1. ARTIFICIAL INSEMINATION Rels 300 / Nurs 330 6 November 2014 http://www.toonpool.com/cartoons/Artificial%20Insemination%20l ove%20Val_22882 300/330 - appleby1

2. Artificial Insemination with partner’s sperm: IUI Intrauterine Insemination: fresh sperm is produced (by partner) 1½ hours prior to insemination sperm specimen is assessed and washed sperm placed in a syringe catheter is inserted through cervix into uterus sperm injected slowly over 5-10 minutes process repeated next day then progesterone suppositories twice a day for remainder of cycle if pregnant, continued progesterone use for 13 wks. 300/330 - appleby2

3. Fertility Drugs / Ovulation Induction Instructions from ReproMed Clinic in Toronto: 1 st day of menstrual bleeding – call office 3 rd day – baseline ultrasound (on full bladder) Days 3 to 10/12: daily fertility medication injections (puregon/pergonal); daily blood hormone levels; daily ultrasounds At ovulation: intra-muscular injection of hCG/profasi Instructions for intercourse for next 2 days; OR, artificial insemination for next 2 days Days 15/16 to 28: progesterone suppositories used twice a day Day 21: blood test for progesterone level Day 28: blood test for pregnancy 300/330 - appleby3

4. What if it is the male partner who has fertility problems? impotence, no sperm, low sperm counts, poor sperm mobility, abnormalities in sperm morphology need for donor sperm for Donor Insemination common practice is to mix the male partner’s sperm with donor sperm – so that both partners are still involved and there is a chance of partner paternity introduces numerous practical & ethical issues: sperm sources; anonymity; confidentiality; payment; genetic/medical health; etc. 300/330 - appleby4

5. http://www.anonymousfathersday.comhttp://www.anonymousfathersday.com (2:10) www.cbc-network.org/2011/06/anonymous-fathers-day/ (court case) www.cbc-network.org/2011/06/anonymous-fathers-day/ 300/330 - appleby5

6. ACCORDING TO NATURAL LAW  Sexual intercourse has 2 meanings:  It is a procreative act  It is an expression of loving union  These 2 meanings should occur simultaneously in each act of intercourse  Neither meaning should be separated from the other  Reproductive technologies “separate the intrinsic connection between the unitive (the act of intercourse) and the procreative (the reproductive purpose of intercourse)” (p.138) 300/330 - appleby6

7. HARMS INTRODUCED Separation of unitive and procreative Separation of genetic, gestational and social parenthood Intrusion of 3 rd parties into the intimate relationship of partners ◦ “deprives the resulting child of the human dignity that rightfully belongs to it” ◦ treats the resulting child as an object Violates the rights of partners to mutual parenthood through one another 300/330 - appleby7

8. Deliberate severing of genetic, gestational and social ties Secrecy, anonymity (Similarities to adoption) Asymmetry in parent/child relationships ◦ Donor sperm (donor ova, donor embryos) Genetic & social ties interpreted according to the intentions of the adult – to be, or not to be, the social parent 300/330 - appleby8

9. Artificial Insemination with Donor Sperm (DI) Male partner is infertile, or no male partner donor semen obtained from a sperm bank ◦ sperm samples are assessed, washed, frozen, stored; purchased; shipped ◦ semen donors are anonymous; they may or may not be paid for their “donation”; currently, payment is prohibited in Canada ◦ medical and genetic screening: genetic diseases; STI’s; HIV; hepatitis; medical history for 3 generations ◦ samples frozen for 6 months, then retested ◦ donor profiles; donor catalogue Data Assisted Donor Selection = D.A.D.S. 300/330 - appleby9

10. http://www.repromed.ca/sperm_donor_catalogue 300/330 - appleby10

11. AI Costs First Home Insemination Cycle: A: Using ReproMed Donor Samples:$1,690 B: Using Xytex Anonymous Donor Samples: $1,790 C: Using Xytex Open-ID Samples:$1,990 Subsequent Home Insemination Cycle Options: A: Using ReproMed Donor Samples:$1,240 B: Using Xytex Anonymous Donor Samples:$1,340 C: Using Xytex Open-ID Samples:$1,540 300/330 - appleby11

12. Xytex Online: https://www.xytex.com/sperm-donor- search/results.cfm?btnAction=Search&c hkCanadian=on&isNewSearch=1 300/330 - appleby12 Prefer an International Donor?

13. FOR GROUP DISCUSSION: Experiences Of Children Conceived By Artificial Insemination 300/330 - appleby13

14. “a child born in wedlock is the child of the husband and wife” Think of your birth certificate. Who is listed on your birth certificate as your mother and father? What would it say if you were an adopted child? What would it say if you were a child conceived by artificial insemination by a sperm donor? What would it say if you were a child conceived by artificial insemination using the sperm of your mother’s partner after his death? 300/330 - appleby14

15. If you were conceived by means of artificial insemination: What would you want to know about your origins? When would you want to be informed about the circumstances of your conception? What concerns might you have? Would you seek out donor or sibling information? How would YOU feel about this? 300/330 - appleby15

16. Newer Issues Self-insemination ◦ “Free sperm exchange on the internet” ◦ CBC Radio; The Current, Tuesday November 8, 2011 ◦ http://www.cbc.ca/video/news/audioplayer.html?c lipid=2165685820 (1 st 10 minutes) http://www.cbc.ca/video/news/audioplayer.html?c lipid=2165685820 Known donors Posthumous sperm retrieval Identities of sperm donors 300/330 - appleby16

17. http://www.repromed.ca/guide_to_home_insemination 300/330 - appleby17

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22. Procreative Liberty and Harms According to Robertson, “those who would limit procreative choice have the burden of showing that [one’s] reproductive actions” would result in tangible & substantial harms ◦ What sorts of potential harms might there be in artificial insemination? ◦ Who might be vulnerable to being harmed by artificial insemination technologies? 300/330 - appleby22