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• Assisted reproductive technology (ART)


  Medical procedures used primarily to address infertility
• ART procedures

  • In Vitro Fertilization (IVF)
  • IntraCytoplasmic Sperm Injection (ICSI)
  • Cryopreservation of gametes or embryos
  • Fertility Medication
• ART


  (by CDC definition) any fertility-related treatments in which eggs, sperm or embryos are handled and manipulated to achieve pregnancy
• ART procedures


  1. Surgically removing eggs from a woman's ovaries

  2. Combining them with sperm in the laboratory

  3. Returning them to the woman's body or donating them to another woman
• Indications for ART


  • Tubal factor infertility
  • Male factor infertility
  • Diminished ovarian reserve
  • Ovarian failure (with donor eggs)
  • Ovulatory dysfunction
  • Unexplained infertility
  • Uterine factor infertility
• Contraindications for ART


  Cardiopulmonary conditions such as pulmonary hypertension and heart failure
• Ethical dilemmas with ART

  • The right to procreate or reproduce
  • The process of In Vitro Fertilization itself
  • The moral status of the embryo
  • The involvement of a third party (donor) in the reproductive process
  • The practice of surrogacy
  • The cryopreservation of pre-embryos
  • The genetic manipulation
  • Experiments on pre-embryo
• In Vitro Fertilization (IVF)


  A process of fertilization where an egg is combined with sperm in vitro (in glass)
• IVF process


  1. Monitoring and stimulating a woman's ovulatory process

  2. Removing an ovum or ova from the ovaries

  3. Letting a man's sperm fertilise them in a culture medium in a laboratory

  4. Embryo culture for 2-6 days

  5. Transferring the fertilized egg (zygote) by a catheter into the uterus
• Donor


  Either she donates her eggs (ova) or he donates his sperm- or embryos to a couple who are enable to become a parent due to infertility
• Gametes


  Sperm and egg cells, when fertilized it is a zygote
• Informed consent and counseling be provided to both the donors of embryos and the recipient to address the potential issues that embryo donation might raise
• Surrogacy


  A woman carries and deliver a child for a couple through In Vitro Fertilization. There should have a legal contract
• Cryopreservation of pre-embryos


  A process that freezes and stores fertilized eggs for later use
• Examples of human genetic manipulation


  • Insertion, Deletion, transposition of genes or DNA sequences in human gametes, human zygotes or early embryos
  • Transfer of ooplasm or nuclei in human zygotes
  • Introduction of artificial chromosomes in human gametes or zygotes
• It is ethically acceptable to experiment on pre-embryos if it is likely to provide significant new knowledge that may benefit human health, well-being of the offspring, or reproduction
• It is legal to abort an embryo or fetus substantially "older' than 14 days, and with appropriate consent, to do research on its tissues, yet it is illegal to experiment on an embryo beyond 14 days that was never intended for implantation
• Ethical issues related to induced abortion

  • The rights of the woman versus the rights of the fetus
  • For those who consider life to begin at conception - abortion always equals murder and is therefore forbidden
  • Those who believe in the absolute autonomy of the woman over her body take the other extreme approach
• Access to safe abortion is critical to the health of women and to their autonomy
• The development of new effective contraceptive methods has a profound impact on women's lives. By the use of contraception- it is possible to lessen maternal, infant and child mortality and to reduce the prevalence of STDs
• Female genital mutilation is still practiced worldwide due to customs and traditions
• Induced abortion


  Raises ethical issues related to the rights of the woman versus the rights of the fetus
• For those who consider life to begin at conception

  Abortion always equals murder and is therefore forbidden
• Those who believe in the absolute autonomy of the woman over her body

  Take the other extreme approach
• The development of new effective contraceptive methods has a profound impact on women's lives. By the use of contraception it is possible to lessen maternal, infant and child mortality and to reduce the prevalence of STDs
• Female genital mutilation is still practiced worldwide
• Female genital mutilation


  It is considered to be medically detrimental to the physical and mental health of women and girls, and is considered by many as oppression of women
• The practice of female genital mutilation has to be stopped
• Recognition of the fetus as a "patient"


  Has a potential effect on women's right for autonomy
• Women have no legal obligation to undergo invasive procedures and risk their health for the sake of their fetuses
• The woman carries ethical obligations toward her fetus. This obligation should not be enforced by the law
• At present, women bear most of the burden of reproductive health. They have the right of access to fertility regulation
• Water birth


  Involves going through labor or delivery while soaking in a tub of warm water
• Most childbirth centres now have birthing tubs available, though typically only for use during labor
• Scientifically, water births appear to improve comfort in the early first stage of labor, but not beyond that
• There is no known benefit of water birth to the newborn. In contrast, there may be bacteria in water that could infect a baby in the tub
• Vaginal seeding


  Is the practice of wiping a baby's mouth, face and skin with its mother's vaginal fluids after C-section. This process transfers vaginal microbes to the baby to help establish the baby's own microbiome to promote good health and fight disease
• The practice of vaginal seeding has some risks, and healthcare providers don't recommend it
• Lotus birth


  Is the practice of leaving the umbilical cord uncut after childbirth so that the baby is left attached to the placenta until the cord naturally separates at the umbilicus. This usually occurs within 3–10 days after birth. The practice is performed mainly for spiritual purposes, including for the perceived spiritual connection between the placenta and the newborn
• Eating the Placenta (Placentophagy)


  Eating your placenta after giving birth can pose harm to both you and your baby