Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-24T11:25:50.971Z Has data issue: false hasContentIssue false

16 - Assisted reproduction

Published online by Cambridge University Press:  30 October 2009

By
Roxanne Mykitiuk  and
Jeff Nisker
Edited by
Peter A. Singer  and
A. M. Viens
Roxanne Mykitiuk
Affiliation:
Associate Professor York University, Toronto Canada
Jeff Nisker
Affiliation:
Professor University of Western Ontario, London Canada
Peter A. Singer
Affiliation:
University of Toronto
A. M. Viens
Affiliation:
University of Oxford
Get access

Summary

Ms. F and Mr. G are trying to have a child. They have been having sexual intercourse approximately three times a week for the past year, and daily around the time when Ms. F thinks she is ovulating. They are both 38 years old. Ms. F has had regular menstrual cycles up to the last three months, in which she has had only two. They are worried they have delayed starting a family too long and will not be able to afford the expensive fertility treatment they may require at Ms. F's age. They have questions regarding the success of in vitro fertilization and the possibility of having twins or triplets.

What is assisted reproduction?

Assisted reproduction enables the deliberate manipulation of the processes and materials of human reproduction outside of sexual intercourse. In describing the practices that constitute assisted reproduction, it must be understood that all such practices are embedded with ethical issues, whether standard therapies such as ovulation induction (Messinis, 2005), insemination with donor sperm (Daniels et al., 2006), and in vitro fertilization (IVF) (Steptoe and Edwards, 1978); emerging practices such as pre-implantation genetic diagnosis (PGD) (Handyside, 1990; Nisker and Gore-Langton, 1995); or practices prohibited under law in many countries, such as the purchase or bartering of oocytes (Gurmankin, 2001; Nisker, 1996, 1997, 2001).

Ovulation induction through clomiphene citrate has been practiced for over 30 years (Messinis, 2005).

Type
Chapter
Information
The Cambridge Textbook of Bioethics , pp. 112 - 120
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abramov, Y., Elchalal, U., and Schenker, J. G. (1999). Severe OHSS: an “epidemic” of severe OHSS: a price we have to pay?Hum Reprod 14: 2181–3.CrossRefGoogle Scholar
Adamson, D. and Baker, V. (2004). Multiple births from assisted reproductive technologies: a challenge that must be met. Fertil Steril 81: 517–22.CrossRefGoogle ScholarPubMed
Alsalili, M., Yuzpe, A., Tummon, I., et al. (1995). Cumulative pregnancy rates and pregnancy outcome after in-vitro fertilization: 5000 cycles at one centre. Hum Reprod 10: 470–4.CrossRefGoogle ScholarPubMed
Barrett, J. and Bocking, A. (2000a). The SOGC Consensus Statement: Management of Twin Pregnancies Part 1. Soc Obstet Gynaecol Canada 22: 619–29.Google Scholar
Barrett, J. and Bocking, A. (2000b). The SOGC Consensus Statement: Management of Twin Pregnancies Part 2. Soc Obstet Gynaecol Canada 22: 607–10.Google Scholar
Ber, R. (2000). Ethical issues in gestational surrogacy. Theor Med Bioethics 21: 153–69.CrossRefGoogle ScholarPubMed
Birenbaum-Carmeli, D. (2004). “Cheaper than a newcomer”: on the social production of IVF policy in Israel. Soc Health Illness 26: 897–92.CrossRefGoogle ScholarPubMed
Blake, D., Proctor, M., Johnson, N., and Olive, D. (2002). Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst Rev 2: CD002118.CrossRefGoogle Scholar
Buckett, W., Chian, R. C., and Tan, S. L. (2005). Can we eliminate severe ovarian hyperstimulation syndrome? Not completely. Hum Reprod 20: 2367 (author reply 2367–8).CrossRefGoogle Scholar
Budev, M. M., Arroliga, A. C., and Falcone, T. (2005). Ovarian hyperstimulation syndrome. Crit Care Med 33(Suppl. 10): S301–6.CrossRefGoogle ScholarPubMed
Byrne, J. (1999). Infertility and premature menopause in childhood cancer survivors. Med Pediatr Oncol 33: 24–8.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Casper, R. F. and Mitwally, M. F. (2006). Review: aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 91: 760–71.CrossRefGoogle ScholarPubMed
Chang, S. (2006). Investigations document still more problems for stem cell research. Science 311: 754–5.CrossRefGoogle Scholar
Cyranoski, D. (2004). Korea's stem-cell stars dogged by suspicion of ethical breach. Nature 429: 3.CrossRefGoogle ScholarPubMed
Daniels, K., Feyles, V., Nisker, J., et al. (2006). Semen donation: Implications of Canada's Assisted Human Reproduction Act, 2004 on recipients, donors, health professionals, and institutions. J Obstet Gynaecol Canada 28: 608–15.CrossRefGoogle Scholar
Delhanty, J. D. E., Griffen, D. K., Handyside, A. H., et al. (1993). Detection of aneuploidy and chromosomal mosaicism in human embryos during preimplantation se determination by fluorescent in situ hybridization (FISH). Hum Mol Genet 2: 1183–5.CrossRefGoogle Scholar
Elster, N. (2000). Less is more: the risks of multiple births. Fertil Steril 74: 17–23.CrossRefGoogle ScholarPubMed
Gurmankin, A. D. (2001). Risk information provided to prospective oocyte donors in a preliminary phone call. Am J Bioethics 1: 3–13.CrossRefGoogle Scholar
Gurmankin, A. D., Caplan, A. L., and Braverman, A. M. (2005). Screening practices and beliefs of assisted reproductive technology programs. Fert Steril 88: 61–7.CrossRefGoogle Scholar
Handyside, A. H., Kontogianni, E. H., Hardy, K., and Winston, R. M. (1990). Pregnancies from biopsied human preimplantation embryos sexed by Y-specific DNA amplification. Nature 344: 768–70.CrossRefGoogle ScholarPubMed
Holzer, H., Casper, R., and Tulandi, T. (2006). A new era in ovulation induction. Fert Steril 85: 277–84.CrossRefGoogle ScholarPubMed
Horsey, K. (2005). European Parliament calls for egg trade ban. IVF.net (http://www.ivf.net/content/page-o1326.html) accessed 10 August 2006.
Human Fertilization and Embryology Act 1990. (London: The Stationary Office).
Kenny, N. P. (1994). The ethics of care and the patient–physician relationship. Ann R Coll Phys Surg Canada 27: 356–8.Google Scholar
Levy, N. (2002). Deafness, culture, and choice. J Med Ethics 28: 284–5.CrossRefGoogle Scholar
Lucena, E., Bernal, D. P., Lucena, C., et al. (2006). Successful ongoing pregnancies after vitrification of oocytes. Fert Steril 85: 108–11.CrossRefGoogle ScholarPubMed
Messinis, I. E. (2005). Ovulation induction: a mini review. Hum Reprod 20: 2688–97.CrossRefGoogle ScholarPubMed
Min, J. K., Claman, P., and Hughes, E. (2006). Guidelines for the number of embryos to transfer following in vitro fertilization. J Obstet Gynaecol Can 28: 799–813.CrossRefGoogle ScholarPubMed
Mishell, D. R., Jr. (2001). Infertility. In Comprehensive Gynecology, 4th edn, ed. Stenchever, M. A., Droegemueller, W., Herbst, A. L.et al., St. Louis: Mosby, pp. 1169–215.Google Scholar
Mullis, K. B. and Faloona, F. A. (1987). Specific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction. Meth Enzymol 155: 335–50.CrossRefGoogle Scholar
Mykitiuk, R. (2002a). Public bodies, private parts: genetics in a post-Keynesian era. In Privatization, Law and the Challenge to Feminism, ed. Cossman, B. and Fudge, F.. Toronto: University of Toronto Press, pp. 311–54.CrossRefGoogle Scholar
Mykitiuk, R. (2002b). Beyond conception: legal determinations of filiation in the context of assisted reproductive technologies. Osgoode Hall Law J 39: 771–815.Google Scholar
Mykitiuk R. and Wallrap, A. (2002). Regulating reproductive technologies in Canada. In Canadian Health Law and Policy, 2nd edn, ed. Downie, J. G., Caulfield, T. A., and Flood, C.. Markham: Butterworth, pp. 367–431.Google Scholar
Mykitiuk, R., Turnham, S., and Lacroix, M. (2006). Prenatal diagnosis and pre-implantation genetic diagnosis: legal and ethical issues. In: Genetic Testing: Care, Consent and Liability, ed. Sharpe, N. and Carter, R.. Hoboken, NJ: John Wiley, pp. 189–218.Google Scholar
Nachtigall, R. D., Becker, G., Friese, C., and Butler, A. (2005). Parents' conceptualization of their frozen embryos complicates the disposition decision. Fert Steril 84: 431–4.CrossRefGoogle ScholarPubMed
Newton, C., McDermid, A., Tekpetey, F., and Tummon, I. (2003). Embryo donation: attitudes toward donation procedures and factors predicting willingness to donate. Hum Reprod 14: 878–84.CrossRefGoogle Scholar
Nisker, J. (1996). J's ladders or how societal situation determines reproductive therapy. Hum Reprod 11: 1162–7.CrossRefGoogle ScholarPubMed
Nisker, J. (1997). In quest of the perfect analogy for using in vitro fertilization patients as oocyte donors. Women's Health Issues 7: 241–7.CrossRefGoogle ScholarPubMed
Nisker, J. (2001). Physician obligation in oocyte procurement. Am J Bioethics 1: 22–3.CrossRefGoogle ScholarPubMed
Nisker, J. (2002). There is no gene for the human spirit. J Obstet Gynaecol Canada 24: 209–10.CrossRefGoogle ScholarPubMed
Nisker, J. (2004). Anniversary of injustice: April Fool's Day, 1994. J Obstet Gynaecol Canada 26: 321–2.CrossRefGoogle ScholarPubMed
Nisker, J. and Gore-Langton, R. E. (1995). Pre-implantation genetic diagnosis: a model of progress and concern. J Obstet Gynaecol Canada 5: 247–62.Google Scholar
Nisker, J. and White, A. (2005). The CMA Code of Ethics and the donation of fresh embryos for stem cell research. CMAJ 173: 621–2.CrossRefGoogle ScholarPubMed
Nisker, J., Baylis, F., and McLeod, C. (2006). Preserving the reproductive capacity of girls and young adolescent women with cancer: informed choice. Cancer 107(suppl 7): 1686–9.CrossRefGoogle Scholar
Nunes, R. (2006). Deafness, genetics and dysgenics. Med Health Care Philos 9: 25–31.CrossRefGoogle ScholarPubMed
Parens, E. and Asch, A. (1999). The disability rights critique of prenatal genetic testing: reflections and recommendations. Hastings Cent Rep 29 (Special suppl. 5).CrossRefGoogle ScholarPubMed
Pastor, C. L., Vanderhoof, V. H., Lim, L. -C., et al. (2005). Pilot study investigating the age-related decline in ovarian function of regularly menstruating normal women. Fertil Steril 84: 1462–9.CrossRefGoogle ScholarPubMed
Pennings, G., Schots, R., and Liebaers, I. (2002). Ethical considerations on preimplantation genetic diagnosis for HLA typing to match a future child as a donor of haematopoietic stem cells to a sibling. Hum Reprod 17: 534–8.CrossRefGoogle ScholarPubMed
Peterson, M. M. (2005). Assisted reproductive technology and equity of access issues. J Med Ethics 31: 280–5.CrossRefGoogle ScholarPubMed
Rao, G. D. and Tan, S. L. (2005). In vitro maturation of oocytes. Semin Reprod Med 23: 242–7.CrossRefGoogle ScholarPubMed
Renwick, P. J., Trussler, J., Ostad-Saffari, E., et al. (2006). Proof of principle and first cases using preimplantation genetic haplotyping: a paradigm shift for embryo diagnosis. Reprod Biomed Online 13: 110–19.CrossRefGoogle ScholarPubMed
Rivard, G. and Hunter, J. (2005). The Law of Assisted Human Reproduction. Markham, ON: Lexis Nexis.Google Scholar
Rodgers, S., Baylis, F., Lippman, A., et al. (1997). Practice Guidelines No. 5: Preconception Arrangements. Ottawa: Society of Obstetricians and Gynaecologists of Canada (http://sogc.medical.org/SOGCnet/sogc_docs/common/guide/pdfs/ps59.pdf).
Royal Commission on New Reproductive Technologies [Patricia Baird, Chair] (1993). Proceed With Care: Final Report. of the Royal Commission on New Reproductive Technologies. Ottawa: Supply and Services Canada.
Shakespeare, T. (1999). Losing the plot? Medical and activist discourses of contemporary genetics and disability. Sociol Health Illness 21: 669–88.CrossRefGoogle Scholar
Sherwin, S. (1992). No Longer Patient: Feminist Ethics and Health Care. Philadelphia, PA: Temple University Press.Google Scholar
Sherwin, S. (1998). A relational approach to autonomy in healthcare. In The Politics of Women's Health: Exploring Agency and Autonomy, coordinator S. Sherwin. Philadelphia, PA: Temple University Press, pp. 19–47.Google Scholar
Sklar, C. A., Mertens, A. C., Mitby, P.et al. (2006). Premature menopause in survivors of childhood cancer: a report from the childhood cancer survivor study. J Natl Cancer Inst 98: 890–6.CrossRefGoogle ScholarPubMed
Steptoe, P. C. and Edwards, R. G. (1978). Birth after the reimplantation of a human embryo. Lancet ii: 366.CrossRefGoogle Scholar
Storrow, R. (2005). Quests for conception: fertility tourists, globalization and feminist legal theory. Hastings Law J 57: 295–330.Google Scholar
Taylor, K. and Mykitiuk, R. (2001). Genetics, normalcy and disability 2(3). ISUMA [Can J Policy Res] 2: 65–71.Google Scholar
Trounson, A. and Mohr, L. (1983). Human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo. Nature 305: 707–9.CrossRefGoogle ScholarPubMed
Vandervort, L. (2006). Reproductive choices: screening policy and access to the means of reproduction 28. Hum Rights Quart 28: 438–64.CrossRefGoogle Scholar
Steirteghem, A., Nagy, Z., Liu, J., et al. (1994). Intracytoplasmic sperm injection. Baillières Clin Obstet and Gynaecol 8: 85–93.CrossRefGoogle ScholarPubMed
Verlinsky, Y., Ginsberg, N., Lifchez, A., et al. (1990). Analysis of the first polar body: preconception genetic diagnosis. Hum Reprod 5: 826–9.CrossRefGoogle ScholarPubMed
Younglai, E. V., Foster, W. G., Hughes, E. G., Trim, K., and Jarrell, J. F. (2002). Levels of environmental contaminants in human follicular fluid, serum, and seminal plasma of couples undergoing in vitro fertilization. Arch Environ Contam Toxicol 43: 121–6.CrossRefGoogle ScholarPubMed
Yuzpe, A. A., Brown, S. E., Casper, R. F., et al. (1989). Transvaginal, ultrasound-guided oocyte retrieval for in vitro fertilization. J Reprod Med 34: 937–42.Google ScholarPubMed
Artificial Conception Act 1985 (W.A.).
Reproductive Technology (Clinical Practices) Act 1988 (S.A.).
Human Reproductive Technology Act 1991 (W.A.).
Infertility Treatment Act 1995 (Vic.).
Infertility Regulations Act 1997 (Vic.).
Research Involving Human Embryos Act 2002 (Cth.).
Australian Government, Department of Health and Aging. http://www.health.gov.au/internet/ministers/publishing.nsf/content/health-mediarel-yr2005-ta-abb048.htm?OpenDocument&yr=2005&mth=5 (accessed 10 August 2006).
Assisted Human Reproduction Act, S.C. 2004, c.2.
Art. L152–1 to L152–10, L673–5 C. santé publ.
Art. 16–7 C. civ.
Art. 311–19, 311–20 C. civ.
Art. 511–18, 511–119 C. pén.
Embryo Protection Act (Embryonenschutzgestz – ESchG) (1990). Federal Law Gazette I, 13 December 1990, p. 2746.
Public Health (Extra-Corporeal Fertilization) Regulations 1987 (Official Gazette, Regulations, 5035 p. 978, 11 June 1987).
Ova Donation for Extra–Corporeal Fertilization Act 2001 (Official Gazette, Statutory Bills, no. 2985 p. 537, 5 March 2001).
Human Assisted Reproductive Technology Act (N.Z.), 2004/9.
In Vitro Fertilisation Act SFS 1988: 711.
The Act Concerning Measures for Research or Treatment Involving Fertilised Human Ova, SFS 1991: 115.
Artificial Conception Act 1985 (W.A.).
Reproductive Technology (Clinical Practices) Act 1988 (S.A.).
Human Reproductive Technology Act 1991 (W.A.).
Infertility Treatment Act 1995 (Vic.).
Infertility Regulations Act 1997 (Vic.).
Research Involving Human Embryos Act 2002 (Cth.).
Australian Government, Department of Health and Aging. http://www.health.gov.au/internet/ministers/publishing.nsf/content/health-mediarel-yr2005-ta-abb048.htm?OpenDocument&yr=2005&mth=5 (accessed 10 August 2006).
Assisted Human Reproduction Act, S.C. 2004, c.2.
Art. L152–1 to L152–10, L673–5 C. santé publ.
Art. 16–7 C. civ.
Art. 311–19, 311–20 C. civ.
Art. 511–18, 511–119 C. pén.
Embryo Protection Act (Embryonenschutzgestz – ESchG) (1990). Federal Law Gazette I, 13 December 1990, p. 2746.
Public Health (Extra-Corporeal Fertilization) Regulations 1987 (Official Gazette, Regulations, 5035 p. 978, 11 June 1987).
Ova Donation for Extra–Corporeal Fertilization Act 2001 (Official Gazette, Statutory Bills, no. 2985 p. 537, 5 March 2001).
Human Assisted Reproductive Technology Act (N.Z.), 2004/9.
In Vitro Fertilisation Act SFS 1988: 711.
The Act Concerning Measures for Research or Treatment Involving Fertilised Human Ova, SFS 1991: 115.

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Assisted reproduction
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.019
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Assisted reproduction
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.019
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Assisted reproduction
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.019
Available formats
×