of implanting. Since the embryologist has to pick three to four embryos for implantation during IVF, why not pick those that are the most viable?
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Who should consider Preimplantation Genetic Diagnosis - PGD?
People who are attempting to conceive when 35 years of age or above, or have a racial or ethnic association to specific diseases, familial association to specific diseases or experiencing continual miscarriages should consider PGD.
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What are the benefits of Preimplantation Genetic Diagnosis - PGD?
PGD increases the possibility for carriers of a genetic disorder to have a normal, healthy baby and it stops the transfer of genetic disorders from one generation to the next. PGD also increases chances of a successful IVF process since most miscarriages (about 50%) during this process occur because of abnormal embryos.
In addition, because genetic testing is done prior to pregnancy, PGD reduces the possibility of having to choose to terminate the pregnancy following a diagnosis of a probable genetic disorder.
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How many genetic disorders can be tested with Preimplantation Genetic Diagnosis - PGD?
PGD is used to test for single gene disorders like Cystic Fibrosis, chromosomal abnormalities such as Down Syndrome and gender linked disorders like Hemophilia A and certain cancers like Breast Cancer. The number of genetic disorders that can be screened depends on whether a disorder's corresponding gene marker has been identified.
Currently, we can test for about two dozen genetic disease including Huntington's Disease, Cystic Fibrosis, Tay Sachs Disease, Hemophilia A, Fragile X Syndrome, and Duchenne Muscular Dystrophy. In the near future, female ovum also can be checked for a gene that increases the propensity to develop breast and ovarian cancer.
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Does Preimplantation Genetic Diagnosis - PGD eliminate the need for amniocentesis and other prenatal screening?
At this time, we still recommend amniocentesis and other prenatal tests. As embryo genetic testing improves we will eventually be able to eliminate prenatal tests like amniocentesis.
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Will Preimplantation Genetic Diagnosis - PGD basically wipe out genetic disorders?
We can't cure the person with a genetic disorder, but we can hopefully stop genetic disorder from being transferred throughout generations and we have the opportunity to greatly reduce the number of children born with these devastating diseases. For instance, the general population has a 2% incidence of breast cancer. Half of these are accidental and half are genetic. PGD will help us to greatly reduce, if not completely eliminate the incidence of breast cancer by half, because we will prevent the transfer of the gene that causes genetic based breast cancer.
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How long has this technology been used?
British physicians were the first to use PGD in 1989. Since then, there have been nearly 200 births resulting from this new technology.
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How many centers in the U.S. offer Preimplantation Genetic Diagnosis - PGD?
Only a few clinics in the United States offer the PGD technology. The Institute for Reproductive Medicine and Genetic Testing is the first in the Western United States to offer this technology.
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What are the first steps in beginning Preimplantation Genetic Diagnosis - PGD?
First, patients consult with us regarding their concerns. We then refer them to a genetic counselor who then evaluates their risk for passing on a genetic disorder. If necessary and if it hasn't already taken place, carrier testing is completed to determine specific genetic disease risks. If it is determined that they would benefit from PGD and if the couple or individual decide to go forward, we begin IVF and the subsequent PGD process.
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Is Preimplantation Genetic Diagnosis - PGD controversial?
Some people believe PGD is wrong because of its sex selection option gives individuals the chance to screen for gender-linked disorders like Hemophilia A. With hemophilia, PGD can eliminate all of the male embryos and allow the embryologist to implant only female embryos thus preventing the transmission of this disease.
The American Society of Reproductive Medicine's ethics committee addressed this issue and recommended that PGD for sex selection to prevent gender linked genetic disorders was appropriate.
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How much does Preimplantation Genetic Diagnosis - PGD costs?
The technology adds about $3,000 to the cost of in vitro fertilization.
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Does insurance cover this test?
Currently, insurance does not cover the test, however, we hope in the near future insurance providers will understand the preventive nature of these tests and cover the costs.
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- Spinal Cord Injuries - SCI -
Each year, over 10,000 people suffer from spinal cord injuries in the United States, predominately men between 16 and 30 years of age. These men face a number of challenges in their daily lives, from reduced mobility to impaired sexual function, and the question “Will I be able to father a child?” can add stress to an already difficult emotional and physical situation.
Although the majority of men with spinal cord injuries are able to have erections sufficient for intercourse, about 90% are unable to ejaculate and require medical assistance to produce semen. Of those couples in which the man can ejaculate during intercourse, only a few successfully conceive a child. This is because the motility of sperm, as well as the number of living sperm, is very low in the semen of men with spinal cord injuries.
Fortunately, procedures are available to help relieve the stress of infertility for men with spinal cord injuries. At the Institute for Reproductive Medicine and Genetic Testing, we believe that there is no reason why these men should not be able to become caring and loving parents.
- The Tyler Medical Clinic Press -
Babies Made to Order?
Los Angeles Times
by Marcela Rojas
Babies Made to Order?
WESTWOOD - In keeping with Chinese tradition, Francis and Alex Mayne knew how important it was for them and their family to have a son to carry on the family name.
After having two healthy girls, the Maynes did not want to risk having a third girl.
"My chances of having a boy are 50/50," said the 30-year-old Glendale resident. "I needed my ratios to be higher because three children was my maximum. I would have stopped at two but there was something inside me that said I want a son.
To combat their dilemma, the Maynes decided to try a procedure called "gender preselection."
Fortunately for the Maynes, Dr. Jaroslav Marik, considered to be the only doctor in Los Angeles to offer gender preselection, has been performing this procedure for the last 30 years from the Tyler Medical Center in Westwood.
"The chances of having a boy are 75 to 80% through this procedure," Marik said. The chances of having a female are at 65% to 70%."
The way gender preselection works is by sorting a man's sperm.
"A woman's eggs are always female," said Marik. "The man carries male and female sperm. If a male sperm fertilizes the egg, then the child will be male."
Marik first collects the semen, which is cleaned in a centrifuge to get rid of the dead and abnormal sperm. Marik estimates that 25% of a man's sperm is dead and 25% is abnormal.
He then takes the remaining sperm and places it in a three-tiered cube filled with blood protein.
Marik explained that since male sperm is lighter and swims faster than female sperm, the male sperm will make it to the bottom of the cube and the female sperm will remain in the top two layers.
The desired sex sperm is then artificially inseminated into the woman's uterus.
"The whole process of collecting the sperm and insemination takes two hours," Marik said. "About how long it takes to get your car fixed."
The cost of sorting the sperm is $125, not including insemination. Marik added that there is no evidence that sperm sorting is harmful to the sperm or the fetus.
After testing this technique in June 1997, the Maynes proudly announced the birth of their son, Christopher Mayne, on Feb. 12, 1998.
"You know before you go in that this is only a chance," Mayne said. "It's not 100%. We just hoped for the best and if it wouldn't have worked out then it was meant to be that we have another girl."
But while the Maynes relish in the new masculine addition to their family, there are many who find gender preselection immoral and controversial even though it is a legal procedure in the United States.
Dr. Alan DeCherney, chairman of the UCLA Department of obstetrics and gynecology said that while he is not against gender preselection, there are a myriad problems that can arise.
"Let's say a couple goes through this procedure and wants a boy," posed DeCherney. "It doesn't work so they get an abortion. Is that right?"
DeCherney added that as far as he knows, Marik is the only doctor in Los Angeles who performs this procedure.
"It is not a common practice because it is only modestly successful," DeCherney said. Marik's figures seem pretty high. When there are better techniques, then it will be more of a moral and ethical issue."
At the Fairfax Clinic in Virginia, investigators are testing a new laser technique to sort sperm that has an 85% success rate, DeCherney said. The American Society for Reproductive Medicine strongly frowns upon gender preselection for family balancing purposes, said spokeswoman Debra Crawford.
"We feel that this technology is not designed so that doctors can play God and help families in that way," Crawford said.
However, the society does think that gender preselection should be used to benefit couples who are trying to avoid genetic diseases.
"When this technology is used to prevent an X-linked genetic disease such as hemophilia or Duchenne's muscular dystrophy, public support is generally strong," a 1994 report the society stated. "However, the use of technology solely to fulfill parental preferences raises many questions...The fear is that availability of preembryo gender selection, other than to prevent an X-linked inherited disease, would foster gender discrimination and anti-social trends..."
Marik maintains that when he first started gender preselection in the early '70s, it was done for the purposes of preventing couples from having children with genetic diseases.
But in time, he extended it to couples who, for example, had two boys and wanted a girl to balance out their family tree.
"I'm not playing God," says Marik. "If I was, then it would work 100% of the time. I'm simply trying to accommodate a human wish."