ASSISTED REPRODUCTIVE TECHNOLOGIES 2

Impact of New Technologies on Human Reproduction

Table of Contents
1.1 Introduction ........................................................................................................................
2
1.2 Trends in ART’s .................................................................................................................
3
1.2.1 Cryopreservation ......................................................................................................... 4
1.2.2 In-Vitro Fertilization (IVF) ......................................................................................... 5
1.2.3 Physiological Intracytoplasmic Sperm Injection (PICSI) and Intracytoplasmic
Sperm Injection (ICSI) ........................................................................................................ 5
1.3 Demographic Projections of ARTs ...................................................................................
6
1.4 Implications of ARTs .........................................................................................................
7
1.5 Increased Awareness Levels with ARTs ..........................................................................
8
1.6 Ethical and Legal Issues ....................................................................................................
9
1.7 Conclusion ........................................................................................................................
10
1.1 Introduction
Since the last decade, human beings, through a combination of intellect and research,
devised strategies for rectifying infertility in both men and women. These methods, known as
ASSISTED REPRODUCTIVE TECHNOLOGIES 3
Assisted Reproductive Technologies (ARTs), give people who cannot reproduce a chance of
enhancing their procreation or production of progeny viably. Some of the recent trends in
ARTs
include Physiological Intracytoplasmic Sperm Injection, Intracytoplasmic Sperm Injection, In
Vitro Fertilization and Cryopreservation (Sunderman et al. 2018). Based on the article by
Casillas et al. (2015), many species, since recent decades, lost their natural fertilization
potentials. The loss may have occurred partly or wholly due to conditions like
oligozoospermia,
azoospermia, obesity, cancer, fallopian tubes obstruction, and increased incidences of the
polycystic ovarian syndrome. The paper revolves around new trends in ARTs, positive and
negative implications, legal and ethical issues and the need for regulation. Based on the
scholarly resources on ARTs, it is clear that there is a need to fill the gap in knowledge on
assisted reproductive technologies and their implications due to the technology evolving.
1.2 Trends in ART’s
In recent years, many developments have constituted assisted reproductive
technologies. Hence, scientists came up with novel mechanisms with which people could
overcome their infertility. In this section, the paper borrows critical concepts from the article
by Casillas et al. (2015) which provides sufficient information on trends in assisted
reproductive technologies. Compared to human beings, domesticated animals like pigs and
bovine have reproductive potentials/fertility rates of 90% and 70% respectively. However,
human beings often have difficulties in reaching an optimal reproductive level. The leading
causes for this in man include anatomical abnormalities, endometriosis, cystic ovarian
follicles,
a malfunctioning genital system in females and males, venereal infections, and nutrient
deficits.
ARTs have shown great promise and benefits in preserving endangered species. Here are
some
assisted reproductive technologies:
ASSISTED REPRODUCTIVE TECHNOLOGIES 4
1.2.1 Cryopreservation
Based on the analysis of the article by Casillas et al. (2015), cryopreservation is a
technique that allows maintenance of the integrity of cells, organs and tissues due to extreme
cold conditions of 80oC to -1960C. In this state, these body elements shut down their
metabolism i.e. their biochemical pathways hence preservation of feasibility, potential and
development. The process has in the recent five decades, enabling the execution of
cryobiology
and gamete conservation. The maintenance possesses many benefits to people such as the
achievement of pregnancy through ART in people undergoing cancer therapies.
The authors argue in an academic context and organize work in topics and subtopics.
Under cryopreservation, several technologies are in place. One method is freezing techniques
under which are vitrification and slow freezing. Slow freezing processes allow for the
lowering
of temperatures gradually and the application of cryoprotection concentrations. The process,
through its slow nature, enables the formation of ice crystals for biological components.
Hence,
these processes have been used efficiently for cryopreservation of embryos, mature oocytes
and sperms. Despite the many applications, slow freezing approaches yield some problems.
The first challenge is the high expense of components like programmable freezing items.
Moreover, the technique takes a prolonged time. Many success rates still constitute the
process with its applications in humans turning crucial. The method also applies
cryoprotectants (CPA) which are compounds allowing integrity on warming, limited
dehydration, all due to formation crystals. These elements (CPAs) allow the reduction of
maximum temperature due to their low toxicity and high water solubility.
Casillas et al. (2015) describe the other method as vitrification which involves
conversion to stable vitreous states of elements in their liquid states. The process of vitreous
states from intracellular liquid water involves rapid cooling and higher intensities of
cryoprotectants.
ASSISTED REPRODUCTIVE TECHNOLOGIES 5
1.2.2 In-Vitro Fertilization (IVF)
The process, since its articulation, has had many benefits for animal and human
reproduction. Casillas et al. (2015) indicate that through a porcine study, high polyspermy
percentages constituted 81% of fertilization efficiency. Polyspermy involves the integration
of
two or more sperm in an egg on fertile processes. The process commonly seen pigs show its
increased potential for humans too. However, the method may have challenges like
polyspermy
and immature oocytes. The problems hence led to the evolution of new studies such as
cytoplasmic and nuclear maturation processes or responses during in vitro fertilization. The
reviews, for example, involve the in-vitro transformation process during maturation. Hence,
the technique of IVF has promise and complements many successful births today.
1.2.3 Physiological Intracytoplasmic Sperm Injection (PICSI) and Intracytoplasmic
Sperm Injection (ICSI)
These two processes show great application and have high similarity in concept. Also,
ICSI forms the most widely applied technique for people with fertility problems. The process
involves direct entry of sperms to the cytoplasm of oocytes through injection. However, the
process shows difficulties especially decondensation failures from a bypass of
fertilizationbased
selection and sperm-oocyte identification. The process allows the development of an
embryo through pronuclear structuration by the male. The process’s success is evident with
10% of successful fertilizations hence live births. The process’s success rate in animals is
only
one pregnancy in sheep, 8-10% in mouse and 21% in a cow (Casillas et al. 2015). The
process,
in some instances, may result in reduced development of the embryo due to sperm ejection,
sex
chromosome abnormalities or failure in oocyte activation.
Hence, these are the three major strategies of assisted reproductive technologies
showing great significance today. Through such, people fear less concerning childbearing and
have absurdity of children, though with high costs and some health failures.
ASSISTED REPRODUCTIVE TECHNOLOGIES 6
1.3 Demographic Projections of ARTs
To best address the demographic projections of assisted reproductive technologies, the
paper borrows concepts from the research by Faddy, Gosden, and Gosden (2018). The
authors
indicate that today, application levels of ARTs increase among people with children born
through this approach constituting a world segment of 0.1%. In future decades, the scenario is
such that parents will give rise to progeny who indirectly or directly attributes their existence
to ARTs. The main issue that Faddy, Gosden and Gosden are that no magnitude projections
in
the demographics have been attempted. With the successful IVF delivery in the last four
decades, the applicability of the procedure seemed unlikely. Recent years hence saw the
application of fertility services, some making changes to the genitalia such as fallopian
blockage. Another primary concept is that by 2013, approximately 5 million individuals
underwent successful ART-based deliveries. Of these, significant approaches done may have
included preimplantation genetic screening and diagnosis, in-vitro maturation, egg/embryo
donation or frozen embryo replacement.
From their analysis, Faddy, Gosden, and Gosden (2018) highlight that with no fertility
successes among people, most people will opt for assisted reproductive technologies to a tune
of 167 million live births by 2100. Also, a significant percentage of these births will have
maximal survival rates and add to the existing population. The birth number also targets a
high
value owing to the possible and significant rise in ART services. If the case scenario happens,
the population of such live births may hit 315 million globally, owing to an annual birth
increase of 10,000-20,000. Hence, the demographics may rise to instances where IVF live
deliveries reach 3%. Through the application of a demographic approach, Faddy, Gosden and
Gosden (2018) hence bring out useful projections essential information for future research.
ASSISTED REPRODUCTIVE TECHNOLOGIES 7
1.4 Implications of ARTs
Some of the significant implications associated with Assisted Reproductive
Technologies (ARTs) are cost and consequences. The article by Connoly, Hoorens and
Chambers (2010) applies an economic perspective in explaining significant ART implications
procedures. With the many application of these procedures previously and today, people
deficiently comprehend their economics and policy issues like equitable, safe, and adequate
financing. In their study, the authors examined several pieces of research on ART
consequences
and costs and evaluated that the USA incurs the highest economic costs directly. The direct
prices are those provided during treatments while indirect one results after the execution of
the
procedures. Various costs incurred by people directly include medical applications like
overhead charges, administrative and counselling services, nursing, hospital charges, embryo
transfer or oocyte retrieval.
As mentioned, the USA has higher costs, when compared to Japan and Northern
European countries. Also, the top prices in the USA are attributed to its rather high-
expenditure
healthcare system nearly twice that of Japan and the Netherlands. On the other hand, indirect
costs constitute the procedure; for example, an increased likelihood of multiple birth
pregnancies. The consequence is that people may less accept parents to these numerous
pregnancies. These costs also surpass those of individual associated reproductive
technologies
thus raising concern. The multiple births also link to increased morbidity and the charges
often
carry forward the prenatal stage. Estimations of indirect and direct costs reach E24 377 for
ART for women in Finland (Connoly, Hoorens and Chambers, 2010). These are figures
rather
hard to raise for most people hence pressure on cost. With the application of ART today, only
a few people seek an understanding of economic aspects relating to children born of ART
procedures. The existence of these children in large numbers yearly, there is input on the
ASSISTED REPRODUCTIVE TECHNOLOGIES 8
economic segment through their lifetime and influence of tax payments, education and
education.
1.5 Increased Awareness Levels with ARTs
One study that describes awareness and perception of ART’s is by Adesiyiun, Ameh,
and Avidime (2011) who undertook a case study of infertile Nigerian women. The situation
in
Sub-Saharan is that a significant population of couples suffer from infertility. Moreover,
infertility among men was recorded as 40% and 55% in women. The attitudes held by these
people are that lack of a child brings segregation from the community; hence children are
essential constituents of societies and families. Thus, childlessness is linked to significant
social and psychological outcomes. Other causes of the high infertility are abortion cases and
STIs like Chlamydia and gonorrhea. The existence of ART’s favored satisfaction of 50%
infertility cases. For example, Denmark shows the highest comprehension of ART at 37%,
while Egypt and Latin America shows the lowest instances of <2%.
The differing figures show differences in attitudes and perceptions of the procedures by
people in different regions. The determination of these awareness levels for different nations
is essential for more effective treatments of infertility, and the organization of public
enlightenment initiatives (Adesiyiun, Ameh, and Avidime, 2011). The study by (Wennberg et
al. 2015) also reviews the issue of awareness and attitudes of ARTs through the case of
Sweden.
Due to the increased knowledge of these procedures, there are societal changes such as
reevaluating
legislations and ethical debates. For example, it is possible for fertility treatments
for lesbian couples and single women in many nations. Based on this study, participants,
females, showed a positive perception and attitudes regarding new methods of treating
fertility.
Expressly, these people indicated high acceptability for the cryopreservation of oocytes
procedure. However, the population showed that these approaches are mainly acceptable for
ASSISTED REPRODUCTIVE TECHNOLOGIES 9
medical purposes than social reasons. The high rates of acceptance show that people prefer
these assistive technologists due to their effectiveness for medical reasons. Another study by
Fortin and Abele (2016) highlight that acceptance among women and positive attitudes result
from increased awareness of ARTs.
Research by Leone et al. (2017) identifies the issue of breaking bad news regarding
ARTs as a method of improving awareness among people. Often, professionals show
difficulty
in revealing such details due to a lack of guidelines. A lack of such disclosure results in
increased medical malpractice cases, deficiency in the quality of care, lower compliance in
treatments, and inadequate care satisfaction. Thus, revealing crucial information to patients
by
healthcare professionals is paramount in avoiding flaws in ART procedures.
In recent times, many feministic views have also developed around assisted
reproductive technologies especially in the 1960s and 70s (Chokr, 1992). The perception then
is that these technologies promoted women dominance in overcoming inequalities, biological
dysfunctions, and enabling reproductive freedoms, choices and rights in women. However,
there developed concerns over policies, psychological, social, legal and ethical problems in
the
1980s. Many feminists believed that these technologies would stir coercion of women,
exploitation, and patriarchal social control.
1.6 Ethical and Legal Issues
With the significant applications of assisted reproductive technologies, it is essential to
consider ethical and legal issues such as regulation. The main question is, should there be
regulation of these methods in healthcare? Currently, people in millions opt for these
procedures but do not comprehend social, legal and ethical challenges. Due to this, utilization
of ART was placed under the scrutiny of professional organizations, government bodies and
the public. For example, regulations in the 1980s demanded the removal of barriers for
accessing ART, pregnancy data transparency and administration of gonadotropins (Brezina
and
ASSISTED REPRODUCTIVE TECHNOLOGIES 10
Zhao, 2012). Many countries also recognize the need for reporting ART requirements and the
outcomes of every procedure. However, some countries lack the need for such legislation.
USA
is a good instance where all ART procedures should report in IVF cycles and embryo transfer
but fails to indicate permitted and transferable embryos. In this case, authors undertake a
review
of financial aspects, practice regulations, reporting regulations, ART utilization scope et
cetera.
The research hence complements the present study on reproductive technologies.
There is a need for more regulation regarding ART procedures, for example, a
limitation of policies. This indicates that many healthcare professionals fail to provide
accurate
information regarding ART procedures to the centre for disease control. Some non-adherence
to ethics and regulations are strategies by some centres for increasing their share in the
market
(Frith and Blyth, 2014).
1.7 Conclusion
From the information above, Assisted Reproductive Technologies (ARTs) have
primary application for recent decades. Through techniques like cryopreservation, human
beings with various forms of fertility problems can successfully have live babies. This paper
also identifies concerns with ARTs such as economic costs. Besides, it also gives a
demographic projection of ARTs as they are gaining prominence presently. The other theme
of this paper is on attitudes and awareness of ARTs, whereby people in different regions have
varying perceptions. Lastly, it identifies a need for ethics and regulations governing ART
procedures; these are essential in avoiding any adverse health concerns in the future. Based
on
the literature review on ARTs, it is clear that much more research is needed on the
implication
of ARTs due to a gap in knowledge as technology is evolving and also due to ethical and
legal
considerations.