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Reproductive Technology

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It involves all the fertility treatments where embryos or eggs are handled ("What is Assisted Reproductive Technology?" 2019). The procedures involve combining sperm with eggs removed from the ovaries and inserting them in an individual. This includes embryo adoption, artificial insemination, in vitro fertilization, and more ("Reproductive Technology"). There are various reasons for individuals to want to have some choice and find out about the genetic makeup of their offspring ("Genetics and reproduction"). Doctors are able to utilize numerous techniques to obtain this information from fetuses and genetically analyze them. The use of technologies, such as in vitro fertilization to create embryos in a lab allows them to be genetically analyzed before implantation. Overall, they can be used for analysis, selection, and possibly in the future to eliminate severe diseases by modifying offspring.


Canada’s Assisted Human Reproduction Act

Approved by the senate in 2004, this legislation addresses all reproductive technologies ("Canada: The Assisted Human Reproduction Act"). They are based on opposing political and social issues, but agree on principle beliefs. It identifies and prohibits unacceptable uses of reproductive and genetic technologies.

Prohibited uses:

  • Creating embryos for research only
  • Making inheritable genetic changes
  • Creating hybrid species that are partially human
  • Cloning
  • Sex-selection when there is no concern of a sex-linked disease
  • Commercial contracts with a surrogate
  • The sale of eggs, sperm, and embryo
  • In vitro fertilization

This technique is usually used for women with fallopian tube issues, unexplained fertility, and endometriosis ("Reproductive Technology"). The patient is given stimulating hormones that cause the maturation and release of a significant amount of eggs. They are then removed with a needle and put in a laboratory dish where they are combined with sperm. This process is costly (several thousands of dollars) and can result in dangerous multiple pregnancies since so many embryos are implanted. Not to mention, the success rate is less than 20%.

In Vitro Fertilization Process
Preimplantation genetic diagnosis process.
  • Preimplantation genetic diagnosis

The process involves testing for the genetic markers of an embryo created through in vitro fertilization ("Genetics and reproduction"). This allows for one or two of the healthiest embryos to be selected and transferred into the womb. It assesses mutations associated with diseases that result in fatalities in early childhood years. For instance, Huntington’s disease, cystic fibrosis, Tay-Sachs, and more. Usually, scientists extract a single cell from an 8-cell embryo and test it. Overall, this technology selects for healthy children.

Molly and Adam Nash Case

Molly Nash’s parents used preimplantation genetic diagnosis (PGD) to select for an embryo that would produce a child with stem cells that could save her life ("Genetics and reproduction"). Born in 1994, Molly was born with Fanconi Anemia: a disorder that disrupts a cell’s capacity to repair its genetic information, eventually resulting in death. To save her life, her parents conceived a second baby without the disorder that would be a fit donor for her.  They accomplished this with the use of PGD and IVF. Adam Nash was born with the stem cells necessary to save Molly in his umbilical cord. Though not legally approved, the procedure was successful.

  • Prenatal Testing

There are tests that can be utilized to analyze fetal DNA ("Genetics and reproduction"). As an example, chorionic villus sampling or amniocentesis, which are invasive treatments. A large needle is inserted through the abdomen, uterus, and amniotic sac of the pregnant person, obtaining genetic information. Chorionic villus sampling involves a needle being inserted through the abdomen or vagina of the pregnant individual, where it then collects placental tissue. Miscarriage is a small, but potential risk of the treatment.

There have been recent developments in non-invasive prenatal testing methods. For example, by analyzing the blood of a pregnant patient. As a result of placental cells occasionally breaking open and releasing fragments of DNA from the fetus, it can be found in the bloodstream. This cell-free DNA can be sequenced and then subject to analysis to reveal fetal information. This technique is commonly used to screen for chromosomal related disorders (e.g. down syndrome). Though, these results are not definitive like the invasive methods.

  • Embryo Adoption

A procedure where an embryo formed from the sperm of a man and egg of a woman are implanted into another woman’s uterus to be raised by her and her partner ("Reproductive Technology").

Advantages, Disadvantages, and Limitations

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Advantages:

These technologies are increasingly being used by homosexual couples, women after menopause, and more. This is because they give them options and allow them to select for a healthy child ("Reproductive Technology").

Disadvantages:

Though the technology improves fertility, it often results in low-birth weight or preterm babies ("What is Assisted Reproductive Technology?", 2019).

Limitations:

These technologies are ineffective in determining all of the physical, behavioral, and mental disorders a child may have ("Genetics and reproduction"). This is because these traits are heavily affected by nurture and genes that haven't been identified by scientists. Additionally, these testing methods do not alter genes, but rather, allow for the analysis of them. Although, recent developments may allow for future genome editing to eliminate deadly diseases (e.g. Huntington’s).

Ethics

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The use of preimplantation genetic diagnosis raised ethical issues, as it allows parents to select embryos over others ("Genetics and reproduction"). The controversy revolves around the fact that individuals may abuse the technology for non-health related issues. For example, to select embryos of a specific sex or select against “disabilities” (e.g. dwarfism). Embryo, egg, and sperm donors may have privacy concerns or fear someone demanding they pay child support ("Reproductive Technology"). This also affects the child, who may wonder about their biological family or medical history. There are also concerns about surrogate parents not wanting to give up the baby, and putting a price on eggs and sperm. The care of embryos is a safety concern (McConchie, 1999). A couple undergoing in vitro fertilization treatment should decide how many embryos they want to implant and only harvest that many. When harvested, they should be all implanted or frozen for later use, depending on what is safer for both the patient and embryo. This raises the issue if it's ethical to freeze embryos that may never be used ("Reproductive Technology: Ethical Issues", 2021). What should they be used for when they stop being viable? How are they divided when a couple gets divorced?

Donor Eggs or Sperm

Using donors can cause issues regarding who the rightful parents are (McConchie, 1999). If they are the donors of gametes, or the individuals who brought up the child. The use of these technologies can result in legal battles over rightful parent ship. As well, whether the children should know all if their parents, and if visitation rights should be a thing.

Surrogate Mothers

There is an ethical dilemma concerning commercializing a woman’s body, allowing them to get payment for growing a fetus ("Reproductive Technology: Ethical Issues", 2021). Should babies be purchasable? Will women resort to surrogacy to make money in desperate situations?

Bonds

In all scenarios, biological parents, surrogates, and adoptive parents can form bonds to children. This can result in a surrogate not wanting to give a child up or adoptive parents not wanting them to abort the child in certain circumstances.  

Post-Menopausal Women

Is it ethical to allow women at ages where medical complications or are common (Fisseha & Clark, 2014)?


Arguments in support:

- Some grandparents raise their grandchildren

-If men can reproduce at old ages, why can't women?

-Individuals have the right to choose when they want to reproduce.

- It would be discriminatory to refuse someone the right to reproduce at an old age.


Arguments Against:

-Natural reproduction occurs during the years women undergo menstruation. Should this be extended artificially?

-Is it ethical to let older individuals have kids when they might die before they become adults? This would be emotionally traumatizing to said child and may result in depression and other issues.

-There is a higher risk of neonatal and obstetrical complications to both the child and parent.

Reference section

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Reproductive Technology: Ethical Issues (2021, November 12). Retrieved from https://www.encyclopedia.com/medicine/medical-magazines/reproductive-technology-ethical-issues

Canada: The Assisted Human Reproduction Act. (n.d.). Retrieved from https://www.geneticsandsociety.org/internal-content/canada-assisted-human-reproduction-act

Fisseha, S., & Clark, N. A. (2014, January 01). Assisted Reproduction for Postmenopausal Women. Retrieved from https://journalofethics.ama-assn.org/article/assisted-reproduction-postmenopausal-women/2014-01

Genetics and reproduction. (n.d.). Retrieved from https://pged.org/genetics-and-reproduction/

McConchie, D. S. (1999, July 17). An Ethical Perspective on Reproductive Technologies. Retrieved from https://cbhd.org/content/ethical-perspectives-reproductive-technologies#:~:text=There are several reproductive technologies which are currently,intrafallopian transfer (ZIFT), and intracytoplasmic sperm injection (ICSI).

Reproductive Technology. (n.d.). Retrieved from http://www.biologyreference.com/Re-Se/Reproductive-Technology.html

What is Assisted Reproductive Technology? (2019, October 08). Retrieved from https://www.cdc.gov/art/whatis.html


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