IVF and Its Place In The Indonesian Society

I Komang Pandu 2106658894

Muhammad Raihan Sabiq 2106658654
Nikolas Nathaniel Kosasih 2106658774
Pandu Putra Sindro 2106719145
Ruben Bisuk Hasiholan 2106658326

University of Indonesia

Depok

2022
 ABSTRACT

IVF became one of the breakthrough innovations in the medical world. Aiming to help
couples to get offspring from their unlikely condition, issues pros and cons from experts from
various fields, claiming it to be a solution, whilst others consider it unnatural. Contrary to the
positive findings, religious beliefs, especially in Indonesia, believed that it is illegal because it is
considered to be complicated in terms of nasab and inheritance in Islam and also is considered
unnatural, against the purpose of a true marriage.
Various experiments were done both domestically in Indonesia and all over the globe.
Some even managed to open IVF practices in hospitals and health clinics with promising results.
We compared local datas and international studies on the results and found out that fresh-cycles
IVF has a more successful rate and also is more popular between couples.

Key Words: IVF, Indonesia, Successful Rate, Illegal, Unnatural, Promising Results,
 CHAPTER 1
INTRODUCTION
1.1 Background
Every couple who just got married, the thing that is very much awaited is to have
children. Getting offspring is something that is expected as a complement to the sweetness of
life. The fruit of the heart is a complement of happiness for couples who have married. Children
are the foundation of all hope. Almost every married couple longs to be blessed with offspring in
their married life. It will be felt incomplete if in marriage they are not blessed or do not have
children as proof of the love of the couple.1
However, getting an offspring is sometimes difficult to realize. Natural fertilization is not
always effective due to damage or closure of the fallopian tubes that carry eggs to the uterus, and
cannot be overcome by opening them or treating them. The husband can also be a factor when
the sperm cells are weak or unable to reach the wife's uterus to meet the egg.2 Those factors can
hinder the success in getting an offspring, so there needs to be an alternative way other than
natural fertilization to handle this problem.
In the last two decades, science and technology in the field of medicine have developed
very rapidly, especially the discovery of new ways of human reproduction. This new method is
called in vitro fertilization. IVF is the result of a collaboration between medical experts and
pharmaceutical technology experts. Reproduction is done by mating sperm and ovarium outside
the uterus in a tube that is prepared in advance for it. After fertilization, it is placed into the
womb of the woman who was prepared in advance and the baby will be born as usual. However,
in its application there are various legal issues that must be addressed. There are many
limitations of how can IVF help on how to get an offspring.

1
Fuadi Isnawan, “Pelaksanaan Program Inseminasi Buatan Bayi Tabung Menurut Hukum Islam Dan
Hukum Positif Indonesia,” Fikri: Jurnal Kajian Agama Sosial Dan Budaya IV, no. 2 (December 17, 2019).
2
Muhammad Idris, “Bayi Tabung Dalam Pandangan Islam,” Jurnal Al-'Adl XII, no. 1 8(2019): 64–75.
1.1.1 Definition
Biomedical development takes place quickly following the development of increasingly
sophisticated science and technology. This development also affects access to pregnancy, which
is often the last resort for pregnancy attempts that have gone through fertility treatment efforts
but have not succeeded. Efforts to get pregnant develop into the IVF process, where pregnancy is
carried out by a husband and wife outside the natural way, namely, fertilization is carried out by
health workers with certain expertise and authority to provide health services.

IVF can also be referred to as "artificial insemination". In medical terms it is known as In

Vitro Fertilization (IVF).3 In Vitro has a Latin meaning in the form of inside while Fertilization is
an English word which means fertilization Then, In Vitro Fertilization (IVF) etymologically
consists of two syllables namely "Fertilization" and "In Vitro." “Fertilization” means fertilization
of a female egg by male spermatozoa, “In Vitro” means outside the body. In Vitro Fertilization
can be defined as the process of fertilization of female eggs by male spermatozoa (part of the
human reproductive process), which occurs outside the body, and Fertilization is also carried out
in a tube.

1.1.2 Procedure
1. Stimulation Phase4
● Hormone injections to female patients
● Drugs are given to stimulate the process of ovulation
● Testing through blood tests or ultrasound will be done to determine the body's readiness
for the egg retrieval process
2. Retrieval of the Female Egg and Male Sperm Phase5
● After the egg cells in the female patient's body have matured, the doctor will take the egg
with a special needle

3
JoAnne Richards, Encyclopedia of Reproduction (Second Edition) (Academic Press, 2018), 92–94.
4
Zahrowati, “Bayi Tabung (Fertilisasi in Vitro) Dengan Menggunakan Sperma Donor Dan Rahim Sewaan
(Surrogate Mother) Dalam Perspektif Hukum Perdata,” HOLREV I, no. 2 (September 2017): 202–203.
5
Ibid 4.
 3. Fertilization Phase6
● After that, the egg will be reunited with the partner's sperm
● The fertilized egg will be stored and monitored in the laboratory
4. Implantation Phase7
● When the embryo is considered mature, it will be inserted through the vagina into the
uterus using a tube called a catheter.
● The female patient will be asked to take a pregnancy test, Two weeks after the embryo
transfer.

1.2 Problem Formulation

● What is IVF? How can it help a lot of people?
● What does the Indonesian Law say about the IVF?
● How do religions in Indonesia view this process?
● Can IVF be accepted by the society in Indonesia?

1.3 Research Method

For this paper, we didn’t do any direct experiment on the In-Vitro Fertilization due to the
lack of access and facilities. So, we decided on doing research online from journals and research
reports on IVF. It means that we are doing this research on a secondary level. From these
research, we used both quantitative and qualitative methods, where the quantitative method is
used to prove that the IVF has a trusted successful rate and we use qualitative methods more on
focusing how the society in Indonesia will react about the development of the IVF in Indonesia
based on their believes and based on the current positive law.

6
Ibid 4.
7
Ibid 4.
 CHAPTER 2
DISCUSSION
2.1 Discussion

At the end of the 19th century, the IVF program became a breakthrough in the medical
world and became a new innovation that Indonesia did not dare to implement. Morula Clinic is
the first pioneer in the application of IVF in Indonesia. Since it was first discovered and entered
Indonesia, the IVF Program (In-Vitro Fertilization) has been done successfully for a lot of times,
and since then so many hospitals and special IVF clinics have been providing IVF services
The success rate is 28% from 7000 fresh cycles and 30% from 1500 frozen cycles. A
frozen cycle is when both of the cells were fertilized and then put inside the freezer of -200
Celsius, and then was put back inside the woman's womb. While the fresh cycles are done by
culture process for 3-5 days before being put back inside the woman;s womb. Results show that
the frozen cycle has a more successful rate. and more popular these days.8

2.2 IVF Based on Indonesian Law

IVF is the result of fertilization of sperm and ovum from a legal husband and wife which
is implanted in the womb of the wife from which the ovum originates. The legal arrangements
related to IVF can be found in Article 127 paragraph (1) of Law no. 36 of 2009 concerning
Health.9
In Article 127 paragraph (1) of Law no. 36 of 2009 concerning Health states that an
attempt to get pregnant outside the natural way can only be carried out by a legal husband and
wife pair and the following provisions:
1. The results of the manufacture of sperm and ovum from the husband and wife concerned are
implanted in the womb of the wife from which the ovum originates;
2. It is carried out by health workers who have the expertise and authority to do so; and
3. At certain health service facilities.

8
Wiryawan Permadi et al., “Frozen vs. Fresh Cycles IVF Outcomes:Retrospective Study from an
Indonesian IVF Centre,” BMC Res Notes Vol. XIV, no. 1 (2021).
9
Salim HS, Bayi Tabung: Tinjauan Aspek Hukum (Sinar Grafika, 1993).
 Based on the explanation of Article 127 paragraph (1) of Law No. 36 of 2009 concerning
Health, methods or programs to have offspring outside the natural way can only be done through
IVF. This is because, this is re-explained in Article 2 paragraph (3) of the Regulation of the
Minister of Health Number 039/Menkes/SK/1/2010 concerning the Implementation of Artificial
Reproductive Technology Services which states that artificial reproductive technology services
can only be provided to married couples who are related to legitimate marriages and as a final
effort to obtain offspring and based on a medical indication.10 Based on these two regulations, it
can be said that only through IVF is it allowed to have offspring outside the natural way in
general.
So, basically sperm and ovum in an attempt to get pregnant through IVF are the property
of a legal husband and wife whose fertilization is done outside the womb.11 This is done by
married couples whose sperm and ova are difficult to fertilize in the womb. So that fertilization
must be done outside the womb with the help of health workers and existing technology. Then
the results of the fertilization are implanted back into the wife's womb from where the ovum
came from. So, the child or baby that is fertilized through IVF is the biological child of the
husband and wife themselves.
Thus, IVF children in inheritance law are included in group I heirs as regulated in Article
852 of the Indonesian Civil Code12, namely:

“Children or descendants, even though born and various marriages, inherit the inheritance of
their parents, grandparents, or their next blood families in a straight line upward, without
distinction of gender or birth first. ”

So, the inheritance law that applies to children from IVF is the same as the inheritance law that
applies to biological children.

10
James Hokkie Mariso, “Analisis Yuridis Tentang Upaya Kehamilan Diluar Cara Alamiah (Inseminasi
Buatan) Menurut Undang Undang Nomor 36 Tahun 2009 Tentang Kesehatan,” Lex et Societatis VI, no. 6 (2018).
11
Edi As’adi and Norma Sari, “The Health Services Legal Problems of in Vitro Fertilization (IVF) Program
Patients in Indonesia,” Jurnal Hukum Novelty XII, no. 1 (2021).
12
Weldo Parinussa, Merry Tjoanda, and Bazrah Latunupo, “Pembagian Harta Waris Kepada Ahli Waris
Dari Perkawinan Pertama Dan Kedua Ditinjau Dari Kitab Undang-Undang Hukum Perdata,” Tatohi Jurnal Hukum I,
no. 4 (June 2021): 356.
2.3 IVF According to Islamic Law

In enacting Islamic Law we need to look at maqāṣid al-sharī‘a, It is a goal, target or end
result in the form of an essential benefit with the enactment of law on humans. It is also known
that the five elements or called uṣūl al-khamsah are part of the needs of al-ḍarurīyah, so
maintaining the five elements is necessary in enacting Islamic Law. Those five elements are
Hifzu Ad-din (protection of religion), Hifzu An-Nafs (protection of the soul), Hifzu Al-'aql
(protection of the mind), Hifzu al-Mal (protection of property), Hifzu an-nasab (protection of
offspring).13
Legally, the baby produced from this insemination has two kinds, namely it is permissible
provided the sperm taken is sperm from a legal husband and wife and is implanted in the wife's
womb (not someone else's womb) and is not allowed, if the sperm taken comes from other men
as well as from other women. The author's view on IVF is that it is okay as long as the sperm
taken is sperm that comes from a legal husband and wife and is implanted in the wife's womb
(not someone else's womb) and also the one who handles it. (man).14
IVF with a system without the involvement of a third party (sperm and eggs from
husband and wife) and transferred to the wife's womb, it is legal and the baby is due to his
parents, as for if the sperm or ovum from the donor is then transferred to the wife's womb, and so
if Sperm and ovum from husband and wife are then transferred to the wife's womb, then the law
is forbidden and the lineage of the child to the mother who conceived and gave birth to him. IVF
In the concept of Maqaid Syariah, it is one of the media that contributes to realizing Hifzu
Ad-din (protection of religion), Hifzu An-Nafs (protection of the soul), Hifzu Al-'aql (protection
of the mind), Hifzu al-Mal (protection of property), Hifzu an-nasab (protection of offspring).15
However, IVF dominates and looks more transparent in the aspect of Hifzu an-nasab (protection

13
Helim, Abdul, Maqasid Al-Shariah Versus Usul Al-Fiqih, Pustaka Pelajar, (2019), Page 24
14
Muh Idris, “Bayi Tabung Dalam Pandangan Hukum Islam”, Jurnal Al-Adl, (2019), Page 75
15
Dr. Jasser Auda, Memahami Maqasid Syariah (PTS Islamika, 2015),.
of offspring).16 To conclude it all up in Islamic Law it is allowed as long as the two parties
involving the plantation of IVF are legal partners.

As it is still considered a new method, not all processes are successful, as there are some
related factors that need to be prepared from both couples from the male and female. These are
some advantages and disadvantages that might happen during the IVF Process.17

Advantages18
● Product (Baby) will be much stronger
Babies from the IVF Program tends to be more stronger, immune to disease because
during the process the best of both cells are chosen
● Giving Hope to couples that are unable to reproduce
IVF became a solution for couple with infertilization problems but want to have kids
● More likely to have twins (32% more likely)
For couples who wanted to have twins, IVF is the solution of more likely to get a twin

Disadvantages
● A Chance of Miscarriage (keguguran)
Research shows that there is a chance that a baby in the womb will miscarry with a
percentage of 15%-25% which may be due to lack of rest or stress.
● Might Get a Hyperstimulated Ovarium Syndrome
A condition in which the mother's ovaries are swollen as a result of the IVF process.
● Might Go Through Ectopic Pregnancy
An ectopic pregnancy is a condition where an egg is fertilized outside the uterus as a
result of IVF.

16
Irham Dongoran, “Bayi Tabung Dalam Tinjauan Hukum Islam”, Jurnal Syariah dan Hukum, (2020),
Page 85
17
Rebecca Fett, It Starts with the Egg (Second Edition): How the Science of Egg Quality Can Help You Get
Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF (Good Reads Author, 2019).
18
 CHAPTER 3
CONCLUSION

3.1 Conclusion

IVF is considered to be an innovation in the medical world that can help a lot of couples
with infertility problems. Promising results and successful rates have attracted a lot more couples
in taking the program to help them as it is growing more and more popular in Indonesia.
Despite the promising results, religious beliefs have a different view of this method in
getting an offspring. It is considered to be complicated in terms of inheritance and is against the
natural purpose of a marriage and the natural process in it. Regardless of that, the Indonesian
government, in collaboration with the Ministry of Health, has produced some laws in regards to
modern artificial technology including the In-Vitro Fertilization practice in Indonesia.
Aside from the pros and cons in the discussion regarding the IVF, we think that what’s
best is decided by each individual or couple. It should be their own choice regarding what they
believe and what they are planning to do regarding their familyhood. We also appreciate the step
that the Indonesian Government has taken to being open and not focusing on cons regarding the
issue.
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