In vitro fertilization ethics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

Ethical Issues

Certain ethical issues have been raised from the beginning when IVF was introduced. These concerns include:

  • Bypassing the natural method of conception.
  • The creation of life in the laboratory.
  • Fertilization of more embryos than will be needed.
  • Discarding of excess embryos.
  • Unnatural environment for embryos.
  • Use of untested technology.
  • Not affordable for many.
  • Misallocation of medical resources.
  • Creation of embryos, then freezing them, and keeping them "in limbo".
  • Exposure of embryos to unnatural substances.
  • Destruction of embryos in research.
  • Potential to create embryos for medical purposes.
  • Potential to select embryos (PGD).
  • Potential to modify embryos.
  • Facilitation of the idea that embryos are commodities.
  • Financial rewards for IVF doctors dissuade them from recommending other methods to couples.
  • Infertility is treated as a disease and not as a symptom of underlying medical problems.
  • The long term effect on frozen embryos is unknown.

Separating the Traditional Mother Father Model

The IVF process requires sperm, eggs, a uterus and a bed. To achieve a pregnancy any of these requirements can be provided by a third person. (a threesome): third party reproduction. This has created additional ethical and legal concerns. The use of IVF provides also greater range of options for single people and same-sex couples wishing to have children. Although both groups already raise children, IVF facilitates this process. Some people object that this could give psychological problems to the child if they grow up without a mother/father.

A number of cases have achieved notoriety:

  • In 2001, a French woman received worldwide publicity when she posed as the wife of her brother in order to give birth to a donor egg fertilized by his sperm. Some saw this as a form of incest; others thought it would prove psychologically unhealthy for the child when he learned how he was delivered; whereas other people simply couldn't see anything wrong with the situation.
  • In a few cases laboratory mix-ups (misidentified gametes, transfer of wrong embryos) have occurred leading to legal action against the IVF provider and complex paternity suits. An example is the case of a woman in California who received the embryo of another couple and was notified of this mistake after the birth of her son.[1]

Pregnancy Past Menopause

While menopause has set a natural barrier to further conception, IVF has allowed women to be pregnant in their fifties and sixties. Women whose uteruses have been appropriately prepared receive embryos that originated from an egg of an egg donor. Therefore, although these women do not have a genetic link with the child, they have an emotional link through pregnancy and childbirth. In many cases the genetic father of the child is the woman's partner. Even after menopause the uterus is fully capable to carry out its function.[2]

Religious Objections

The Roman Catholic Church is opposed to most kinds of in vitro fertilization (although GIFT is accepted because fertilization takes place inside the body and not inside a Petri dish) and advocates that infertility is a call from God to adopt children. According to the Catholic Church, it "infringe[s] the child's right to be born of a father and mother known to him and bound to each other by marriage."[3] Also, embryos are discarded in the process, causing them to die. Catholics and many people of other faiths or none see embryos as human lives with the same rights as all others and, therefore, view this procedure as unacceptable.

Regulatory Events

While in the United States IVF programs operate under voluntary guidelines, programs in many other countries are subject to regulations that regulate many aspects of IVF practice. In such settings regulations may dictate:

  • The number of oocytes that can be fertilized.
  • The number of embryos that can be transferred.
  • The use of cryopreservation.
  • The use of third party reproduction.
  • The ability to perform tests or interventions on the embryo.

In 2004, the government of Italy made it a crime to freeze human embryos or to perform preimplantation diagnosis.

References

  1. Ayers C (2004). "Mother wins $1m for IVF mix-up but may lose son". Timesonline. [1]. Text " volume " ignored (help); Text " issue " ignored (help); Text " pages " ignored (help)
  2. Parks, Jennifer A. (1996). "A closer look at reproductive technology and postmenopausal motherhood". CMAJ. 154 (8): 1189–91. PMID 8612255.
  3. Catechism of the Catholic Church section 2376

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