title: Sex and reproduction: an evolving relationship.
abstract: BACKGROUND
  Although sexual activity has, until very recently, been essential to reproduction, this did not preclude the non-reproductive importance of sexual relationships and non-conceptive copulations. Technological advances, however, now allow for both sex without reproduction and reproduction without sex. This review summarizes social and ethical commentaries on the new relationship between sex and reproduction.
  
  
  METHODS
  For each main area discussed, a systematic search was made using (depending on the subject) PubMed, Medline, ScienceDirect, classic books, Google and/or religious websites. The search focused on publications between 1975 and 2009, although some materials from the first part of the 20th century were also utilized.
  
  
  RESULTS
  The classic picture of sex for reproduction and bonding between mating partners is increasingly being replaced by reproduction separate from sexual activity. Although not every advance in assisted reproduction produced, per se, a further separation from sexual intercourse, these two fundamental human activities are today increasingly carried out independently, as reproduction is possible, not only without sex, but even through the intervention of more than two partners. The possibility of reproduction with only one or even no gametes, although highly controversial and not yet feasible, is nonetheless being investigated.
  
  
  CONCLUSIONS
  Technological advances in the field of reproductive biology have enabled couples considered infertile to conceive and have healthy babies, causing a revolution in culture and customs. Today the independence of sex and reproduction is established and in the future human reproduction may move even further away from the sexual act, an option definitely unacceptable to some ethicists.
authors.affiliation: Department of Obstetrics and Gynaecology, Sapienza University, Rome, Italy. giuseppe.benagiano@uniroma1.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Benagiano
authors.forename: Sabina
authors.initials: S
authors.lastname: Carrara
authors.forename: Valentina
authors.initials: V
authors.lastname: Filippi
mesh_terms: D003075:Coitus / Q000523:psychology; D003268:Contraception Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D012098:Reproduction; D027724:Reproductive Techniques, Assisted; D012725:Sexual Behavior; D019529:Sexuality / Q000523:psychology