L16 Ethical issues in ​Assisted Reproductive Technology​

Ethical concerns: In [blank_start]vitro[blank_end] fertilisation Argument from conjugal meaning;​ Identity concerns; ​ Feminist arguments; ​ Safety​ - Privately funded​, Relied on animal experiments ​(no [blank_start]primate[blank_end] research conducted​). No research protocol​. Safety studies only in last [blank_start]2 and a half[blank_end] decades.​

Spectrum of moral views​ of an embryo: 1. Full moral status at [blank_start]fertilisation[blank_end]: ​equal human being. 2. Gradualist approach​: Moral status [blank_start]increases[blank_end] as the embryo develops​. Limits imposed ([blank_start]14[blank_end] day limit on development NZ)​ 3. No moral status

NZ statistics; Infertility: ​ - attempt to conceive for > [blank_start]12[blank_end] months, and/or need [blank_start]medical assistance ​[blank_end] - common amongst women [blank_start]25-50[blank_end] in Otago/Southland​ - 1 in 4 women reported infertility (cf [blank_start]1:6[blank_end] in high income countries)​ - Over [blank_start]two-third[blank_end] of infertile women sought medical help to conceive​ - Risk factors about equal for the sexes. Increasing [blank_start]age[blank_end], very underweight or obese, STI ([blank_start]chlamydia[blank_end])​.

Male causes of infertility: ([blank_start]30[blank_end]% of infertilities)​ Problems with [blank_start]sperm[blank_end] production / transport​ Female causes of infertility: Blocked [blank_start]fallopian[blank_end] tubes​ [blank_start]Ovulation[blank_end] problems​ Presence of seminal [blank_start]antibodies[blank_end] ​ [blank_start]Endometriosis[blank_end]​ Unexplained​

Publicly funded treatment priority is ranked by Clinical Priority Access Criteria. Allocated points​: Objective criteria​ - [blank_start]duration[blank_end] of infertility; number of [blank_start]children[blank_end]; [blank_start]sterilization[blank_end] status;​ Social criteria -​ diagnosis; ​ [blank_start]female[blank_end] age. ​Scores above [blank_start]65[blank_end] ‘eligible’ for public treatment - waiting list​. To be accepted for public treatment - must be >[blank_start]40[blank_end], non-smoker ([blank_start]3[blank_end] months), BMI <[blank_start]32[blank_end]​.

What if there's risk of serious genetic disease?​ - Remain childless​ - Adoption​ - [blank_start]Donor[blank_end] sperm/eggs​ - Preimplantation Genetic Diagnosis: IVF​ with a [blank_start]biopsy[blank_end] – remove cells from embryo​ to test ([blank_start]single[blank_end] gene disorders, X or Y [blank_start]chromosome[blank_end] related disease). Select healthy embryos for transfer​. Risk from embryo biopsy: [blank_start]same[blank_end] as IVF/ICSI​. Approx $14,000 NZD​.

Objections to PGD in general​ [blank_start]Moral[blank_end] status of the embryo;​ Unnaturalness / Playing God arguments;​ Revival of [blank_start]Eugenics[blank_end];​ [blank_start]Disability rights[blank_end] arguments: encourages negative attitudes towards disabled​.