In Vitro Fertilization (IVF), is the procedure whereby human babies are conceived, not in the womb but in a test tube or a Petri dish. This procedure has become one of the greatest developments in the world of medical technology. In Vitro Fertilization has given infertile couples the chance to conceive and bear a child from a full term of pregnancy. Without this procedure, their infertility would render them childless.
There are many aspects of the IVF program that have been both praised and criticized. The legal, ethical and social repercussions of the IVF program have created great debate and controversy. This essay will demonstrate the procedures used in the IVF program and set out the arguments for and against it.
There are many reasons why couples cannot conceive or bear a child for a full term of pregnancy. The process of natural fertilization can only be achieved if the male and female reproductive organs are functioning without any abnormalities.
The reproduction process begins with the male producing sperm in the testes and the female producing an egg in the ovaries. Once every 28 days or so, an egg matures in the ovary, bursts from its follicle and enters the Fallopian tube.
Once sexual intercourse has taken place, millions of sperm released from the penis swim up the vagina, through the uterus and into the Fallopian tube. ‘A single sperm fertilizes the egg; the others are locked out.’ (Time, 1997, pg. 66) Once the egg has been fertilized, cell division begins and the embryo drifts down the Fallopian tube. The embryo reaches the uterus in about a week. The embryo anchors itself to the wall of the uterus where it develops into a foetus. The foetus feeds off nutrients and oxygen provided by the placental lining in the uterus.
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... to help them. This process of IVF is still new, the first reported successful IVF procedure was recorded in 1981 and ... joining, called fertilization, happens within the fallopian tube, which joins the ovary to the uterus. However, in some situations natural conception ... specifically for her individual condition. To establish that the egg's development is suitable, the woman will be given ultrasound ...
There are several conditions in both males and females that cause abnormalities in the functioning of natural fertilization.
Firstly, a condition in women called Endometriosis causes infertility. ‘It is a condition where pieces of uterine tissue leak out of the uterus into the Fallopian tube.'(Fertility Rights, 1993, pg. 6) It causes blockages in the Fallopian tubes and ‘is associated with infertility even when the Fallopian tubes are not actually blocked.’ (Fertility Rights, 1993, pg6)
Secondly, the cause of infertility in men is a reduced sperm count, or low sperm motility, which greatly reduces the chances of successful fertilization.
And lastly, ‘about 10% of infertility is due to unknown causes.’ (Fertility Rights, 1993, pg. 6) After one year of infertility, couples whose infertility has been investigated without ascertaining cause may be admitted to IVF.
The three causes of infertility mentioned are the most common among infertile couples, although, problems such as a loss of production of eggs due to radiation treatment or damage to the reproductive organs due to bad accidents can also be a reason for infertility.
Many of the conditions which cause infertility can be overcome and pregnancy can be achieved by using one of the many artificial impregnating techniques and treatments. These include:
IVF – in Vitro Fertilization is the process ‘where eggs are harvested from the ovary and fertilized in a Petri dish. After embryos begin to develop, they are placed in the uterus.’ (Time, 1997, pg. 66) This process is carried out while the patient is under general anesthetic and fine needles and tubes are used to retrieve eggs and implant embryos. The treatment cycle for IVF is as follows:
‘1 Follicle growth (stimulated by injections).
2 Timing of ovulation (based on blood tests and ultrasound
scan).
3 Egg collection from the follicles (egg pick-up), using the
ultrasound machine.
4 Fertilization of eggs with partner’s sperm.
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5 Embryo transfer to the uterus (ET).
6 Pregnancy test (a blood test)’ (Fertility Rights, 1993, pg. 9)
GIFT – Gamete Intra-Fallopian Transfer is a procedure which resembles a more natural conception. ‘In GIFT, eggs are collected from the female but instead of being fertilized in the laboratory, the eggs and sperm are placed directly into a normal Fallopian tube using a fine plastic tube.'(Fertility Rights, 1993, pg. 7) Implantation of the embryo following this procedure is more successful than in IVF. The treatment cycle for GIFT is as follows:
‘1 As for IVF.
2 As for IVF.
3 Egg collection from the follicles, using the ultrasound machine.
Mixing with partner’s sperm, and placement in the Fallopian tubes. In the case of the Delayed Gift procedure, an egg collection using the ultrasound machine is performed. About five hours later, the woman has a laparoscopy and the eggs and sperm are placed into the Fallopian tubes.
4 Pregnancy test.’ (Fertility Rights, 1993, pg.9)
TEST – Tubal Embryo Stage Transfer combines the IVF and GIFT techniques. ‘The eggs are fertilized as in IVF and grown in a culture medium in the laboratory until the embryo reaches the four-cell stage.'(Fertility Rights, 1993, pg. 7) As in the GIFT procedure the embryos are returned to the Fallopian tubes. The treatment cycle for TEST is as follows:
1 As for IVF.
2 As for IVF.
3 Egg collection from the follicles, using the ultrasound machine.
4 As for IVF.
5 Embryo transfer to the Fallopian tubes using the laparascope or via guidance with the ultrasound.
6 Pregnancy test.’ (Fertility Rights, 1993, pg.9)
This procedure is used for women whose Fallopian tubes are normal, but whose partners have sperm unsuitable for the GIFT procedure. ‘In cases where one or both of the Fallopian tubes are not blocked, then GIFT may be used unless the sperm is of too poor a quality, in which case TEST is recommended.’ (Fertility Rights, 1993, pg. 7)
Fertility Drugs – Women usually produce one egg a month. Drugs can cause multiple eggs to ripen and increase the chance of pregnancy.
Sperm Injection – In this procedure ‘using an ultrafine needle, a single sperm is injected into an egg to achieve fertilization.'(Time, 1997, pg. 66)
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Donor Eggs – Eggs are taken from one woman and fertilized in a Petri dish. The resulting embryos are implanted in another woman.
Frozen Embryos – Extra embryos created during the In Vitro process can be frozen and stored for use in the future.
Use of these many wonderful procedures has enabled a small percentage of infertile couples to experience childbirth. Although these procedures are seen as a gift from God, they have been placed under scrutiny by a number of different groups of people and many ethical, legal and social issues have been raised.
There are compelling arguments for the use of IVF and related procedures and for its restriction. These arguments will be outlined in the following.
Arguments for the use of IVF and related procedures:
• Approx. 20 000 infertile couples in Australia enter the IVF program annually, ‘fully aware that the chances of a full term pregnancy and a healthy child are slim.’ (Fertility Rights, 1993, pg. 23) The IVF program gives them the opportunity to create life and to give birth.
• Infertile couples are discriminated against by society. Infertile couples often say ‘society treats IVF as though it caters to the whims of a self-indulgent group who simply cannot accept the limitation nature has placed on them.’ (Fertility Rights, 1993, pg. 23)
• This procedure relieves the pain of infertility knowing IVF is an option that may work, as some women do not feel fulfilled unless they have experienced the profound act of creation of life.
• Women, post or pre-menopausal should have the choice of using IVF, just as they have the choice to use contraception and abortion.
• IVF and Embryo research increases medical knowledge and paves the way for the eradication of diseases. This research involves working on early embryos. They are not seen as humans as they cannot feel, think or be aware, so many believe that the procedure is acceptable.
• “Clinics are taking a more rounded approach to infertility, widening the focus from egg and sperm to the emotional health of the couple. They place more emphasis on counseling, and have begun to acknowledge, upfront, the possibility of failure,” says Dr. John Mc Bain, chairman of the Melbourne IVF group. (Time, 1997, pg. 67)
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Just as there are compelling arguments for the use of IVF and related procedures, there are compelling arguments for its restriction.
Arguments against using IVF and related procedures:
• Many people, including numerous religious groups, believe that infertility is natures’ intention and should be left alone.
• Human life starts at conception; experimenting on and disposing of embryos is interfering with nature and destroying human life.
• The side effects that women suffer from IVF are horrendous. There is risk involved in the operation of harvesting eggs, and drugs used in super-ovulation ‘increase the risk of ruptured ovaries, ovarian cysts, migraines, dizziness, vision-related problems, weight gain and depression.'(Fertility Rights, 1993, pg. 29)
• There are no limitations on embryo research. It will roll forward as restrictions will not stop it advancing careers and professional reputations, which are seen as more important than morals.
• IVF research will not lead to the eradication of disease. This is a fantasy based on the lack of knowledge about the nature of genes.
• Couples are subject to exploitation as there is big money involved in the procedure. Information is often misleading and confusing.
• From the feminist perspective, there is a strong argument that IVF and experiments depend upon the exploitation and abuse of a woman’s body. They also believe it is intervention in natural processes which indicates ‘the way in which women are perceived by the medical profession.’ (Fertility Rights, 1993, pg.31)
• Genea Corea, author of ‘The Mother Machine’, believes that the choice of sexes will lead to the centuries old tradition of rejecting female babies in favour of male babies.
• The religious view on IVF, “there is a greater duty to look after those who are already here than there is to produce new life at unknown moral cost,” Pope John Paul. (Fertility Rights, 1993, pg. 33) IVF babies are also seen as a ‘gross luxury.’ (Fertility Rights, 1993, pg. 33)
• ‘Numerous hospital visits, repeated examinations, surgery, tests, and anxiety places great stress on relationships.’ (Fertility Rights, 1993, pg. 34) Hormone treatments cause mood swings which test relationships to breaking points. If the procedure fails, it often causes depression, and leaves the couple demoralised, distressed and grief stricken.
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• Embryos are left in limbo when a couple divorces or a partner is killed.
• Single mothers and homosexuals abuse the opportunity of using IVF, as couples that are infertile genuinely need the procedure.
• IVF gives post-menopausal women the chance to have a baby. This is seen as not fair on the child. John Paris, professor of bioethics states “when the child is of college age, ” speaking of a 62 yr. old woman’s offspring “his mother will be 80.” (Time, 1997, pg.69)
• The success rate is 10% – 15% – a very slim chance.
The arguments presented by the IVF debate clearly indicate that many different people have different beliefs and it cannot be said that either side is correct.
Beyond the issues of affordability and expectations, and beyond concerns about aging mothers and the disposal of frozen embryos, a single ethical question underlies all assisted reproduction, from fertility drugs to the still untested idea of human cloning: Have we the right to play God by intervening in this most basic of biological functions?
The Catholic Church’s answer is no. But some clinicians believe playing God is an unfair description of assisted reproduction. Whatever the concerns raised by their work, the scientists who are pushing for assisted reproduction reject any suggestion that their work is morally repugnant. And, so clearly, do the tens of thousands of infertile couples who seek their help.
It is extremely difficult to have an unbiased answer for this question as opinions are given depending on each persons individual situation.
References
1. Pyers and Gott, “Fertility Rights – The IVF Debate,” CIS Publishers, 1993.
2. Everton Brice, Cray, Graff, Mondi, Horsburgh, “Time magazine – The New Revolution In Making Babies,” Time Publishers, 1997.
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