1. ARTIFICIAL INSEMINATION Rels 300 / Nurs 330 5 November 2015 http://www.toonpool.com/cartoo ns/Artificial%20Insemination%20lov e%20Val_22882 300/330 - appleby1

2. 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. Artificial Insemination with partner’s sperm: IUI 300/330 - appleby2

3. 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 Fertility Drugs / Ovulation Induction 300/330 - appleby3

4.  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. What if it is the male partner who has fertility problems? 300/330 - appleby4

5. http://www.anonymousfathersday.comhttp://www.anonymousfathersday.com (2:10) www.cbc-network.org/2011/06/anonymous-fathers-day/ (June 2011 court case in BC) ↓ Interesting issues discussed on this website ↓ www.cbc-network.org/2011/06/anonymous-fathers-day/ 300/330 - appleby5

6.  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.189-191) ACCORDING TO NATURAL LAW 300/330 - appleby6

7.  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 HARMS INTRODUCED 300/330 - appleby7

8.  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 Deliberate severing of genetic, gestational and social ties 300/330 - appleby8

9. 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. Artificial Insemination with Donor Sperm (DI) 300/330 - appleby9

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

11. 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 AI Costs 300/330 - appleby11

12. Prefer an International Donor? Xytex Online: http://www.xytex.com/patient_sdp.cfm http://www.xytex.com/patient_sdp.cfm 300/330 - appleby12

13. Donor Insemination Costs http://www.repromed.ca/userfiles/file/rml%20fee%20schedule%20ma y%202011%20(2).pdf 300/330 - appleby13

14. for Group Discussion: Experiences Of Children Conceived By Artificial Insemination 300/330 - appleby14

15. 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? “a child born in wedlock is the child of the husband and wife” 300/330 - appleby15

16.  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? If you were conceived by means of artificial insemination: 300/330 - appleby16

17. Newer Issues: Free sperm exchange on the internet; advertising for sperm on “Kijii”-type sites; known donors; posthumous donors 300/330 - appleby17

18. http://www.repromed.ca/guide_to_home_insemination 300/330 - appleby18

19. 300/330 - appleby19

20. 300/330 - appleby20

21. 300/330 - appleby21

22. 300/330 - appleby22

23.  Whose personal dignity and autonomy are promoted or harmed?  What are the potential benefits of reproductive technologies?  Who are the beneficiaries?  What are the potential risks and harms of reproductive technologies?  Who is most likely to be harmed?  Are there justice issues in the provision of reproductive services?  Issues of fairness, equality, equitable access? Evaluating reproductive technologies 300/330 - appleby23

24. 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? Procreative Liberty and Harms 300/330 - appleby24