Assisted Reproductive Technology (ART) and intro Vitro fertilization
Introduction
Assisted Reproductive Technology (ART) and intro Vitro fertilization has helped many couples who suffer from infertility. It has also led to many ethical, social, and legal challenges. This paper seeks to identify aspects of ART that are relevant in our society. While doing so, the paper will also discuss different ethical, social, and legal challenges that come with this technology. ATR has caused various shifts in the way physicians and the broader population view ethics and infertility. With the current trend, advancing technology might exacerbate legal, social, and ethical issues that concern ART. The idea of ART challenges how contemporary society views human life, genetic offspring’s equality, and social justice.
Additionally, the issues will require the legal systems to restructure their current laws to incorporate the challenges brought by the ART. However, society has the sole responsibility to ensure that ART achievements are responsibly and socially implemented. (DeMarco, 1991) ART has become a useful technology that has treated many couples who are infertile across the world. In contrast, the use of this technology has caused many ethical, social, and legal challenges. This paper will, therefore, evaluate the challenges brought by the ART and provide an outline of the legal, ethical, and social problems.
Background
Infertility has always been an area where medics or physicians have fewer means to assist their affected patients. With the birth of Louise Brown born in 1978 through the in vitro fertilization (IVF), the landscape in this field of medicine has dramatically changed. Louise Brown was the first baby conceived in a laboratory and known as the first test-tube baby. ART has been important to infertile couples, scientists and clinicians can’t be overstated and IVF has also improved in its use and availability across the globe. Over 70 million couples around the world are troubled by infertility, and since the success of the first IVF in 1978, its use and other technologies have become useful and frequent. In the past years, using ART has increased at an annual rate of 5% to 10%.About sixty thousand cycles of IVF in the US, seventeen thousand pregnancies, and fourteen thousand successful births were initiated in 1996.In 2009, approximately 3.4 million children were born across the globe after the utilization and treatment, which has highly increased in developed countries. (O’Donavan, 2002)
The use of ART across the globe has triggered a desire by the public, professional organizations, and governmental organizations to form mechanisms that would evaluate the utilization of this technology. The advances in the area of ART are concerned with ethical and societal issues. As a result, professional societies and legislations have made an attempt to address the concerns. An example is the American Fertility Society, which published the first guidelines in 1986 for implementing ART in an ethical manner within the US. The nature of ART is dynamic, and its rapid evolution needs a comprehensive and frequent evaluation by society and professional organizations. At around the 1980s, concerns that surround ART focused on the transparency of pregnancies, administration of gonadotropins, and solving economic barriers associated with access to ART. (Holmes, 2002)Some of the concerns like reporting any requirement for results on pregnancy from ATR has to be subject to legislation in different countries across the globe. Additionally, requirements for reporting also include the number of embryos that a person transfers. Their measures have been significant in correlating the risks associated with many gestations when two or more embryos are transferred. However, different nations that report the regulations don’t have clear legislation that defines the patterns that are practiced. An example is in the US, where a physician is mandated to report the number of transferred embryos in a cycle of IVF. However, there is no legislation that provides for the number of embryos to be transferred. Many nations now have estimates of IVF activity through the requirement of mandatory reports on registries. In 1992, the Fertility Clinic Success Rate and Certification Act were created in the US to define the current statistics on IVF.The laws require any clinic that provides IVF services in the US to file all the information around cycles of IVF and the rates of pregnancy. At the federal level, the regulations are not limited to registries. Many countries have adopted legislation to define the parameters that are acceptable in ART practice. With the transfer of many embryos in a single cycle would increase the rate of many births. Due to the increase in health risks and social costs that comes with multiple births, the guidelines and legislation is being introduced in many nations to restrict the number of embryos to be transferred in a cycle of IVF in order to limit many gestations. The reporting on the outcomes of IVF cycles doesn’t include any information on the parental or maternal history. In many nations across the world, the national registries are present to help evaluate data associated with the IVF cycles at the international and national scale. The International Federation of Fertility society (IFFS) is responsible and accountable for the regulations on ART across the globe. (Maura, 2003)The rates of pregnancy of IVF are high as compared to the ones reported earlier. Currently, the efficiency of IVF is efficacious and cost-effective in being pregnant as compared to other modalities like intrauterine insemination. Due to the increase in the efficiency of IVF, which results in many gestations, pregnancies also increase. As a result, current data has shown that a single transfer of an embryo with subsequent transfers results in equal rates of pregnancy. The transfer of a single embryo can decrease the health risks and maternal that is associated with many pregnancies on gestation.As a result, the transfer of a single embryo would increase in the future. The variability of statutes to regulate IVF exists in many nations or even provinces/states within single nations. An example is while trying to minimize many pregnancies from gestation that results from ART; different laws limit the number of embryos to be fertilized or transferred in an IVF cycle. In different cases, the guidelines, regulations, or the economic pressure force victims to travel across the international border in order to access health care services that are not available in the native country. This is a practice which is known as Cross Border Reproductive Care (CBRC), which is said to account for 10% of the total number of IVF cycles across the globe. (David, 2003)
One of the most oblivious and controversial ethical issues surrounding Artificial Reproductive technology is the financial capability or otherwise inequitable access to its provision. It’s evident that ART is mainly practiced in countries or cities with some sorts of economic and financial strength or broad availability of resources.For example, the cost of conducting an IVF in the US is about USD 9,266; the figure goes on further to about 25000 USD to 41000 in countries such as the United Kingdom and Scandinavia. Additionally, it’s nearly impossible to receive any kind of insurance or funding of sorts. This has to lead to critics from communities where there is an aging population and would prefer to try artificial reproductive technology to supplement the population but would otherwise not afford to do the same because of the accompanying cost. (Rae, 1996)
Donor Gametes is another aspect of Artificial Reproductive Technology that draws a lot of ethical and social issues. It can be performed in the form of donor oocytes or donor sperm. This has been practice for centuries and has been categorically traced back to 1800 and mid-1980. However, over time it has been evident that particularly oocytes procedure warrants a lot of medical risks considered it must be procured through IVF hence exposure to complications such as hyperstimulation syndrome that affects the ovary. It is consequently ethically paramount that before a woman goes through such a process, then full and formal consent has been issued to avert any cases of coercion or duress. The international body of Obstetrics and Gynecology has more than once expressed his concern with the oocyte donor procedure, arguing that its compensation may lure women into proceeding with the process irrespective of their best interest their health, the goal being to earn money. This has to lead to ethical concerns as it depicts a more sort of buy and sells human being market, which is inherently immoral. Due to the controversy surrounding acolyte donation and the huge compensation attached to it federal state have been forced to come up with relevant regulation to govern its practice. Another exciting and controversial issue has to do with the issue around the identity of the sperm donor. To what extent should such anonymity be preserved? Given that it’s naturally and universally crucial for a human being to recognize his genetic roots. (Nadelli, 2004)
Another pertinent and fundamental aspect of artificial reproduction is the issue surrounding surrogacy and Gestational carriers. Surrogacy refers to where a woman accepts to carry her oocytes but rather with the sperms of another couple with a view of relinquishing the child to the couple upon delivery. In contrast, gestational carrier refers to where couples go through an IVF, and using their genetic gametes puts the resulting embryo into the womb of another woman for conception and subsequently relinquish the child to the donor couples. It does not go without saying that such arrangements have very thematic and ethical elements in their nature and practice. Is it ethically and inherently right for birth mothers to relinquish his rights in blatant terms selling parental rights? This has been the center of the debate on whether such birth mothers can upon delivery refuse to honor their end of the contract to give the couples in question the baby upon delivery. As a result, some individuals have had concerns; that’s it’s morally not right. Another central concern to the commodification of this procedure is the possibility of the financial pressures associated with life. Consequently, some would take this as an opportunity to make money thereafter, bringing an element of possible exploitation. Compensation in a gestational carrier is quite lucrative and can approximately attract a sum of atleast 20000 dollars in the USA and even higher in other countries.
Pre-implantation genetic screening is where embryos are characterized in accordance with the genetic composition by virtue of immense stride in research. It is being used to differentiate embryos based on gender. If PGD is done in the best interest of averting medical abnormalities such as sex link disorder, then it’s prudent that it be embraced. However, if such technology is intended to be used in deliberate sex selection, then it can be questioned based on ethics and morality. It brings about the analogy that science is being used to defeat natural order by manipulation of genetic materials and can lead to maybe according to the cultural setup of the community preference to a particular type of Gender (Miller, 2007)
Female fertility preservation refers to when a woman decides to freeze the embryo to such a time that she is ready to use it for conception. It is synonymous with terminal illness patients, especially cancer fighter who may prefer to freeze their embryo or sperms up to the time they would have recovered. This procedure is particularly sentimental to cancer patients as chemotherapy elements used in treatment may be toxic to the ovaries resulting in reduced fertility. Consequently, the cancer patient has had the opportunity to deliver by IVF as a result of the ovarian tissue transplant. Proponents have argued that in future women would postpone childbearing to a later time that they would feel ready and comfortable.However, as currently practiced, these services are super expensive and could not have been bought by JM. The ethical and social issue arising is the aspect that its only available to persons with the financial capacity
In the IVF cycle, embryos are transferred in cryopreserving for the underlying reason for a presumptive pregnancy in the future. Subsequently, some of these embryos have never been used and are consequently stored indefinitely. These numbers have over the years risen to the point that it has lead to a debate as to whether its ethically and morally right In the USA it is estimated that there are more than 350000 embryos and only four possibilities exist as to regards of their fate, they include Donation to research, Indefinite storage, Donation to needy parents for eventual purposeful use and finally discarding and thwarting them. All these methods have had opponents and proponents irrespectively every nation has enacted laws to deal with cryopreservation that the ethical and moral implication has never been subject to resolve. Is it right that natural order in relation to embryos can be subject to scientific storage or even ultimate destruction? Such a question has, over the years, ignited fierce debates as to what is right and should stand before the social eye. (Smith, 2015)Controversial questions still exist when we discuss IVF, although multiple studies and research have clinically found that there are medical risks associated with Artificial Reproductive Technology. Despite all these issues, there is an ultimatum that IVF provides people the avenue to enjoy parenthood, which is fundamental in the life of a human being.Regardless of the cumulative medical and ethical concerns, IVF will still be practiced by dissuading infertile couples over the world hence the need to find a consensus on this matter once and for all. Technology in assisted reproduction technology has always been revolutionary. This is evident in regards to main families who would instead want or in need of a matching sibling donor to use his genetic tissue in treating an extremely existing child who is sick and in need of such intervention. As much as it gives support to an unfortunate, assisted reproductive technology must also conform to the moral and ethical aspect that duly arises from its use and daily practice. This provides a sort of a holistic approach where both and proponents of assisted reproductive technology find a balance of consensus.
Conclusion
In the last century, ART has turned out to be one of the widely successful and used medical technologies. Since it gives hope to many couples who suffer from infertility, ART presents new legal, social, and ethical questions that our society has to address. Different countries have attempted to adopt regulations on ART. The legislation and guidelines should be adopted in the area of ART reports, testing genetics, social inequalities which might raise barriers to the financial status of ART, laboratory techniques that emerge and improve gamete and embryo survival and the rights of individuals to that concern genetic offspring’s to set embryo or gamete donation. These ART aspects will become areas of increased debates and controversies in the near future. However, big shares of legal and ethical issues that surround ART are yet to be solved. Society needs to reconcile and support the ART equitably and responsibly in order to improve healthcare access. In addition, the myriad of issues that are not solved and involves the Donation of embryo or gamete has to be considered in great detail in the future of legal and social discussions. The area of ART is dynamic and keeps changing. Different forms of ART that include pre-implantation genetics; the new technology changes the capability of ART. Because of the increased evolving nature of ART, legislations might not be able to address and keep pace with the ethical and legal concerns that change and emerge in the area. (Martin, 2010)As a result, there is a need for physicians and medics to continue monitoring these concerns and to ensure that technologies associated with ART are given and offered in a manner that balances the moral and social responsibility and the care for patients. (Chambers, 2009)
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