In Vitro Fertilization

The union of sperm and ovum under laboratory conditions. One or more mature oocytes are removed via laparoscopy and fertilized After 40 hours of fertilization(first cell division), the ova is inserted in the uterus. Women: blocked or damaged fallopian tubes, absent cervical mucus; men: oligospermia, antisperm antibodies May use donors ovum; GnRH, clomiphene citrate or human menopausal gonadotropin Before, multiple fertilized eggs returned to uterus had lower chance of surviving neonatal period The eggs may be preserved(egg cytopreservation) Serum pregnancy test is given after 11 days

What is it?

 Recovery rate for harvesting ripened eggs is about 90% and ability to fertilize eggs by sperm in vitro is high Pregnancy rate is 38-42% 25% ends in spontaneous abortion; do not result in an increase of birth defects Multiple pregnancy of more than two zygotes requires selective termination of gestational sacs to make room for only twointraabdominal injection of potassium chloride Expensive $10,000 dollars per cycle High risk of maternal infection Puts on psychological strain

ETHICAL CONCERNS

 Numbers transferred to the uterus varies on the womans age Relative to life starts at fertilization, some PEs are destroyed or used for research; ovaries are frozen Selective pregnancy reduction Treated as things where parents pick traits instead of leaving them to nature

Pre-embryo

MEDICAL ETHICS

 Questioning ethical and moral issues for doctors Facilitating multiple births for a woman with no means of support V.S. letting the client decide

COMPLICATION OF PARTIES INVOLVED

 May concern up to 5 parties, sperm from a man, egg from a woman and implantation into a another woman Baby may be raised by a separate couple

ISSUE 2: RISKS TO THE INFERTILE COUPLE OR THE EXPECTED OFFSPRING BY THE PHYSICIAN

 Multiple pregnancy: high blood pressure, uterine bleeding, complications with delivering the baby

ISSUE 2: RISKS TO THE EXPECTED OFFSPRING BY COUPLE

 Multiple pregnancies: low birth weight of the child and premature birth Greater risk for spina bifida-transposition of the vessels and birth defects-heart valve defects, cleft lip, cleft palate, digestive system abnormalitie Wiedemann syndrome(asymmetrical limbs, big tongues, high kidney tumor risk) Angelmann syndrome(speech impairment and mental disability) Lesser usage of fertility drugs led to lesser embryonic abnormalities and uterine cancer Versus the increased incidence of defects does not justify banning the technique to protect the offspring, because without these techniques these children would not have been born at all

INTERESTS IN EXISTING

 It is futile to argue whether a baby should be born or not be born; or whether they should exist to be better or worse, when they are non-existent

POSSIBLE HARM DONE TO THE COMMUNITY

 Medical interventions done may be wasted on the sick infant instead of allotting these on other individuals.