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The Ethics of Assisted Reproduction Practices

Instructor: Heather Adewale

Heather has taught reproductive biology and has researched neuro, repro and endocrinology. She has a PhD in Zoology/Biology.

Imagine this...dreaming about having a baby and being told its not possible. Well, at least not in the conventional way. What other options are there? In this lesson, learn about just some of the reproductive technologies we have to help women become pregnant.

Lights, camera, action! Fade to image 1. A little girl playing dress up with her doll, she changes its diaper and rocks it to sleep. Image 2. The girl has grown and is taking care of her brothers and sisters. Image 3. A wedding, a happy couple. Image 4. A negative pregnancy test, and another one, and another one. Disappointment for the happy couple.

Sadly this is the scene for millions of Americans. Impaired fecundity, the inability to conceive and/or carry a fetus to full term, affects almost 7 million women in the US alone. For women this can be one of the most stressful times in their life. The cause? It could be something as simple as removing estrogens like soy from your diet or as complicated as poor egg development or even a hostile uterus!! Yes girls, your uterus can be hostile... the environment created by it might actually be killing all the sperm before they can reach the egg! Or it may not be ideal for implantation of the egg. But, there is hope!

What can we do about it? Well advances is medical research have created ART, or Assisted Reproductive Technologies. These are procedures aimed at helping women obtain pregnancy. They are usually considered after 6-12 months of unsuccessful attempts to conceive. The main types of ART are: IUI, IVF, and third party assistance.

ART: IUI

1. Intrauterine Insemination (IUI) is when the male's sperm is placed inside the female's uterus using a long tube. This might help you remember. Intra means inside while uterine refers to the uterus, where a fetus develops inside the mother. So intrauterine means 'inside the uterus', that's where the sperm are placed. But why? Well, the main job of sperm is to reach and fertilize the women's egg. But sometimes they have trouble getting there they may need a little help. Some may not swim very well, the male may not be able to form an erection, or if the female has scarring on her cervix, the entrance to the uterus. Any of these conditions could impair the sperm's ability to reach the egg.

In IUI the sperm are injected directly into the uterus using a long tube.
Intrauterine Insemination

ART: IVF

2. In Vitro Fertilization (IVF)is when both the egg and sperm are removed from the reproductive organs of the female and male. For males this is pretty easy, but for females it's a little trickier. First, the development of eggs is stimulated through hormones, then the doctor retrieves them from the female. This is useful when a women has trouble releasing eggs on her own. The eggs and sperm are placed in a dish so fertilization can occur. Doctors watch over the eggs until they become embryos, fertilized eggs that have started cell division but have not developed any organs yet. The embryos are placed into the female's uterus. Remember how we talked about that hostile uterus?! Well, if needed the doctor can help make the uterine environment a little more friendly before implanting the embryos.

Sounds pretty cool right? But there are some potential problems, every embryo has the potential to develop into a baby if implanted, however, not all embryos are implanted. Extra embryos are destroyed or frozen. So the question is, are those embryos alive? If they are, would destroying them be considered murder? The answers to these questions are for each person to decide on their own. Some people believe that life begins at fertilization, and if that is the case then yes, they are alive. But others believe that life doesn't begin until later and so the destruction of the embryos isn't ending a life.

ART: Third Party Assisted

3. Donation of egg or sperm is another option for those whose eggs or sperm are not healthy enough to produce a baby. It's similar to IVF but the egg and/or sperm can be obtained from a donor. The embryo is then be placed inside the mother or a surrogate.

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