In Vitro Fertilization: The A.R.T. of Making Babies (Assisted Reproductive Technology)

Types of assisted reproductive treatment
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The industry has been accused of making unscientific claims, and distorting facts relating to infertility, in particular through widely exaggerated claims about how common infertility is in society, in an attempt to get as many couples as possible and as soon as possible to try treatments rather than trying to conceive naturally for a longer time.

This risks removing infertility from its social context and reducing the experience to a simple biological malfunction, which not only can be treated through bio-medical procedures, but should be treated by them. When it was first opening up in late s, early 80s, it was meant to be the last resort.

In vitro fertilisation

Now it's a first resort. I think that's an injustice to women. I also think it can harm women in the long run. All pregnancies can be risky, but there are greater risk for women who are older and are over the age of The older the women the riskier the pregnancy. As women get older, they are more likely to suffer from conditions such as gestational diabetes and pre-eclampsia. If older women do conceive over the age of 40, their offspring may be of lower birth weight, and more likely to requires intensive care.

Because of this, the increased risk is a sufficient cause for concern. The high incidence of caesarean in older mothers is commonly regarded as a risk. Though there are some risk with older women pregnancies, there are some benefits associated with caesareans. A study has shown that births over 40 have a lower rate of birth trauma due to increased delivery by caesarean. Though caesarean is seen to benefit mothers over 40, there are still many risk factors to consider. Caesarean section may be a risk in the same way that gestational diabetes is.

Women conceiving at 40 have a greater risk of gestational hypertension and premature birth. The offspring is at risk when being born from older mothers, and the risks associated with being conceived through IVF. Although menopause is a natural barrier to further conception, IVF has allowed women to be pregnant in their fifties and sixties. Women whose uteruses have been appropriately prepared receive embryos that originated from an egg of an egg donor. Therefore, although these women do not have a genetic link with the child, they have a physical link through pregnancy and childbirth.

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In many cases the genetic father of the child is the woman's partner. Even after menopause the uterus is fully capable of carrying out a pregnancy. A statement from the ASRM found no persuasive evidence that children are harmed or disadvantaged solely by being raised by single parents, unmarried parents, or homosexual parents. It did not support restricting access to assisted reproductive technologies on the basis of a prospective parent's marital status or sexual orientation.

Ethical concerns include reproductive rights, the welfare of offspring, nondiscrimination against unmarried individuals, homosexual, and professional autonomy. A recent controversy in California focused on the question of whether physicians opposed to same-sex relationships should be required to perform IVF for a lesbian couple. Guadalupe T. Benitez, a lesbian medical assistant from San Diego, sued doctors Christine Brody and Douglas Fenton of the North Coast Women's Care Medical Group after Brody told her that she had "religious-based objections to treating her and homosexuals in general to help them conceive children by artificial insemination," and Fenton refused to authorise a refill of her prescription for the fertility drug Clomid on the same grounds.

Nadya Suleman came to international attention after having twelve embryos implanted, eight of which survived, resulting in eight newborns being added to her existing six-child family. The Medical Board of California sought to have fertility doctor Michael Kamrava, who treated Suleman, stripped of his licence.

State officials allege that performing Suleman's procedure is evidence of unreasonable judgment, substandard care, and a lack of concern for the eight children she would conceive and the six she was already struggling to raise. On 1 June the Medical Board issued a ruling that Kamrava's medical licence be revoked effective 1 July Some children conceived by IVF using anonymous donors report being troubled over not knowing about their donor parent as well any genetic relatives they may have and their family history.

Alana Stewart, who was conceived using donor sperm, began an online forum for donor children called AnonymousUS in The forum welcomes the viewpoints of anyone involved in the IVF process. In the U. In , a website called Donor Sibling Registry was created to help biological children with a common donor connect with each other.

In , a documentary called Anonymous Father's Day was released that focuses on donor-conceived children. During the selection and transfer phases, many embryos may be discarded in favour of others. This selection may be based on criteria such as genetic disorders or the sex. For those who believe that this is at the moment of conception, IVF becomes a moral question when multiple eggs are fertilised, begin development, and only a few are chosen for implantation.

If IVF were to involve the fertilisation of only a single egg, or at least only the number that will be implanted, then this would not be an issue. However, this has the chance of increasing costs dramatically as only a few eggs can be attempted at a time. As a result, the couple must decide what to do with these extra embryos. Depending on their view of the embryo's humanity or the chance the couple will want to try to have another child, the couple has multiple options for dealing with these extra embryos.

Couples can choose to keep them frozen, donate them to other infertile couples, thaw them, or donate them to medical research. In the realm of medical research, the couple is not necessarily told what the embryos will be used for, and as a result, some can be used in stem cell research, a field perceived to have ethical issues. The Catholic Church opposes all kinds of assisted reproductive technology and artificial contraception , on the grounds that they separate the procreative goal of marital sex from the goal of uniting married couples.

The Catholic Church permits the use of a small number of reproductive technologies and contraceptive methods like natural family planning , which involves charting ovulation times, and allows other forms of reproductive technologies that allow conception to take place from normative sexual intercourse, such as a fertility lubricant. Pope Benedict XVI had publicly re-emphasised the Catholic Church's opposition to in vitro fertilisation, saying that it replaces love between a husband and wife.

The Catechism of the Catholic Church, in accordance with the Catholic understanding of natural law , teaches that reproduction has an "inseparable connection" to the sexual union of married couples.

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Hindus welcome IVF as gift for those who are unable to bear children and have declared doctors related to IVF to be conducting punya as there are several characters who were claimed to be born without intercourse, mainly Kaurav and five Pandavas. Within the Orthodox Jewish community the concept is debated as there is little precedent in traditional Jewish legal textual sources.

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Regarding laws of sexuality , religious challenges include masturbation which may be regarded as "seed wasting" [] , laws related to sexual activity and menstruation niddah and the specific laws regarding intercourse. An additional major issue is that of establishing paternity and lineage. For a baby conceived naturally, the father's identity is determined by a legal presumption chazakah of legitimacy: rov bi'ot achar ha'baal - a woman's sexual relations are assumed to be with her husband. Regarding an IVF child, this assumption does not exist and as such Rabbi Eliezer Waldenberg among others requires an outside supervisor to positively identify the father.

Many people of sub-Saharan Africa choose to foster their children to infertile women. IVF enables these infertile women to have their own children, which imposes new ideals to a culture in which fostering children is seen as both natural and culturally important. Many infertile women are able to earn more respect in their society by taking care of the children of other mothers, and this may be lost if they choose to use IVF instead.

As IVF is seen as unnatural, it may even hinder their societal position as opposed to making them equal with fertile women. It is also economically advantageous for infertile women to raise foster children as it gives these children greater ability to access resources that are important for their development and also aids the development of their society at large.

If IVF becomes more popular without the birth rate decreasing, there could be more large family homes with fewer options to send their newborn children. This would ultimately stifle the children's and the community's growth. Studies have indicated that IVF mothers show greater emotional involvement with their child, and they enjoy motherhood more than mothers by natural conception. Similarly, studies have indicated that IVF fathers express more warmth and emotional involvement than fathers by adoption and natural conception and enjoy fatherhood more.

Some IVF parents become overly involved with their children. Research has shown that men largely view themselves as 'passive' contributors [] since they have 'less physical involvement' [] in IVF treatment. Despite this, many men feel distressed after seeing the toll of hormonal injections and ongoing physical intervention on their female partner. For others, this led to feeling socially isolated. Many fertile couples [ citation needed ] now demand equal access to embryonic screening so that their child can be just as healthy as one created through IVF.

Mass use of PGD, especially as a means of population control or in the presence of legal measures related to population or demographic control, can lead to intentional or unintentional demographic effects such as the skewed live-birth sex ratios seen in communist China following implementation of its one-child policy. In Australia, the average age of women undergoing ART treatment is The key challenges are lack of awareness, affordability and accessibility. Israel has the highest rate of IVF in the world, with procedures performed per million people per year.

The second highest rate is in Iceland, with procedures per million people per year. Israel provides unlimited free IVF procedures for its citizens for up to two children per woman under 45 years of age. In other countries the coverage of such procedures is limited if it exists at all. Up to three IVF treatments are government subsidised for women who are younger than 40 and have no children, but the rules for how many treatments are subsidised, and the upper age limit for the women, vary between different county councils.

Single women are treated, and embryo adoption is allowed. There are also private clinics that offer the treatment for a fee. The National Institute for Health and Care Excellence NICE recommends up to 3 cycles of treatment for women under 40 and one cycle for some women aged between 40 and 42, but financial pressure has eroded compliance with this recommendation.

CCGs in Essex , Bedfordshire and Somerset have reduced funding to one cycle, or none, and it is expected that reductions will become more widespread. Funding may be available in "exceptional circumstances" — for example if a male partner has a transmittable infection or one partner is affected by cancer treatment. The Human Fertilisation and Embryology Authority said in September that parents who are limited to one cycle of IVF, or have to fund it themselves, are more likely choose to implant multiple embryos in the hope it increases the chances of pregnancy.

This significantly increases the chance of multiple births and the associated poor outcomes, which would increase NHS costs. The president of the Royal College of Obstetricians and Gynaecologists said that funding 3 cycles was "the most important factor in maintaining low rates of multiple pregnancies and reduce s associated complications". Utilisation highly increases with availability and IVF insurance coverage, and to a significant extent also with percentage of single persons and median income.

Many fertility clinics in the United States limit the upper age at which women are eligible for IVF to 50 or 55 years. Government agencies in China passed bans on the use of IVF in by unmarried women or by couples with certain infectious diseases. Sunni Muslim nations generally allow IVF between married couples when conducted with their own respective sperm and eggs, but not with donor eggs from other couples.

But Iran, which is Shi'a Muslim, has a more complex scheme. Iran bans sperm donation but allows donation of both fertilised and unfertilised eggs. Fertilised eggs are donated from married couples to other married couples, while unfertilised eggs are donated in the context of mut'ah or temporary marriage to the father.

By Costa Rica was the only country in the world with a complete ban on IVF technology, it having been ruled unconstitutional by the nation's Supreme Court because it "violated life. A law project sent reluctantly by the government of President Laura Chinchilla was rejected by parliament.

President Chinchilla has not publicly stated her position on the question of IVF. However, given the massive influence of the Catholic Church in her government any change in the status quo seems very unlikely. The decree was added to the country's official gazette on 11 September.

Opponents of the practice have since filed a lawsuit before the country's Constitutional Court. All major restrictions on single but infertile women using IVF were lifted in Australia in after a final appeal to the Australian High Court was rejected on procedural grounds in the Leesa Meldrum case. A Victorian federal court had ruled in that the existing ban on all single women and lesbians using IVF constituted sex discrimination.

Federal regulations in the United States include screening requirements and restrictions on donations, but generally do not affect sexually intimate partners. From Wikipedia, the free encyclopedia. For other uses, see IVF disambiguation and Test tube baby disambiguation. Further information: Infertility. Main article: Controlled ovarian hyperstimulation. Main article: Natural cycle in vitro fertilisation.

Further information: Final maturation induction. Further information: Transvaginal oocyte retrieval.

Main article: Embryo culture. Further information: Embryo quality. Main article: Embryo transfer.

Introduction

Main article: Luteal support. Main article: Preimplantation genetic diagnosis. Main articles: Oocyte cryopreservation and Embryo cryopreservation. Further information: Embryo donation and Egg donor. Main article: History of in vitro fertilisation. See also: Donor conceived person. Further information: Donor conceived person.

Main article: Religious response to assisted reproductive technology. Retrieved 21 May The year-old, whose pioneering conception by in-vitro fertilisation made her famous around the world. Human Fertility. Retrieved 5 November Retrieved 8 December Human Reproduction.

Society for Reproductive Medicine. Retrieved 6 November The Canadian Press.

In Vitro Fertilization: The A.R.T. of Making Babies by Geoffrey Sher

Centers for Disease Control and Prevention. Archived from the original on 31 March Retrieved 25 March Retrieved 14 July Day to Day , National Public Radio. Fertility and Sterility. Human Reproduction Update. Reproductive Biology and Endocrinology. Bibcode : PLoSO Department of Health UK. The Cochrane Database of Systematic Reviews. Bibcode : PNAS.. The New England Journal of Medicine.

Part II--Mental health and development outcomes". Infants, Children, and Adolescents, 7th Edition. VitalBook file. Women's Health. Retrieved 22 May By Peter Kovacs. Archived from the original on 21 May Retrieved 2 November Retrieved on 3 August Talking Point on morality and human embryo research". EMBO Reports. RFID Journal. Who regulates preimplantation genetic diagnosis in Brazil? Reproductive Biomedical Online. The Independent. Retrieved 12 November More 'designer' options. The Guardian. Nature biotechnology, 32 1 , CBS News.

The Hastings Center Report. Los Angeles Times. Wall Street Journal. Retrieved 21 March Associated Press. Christianity Today. Archived from the original on 18 July Washington Post. Greenfield Daily Reporter. Archived from the original on 2 July Rome: Vatican.

Retrieved 25 November Section ". Retrieved 30 May Culture, Medicine and Psychiatry. Africa Today. The diversity of regulation and public financing of IVF in Europe and its impact on utilization. The Australian.

Steven J. Niven 2 February Dictionary of African Biography. BW Businessworld. Retrieved 8 July Retrieved 23 February NHS cuts to fertility treatment 'will deny thousands parenthood ' ". BBC News. Retrieved 30 October National Institute for Health and Clinical Excellence.

February Retrieved 16 February Retrieved 5 September Healthcare Leader. Retrieved 5 October Retrieved 24 December Health Service Journal. Retrieved 26 December Retrieved 8 October Archived from the original on 15 July Archived from the original PDF on 7 July El Pais. Retrieved 5 January US Food and Drug Administration. Archived from the original on 7 February Henig RM New York: Houghton Mifflin. Singapore Medical Journal. Assisted reproductive technology. Female Male Fertility clinic Fertility testing Fertility tourism.

Assisted zona hatching Autologous endometrial coculture Cytoplasmic transfer Embryo transfer Gestational carrier In vitro maturation Intracytoplasmic sperm injection Oocyte selection Ovarian hyperstimulation Preimplantation genetic diagnosis Snowflake children Transvaginal ovum retrieval Zygote intrafallopian transfer. As new reproductive technologies have advanced rapidly, questions regarding the consequences for children conceived with the help of these procedures have lagged far behind.

Psychological literature suggests that the stress of infertility may lead to dysfunctional patterns of parenting and may result in negative outcomes for the child 5 or that IVF parents will be overprotective of their children or have unrealistic expectations of them. Hahn 7 reviewed the psychosocial well-being of parents and their children born after assisted reproduction. The objective of the paper was to critically review the empirical literature published on this topic since Several common findings appeared across the literature reviewed.

No statistically significant differences in child functioning in terms of emotions, behaviour, self-esteem or perceptions of family relationships were reported at that time. However, Hahn does cite work by Levy-Shiff et al. No significant difference was found in IQ or cognitive performance, but IVF children rated on socioemotional adjustment were reported by their teachers to be more anxious, depressed and aggressive than their peers.

This is the only report to date of poorer emotional adjustment of IVF children. An article by Golombok et al. The few differences in parent-child relationships that were identified appeared to be associated with the experience of infertility rather than the IVF procedure itself. The IVF children were found to be functioning well and did not differ from the adopted or naturally conceived children on any assessments of social or emotional adjustment. Hahn and DiPierto 3 examined the associations between homologous IVF and quality of parenting, family functioning and emotional and behaviour adjustment in three- to seven-year-old children.

A cross-sectional survey conducted in Taiwan compared 54 IVF mother-child pairs and 59 mother-child pairs with children conceived naturally. IVF mothers reported a greater level of protectiveness toward their children than control mothers. Teachers, blind to condition, rated IVF mothers as displaying greater warmth but not more overprotective or intrusive parenting behaviours than mothers of control children. Teachers scored children of IVF as having fewer behavioural problems than control children. In contrast, IVF mothers reported less satisfaction with aspects of family functioning.

Family composition was found to moderate parenting stress: IVF mothers with only one child perceived less parenting stress than did those in the control group. The pilot study compared 31 IVF families and 31 families with a naturally conceived child when the children were two years old. Twenty-seven IVF and 23 control families participated again when the children were eight to nine years old.

Researchers have suggested that IVF parents have more emotional involvement and warmth towards their child 4 and less parenting stress. Finally in the most comprehensive study to be reported so far, Barnes et al. This study involved 1, five-year-old children in approximately equally sized groups either conceived naturally, by conventional in vitro fertilisation and by intracytoplasmic sperm injection from five European countries Belgium, Denmark, Greece, Sweden, and the United Kingdom. However, there were some interesting findings. Firstly, ART families found the experience of parenting more positive than naturally conceiving families.

Secondly, they were less committed to work than naturally conceiving families. Thirdly, there was no evidence of child temperament problems or difficulties in the dyadic relationship. Notwithstanding these caveats, all scores were normal in all groups; these were relative differences whose clinical significance remains unknown. Overall, the existing literature is reassuring. There are far more important issues beyond the brief of this report that definitely have implications for public policy. These include the major problems in ART resulting from higher-order births, prematurity and disability and the impact of falling fertility, as noted below.

Sutcliffe AG. Encyclopedia on Early Childhood Development [online]. Updated November Accessed July 8, Skip to main content. November , 2 nd ed. PDF version.

Assisted Reproductive Technology

Subject Research to date has focused on: a parent-child relationships in IVF families; b investigation of maternal skills in IVF families compared to families with naturally conceived children; c consideration of relationships in non-traditional family groups, e. Non-participation and non-representative samples are also issues. Research Context In the initial stages of the development of assisted reproduction, ethical, legal and medical issues were raised.

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In Vitro Fertilization: The A.R.T. of Making Babies (Assisted Reproductive . This book contains NEW information about IVF techniques and technology. In Vitro Fertilization: The A.R.T. of Making Babies (Assisted Reproductive Technology) [Geoffrey Sher, Virginia Marriage Davis, Jean Stoess] on Amazon. com.

Key Research Questions Are these children being raised in a different socio-emotional environment than their naturally conceived peers? Does non-traditional family life e. Are children who are denied their genetic and conceptional origins ultimately at risk of problems with their long-term psychological well-being, as has been shown in adopted children?