Reproductive Technology

By Jon Sterngass

Allows readers to use critical thinking to create informed opinions on where they stand on the issue of reproductive technology.

• Language: English
• Publisher: Rosen Publishing
• Release date: Jan 15, 2012
• ISBN: 9781608706464

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Copyright © 2012 Marshall Cavendish Corporation

Published by Marshall Cavendish Benchmark

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Library of Congress Cataloging-in-Publication Data

Sterngass, Jon. • Reproductive technology / Jon Sterngass. • p. cm. —(Controversy!)

Includes bibliographical references and index.

ISBN 978-1-60870-494-1 (Print) ISBN 978-1-60870-646-4 (eBook)

1. Human reproductive technology—Juvenile literature. 2. Human reproductive technology—Moral and ethical aspects—Juvenile literature. I. Title. • RG133.5.S75 2012

174.2’8—dc22 • 2010036705

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p. 26; Mohsen Nabil/AP Photo: p. 38; Musa Al-Shaer/AFP/Getty Images via Newscom: p. 39;

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Printed in Malaysia (T)

135642

Contents

1. Common Procedures in Reproductive Technology

2. The Religious Perspective

3. The Shadow of Eugenics

4. Genetic Manipulation

5. Controversies Surrounding Sperm and Egg Donation

6. Brave New World?

Notes

Further Information

Bibliography

Index

Infertility among those who would like to become pregnant has led some women to high-tech treatments unheard of only decades ago. This graphic shows a more low-tech method: a woman trying to catch sperm in a net.

1    Common Procedures in Reproductive Technology

MANY PEOPLE IN THE UNITED STATES HAVE INFERTILITY problems. According to the Centers for Disease Control and Prevention (CDC), there were about 62 million women of reproductive age in the United States in 2002. Of those, about 1.2 million, or 2 percent, had had an infertility-related doctor’s appointment in the previous year. An additional 10 percent had received infertility services at some time in the past. Seven percent of married couples in which the woman was of reproductive age (2.1 million couples) reported that they had not used contraception for twelve months and the woman had not become pregnant.

Since, however, more than 10 percent of all couples worldwide are infertile, this is not just an American problem. The percentage of couples with fertility problems is probably even greater in developing nations, where people have less access to health care and populations are generally less healthy. The stigma is also greater in developing countries, where many people view infertility as a personal failing or even a curse. Women who cannot conceive may face devastating ostracism, as well as physical abuse. If you are infertile in some cultures, you are less than a dog, says one Belgian fertility clinic staffer.

Many men and women have found a solution to the problem of infertility in the development of increasingly sophisticated reproductive technologies. These are techniques used to overcome infertility, to increase fertility, or to influence or choose certain genetic characteristics of children. These techniques include artificial insemination, sperm and egg donation, in vitro fertilization, preimplantation genetic diagnosis, and amniocentesis.

These medical advances thrill the world with the possibility of the elimination of disease and the ability to provide a better future for humanity. However, they also create anxiety about the creation of designer babies and clones, as well as the risk that these benefits of scientific progress will be available mainly to affluent people in developed countries.

Each type of modern reproductive technology brings a range of ethical issues. Each provokes controversies involving the boundaries of government control, private choice, religious belief, and parental wishes. Some of these issues have been debated for many years in regards to child adoption. Others, such as genetic selection and so-called designer babies, are relatively new.

Reproductive technology is moving so quickly that many important social, ethical, and legal considerations are lagging behind. Who should regulate the new technologies, and how should they be regulated? To what degree, if any, should market forces control who has access to new scientific discoveries? What are the rights and obligations of the various parties, such as sperm and egg donors, the children born through reproductive technology, and parents who choose these techniques? Before these issues are considered, it is essential to examine some of the more common procedures in modern reproductive technology.

Sperm Donation

One of the more low-tech forms of reproductive technology is sperm donation, in which a man donates his semen in order to engender a child in a woman who is not the man’s sexual partner. Originally, private doctors used sperm donation to help couples overcome male fertility problems, such as low sperm count. Since 1990, however, the technique often has been used by single women, as well as lesbian couples, as a way to have children.

Most pregnancies achieved by sperm donation are begun by means of artificial insemination. A sperm donor may donate his sperm to women through a clinic or sperm bank. On the other hand, he can use a sperm agency, which makes private arrangements between sperm donors and recipient women. In the last two decades, sperm donation has become extremely commercial. Agencies offer catalogs of donors directly to would-be parents, as well as photos, and audio and video recordings.

The typical sperm donor in the United States is anonymous, meaning that his identity is not revealed to the recipient. Doctors require potential donors to undergo a battery of physical tests and to provide their medical history. In the United States, sperm donors receive payment, technically for their time, usually between $50 and $200. The fresh sample is then processed and frozen into several small vials. Following a quarantine period, the samples are thawed and used to impregnate women.

The number of children fathered by a single donor can vary. A sperm bank may impose its own limits. However, some American donors may produce large numbers of children. Outside of the United States, most countries limit the number of children born from one donor.

Sometimes, donors and recipients arrange donations privately. Recipients may approach a friend or relative, obtain the name of a private donor by advertising, or use an Internet site. Private donations may not cost the recipients anything, but they carry greater risks associated with any unscreened body fluid contact. In most states, anonymous donors to a sperm bank enjoy certain legal protections that are not always available to personal donors. A personal donor, if traced, can be considered by the courts to be the legal father of each child produced by his sperm.

Although there is no official count of donor-conceived children, one estimate is that one million Americans are the biological children of sperm donors—mostly by anonymous fathers—with about 30,000 to 60,000 more born each year.

In Vitro Fertilization (IVF)

Since 1990, sperm donation has often been linked with in vitro fertilization, known by the acronym IVF. In vitro literally means in glass, as in a test tube. (A related term, in vivo, means in a living organism.)

Because an IVF procedure consists of several steps over a twoweek period, it is usually described as a cycle of treatments instead of a single procedure. An IVF cycle begins when doctors give a woman a series of hormone injections to stimulate the ovaries to produce ten or more eggs (ova, or oocytes). The eggs are removed surgically and fertilized with donor sperm in a laboratory. Doctors then transfer some of the resulting embryos into a woman’s uterus. Several eggs are usually implanted because of the possibility that some of the eggs will fail to develop. Nine months later, a so-called test-tube baby is born.

The first successful human pregnancy achieved through IVF occurred in 1977 when gynecologist Patrick Steptoe and research physiologist Robert Edwards pioneered the technique. On July 25, 1978, the conception resulted in the world’s first IVF baby—Louise Brown, born in Manchester, England. The first successful IVF in the United States was performed in 1981. In October 2010, Robert Edwards received the Nobel Prize in Medicine for the development of in vitro fertilization.

Because each in vitro fertilization procedure takes place over the course of a few weeks, many women keep a diary that documents the process.

IVF is often used by women who cannot ovulate or whose eggs might transmit a harmful genetic condition. This technology also overcomes the problem of scarred, damaged, or blocked fallopian tubes, which prevent sperm from reaching the eggs and the eggs from reaching the uterus. It can even allow men with low sperm counts to conceive because their sperm samples can be concentrated and deposited right next to the ripe eggs.

A variation of the IVF procedure involves a specialized technique known as intracytoplasmic sperm injection (ICSI). In ICSI, doctors inject a single sperm directly into the woman’s egg. This technique allows a man whose sperm had proved to be too weak or too few for IVF to fertilize his wife’s eggs.

Sometimes embryos are transferred to the uterus on the third day after conception. Other doctors prefer to wait until the embryo becomes a blastocyst—usually between days 5 and 8. A blastocyst is a spherical cell mass of about 150 cells. It consists of an outer embryo lining,