Group 2

1
 ARTIFICIAL
REPRODUCTION

2
❖ Discuss artificial reproduction, its processes and risks, as well as
its moral and ethical issues and considerations, and legality in
the Philippines.
❖ Identify the types of artificial reproduction
- Artificial Insemination
- In-Vitro Fertilization
- Surrogacy
❖ Appreciate the role of the nurse in his/her participation in the
delivery of safe, effective and efficient care to patients.

3
5
6
7
8
9
10
According to EXECUTIVE ORDER NO. 209 or THE FAMILY CODE OF THE PHILIPPINES under PATERNITY
AND FILIATION

11
CHAPTER 1. LEGITIMATE CHILDREN

Art. 164. Children conceived or born during the marriage of the parents are legitimate.
Children conceived as a result of artificial insemination of the wife with the sperm of the husband or
that of a donor or both are likewise legitimate children of the husband and his wife, provided, that
both of them authorized or ratified such insemination in a written instrument executed and signed by
them before the birth of the child. The instrument shall be recorded in the civil registry together with
the birth certificate of the child. (Executive Order No. 209, s. 1987)

12
Louise Brown
 is a procedure in which eggs are removed
from a woman and fertilized in laboratory dish
(either husband or another man) embryos are
then implanted in a woman where egg may be
brought to term. (Edge & Groves, 2019)

•infertility
•desire to have a child without male partner (Staff,
2019)
15
 -Fertility
-Semen Sample
-Donor sperm

16
Ovarian Stimulation
Egg Retrieval
Sperm Retrieval
Fertilization
Embryo transfer

17
 If you're using your own eggs during IVF, at the start of a cycle you'll begin treatment with
synthetic hormones to stimulate your ovaries to produce multiple eggs — rather than the single egg that
normally develops each month. Multiple eggs are needed because some eggs won't fertilize or develop normally
after fertilization.

To determine when the eggs are ready for collection, your doctor will likely perform:
•Vaginal ultrasound, an imaging exam of your ovaries to monitor the development of follicles where eggs mature
•Blood tests, to measure your response to ovarian stimulation medications — estrogen levels typically increase
as follicles develop, and progesterone levels remain low until after ovulation

18
•During egg retrieval, you'll be sedated and given pain medication.
•Transvaginal ultrasound aspiration is the usual retrieval method. An ultrasound probe is inserted into your
vagina to identify follicles. Then a thin needle is inserted into an ultrasound guide to go through the
vagina and into the follicles to retrieve the eggs.
•If your ovaries aren't accessible through transvaginal ultrasound, an abdominal ultrasound may be used to
guide the needle.
•The eggs are removed from the follicles through a needle connected to a suction device. Multiple eggs can
be removed in about 20 minutes.
•After egg retrieval, you may experience cramping and feelings of fullness or pressure.

19
•Mature eggs are placed in a nutritive liquid (culture medium) and incubated. Eggs that appear healthy
and mature will be mixed with sperm to attempt to create embryos. However, not all eggs may be
successfully fertilized.

20
 If you're using your partner's sperm, he'll provide a semen sample at your
doctor's office or a clinic through masturbation the morning of egg retrieval.

• Other methods, such as testicular aspiration — the use of a needle or surgical procedure
to extract sperm directly from the testicle — are sometimes required.

•Donor sperm also can be used.

•Sperm are separated from the semen fluid in the lab.

21
 Fertilization can be attempted using two common methods:

healthy sperm and mature eggs are mixed and incubated

overnight.

In ICSI, a single healthy sperm is injected

directly into each mature egg.

22
 Embryo transfer is done at your doctor's office or a clinic and usually takes place two to five
days after egg retrieval.
➢You might be given a mild sedative. The procedure is usually painless, although you might experience
mild cramping.
➢The doctor will insert a long, thin, flexible tube called a catheter into your vagina, through your cervix
and into your uterus.
➢A syringe containing one or more embryos suspended in a small amount of fluid is attached to the end
of the catheter.
➢Using the syringe, the doctor places the embryo or embryos into your uterus.
If successful, an embryo will implant in the lining of your uterus about six to 10 days after egg retrieval.
(Staff, 2019)

23
24
(Staff, 2019)

25
26
➢The process results in extra or “spare” embryos that may then be disposed of, frozen, or experimented
on, none of which is without its detractors.
➢ For those who believe human life is sacred from the moment of conception then the process of IVF
and what happens to excess embryo becomes a moral dilemma.
➢ Although 90% success rate with thawed embryos may be acceptable to laboratory animals, probably
not acceptable with humans particularly if failure or partial failure is not detectable in later life
➢ Once frozen, embryos may outlive the donor thus increase possibility of postmortem conception and
birth.
➢ Use of embryonic tissue in medical research with the aim to treat diseases like Parkinson also for
transplantation (Edge & Groves, 2019)
28
According to the Fourteenth Congress of the Philippines S.B. 1342,
the Constitution, Article II, Section 15 provides: the State shall
protect and promote the right to health of the people and instil
health consciousness among them. A fundamental part of human
experience is fulfilling the desire to reproduce.
Unfortunately, millions of Filipino women and men are suffering
from infertility. While recent improvements in therapy make
pregnancy possible for more couples now than in past years, the
majority of group health plans do not provide coverage for
infertility therapy; thus making it impossible for low and middle
income families to avail of the technology. This bill seeks to require
coverage for the treatment of infertility in any group health plan or
individual health insurance
This act is an act requiring coverage for the treatment of infertility
in any group health plan or health insurance. This Act shall be
known as the “Family Build Act of 2007” which also has standards
relating to benefits for treatment of infertility. A group health plan
and a health insurance issuer, offering health insurance coverage
for treatment of infertility deemed appropriate by a participant or
beneficiary and the treating physician. Such treatment shall include
ovulation induction, artificial insemination, in vitro fertilization
(IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian
transfer (ZIFT), intracytoplasmic sperm injection (ICST), and may
other treatment provided It has been deemed as ‘non-
experimental’ by the Secretary of Health
In case of assisted reproductive technology (ART) , coverage shall
be provided if the participant or beneficiary has been unable to
bring a pregnancy into a live birth through less costly medically
appropriate infertility treatments.The patient has not undergone
four complete oocyte retrievals. The ART include in vitro
fertilization, gamete intrafallopian, ZGIT, embryo
cryopreservation, egg or embryo donation and surrogate birth. A
group health plan and a health insurance coverage, in connection
with a group health plan.
Any law, presidential decree or insurance, executive order, letter
of instruction, administrative order, rule or regulations contrary to
or inconsistent with, the provisions of this Act is hereby repealed
modified or amended accordingly. Nothing in this Section shall be
construed to require a participant or beneficiary to undergo
infertility therapy
 It occurs when a woman agrees to carry a
baby to term and give it up to another set of parents to
raise.

▪ The contracting couple may be unable to contribute

genetic material for some reason or the female is unable
to carry baby to term

▪ sometimes done for money or favor

35
36
 When a woman offers herself to carry the child of an infertile couple — or of others
— for philanthropic reason, not for money.

When it is carried out for financial gain, and is often called womb for rent or womb
for hire: “a woman offers herself to carry a pregnancy in exchange for money.”

37
38
➢ Unethical for women to be used

➢ Economic opportunity for women who have few economic option

➢ Legitimacy of selling humans

➢ Pregnancy viewed as deeply personal experience that should never be undergone for the sake
of others

➢ What if birth mother changes her mind?

39
➢ Kantians find practice of surrogacy problematic since birth mother is clearly used as an
incubator and not regarded as rational actor.
-Kantians in favor as long as long as there is no overt coercion and if woman is
paid and agrees to donate her body for selfless reasons and is acting as rational; and
autonomous individual
- Kantians disagree with it are more likely to compare the practice to a clinical
form of prostitution without the act of sex

40
➢ Utilitarian argument against surrogacy could grant simple equation which is the birth
mother is given money and the contracting parents get a child they could not otherwise have
but then argue that the long term consequences un one or more ways.
- another argument argues that pain of separation of birth mother outweighs the
happiness gained by the contracting parents. (Edge & Groves, 2019)

41
42
 According to the Thirteenth Congress of the Republic of the Philippines Senate Bill No.
2344 introduced by Senator Manny Villar, surrogate parenting is a concept that is relatively new in this
country, although for a long time it has been widely known in the U S . and in other well- developed
countries. Surrogate motherhood is nothing but baby selling. It is similar to the generic experiments
that are done with animals who are bred for certain purposes. A woman becomes a surrogate mother
when she agrees to conceive a child in her womb only to give away the child after birth to another
person for a valuable consideration. Babies are not products like microwave ovens and automobiles.

43
 Pregnancy should never be reduced to a commercial service. The enclosed bill proposes to
penalize not only surrogacy arrangement but also the act of selling infants by their mothers. The
practice of surrogacy arrangement is morally and religiously wrong. We see no difference between
surrogate motherhood and black-market baby selling. Hence, both practices are outlawed in this bill.

44
Bibliography:
Babor, E. R. (2010). Bioethics: A Philosophical Journey and a Critical Analysis into the Life
Sciences -- A Guide to a Health Care Provider. Quezon City, Philippines: C & E
Publishing, Inc.
National Center for Chronic Disease Prevention and Health Promotion, Division of
Reproductive Health. (2019). What is Assisted Reproductive Technology?. Retrieved from
https://www.cdc.gov/art/whatis.html
Executive Order No. 209, s. 1987. (n.d.). Retrieved from 0fficialgazette.gov.ph:
http://www.officialgazette.gov.ph/1987/07/06/executive-order-no-209-s-1987/
Edge, R. S., & Groves, J. R. (2019). Ethics for Healthcare: A Guide For Clinical Practice.
Quezon: C&E Publishing, Inc.
(2019). In-vitro Fertilization. In R. S. Edge, & J. R. GROVES, ETHICS FOR
HEALTHCARE: A GUIDE FOR CLINICAL PRACTICE (Pp. 201-203). Quezon: C&E
Publishing, Inc.
( Staff, M. C. (2019, June 22). Mayo Clinic. Retrieved from
https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-
20384716?fbclid=IwAR3ix4vXo5gotjZZGlbqM4ABEzvCCWodd3xXDR7aJwKkptDOQMogl
3JTUW0
(2019). Surrogacy. In R. S. Edge, & J. R. Groves, Ethics For Healthcare: A Guide For
Clinical Practice (Pp. 203-205). Quezon: C&E Publishing, Inc.
45
46