Medically Assisted Reproduction and Genetics, Term Paper Example

The issue of medically assisted reproduction and genetics is not new. The first successful IVF birth was in 1978. In the following decades, assisted reproductive technology (ART) has advanced to include genetic screening for diseases like Down Syndrome. Today, couples can even choose the gender of their children born through ART by undergoing pre-implantation genetic diagnosis (PGD) (Harper, 2022). This procedure allows couples to select a genetically normal embryo or has a single known disease. However, every time research advances in reproductive medicine, the ethical issues become more complicated. The latest developments in the field are creating major concerns regarding human rights violations and racial discrimination against people with less desirable genetic traits. This paper seeks to highlight the ethical issues.

Examples of the Assisted Reproductive Technologies

Preimplantation Genetic Diagnosis (PGD) – The use of genetic material extracted from an embryo or other cell before it’s implanted into the uterus. This test can identify up to 90% of embryos with inherited genetic conditions in which embryos fail to form normally because of mutations in the DNA. PGD is not a guaranteed method of preventing congenital disabilities, but it’s often used when there are known problems with pregnancy or when parents want to avoid passing on genetic defects to their children (Harper, 2022).

Gamete Intrafallopian Transfer (GIFT) – In this procedure, eggs are removed from a woman’s ovaries and transferred directly into her partner’s fallopian tubes, which are then sealed off for about a week before the attachment occurs. The resulting embryos are then transferred into her. It is one of two alternatives for women who do not produce eggs through their menstrual cycle. Women who can’t carry a pregnancy are aided by using test tubes.

Principles and Ethical Issues of Assisted Reproductive Technology

The process of assisted reproductive technology (ART) is often shrouded in secrecy. While patients must have access to quality health care, there is a fine line between informed consent and coercion. When the risks of pregnancy are well understood, doctors have to explain the options available to patients. When a patient says no, the physician has to respect that decision and work with them to find another solution. It is also important to understand that many ART treatments involve genetic testing and intervention; most people would not know their child was conceived with medical assistance until they are born. In this scenario, even if the doctor informs that their child was conceived through ART, they still need to decide whether or not they want treatment (Leah, 2022). The ethics of ART are changing daily, we learn more about the risks and benefits of specific procedures every day, but there are some general principles here for everyone to follow. First of all, no one should be pressured into undergoing genetic testing without their knowledge and consent. The patient must be fully informed about all medical options before deciding. If they decide to undergo genetic testing and treatment, they will need to make sure that it is medically necessary.

A medical practice cannot ethically perform IVF, or other reproductive technologies, without the patient’s informed consent. The American Society for Reproductive Medicine (ASRM) ethics committee is charged with establishing ethical guidelines regarding the practice of assisted reproductive technology. The following principles should guide practitioners in their work to the best of their abilities:

1. Respect for autonomy: Clinicians must respect a patient’s autonomy in her reproductive decisions, including her choice to have an IVF cycle with donor eggs or embryo freezing and her choice of physician to assist in such decisions (Leah, 2022).
2. Respect for equality: Clinicians must ensure a non-discriminatory environment that treats all patients without regard to race, ethnicity, sexual orientation, gender identity or expression, religion or other factors that do not affect health and ability to provide informed consent.
3. Respect for integrity: Clinicians must ensure all participants are treated honestly, fairly and ethically in all matters related to assisted reproduction technologies. They must also help patients understand any limitations they may face due to such technology.

Significance of the Assisted Reproductive

Medically assisted reproduction (MARS) refers to medical techniques and drugs to assist a woman’s body in carrying a pregnancy to term. This includes IVF (in vitro fertilization), intracytoplasmic sperm injection (ICSI) and single embryo transfer (SET). In vitro fertilization is the most common form of MARS for women who cannot conceive naturally. It involves surgically removing eggs from the woman’s ovary, fertilizing them in vitro with a man’s sperm and then returning them to the woman’s uterus (Bartha, Rosario, Isasi, 2004 The process requires a few months of treatment. Intracytoplasmic sperm injection is an alternative method used when an egg cannot be retrieved from the ovary. The sperm is injected directly into the egg then placed back into the uterus for implantation.

Reproduction is a fundamental aspect of life. However, it is also a highly controversial one. People have been interested in creating new life since the dawn of humanity, but the debate over where to draw the line on reproductive technology has become increasingly divisive and contentious. The 2010 Supreme Court ruling in vitro fertilization (IVF) cases was pivotal in this debate. In that case, two women appealed to the high court after they were denied IVF treatment because they were not married, a requirement under state law (Passet-Wittig, and Bujard, 2021). The court ruled that such laws violate a woman’s right to use technology to improve fertility without government interference.

However, assisted reproduction has also come under criticism recently. The United States is one of the few countries that lacks a national policy regarding assisted reproductive technologies. In most countries, it’s illegal to use a sperm donor’s egg when women are infertile, but not in the US. Many couples struggle to conceive using their eggs, and some fertility clinics are making money by selling eggs and sperm to others who want to start families. Many reproductive clinics are not telling patients that they will be paying for their gametes and that they’ve agreed to participate in medical research on infertility (Akande, Dipeolu,  and Ajuwon, 2019). This means they can not fully understand the risks of using donated gametes or their chances of success. These practices are currently unregulated, which means patients do not know whether they consent to participate in research or the potential risks of doing so.

Conclusively, this paper has discussed the ethical issues in applying medically assisted reproduction and genetics. The reproductive technology and genetic engineering laws have changed significantly over the last five years, with legal issues becoming contentious. While many couples use reproductive technologies to achieve pregnancy, others choose not to use these technologies. The ethics of fertility treatments are a divisive issue, with some people believing that even if a treatment creates a child with disabilities, the child should be allowed to live. Others believe it is unethical and immoral to create children with life-altering conditions who may not survive adulthood.

References

Akande, S. O., Dipeolu, I. O., & Ajuwon, A. J. (2019). Attitude and willingness of infertile persons towards the uptake of assisted reproductive technologies in Ibadan, Nigeria. Annals of Ibadan postgraduate medicine, 17(1), 51-58.

Bartha M. Knoppers, Rosario M. Isasi, ( 2004), Human Reproduction, Volume 19, Issue 12, Pages 2695–2701

Harper JC;Aittomäki K;Borry P;Cornel MC;de Wert G;Dondorp W;Geraedts J;Gianaroli L;Ketterson K;Liebaers I;Lundin K;Mertes H;Morris M;Pennings G;Sermon K;Spits C;Soini S;van Montfoort APA;Veiga A;Vermeesch JR;Viville S;Macek M; ; (2022). Recent developments in genetics and medically-assisted reproduction: From research to clinical applications †‡. Human reproduction open. Retrieved February 4, 2022, from https://pubmed.ncbi.nlm.nih.gov/31486804/

Passet-Wittig, J., & Bujard, M. (2021). Medically assisted reproduction in developed countries: Overview and societal challenges. Research handbook on the sociology of the family

Leah Seigel. (2022). Americanbar.org. Retrieved February 4, 2022, from https://www.americanbar.org/groups/judicial/publications/appellate_issues/2019/winter/reproductive-genetics-ethics-and-the-law/