Reproductive Technologies

Is it helpful to women that reproductive technologies, such as hormonal contraception, egg selling and surrogacy, are available in the international marketplace?

In this essay, I have shown that it is helpful to women that reproductive technologies are available in the international marketplace. Reproductive technology is the term used to illustrate the variety of medical treatments available to help couples to conceive (Zolbrod, 1993). Modern technologies include artificial insemination (AI) which involves sperm injection to the woman’s cervix, vagina, uterus or fallopian tubes from either her spouse or a donor.

In Vitro Fertilization (IVF) is literally means fertilization in a test tube whereas surrogacy is a technique whereby a woman delivers a child for another woman or couple. Sometimes she may be the child’s biological mother or she may be just be a gestational mother whose work is to carry the pregnancy to delivery after having been implanted with an embryo in her uterus. There are two forms of surrogacy, commercial type and altruistic type.

Commercial type is where carrier of the child is remunerated for her services and altruistic type is where the bearer receives no money as payment. The relationship between women and reproductive technology is a very important issue for women since it relates directly to their bodies, their physical condition and to their position in society (Rothman, 1989). Majority of the infertile women seeks assistance for reproductive technology from clinics. Reproductive infertility is the inability to conceive or carry a baby to a term. This term is described as at least 12 months duration of practicing regular, unprotected sexual intercourse (Leiblum, 1997).

There are several disorders that result in reduced fertility or infertility. These include: ovulation disorder which may be caused by hormonal disorder, pelvic inflammatory disease which caused by sexually transmitted infections, fallopian tube blockage and cyst formation (endometriosis), polycystic ovarian syndrome, hormonal imbalance and congenital anomalies that affect the reproductive anomalies, such as absent or multiple uterus (Sonya, 2001).

Consequently, environmental and occupational exposures to chemicals are hazardous to conception and gestation. In addition, other factors more amenable to human control are age, weight, exercise, stress and psychological factors, and drug abuse.

Fertility decreases after the age of 30 for women and the decline becomes more pronounced with time. Studies have shown that both under and over-weight women are at risk of conceiving due to the menstrual cycle irregularities. Exercising for more than 60 minutes per day have also contributed to cause irregular menstrual cycle hence compromising the reproductive fertility for women. The use and abuse of illicit drugs such as tobacco, alcohol has also been associated with high miscarriages risks and irregular menstrual cycle (Sonya, 2001).

Between 10-15% of couples are infertile in the reproductive bracket age (Wallrap, 1999). In the past there were only two solutions available for childless couples. Many couples have expressed a strong desire to have their own child rather than adopt. Couples who can not have children are disgusted and distressed and undergo a length period of loneliness and grief.

Over the past three decades, significant scientific and medical progress in reproductive technology have changed the way women can have kids and even definitions of parenthood and biological relationships. For example, In Vitro fertilization (IVF), scientists had a chance of putting together an egg from a woman and a sperm from the male counterpart in a test tube. This led to the first ever test tube baby in the human history, foetus conception took place outside a woman’s body without the natural sex intercourse (Neumann et al. 1994).

In the present day, assisted reproductive technology (ART) consists of not only to IVF methods but also to several other methods which are tailored to suit each patient’s unique conditions. These techniques may be combined with various therapies, which may include fertility drugs to raise the percentage of success.

Between 1997 and 2000 the number of live-birth deliveries from ART increased by 72%. In today’s world, over 2% of all American babies, more than 36,000 are born each year using ‘artificial’ technologies. Generally, ART achieved live-births in more than 28% of cycles by use of fresh, non-donor eggs or embryos from 15% in 1988 (Alsalli et al. 1995). ART are invasive and financially draining procedures (Neumann et al. 1995).

As of today there is no health effects associated with children born using ART procedures. But most doctors are pessimistic about this method and recommend that it should be applied as a last alternative for having a baby. Reproductive technology has generated controversial debates on the moral, ethical, and legal perspectives. It is very important and helpful for women around the world to have access to reproductive technologies. Reproductive technologies can be very supportive for a number of patients and it’s unique among medical methods because the objective is aimed specifically at bearing new persons and family relationships.

On the other hand, ethical dimensions about the intrinsic nature of a number of techniques and the precise contexts in which many techniques are used should be addressed first. For example, IVF allows a woman to carry a foetus which is genetically not related to her, as either the recipient of an embryo donor or as a contracted surrogate mother. Although both the genetic mother and gestational mother are the supposed biological mothers, none of them is consistently identified as the legitimate mother (Rothman, 1989). Recently a case in Philadelphia involving a group of five reproductive individuals left the resultant child with no legitimate parent until she was 5 years old (Buzzanca, 1998).

To add more complex into this, family variations such as women bearing their own genetic related offspring and the controversial reproduction by members of same-sex partners have challenged the legality and historical norms. This may lead to the child having no social and legal support from the society. On the other hand, the donor and recipient privacy are protected, but at the same time it undermines the right of a child in regard to knowledge of their ancestral heritage and genetic past.

Families have often had problems with making decision to when, how, and whether to share the donor information with the kid. Women ought to be informed fully and a fair representation made to them of all the likelihood of the emotional, medical and social outcomes or risks. Unluckily, most clinics often lack adequate information to provide the complete revelation required for women to make informed choices (Shanner, 1995).

Educative counseling and support should be given to patients to enable them make these profoundly meaningful life choices (Leiblum, 1997). This will also prepare them for further outcomes such as multiple births, medical complications, pregnancy miscarriage and not having the pregnancy at all, among others. The outcome of such procedures should be emphasized to patients first before they agree to proceed. The Royal Commission on Reproductive Technologies (1993) did question some of the methods used, but fortunately most of them have since proven effective, (Alsalili et al. 1994).

However, modern techniques are being introduced into experimental use without patients appreciating that they are still on trial. Clear clarification must be made among measures that are untried, innovative and common but not yet authenticated. Further, additional key factors that encourage researchers in this area of reproductive technology include; the actual desires to conquer infertility, to attain professional progress, to help the patients (women) and to acquire economic growth. These reasons have resulted in rapid technological advancements that have outpaced social and moral perceptions.

The agony caused by unproductiveness in women deserves a supportive and compassionate response. The complexity lies in making sure that access to medical necessity and appropriate treatment are available. This must be done while avoiding the inappropriate use at both the patient and health policy levels. Limiting the public monetary support for ARTs have however promoted difficulties in treatment for less privileged women (Nisker, 1996). Consequently, free of charge project have shown to promote the use of partially tested technology. Most importantly, providing the safest and more reliable treatment that suits a patient’s requirements is crucial to ethical health care service.

According to Neumann (1995) and Callahan (1994), specific health care interventions should be justified by continual evidence-based evaluation of the intervention’s safety and effectiveness. Furthermore, the complete expenses of the intervention to the health care scheme and the accessibility and eligible results of other options must be assessed. The ideal based assessments consist of a well balanced health care priorities and the right of reasonable access to the best obtainable interventions in all types of health care requirements. The collective effects of improved practice, such as support of pronatalist attitudes in the case of assisted reproduction technology, must also be considered.

In addition, societal factors have extensively been used as criteria to access this assisted reproductive technology. A major concern for the well-being of children born from a potential parent having a history of violence and drug abuse must be distinguished from children born by single parents and partners of same-sex. The community’s interest to stop supporting children well-being and parenting must be equally balanced in spite of socio-economic status.

In addition, pregnancy in women of advanced age raises the fear that the parents’ strong health and life prospective chance is likely to end before the child reaches adulthood. Today, reproductive technologies have turned out to be a marketplace and therefore women must be cautious in selecting a clinic. Women who donate their reproductive tissues are likely from lesser socioeconomic margin, whereas the corresponding recipients tend to be more economically privileged.

The treatment cost during a reproductive technology procedure can be reduced by sharing ova or embryos (Nisker, 1997). This is a form of deal (sale) where the donor’s treatment package is paid for by the recipient in substitute for acquirement of ova or embryos. Programs that involve sharing of these parts may also weaken an informed consent. As a consequent this could outshine the implications of donation intended for both the donor and recipient.

ARTs is growing rapidly and denial to women regarding a right to reproduce has been challenged (Shanner, 1995). In some states, for example, Ontario State the government has funded the IVF medicals, in cases of bilateral obstruction of the fallopian tubes which is in accordance with recommended opinions’ of the Royal Commission on Assisted Reproductive Technologies (The Commission; 1993).

In this essay it has been shown Infertility and ARTs pose challenges on the number of births. Some of the factors contributing to infertility such as, drug abuse such as smoking and alcohol, medications, nutrition, pressure and work-related exposures can be controlled and therefore the partners should address them. Fundamental health problems that contribute to infertility ought to be investigated and treated correctly before attempting ARTs.

For the partners or single mothers to make right and informed decision, doctors should explain and provide simply understood tables of live-birth rates involving all initiated pregnancies with specified cause of infertility and age of the prospective patients. The specialists in this area must help patients to acquire and understand these data clearly. It is therefore recommended that counseling be carried out by the primary care specialists in marriage and infertility.

The importance of counseling the patients first is to prepare them for various outcomes. For example, ARTs may result into medical side effects such as pregnancy loss, multiple births and legitimacy complications or the treatments failure to produce a healthy child the couple desires to raise. In this since, both partners are advised to address their personal concerns such as their personal esteem, outside pressures from family members, friends and cultural beliefs.

References

Alsalili, M., Yuzpe, A., Tummon, I., Parker, J. & Daniel S. 1994, ‘Increasing pregnancy rates and pregnancy outcome after in-vitro fertilization: > 7000 cycles at one centre’, Human Reproduction, vol. 10, no.2, pp.470-4.

Callahan, T. L., Hall, J.E., Etner, S.L., Christiansen, C.L., Grene, M.F. & Crowlet, W.F. 1994, ‘The economic blow of multiple-gestation pregnancies and the contribution of assisted-reproduction techniques to their occurrence,’ New England Journal Medicine, vol. 331, no.4, pp. 244-9.

Leiblum, S. R. (ed.) 1997, Infertility: psychological issues and counseling strategies, John Wiley & Sons, N. Y. Marr. of Buzzanca, 1998, CA 4/3 G022147.

Wallrap k, Mykitik R.&, A. (eds) 1999, Regulating reproductive technologies in Canada. In: Downie JG, Caulfield TA, France health law and policy. Markham (ON), Butterworth.

Neumann, P. J., Gharib, S. D & Weinstin, MC (1995), ‘The costs of successful delivery with in vitro fertilization’, New England Journal Medicine, vol. 331, no.4, pp.239-43.

Nisker, J. A. 1996, ‘Rachel’s ladders or how societal situation determines reproductive therapy’, Human Reproduction, vol. 11, no. 6, pp.1162-7.

Nisker, J.A. 1997, ‘In quest of the ideal analogy for using in vitro patients as donors’, Woman’s Health Issues vol. 7, no.4, pp. 241-7.

Rothman, B. K. 1989, Recreating motherhood, WW Norton New York.

Shanner, L. 1995, ‘Informed consent and insufficient medical information’ Lancet, vol. 346, pp.251.

Shanner, L. 1995, ‘The right to produce offspring: when rights claims have gone wrong’, McGill Law Journal, vol. 40, no.4, pp. 823-7.

Sonya, N. 2001, Reproductive Infertility: Prevalence, Causes, Trends and Treatments, Parliamentary Information and Research Service, Library of Parliament, Ottawa.

The Commission, 1993, Royal Commission on New Reproductive Technologies, Proceed with care: final report, Ottawa.

Zolbrod, A. 1993, Men, women and infertility: intervention and healing strategies, Lexington Books, N. Y.