The Warnock Report HMSO Report of the Committee of Inquiry into Human Fertilization and Embryology (1984). Infertility is generally defined as the inability to conceive after 12 months of unprotected intercourse2• The definition of infertility can also include "infertility, which means the inability to conceive or fertilize, and pregnancy loss, which means the inability to carry a pregnancy to term to term through spontaneous abortion and stillbirth.
CONCLUSION
PRE-CONCEPTION 2.1.INTRODUCTION
SELECTION OF THE DONOR
- CONCLUSION
It is therefore clear that sperm can be obtained without gonadal transplantation. It is stated that post-mortem sperm procurement may be permitted with written consent of the donor.
SELECTION OF THE GAMETES
- SELECTION OF THE SPERM
- SELECTION OF THE EGG
- CONCLUSION
World Health Organization standards indicate that a normal semen sample should contain at least 20 million sperm, with at least 50% having good to excellent progressive forward motility within 60 minutes after ejaculation75• Seminal plasma (semen) contains factors that inhibit fertilization76•. Therefore, it is claimed that the egg donor has at least one child99 before being accepted into the egg donation program.
SELECTION OF THE RECIPIENT
- CONCLUSION
Pregnancy in an older woman should be carefully monitored to reduce the risk of death. Older women are at greater risk of complications during pregnancy, but if it is a risk they are already aware of, then it is their choice to continue with fertility treatment.
2.S.SELECTION OF THE DOCTOR
- CONCLUSION
- MEDICAL ASPECTS
- THE EGG DONOR
- AGE OF RECIPIENT
- THE EGG
- THE SPERM
- ETHICAL ASPECTS
- DONOR ANONYMITY
- GAMETE DONORS
- SELECTION OF DONOR
- S.EGG DONOR
- AGE OF EGG DONOR
- USE OF FOETAL EGGS
- CONCLUSION
It is argued that if the recipient is over 40 years of age, she is informed about the alternative of egg donation. The consent of the recipient and her husband if married must also be obtained in writing. The child also has no medical/genetic history of the donor that could be relevant for an accurate diagnosis of disease and.
Is the creation of a child after the death of the father in the best interests of the child. The use of fetal eggs can pose an ethical problem when the informed consent of the donor and the recipient is obtained. Patients with a high probability of success can be placed at the head of the waiting list.
The child born is considered to be the legitimate child of the woman and her husband.
CONCEPTION AND PRE-IMPLANTATION DIAGNOSIS
CONCEPTION
- MEDICAL ASPECTS
- ETHICAL ASPECTS
- LEGAL ASPECTS
- CONCLUSION
With IVP, due to the higher number of sperm present, it is more likely that more sperm can enter at the same time. In vivo, only about 100 sperm reach the vicinity of the egg2• Eggs that are left to mature for several hours in the laboratory develop the ability to prevent more than one sperm from entering the egg13. Culture media must be able to support the fertilization process and must provide adequate energy sources to maintain sperm motility and egg metabolism14.
When multiple eggs are fertilized, the recipient should be informed of the alternatives available in relation to the fertilized eggs. Before a woman consents to treatment, she must know the nature and extent of the risk and appreciate and understand the nature of the risk23. The embryo was taken out of the incubator and left to die without notifying or obtaining the consent of the gamete donors.
The creation of the in vitro embryo has brought with it many ethical and legal problems, e.g.
PRE-IMPLANTATION DIAGNOSIS
- MEDICAL ASPECTS
- ETHICAL ASPECTS
- LEGAL ASPECTS
- CONCLUSION
However, Tarin and Handyside state that there is a limitation to the number of cells and cell mass that can be biopsied without seriously reducing the viability of the embryo037. They state that if a single cell is removed at the two-cell stage, it may compromise the embryo's ability to form normal blastocysts for in vivo development. Preimplantation diagnosis at the blastocyst stage (5-6 days after insemination) is not recommended due to the low pregnancy rate39.
It is believed that biopsy of a quarter of the cell mass of the embryo on the third day after insemination is the optimal stage for biopsy4o. Some of the reasons may include the prospect of poverty, continued war, or for some people, the risk of passing on a harmful genetic disease to their offspring. If a doctor fails to inform the prospective parents of the risk of a genetic disease, or to correctly perform and interpret laboratory results that would reveal an abnormality in the embryo, the parents of a affected child choose to bring an action against him regarding his negligence.
The doctor must fully inform the expectant parents that the results of laboratory tests cannot be guaranteed.
IMPLANTATIONIEMBRYO TRANSFER
- MEDICAL ASPECTS
- ETHICAL ASPECTS
- LEGAL ASPECTS
- CONCLUSION
Bleeding and damage to the cervix at the time of embryo transfer reduce the implantation rate of the embryo. 7 V.T.Goudas, D.G.Hammitt, M.A.Damario, D.R.Session, A.P.Singh and D.A.Dumesic 'Embryo Transfer Catheter Blood Is Associated with Reduced Embryo Implantation and Clinical Pregnancy Rates Using In Vitro Fertilization - Embryo Transfer No. 5 Fertility and Sterility 878-882. II J.Meriano, A.Weissman, E.M.Greenblatt, S.Ward and R.F.Casper 'Embryo Transfer Catheter Choice Affects Embryo Implantation After IVF No.4 Fertility and Sterility 678-682.
Fierlbeck and G. Rassner 'Anaphylactic reaction to bovine serum albumin after embryo transfer No.4 Fertility and Sterility 771-. The presence of bacteria in the cervix at the time of embryo transfer is associated with a decrease in IVF-ET success rates20. 20 R.Fanchin, A.Harmas, Farida Benaoudia, U.Lundkvist, F.Olivennes and R.Frydman 'Microbial flora of the cervix assessed at the time of embryo transfer has an adverse influence on in vitro fertilization outcome No.5 Fertility and Sterility 866- 870.
It is argued that embryo transfer should be carried out in skilled hands to eliminate any risk to the recipient.
PREGNANCY
- PRENATAL TESTING
- MEDICAL ASPECTS
- ETIDCAL ASPECTS
- LEGAL ASPECTS
- CONCLUSION
These cells can be tested for the sex of the fetus and for genetic diseases. A sample of the amniotic fluid that surrounds the fetus is taken and analyzed to detect chromosomal or genetic abnormalities. The complications associated with CVS include an increased incidence of limb reduction defects, vaginal bleeding or spotting, infections and rupture of the membranes44• Risks associated with amniocentesis include septic shock, amniotic fluid leakage, vaginal bleeding, cramping and lower abdominal discomfort45•. Fetal blood tests also have risks that include membrane rupture, bleeding from the puncture site, and thrombosis.
Some of the prenatal techniques are invasive and the doctor performing the prenatal examination must inform the woman of all the risks. The ethics of beneficence must outweigh the harm done in performing the test. Pregnant women who undergo the tests to determine the sex of the fetus will be subject to the same fine and imprisonment).
Further testing should only be performed if necessary and with the woman's informed consent.
SELECTIVE REDUCTION
- MEDICAL ASPECTS
- ETHICAL ASPECTS
- LEGAL ASPECTS
- CONCLUSION
Because most infertile patients desperately want a child, they are unaware of the real 'cost' of a triplet pregnancy. Due to the large number of fetuses present, DNA studies of chorionic villus sampling material and. The act refers to the separation and expulsion of the contents of the uterus, but does not refer to the death of the fetus in the womb.
The fact that selective reduction does not terminate a pregnancy by expelling the contents of the uterus is irrelevant. A termination of pregnancy may therefore involve the termination of one or more pregnancies and the continuation of other pregnancies to term. It is argued that without evacuation of the uterus, and without termination of the pregnancy as a whole, selective reduction falls outside the scope of the law.
Selective reduction is acceptable in a multiple pregnancy when it represents a clear threat to the life or health of the mother and reduction of the fetus can reduce the risk.
4.S.EUGENIC SELECTIVE REDUCTION
CONCLUSION
It is the mother's right to make a decision about the fate of the unborn children with the help of her doctor and guided by the law. Up to and including the 12th week of pregnancy, the decision to terminate a pregnancy is the woman's decision. From the 13th week to the 20th week, the woman can request a termination of pregnancy, but the medical practitioner makes the decision after consultation with the woman.
The decision to terminate a pregnancy after the 20th week must be made by a doctor in consultation with another doctor or midwife.
CHAPTERS
THE SURPLUS EMBRYO
- RESEARCH
- MEDICAL ASPECTS
- ETHICAL ASPECTS
- LEGAL ASPECTS
- CONCLUSION
- DONATING THE EMBRYO TO ANOTHER COUPLE
- I.MEDICAL ASPECTS
- ETHICAL ASPECTS
- CONCLUSION
- ALLOWING THE EMBRYO TO DIE
- CRYOPRESERV ATION
- CONCLUSION
Research on embryos is justified under the condition that the aim of the experiment is to improve the human condition9. The whole issue of embryo research is based on the question of whether or not an embryo is a person. The proposed new regulations for artificial insemination allow the donation of an embryo to another couple with the consent of the recipient and her spouse33.
It is submitted that embryo donation should be allowed with the consent of both genetic donors. If the embryos are destroyed intentionally, it is said that this would be a violation of the parents' right to dignity54. It is submitted that the couple for whom the embryos are created should determine the fate of the embryos.
If the embryos are deliberately destroyed, it is argued that this would violate their parents' right to dignity.
BIDLIOGRAPHY
Ethics Committee of American Fertility Society 'Donoræg in vitro fertilization Fertility and Sterility Supply 1. Ethics Committee of the American Fertility Society' Ethical Considerations of the New Reproductive Technologies No.6 Fertility and Sterility 43S. Potentiel risiko for lys- og stuetemperatureksponering for præimplantationsembryoer nr. 6 Fertilitet og sterilitet 938-944.
Microbial flora of the cervix assessed at the time of embryo transfer adversely affects in vitro fertilization outcome No. 5 Fertility and Sterility 866-870. The choice of embryo transfer catheter affects embryo implantation after IVF No. 4 Fertility and Sterility 678-682. The kinetics of the acrosome reaction of human spermatozoa and its correlation with in vitro fertilization No. 4 Fertility and Sterility 889-894 Tarin J.J.
Establishing a Successful Embryo Donor Program: Medical, Ethical and Policy Issues No.4 Fertility and Sterility 604-608.
