Infertility and ‘miracle’ babies Week 17 Sociology of Human Reproduction

Recap Considered the social construction of motherhood and the family Considered the concept of ‘good motherhood’ Looked at the issue of teenage pregnancy

Outline The background of assisted reproductive technologies Consider infertility as a social concept Look at the implications for the division between social and biological parenthood

Birth of a new Age? 25th July 1978 birth of Louise Brown World’s first IVF baby (‘test-tube’) Since then rapid expansion of technological treatments for infertility and other treatments based on these procedures

Assistive Reproductive Technologies ARTs cover a range of possibilities including: In-vitro fertilisation (IVF) Intrauterine insemination (IUI) Gamete intra-fallopian transfer (GIFT) Intra-cytoplasmic sperm injection (ICSI) Pre-implantation genetic diagnosis (PGD) Using donor gametes (eggs and/or sperm)

What do you know about ARTs What do you know about ARTs? In general terms are they a good or bad possibility?

Experimental medicine? Despite decades of research, ARTs are a difficult and painful process which is largely unsuccessful On average 75% of IVF attempts fail Age and reason for treatment related ARTs can carry serious health risks

Treatment cycle Drugs to suppress ovulation, then drugs to induce ovulation Super-ovulation common (lots of eggs) injections, hormonal nasal sprays and numerous tests Egg 'recovery’ (surgical procedure) and fertilisation Developing embryo(s) will be placed in the womb (max 3 in UK). Waiting to see if a pregnancy develops

Risks of treatment The cycle can fail at any point Drug reactions are fairly common hot flushes, nausea, mood swings, headaches, weight gain and heavy periods Ovarian-hyperstimulation syndrome (OHSS) Rare complication but can lead to permanent kidney damage or death Increased risk of pregnancy complications

Controlling ARTS In the UK, people undergoing ARTs are usually informed as to both the risks and likelihood of failure HFEA oversees clinics and success rates are publicised

Despite the high risk of both treatment side effects and failure, IVF retains a general image of a benevolent technology which produces ‘miracle babies’. Why do you think this is?

What is Infertility? No agreed diagnosis of infertility Inability to conceive whilst having regular sexual intercourse over a period of time (usually between 1-3 years) May include the inability to carry a pregnancy to term

Infertility and ART ARTs are not a treatment for infertility They do not enable the body to go back to ‘normal’ functioning Labelling a couple infertile is not an exact science ‘Unexplained’ infertility is common Estimates vary but significant numbers of people with unexplained fertility would conceive without intervention in time Only one partner may have a problem

Infertility and ART Individuals undergoing treatment may already have children From previous relationships Adopted Children with disabilities Individuals may be undergoing treatment for someone else Egg donation/egg sharing Decline in research in prevention of infertility

Why do you think so many people turn to ARTs given that they are so unreliable and carry significant risks to health?

Infertility and Stigma Ideas about womenhood are interrelated to motherhood Considerable stigma exists against ‘barren’ women Women who cannot conceive still feel ‘failures’

Choosing ARTs? Many women report that they felt they had to ‘try everything’ Consequently, ARTs are not just a option Their existence means that they have become compulsory

Endless options ARTs are not a single option Treatment cycles can be varied depending on earlier responses to drug combinations So trying everything is rarely possible

Choosing ARTs? 'IVF only makes life more difficult… I would have had to accept it a long time ago if it weren't for IVF. At twenty-eight I could have either gone for adoption or accepted my situation so I'd be five years down the line towards that and getting on with my life. Now you're in a better position to do that when you're twenty-eight than when you're thirty-eight. If you've missed all your career boats and burned all your career bridges because you've spent the last ten years chasing fruitless treatment you've actually missed out a lot on life' (Beth Carter quoted in Franklin 1997:177/8)

What impact do you think the existence of ARTs has had on the experience of infertility?

Biological imperative? Imbedded in ARTs is the notion that biological parenthood is preferable It both builds on and reinforces the notion that this is what makes ‘real families’ How important really is a biological link?

Biological imperative? Biological fatherhood used to be the basis of inheritance Children as property rather than people? Genetic inheritance has now seen as importance Bodies at risk? But good parenting is about the provision of love and security Does not need a biological relationship

Biological Imperative? The biological imperative is further undermined by the growing use of donor gametes In the UK, only expenses are allowed Egg donation is a developing market Recruitment of poorer women common $6,500 plus expensive gifts

Choosing ARTs ARTs thus build on and reinforce pre-existing cultural constructions All women should be mothers Biological links are more importance than social parenthood Choosing ARTs therefore becomes the ‘normal’ choice for the involuntary childless

‘Alternative’ Families ARTs were developed to support normative ideas about families But also allow possibility of other family forms. Single women and gay and lesbian couples increasingly use ARTS to have their own ‘families’ This can considered more problematic than the health risks involved.

Summary ARTs are a product of its specific cultural circumstances Its justifies its own existence though pathologising infertility This reinforces ideas about the necessity of biological parenthood