Assisted Reproductive Assisted Reproductive TechnologiesTechnologies

Causes of Infertility

• About 15% of North American Couples are infertile. Reasons for this include not enough sperm produced (male), not enough hormones produced (female), damage to reproductive organs caused by a disease (like some sexually-transmitted diseases or mumps in adult men), chemotherapy or radiation therapy to fight cancers.

Artificial Insemination (AI)• When sperm are callected from a male and then injected into a female

this is called artificial insemination (AI). This was first done with animals (especially dairy cattle) but has been used the past 30 years for humans also. If a man is infertile, his sperm can be concentrated or sperm from another man can be selected from a donor (usually anonymous) to produce a child. What issues does this procedure raise?

In Vitro (“In Glass”) Fertilization• When eggs and sperm are combined outside the body in some glass

apparatus, this is called in vitro fertilization. It happens that some women’s fallopian tubes become blocked making it impossible for sperm to meet eggs. Eggs can be taken from the woman, fertilized with the husband’s sperm outside of the body and then implanted in the uterus.

In Vitro Fertilization Issues• To increase the success of in vitro fertilization, doctors inject extra

hormones that cause a woman to produce many eggs rather than the typical single egg. More than one fertilized egg is implanted since they may not all survive. Success rates range from 40% to 10%, decreasing as the female’s age increases. Besides being costly, IVF increases the chances of multiple births and has some mildly unpleasant side effects for the woman when she is given extra hormone injections.

Nadia Suleman: InfertileNadya Suleman, a University graduate, married but was unable to get pregnant. She wanted to pursue IVF to have children but her husband did not want “test tube” babies. After their divorce in 1997, Nadya used IVF to have six children using a doctor who has since been suspended from the American Society for Reproductive Medicine.

Nadya Sulemen:OctomomIn 2008, Nadya had 6 embryos still left over from the IVF procedures, so she decided to have them implanted all at once. (She probably expected to get so much attention giving birth to six babies that this would help pay for the cost of raising 12 children by herself). Two of the 6 embryos split forming twins so she gave birth to 8 babies.

Nadya Suleman: Scorned by ManyNadya did not get the favourable publicity she expected because many felt it had been irresponsible for her to have extra children when she already had six and was a single mom. She now is struggling to raise 14 children by herself.

IVF Embryos Stored – What to do with them?

• Storing IVF embryos for years is common. Sometimes a person thinks they will use these later. The IVF process often produces more embryos than is needed in order to try a number of times. When a person who owns these embryos dies, what should be done with these embryos? Disposal? Research? Adoption? Are embryos human beings whose rights need to be protected?

Gamete Intrafallopian Transfer (GIFT)

• GIFT involves mixing sperm and eggs outside the body and then injecting the mixture into the mother’s fallopian tubes where normal fertilization can occur.

Intracytoplasmic Sperm Injection (ICSI)

• ICSI is a procedure in which a single sperm cell is injected into an egg cell and this fertilized egg is then implanted into the uterus of the mother. ICSI is used when the would-be father has severe fertility problems. About 25% of ICSI procedures are successful.

Surrogates

• A woman who agrees to carry another couple’s baby is a surrogate mother. She is paid to have embryos implanted in her uterus or to have sperm injected by AI. In any pregnancy the mother becomes attached to the child she is carrying so a surrogate mother sometimes finds it difficult to give up the baby she has carried.

The Sterns Seek a Surrogate• In 1985, William and Elizabeth Stern of New Jersey

contracted with Mary Beth Whitehead for her to carry a child for them. Elizabeth Stern had multiple sclerosis and was worried a pregnancy might leave her paralyzed.

Mary Beth Whitehead

• Sperm from William Stern was used to fertilize an egg from Mary Beth Whitehead. After Mary gave birth in 1986, she asked for the baby back, threatening suicide. She took the child and left New Jersey. The Sterns froze her bank accounts and issued warrant for her arrest.

First Court Gives Custody to the Sterns

• In 1987, the New Jersey Superior Court awarded custody to the Sterns. This was followed by a 1988 New Jersey Supreme Court ruling that suspended the decision and returned the case to Family Court. This court gave custody to the Sterns with visitation rights to Mary Beth.

Melissa Stern (Formerly Sara Whitehead)• In 2004 at the age of

majority, Melissa (the Stern’s child) legally ended Mary Beth’s parental rights and was adopted by the Sterns. Melissa majored in Religious Studies and has written about the long term implications for the Children of Surrogacy arrangements.

Multiple Parents for Some IVF Babies

For parents whose sperm and eggs are problematic, it is possible to use donor eggs and donor sperm to produce embryos that are carried by a surrogate mother. In this case there are five “parents”. Who are the parents? What rights does the child have to know and develop relationship with all the participating individuals?

Gays and Lesbians Having Children

Using surrogates and/or sperm/egg donors makes it possible for gay couples and lesbian couples to have children.

Mother Hiring a Surrogate to Carry Her Dead Son’s Child

Marissa Evan’s son received a mortal brain injury trying to stop a bar fight. In earlier conversations he had indicated that he would like three sons. At his death, Marissa received court permission to harvest his sperm, found a surrogate (in Mexico) and an egg donor (from Russia), and hopes to have a grandchild soon.

Commercializing Human Reproduction?

Human reproduction is becoming a business with persons selling sperm, selling eggs, selling their womb. What happens when parents and IVF children are reduced to customers and merchandise?

Selling Other Persons’ Children

In 1991 Debbie and John Challender, after trying for 10 years to conceive using ART, consulted with Dr. Ricardo Asch, a fertility specialist at University of California at Irvine (UCI). He harvested over 40 eggs and sperm from the couple and using IVF produced numerous embryos which were frozen for later use. A number of these embryos were implanted in Debbie and she had a baby boy in 1992 at a cost of

$10 000.

Selling Other Persons’ Children

Later a reporter who had obtained Asch’s records visited the couple and showed them that Asch had sold three of their embryos to another woman. They were devastated that three of their “children” had been sold.

Selling Other Persons’ Children

It was determined that Dr. Asch had in 30 cases sold other couples’ embryos to various other couples. Asch was fired from UCI and criminally charged. He fled to Mexico and in 2010 Mexico started extradition procedures against Asch to send him to the US to stand trial.

IVF in BC• In 1983 BCs first IVF baby, Robbie Reid, was born in BC.

From 1983 - 2003, there have been 1500 IVF babies born in BC.

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