A Baby Boom
Through Assisted Reproduction
On
NINE months earlier, Louise had been conceived in a laboratory through a process called in vitro fertilization (IVF). By means of this procedure, an egg extracted from her mother was united with a sperm in a glass dish. Two and a half days later, after the egg cell had subdivided into eight microscopic cells, this little cluster of dividing cells was inserted into her mother’s uterus to develop normally. Louise’s birth opened up a whole new chapter in the treatment of infertility.
IVF gave momentum to what is now known as assisted reproductive technology (ART), which includes all kinds of fertility treatments in which both egg and sperm are handled. Consider some examples. In 1984 a woman in , , gave birth to a baby developed from an egg donated by another woman. The same year, in , a baby was born from an embryo that had been frozen. In 1994 a 62-year-old woman in gave birth, using donated eggs and her husband’s sperm.
A Progressive Development
Now, some 25 years after Louise Joy Brown was born, researchers have assembled a battery of medicines and high-tech procedures that have utterly transformed infertility treatment. (See the boxes “Some Types of Fertility Treatments” and “What Are the Risks?”) Such breakthroughs have led to a dramatic increase in the number of children born by means of assisted reproduction. In 1999, for example, ART resulted in the birth of over 30,000 babies in the alone. In some Scandinavian countries, between 2 and 3 percent of the children born each year have been conceived by such means. Worldwide, about 100,000 children are born annually as a result of IVF treatment. It has been estimated that about one million such children have been born since 1978. ART is used mainly in developed countries. Each treatment, or cycle, costs thousands of dollars, and national health services, employer-sponsored plans, and private insurances do not usually cover the costs. Time magazine noted that “a 45-year-old woman who has gone through seven cycles of IVF can easily spend $100,000 on treatment.” Nevertheless, assisted reproduction gives hope to many infertile couples whose only alternative when it comes to having children has been adoption. Now the various infertility techniques address many of the female and male causes of infertility.
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Why So Popular?
One reason for the popularity of assisted reproduction is the modern life-style. A report published by the American Society for Reproductive Medicine states: “The average age of childbearing has increased over the past three decades as more women have pursued higher education and careers and postponed marriage. Concurrently, a large cohort of women born during the ‘Baby Boom’ (1946-1964) have reached their late reproductive years, resulting in more women in this age group seeking assistance for infertility.”
Some women may not realize how quickly their fertility declines as they get older. According to the U.S. Centers for Disease Control and Prevention, by the time a woman is 42 years old, her chances of having a baby using her own eggs are less than 10 percent. Donor eggs are thus often used for older women seeking ART treatment.
In a new twist, some infertile couples resort to embryo “adoption,” obtaining an embryo left over from the infertility treatment of another couple. It is estimated that in the alone, about 200,000 frozen embryos are being stored. A CBS news report recently revealed: “Embryo donation has been quietly taking place on a small scale for years.”
Not surprisingly, the developments in the field of assisted reproduction raise a number of questions. How may this kind of childbearing be viewed from an ethical and moral standpoint? What is the Bible view on this matter? These and other questions will be discussed in the next article.
The Choices, The Issues
Imagine the anguish of a married couple who desperately want to have a child yet because of infertility cannot. They look to medical science for help and find that many techniques and therapies have been developed to overcome infertility. Does it matter which one they choose, if any?
TODAY infertile couples have options that were not available just decades ago. But along with the choices comes a serious question, What are the ethical and moral implications of assisted reproductive techniques? Before we consider that, though, let us see how various religious groups view such treatments.
What Do Religious Groups Say?
In 1987 the Catholic Church issued a document that addressed the morality of fertility procedures. The statement, known as Donum Vitae (The Gift of Life), held that if a medical technique assists the marriage act in achieving conception, such a treatment may be viewed as moral. On the other hand, the document indicated that if a medical procedure replaces the marriage act, such a treatment is morally wrong. According to this view, surgery to correct tubal blockage and the use of fertility drugs would be considered moral, but test-tube fertilization would be immoral.
The following year a Congressional committee surveyed religious groups as to their stand regarding fertility treatment. The final report showed that a majority of them accepted traditional medical interventions, artificial insemination using the husband’s sperm, and in vitro fertilization treatment, provided that both the egg and the sperm belonged to the married couple. Moreover, most of the groups surveyed declared that the destruction of embryos, artificial insemination by a donor, and surrogate motherhood are morally wrong.
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In 1997 the European Ecumenical Commission for Church and Society (EECCS), a body of Protestant, Anglican, and Orthodox churches, indicated in a position paper that in their ranks there are divided opinions on assisted reproduction. Emphasizing that individual conscience and personal responsibility are involved, the paper stated: “The implication is that it is difficult to speak of ‘the’ position of the member churches of EECCS. There is, rather, a plurality of positions.”
It is evident that opinions on assisted reproduction differ a lot. The UN World Health Organization admits that the field of assisted reproductive techniques “constantly challenges social norms, moral and ethical standards and legal systems.” What are some factors that people should consider before making a decision involving assisted reproduction?
What Are the Issues Involved?
A basic factor to consider is the status of a human embryo. This relates to the crucial question, When does life begin—at conception or later on during pregnancy? The answer would certainly affect the decision that many married couples make regarding treatment. If, for example, they believe that life begins at conception, then there are some key questions that must be considered.
- Should the couple allow doctors to follow the common procedure of fertilizing more eggs than the one or more being inserted, thus keeping a surplus stock of embryos for future use?
- What would happen to such stored embryos if the couple became unable or unwilling to have more children?
- What would happen to any stored embryos if the couple divorced or if one of them died?
- Who would shoulder the weighty responsibility for destroying such embryos?
The issue of what is to be done with unused or stored embryos cannot be dismissed lightly. Legal guidelines in certain countries now demand that the couple present a written consent specifying how the extra embryos should be handled—that is, if they should be stored, donated, used for research, or allowed to perish. Couples should be aware that in certain places it is ethically acceptable for a fertility clinic to destroy stored embryos without any written authorization if they have been abandoned for more than five years. Today, hundreds of thousands of frozen embryos are stored at clinics worldwide.
Another factor to consider is that couples may be urged to donate unused embryos for stem cell research. The American Infertility Association, for example, has encouraged couples to make their unused stored embryos available for research. One purpose of stem cell research is to find new ways of treating illnesses. But this field of research has been a subject of much controversy because the process of extracting embryonic stem cells essentially destroys the embryo.
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New genetic technologies raise yet other ethical issues. Consider, for example, preimplantation genetic diagnosis (PGD). (See the box “What About Preimplantation Genetic Diagnosis?”) This technique involves submitting embryos to genetic screening and then selecting the one—perhaps of the desired gender or free of a certain disease-causing gene—that is to be implanted into the uterus. Critics warn that PGD could lead to gender discrimination or that it might eventually be used to let couples choose other genetic traits for their children, including hair or eye color. PGD raises the ethical question, What happens to the embryos that are not selected?
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Will the Marriage Bond Be Affected?When considering certain forms of fertility treatment, there is another aspect to consider. How would the use of a surrogate mother or donated sperm or eggs affect the marriage bond? Some techniques may introduce a third party (a donor) or even a fourth party (two donors) or a fifth party (two donors and a surrogate mother) into the childbearing process. Regarding treatment that involves donated genetic material, the parties involved need to consider other factors too.
What About Anonymity?The policy in many countries is to keep donors anonymous. The Human Fertilisation and Embryology Authority, which regulates the use of human reproductive material in , explains: “Except where donation is intentionally between people known to each other, current and past donors will remain anonymous to the couples treated with their eggs or sperm, and to the children who may be born as a result of that treatment.” However, this policy of anonymity is the subject of heated debate in some places. A few countries have changed their policy or laws accordingly. Those who are against the policy of anonymity emphasize that children must have a full sense of their identity. A report says: “Over 80 per cent of adopted people search for birth relatives, many of them to help satisfy the long-standing curiosity about origins which most people share. Almost 70 per cent want to identify important background information about possible hereditary medical conditions of birth parents.” Another report, based on interviews with 16 adults conceived by donor insemination, revealed that “many were shocked to discover their biological origins.” The report added: “Many of the children faced problems with personal identity and feelings of abandonment. There were feelings of deceit and mistrust towards the families.” How Will You Decide?Medical science will no doubt carry the development of assisted reproduction even further. Some predict that in the future 30 percent of all babies born will be the result of this technology. The debate over the ethical and moral issues involved will continue. True Christians are guided by an even more important consideration—the viewpoint of our Creator, the one who arranged for procreation. (Psalm 36:9) Of course, the Bible does not directly comment on modern assisted reproductive techniques, for such procedures were not available in Bible times. However, the Bible does set out clear principles that indicate God’s thinking and viewpoint. (See the box “What Does the Bible Say?”) Such principles help us to make decisions that are ethical and moral and that leave us with a clear conscience before God.— 1 Timothy 1:5 . * The dictionary defines a surrogate mother as “a woman who becomes pregnant usually by artificial insemination or surgical implantation of a fertilized egg for the purpose of carrying the fetus to term for another woman.” # See the series “Stem Cells—Has Science Gone Too Far?” in the , issue of Awake!
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