Artificial Insemination and in-

vitro Fertilization
 Introduction of AI

Definition: Artificial introduction of

semen into the vagina, uterus or cervix
by a cannula to bring about pregnancy,
is called artificial insemination
[About 5% male are infertile]
Contd.

Considerable ethical & legal problems

have arisen due to the development
of methods for initiating pregnancy
other than normal sexual intercourse
Contd.

There is great legal, moral & religious

controversy over these matters &
opinion vary widely
Contd.

If a donor provides many samples,

there is a risk of inadvertent incest
between the numerous offspring
 Types of AI

1. AIH (Artificial insemination husband

or homologous)
This has virtually no legal or ethical
difficulty
2. AID (Artificial insemination donor or
heterologous) This
presents many problems
 Contd.

3. AIP (Artificial insemination mixed or

pooled)
In this case the husband’s semen is
mixed with the donor one & then
introduced into the wife’s uterus
This is more convenient than the AID
 Indications of artificial
insemination

When the husband is impotent

When the husband is sterile
Rh incompatibility between husband
and wife
When the husband is suffering from
hereditary disease
 Contd

 When the husband is unable to

deposit semen in the vagina due to
hypospaediasis/epispaediasis
 Widows and unmarried woman
desiring for children
 When some disease likely to be
transferred from the father to the off
springs
 Prerequisite/Precaution/
Criteria of artificial
insemination
Written consent of the woman to be
inseminated and her husband must be
kept
Consent from the donor and his wife
is essential
Secrecy of the identification from both
the donor and wife (recipient) should be
maintained
 Contd
The donor should not know to whom
the semen is donated and the
outcome of insemination
The donor should have the following
criteria:
Must be healthy
Absence of disease (he should be
screened for all available tests
including chromosome studies for
possible genetic effects)
 Contd
No hereditary disease
Religion should be maintained
Race should be maintained
Same blood group, should not be any
Rh incompatibility
Age must be 30-40 years
Donors family must be completed
Married person better and the donor
should have his own child
 Contd
The donor must not be a relative of
either spouses
In suitable cases, the husband’s
semen and donor’s semen should be
mixed
A female attendant must be present
to prevent---
Male doctor – sexual assault
Female doctor---- indecent assault
Doctor, donor--- semen exchange
 Contd
The donor should give a written,
declaration that he will not prefer
parenthood claim for child
The physician who performed AI
should have permission in giving
opinion in selecting best doctor
The couple should be psychologically
fit and emotionally stable
 Contd

The entire story should be written and

it should be kept close secret in a
safe place
The doctor should leave instruction
that--- “please destroy it after my
death”
Usually a single donors semen is not
used to produce more than 10
children
 Contd.

Recently there has been an

increasing demand for AI child to
have the right to know of its origin &
when gets mature to discover the
identity of its biological father
 Medico legal importance

The following question may arise: ---

Divorce : if AI done without the
husbands consent.
Legitimacy e.g. child remain
illegitimate in case of widow and
unmarried woman & in case of married
women husband doesn’t adopt the child.
 Contd

 Adultery : AID gives rise the question

of adultery.
 Natural birth: child will be remain to
be natural child if the parents don’t
disclose.
 Incest: risk of incest exist between
children born by AI & child of donor.
 Inheritance of property
 Merits of AI

Gives the experience of motherhood

to a barren woman
It makes some sterile couple happy
 Demerits

The husband may feel humiliation due

to his impotency or sterility and also
due to presence of child of some other
persons (donor)
The child may suffer from mental
trauma, if he learns about his past
 Contd

The husband may develop psychiatric

problems
A neurosis may develop in the
mother’s thinking that the child
belongs to her alone
In case of unmarried woman and
widow the child remain illegitimate
 Contd

 She may develop an obsession to

know the donor and to have a 2nd
child from the same donor
 There’s remote chance of incest
between the off springs of the donor
from his wife’s side and recipient side.
Because the identity of the donor
remains a secret
 Contd

Artificial insemination is not a ground

for nullity of marriage but it is a
ground for divorce if it was done
without the consent of the husband.
In such a case, the doctor also gets
implicated with legal complexities
The husband may develop bitter
feeling if the child is mentally
retarded or physically deformed
 Source of semen

Husband (AIH)
Donor (AID)
Pooled (AIHD)
 Methods of collection
Semen is obtained by i) masturbation, ii)
use of an electric stimulator. Then
collected in a washed condom and 1 ml
is deposited into or near the cervix by
means of injection.
Woman’s menstrual cycle is closely
observed by tracking basal body
temperature or ovulation kits or USG or
bloode test.
 Contd

The time of maximum fertility coincides

with that of ovulation. Ovum can
survive for a maximum up of to 24
hours without fertilization after it leaves
the ovary. Similarly spermatozoa
survive for a maximum of 24 hr within
female genital tract. Averagely 6-24 hr
for travelling from vagina to tubes.
 Surrogate mother

Surrogate mother (womb leasing): a

surrogate mother is a woman who by
contract agrees to bear a child for
someone else
It is intended to help a couple of
whom the female is infertile but the
male is not sterile, he is reproductive
 Types of surrogacy

A. Full surrogacy : where embrayo is

provided by commissioning couple
B. Partial surrogacy: the carrying
woman has her egg fertilized.
Contd
 Medico legal importance of
surrogate mother

Legitimacy
Adultery
Incest
Natural birth
Nullity of marriage & divorce.
 Test tube babies: IVF (In Vitro
Fertilization)

If fertilization is done in vitro (in vitro

fertilization-IVF) outside the uterus and
then embryo is implanted into the
uterus up to the termination of
pregnancy then the born child is called
test tube baby.
 Contd

Procedure : Controlled ovarian hyper

stimulation with exogenous
gonadotropins oocyte retrieval via
transvaginal sonography
Fertilization of oocyte sperm in culture
formation of zygote allowing to
develop for 3-5 days Transcervical
transfer of zygote to endometrium
under US guidance (blastocyst stage).
 Indication of IVF

Here causes related to mother-

When ovulation doesn’t occur
Blockage of fallopian tube
Uterus Cant impregnate fertilized ova
Uterus is not fit for pregnancy.
 Possible situations may arise from
IVF
Sperm Ovum Uterus

Husband Wife Wife

Donor Wife Wife

Husband Donor woman Wife

Husband Wife Surrogate

Donor Wife Surrogate

Husband Donor woman Surrogate

 Cloning

Asexual reproduction of genitically

identical duplicate is called cloning.
Clone is an organism that has the
same genetic information as other
organism. A clone is said to be all
descendants derived asexually from a
single individual
 Contd
Procedure:
DNA is taken out from a oocyte and put
in a petridish together with a donor cell
and electric current is sent to fuse as a
zygote. This cell then grows and
divides like a fertilized egg cells and
then it becomes a blastocyst. This is
implanted in a surrogate mother.
Scotland produced first cloned sheep
from Dolly in 22 feb,1997
 Types
1. Reproductive cloning- making cloned
human.
2. Therapeutic cloning-
a) Embryo cloning- used therapeutically
to treat cancer, alzihmer’s disease,
heart disease etc.
b) Cloning cells from an adult for use in
medicine.
 MLI

i) Identification – problem with several

persons with same face & same
genetic factors.
ii) Paternity & maternity- A person may
have some children by normal
sexual union, while some other by
cloning.
iii) Religious & social acceptance – It si
still not there.
That’s it.

Thanks a lot….