Fertility Treatment What is IVF? What is PGD?

Methods of Infertility Treatment IVF (In-vitro fertilisation): when the egg from the woman is fertilised outside the womb using either the husband’s or a donor’s sperm and then replaced in the womb AIH (Artificial Insemination by Husband): When sperm from the husband is inserted into his wife by mechanically means. AID (Artificial Insemination by Donor): When sperm from a donor, other than the husband, is inserted into the woman by mechanically means. H F E A All methods of fertility treatment and cases of experimentation in the UK are monitored by the Human Fertilisation and Embryology Authority Egg Donation: When an egg is donated by another woman, fertilised using IVF by the husband’s sperm and then placed in the wife’s womb. Embryo Donation: When both egg and sperm from donors are fertilised using IVF and the inserted into the woman’s womb. Surrogacy:When the egg and sperm of a couple are fertilised by IVF then placed in another woman’s womb. Or, the sperm of a husband is artificially inseminated into another woman to have the baby for them. The baby is handed over at birth.

Infertility can effect anyone.

Patricia Rashbrooke had a baby at 62 using IVF What is your view and why? Think of one argument for and one argument against

Miracle IVF twins Bailey and Megan Orrells were born a record-breaking four years apart. What do you think a Christian would say about this? "Her birth is incredible. There are no embryos left and it's not going to happen again. We're blessed - some -body up there is watching over us.“ Mrs Orrells

Embryology for and against. Read the statements – outline for and against.

PGD: Genetic testing performed prior to embryo transfer Engineering 124; Spring 2003 “The debate [around PGD] has been building since the late 1980s, when doctors at London's Hammersmith Hospital learned how to tease a cell from a 3-day-old embryo and study its chromosomes for gender.” (Zitner 2002) Adds $2000 to IVF Reduces rate of miscarriages from 23% to 10% Does not increase chance of pregnancy

Removal of one cell for testing Commonly, more than 100 diseases can be detected through testing, including… Hemophilia A Muscular dystrophy Tay-Sachs disease Cystic fibrosis Down Syndrome Removal of one cell for testing Engineering 124; Spring 2003

Viable and Desirable? “This information is helping parents choose which embryos they want--and which to reject as unhealthy, or merely undesirable.” (Zitner 2002) Engineering 124; Spring 2003

Undesirable Embryos Disease Free Embryos Frozen in storage Donated to infertile couples Donated to stem cell research/usage Disease Carrying Embryos Donated to research Discarded Engineering 124; Spring 2003

Ethics: The issues at hand… Engineering 124; Spring 2003 World Views Ethics: The issues at hand… Utilitarianism Rights Ethics Care Ethics … weighing the goal of pregnancy and live birth against the medical and moral risks of multiple gestation. …requires society to make a decision on when life begins. …using PGD inherently makes assumptions about the quality of life, challenging basic tenets of society such as equality.

Ethics Address the suffering of the mother due to her inability to have a child “naturally” “When having children, people…often roll the genetic dice and hope for the best. With embryo sorting, "they can start their pregnancy on Day One with a commitment to continuing it." (Zitner 2002) PGD can save parents massive heartbreak and financial strain Address the view of the potential child Will the child have adequate support and a stable home? If there are multiple fetuses, will the children receive adequate care/attention? “[PGD has] the goal of stopping deadly genetic diseases such as Tay-Sachs and Huntington’s. This research has growing support because it can save children from enormous suffering and early death.” (Wagner 2003) Some ethicists would be in favor of IVF and PGD as long as the decision is loving and promotes positive relationships.

Rights Based Ethics Embryos are mass-produced, screened, discarded and used in experiments: are they products or people with rights? Based on John Locke’s principles, all people have the right (in America) to “life, liberty and the pursuit of happiness.” What becomes of the idea that everyone is created equal if you start designing children? Loss of autonomy because of a necessity to be competitive in society Inherently discriminatory; makes assumptions about quality of life "Most people with disabilities rate their quality of life as much higher than other people think. People make the decision [to reject embryos] based on a prejudice that having a disability means having a low quality of life.“ Engineering 124; Spring 2003

Utilitarianism The alleviation of suffering for many is important. Engineering 124; Spring 2003 Utilitarianism The greatest good for the greatest number suggests that… The alleviation of suffering for many is important. IVF helps many infertile couples achieve a life-long dream of having a child. PGD helps those same couples reach their goal of a disease free child. A disease free society is preferable for all members.

International Policies on PGD Banned PGD for ALL usages Used to select child’s gender only when there is medical need Clinics set policies; no federal or state restrictions

Therapeutic Cloning

Therapeutic cloning is taking genetic material out of an embryo and replacing it with DNA from another individual. The embryo is used to develop stem cells then destroyed. This could be used to create replacement organs which the body would recognise as its own.

Benefits include the possibility of improving the human race and affecting the way our evolution progresses, allowing infertile couples to have biological children, a method to allow experimentation on life threatening illnesses.

In therapeutic cloning an embryo is not implanted into the womb of a woman. Instead, stem cells are removed after the embryo starts dividing in the first 14 days after fertilization. This kills the embryo. Stem cells have the ability to reproduce and become one of many types of cells including skin, liver cell, hair or blood cells. These cells are then used to grow the type of tissue or organ that is needed. They are genetically identical to the patient who donated it, eliminating the problem of organ or tissue rejection. At present, if someone has an organ transplant, their body could reject the donated organ.