The article reviewed in this paper is ‘In vitro fertilization as a Medical Treatment for male or female Infertility’ published by Health Technology Advisory Committee (HTAC) in 2002. The paper was chosen because it comprehensively covers the subject of in vitro fertilization (IVF). In summary the paper looks at the history of the technology, the major approaches available, the outcomes, the success rate and the funding/ insurance policies on the same. In vitro fertilization is modern technology that is employed in the medical field as a remedy for infertility in either man or female. The message conveyed by the author is that although IVF may not cure infertility it affords infertile couples an opportunity to have children of their own. Other sources focus more on the IVF health risk to the child and the mother, the financing of IVF by insurers and the regulation of the technology. The main discrepancy is that while other sources focus on entrenching the debate surrounding IVF the article reviewed in this paper is mainly informative. Other sources agree with the article reviewed in this paper with regard to the technical aspects of IVF, the risks and benefits.
2.0 IVF Technologies
In standard IVF process, the woman is given human hormones to stimulate ovulation. This results in production of more than one egg and some eggs are removed using a thin needle directed by ultrasound or by a minor surgery to extract the eggs from the ovaries. Mature eggs are then selected under a microscope, mixed with sperms and incubated for 8. 2 to 3 healthy embryos are selected and then transferred to the woman’s uterus after 44-72 hours where it is implanted and grows to a fetus. Some of the embryos are usually frozen for use in case the first IVF attempt fails.
IVF can be achieved through micromanipulation. This can either be Intracytoplasmic Sperm Injection (ICSI) or assisted zona hatching. ICSI is employed in cases where either there is a low sperm count or the sperms are immotile or they are irregularly shaped. In this case, the sperms are injected into the egg by use of a microscope and micro tools. In zona assisted hatching, a small hole is made on the zona pellucida before the embryo is transferred into the uterus of the woman. This method is used if the woman’s egg has a thick zona layer or in older women or women who previously had an IVF and it turned out negative.
3.0 Risks and Ethical issues
IVF is associated with a number of risks. First and foremost, there are higher chances of multiple pregnancy due to the fact that more than one embryo is transferred into the uterus. This increases the risk of miscarriage and other complications. Secondly, women who have fallopian tube related infertility are at a higher risk of having ectopic pregnancy following an IVF. In addition, the use of human hormones to stimulate ovulation can result in hyper stimulation syndrome. In mild cases the ovaries become swollen and are painful while in severe case there is increased fluid in the body which can result in stroke, heart failure, kidney failure.
IVF has been a very controversial issue because of the many ethical, legal and medical issues raised. The main ethical concerns have to do with the screening of embryos for genetic disorders, the ownership and the control of frozen embryos, access to IVF (whether age, socioeconomic, lifestyle, medical condition and/or marital status should be considered in deciding the recipients of the technology) and insurance cover for IVF.
4.0 Personal position
I would support IVF for a fertile couple wishing to have a child of their own. This technology is particularly vital because there are cases where other infertility remedies such as surgical unblocking of the fallopian tubes, fertility drugs, and artificial insemination may fail or be impractical. Unlike the adoption option, the preference of those against IVF, IVF allows an infertile couple to extend their genetic line; which is important in many cultures. IVF allows infertile women to experience pregnancy and which has is vital for the formation of an early bond between the mother and the child and is not possible in adoption cases. However it is important to legally regulate the IVF technology so that it is not abused by science for instance be used as a means of harvesting stem cells. It should also be regulated to make it accessible to as many infertile couples wishing to have children of their own as possible. In other words it should be available at an affordable cost so that it is not just a solution for the rich.
Health Technology Advisory Committee (HTAC). (2002, May 23). In Vitro Fertilization As A Medical Treatment For Male or Female Infertility. pubmed , pp. 34-37.