Infertility and public health
Family-Building in the Artificial Reproduction technology
The primary purpose of Assisted/Artificial Reproductive technologies (ART) is treatment to infertility enabling conception and safe delivery of healthy children.
ART had enabled millions of people around thing the world to have biological children rendering a helping hand to infertile women and men, single parents ,lesbians ,gays and trans genders to form genetically related families which otherwise would have been impossible.
ART encompasses a variety of technologies:
1. In-vitro fertilization: Fertilization takes place outside the woman’s body in which eggs
(from the woman trying to get pregnant) are fertilized with sperm (from the donor or partner) and returned to the uterus.
2. Artificial Insemination: Fertilization is made to happen inside the woman’s womb where the sperm of a donor is prepared and after calculating the best time for fertilization to occur is inserted into the uterus.
3. Cryopreservation: Freezing of bodily materials for future use which preserves their fertility almost indefinitely.
4. Surrogacy: This is a re productive method where a woman’s womb is rented and she goes through pregnancy and delivery for someone else.
A case Study:
Jen is a 40-year-old single woman who has for many years dreamed of having biological children of her own. There are no medical obstacles preventing her from conceiving and carrying a baby to term. Her only setback is that she does not have a spouse/partner with whom to participant in the process. Moreover, she has no intentions of getting married in the foreseeable future. She decides to meet with a local reproductive endocrinologist (RE) to pursue donor insemination. After four attempts, Jen is successful in becoming pregnant.
This new parenting path raises a difficult and disturbing ethical question of the individual’s right to procreate and poses some key concerns as.
1. What are the issues involved in conceiving a child through ART?
2. What does literature say about single parenting and parenting of children
conceived through ART?
Many experts such as John Robertson, a U.S. attorney of reproductive technology argued for this procreative liberty asserting that since the U.S constitution affords people the right to procreate it also gives the right to procreate unnaturally, (as cited in Susan Lewis Cooper & Ellen Sarasohn Glazer, 1998). There is also a concern of morality to create children from donor gametes when there are already children who have been abandoned and need homes
Elizabeth Bartholet, an attorney, adoptive mother, (Houghton Mifflin, 1993) is critical of these technologies. She believes that ART clinics intentionally convince couples to these reproductive methods above adoption assuring them of a stronger bond with their children.
Bartholet argues that what she sees as objective counseling would steer more infertile couples away from technological means of reproduction to adoption.
In an influential book Susan Lewis cooper and Ellen Sarasohn Glazer (1998) focused on the key considerations while conceiving and parenting children by ART which include.
1The right to procreate versus morality: Although sperm donation has been occurring for over a hundred years, to raise a child with unknown genetic parent is not right. On the other hand to deny a would be parent the right to procreate threatens one’s freedom of choice.
2The right to know the truth about one’s genetic origins versus maintaining secrecy of donor: Although sperm banks provide information about donor’s medical history many couples using donor insemination choose not to tell their children about their origins and many health care professionals argue against denying children of their identity as morally unacceptable.
3. Liberation versus exploitation of women for reproductive purposes: Although many believe ART opens up choices to women to take charge of their lives others believe that they are a curse on the families as ARTs pose serious health risks on women (the ovum donors, surrogate mothers) not intended to be parents incase of a miscarriage. However financial incentives may be an inducement for these potential risks that they may undergo and this leads to exploitation.
4The heath of the children conceived through ART: There is a high probability of multiple births occurring through ART. Also there is a strong association of birth defects, congenital diseases and chromosomal abnormalities like Down syndrome among infants born through ART.
5. Discriminatory policies: As policies embedded in state laws, policies of fertility clinics and clauses that allow physicians to “opt out” of treating certain people create barriers to the people wanting to use the technology.
Despite all these pressing issues while comparing and contrasting IVF families and naturally conceived families, Professor Golombok, (2001) who conducted a research survey on ART born children found ART children to be functioning well and had fewer behavioral problems. Scholarly findings prove that IVF families have more emotional involvement and warmth towards their child and reported less parenting stress, but showed some evidence of over protection and setting unrealistic expectations on their children which only reflect their special path from infertility to parenthood.
No evidence of problematic child parent relationship was found and ART children scored well with respect to cognitive, social and emotional development. There is no evidence that children are harmed or disadvantaged solely by being raised by single, unmarried or homosexual parents. Thus existing literature is reassuring. It states that a child conceived by ART does nor have an effect on psychological development
Though many critics pose religious objections and inevitably argue that ART method interferes with nature and the natural by entrusting the life and identity of the embryo into the power of doctors and biologists which establishes a dominion of technology over natural human origin, we should all know when to draw a line between protecting personal private decisions about reproduction and allowing societal involvement.
For example should a women store their ovarian tissue to first have their careers and then have babies in their fifties or should HIV patients parent such babies born through ART is left to one’s own choice. It should be our immense responsibility to make appropriate use of the provision of these reproductive methods within a defined ethical framework not only for the welfare of the people involved but also to safeguard the future of the children born through assisted reproductive technologies.
ElizElizabeth Bartholet (Houghton Mifflin, 1993), Family bonds: Adoption and politics of parenting
GolGolombok S, Mac Callum F, Goodman E (2001); The “Test tube “generation: Parent-Child
relationships and the psychological well being of children in vitro fertilization at
adolescence .Child development 72(2), 599-608.
SuSusan Lewis Cooper & Ellen Sarasohn Glazer (1998); “Choosing assisted reproduction: social,
ethical and emotional considerations”.
Vic Vic Larcher (2007, 23 March); The health of children conceived through assisted reproductive
technologies.92 🙁 668-669).