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

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

3. 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

4. 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

5. 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)

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

7. 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

8. 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

9. 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

10. 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

11. 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?

12. 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

13. 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

14. 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

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

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

17. 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

18. 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

19. 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)

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

21. 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?

22. 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

23. 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

24. 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

25. ‘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.

26. 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