Archive for In Vitro Fertilization (IVF)
A leading British immunologist has warned that many fertility clinics are offering women an unnecessary, potentially dangerous and possibly counterproductive treatment. Ashley Moffett, of the University of Cambridge, says that many clinics administer steroids or intravenous immunoglobulin to lower the level of uterine natural killer cells — despite the fact that there is scant evidence that this will increase fertility.”This has somehow slipped through the net of any regulation,” Dr Moffett told Nature Medicine. “It is bizarre that women who may be in early pregnancy are exposed to this sort of risk.” Immunoglobulin has a number of potential side effects, including kidney failure and hepatitis. The UK’s fertility regulator only deals with the creation and handling of embryos, not drug regimes for fertility patients.
“The get-out clause is that [doctors] discuss it with their patient,” says Raj Rai, of Imperial College London. “But this is disingenuous, because how is a patient supposed to decide?” ~ Nature Medicine, June 07
Glowing newspaper profiles of IVF doctors who bring bundles of joy to desperate couples are common enough in the US, the UK and Australia. But it is seldom that they emphasise how often the doctor consults the Bible for guidance. Recently, the Kampala Monitor profiled Dr Edward Tamale Ssali, who practices in Bukoto, in southern Uganda. He is responsible for the first birth of a frozen embryo baby and the first birth to a surrogate mother in East and Central Africa. A devout Christian, he rises every day at 5am and reads his Bible. He also hosts a TV program, Faith and Science, on Sundays. “I would be earning a lot overseas but I decided to station here,” he told the Monitor. “There is more to life than money. The Bible says that the life of a man doesn’t consist in the things that he owns.” ~ Monitor, Jun 3
There are many couples who do not want to have a baby with Down syndrome,” said Deborah A. Driscoll, of the University of Pennsylvania, an author of the recommendations. “They don’t have the resources, don’t have the emotional stamina, don’t have the family support. We are recommending this testing be offered so that parents have a choice.”
But as the Times points out, doctors often paint too gloomy a picture. “She may be able to count change for the bus,” one doctor told a pregnant Delaware woman. “But what’s going to happen when the bus doesn’t come?” Her Down syndrome daughter, now 5, does not yet take the bus, but she does ride horses. ~ New York Times, May 9
Genetic testing is shaking the mindset even of abortion advocates, says the New York Times. Although 70% of Americans would support women who terminate a pregnancy if a child has a serious genetic defect, all but the staunchest supporters of pro-choice policies question whether any defect whatsoever is reason enough. The problem is that the pro-choice stand is colliding with a commitment to tolerance of human difference. And now that tests make it possible to select for late-onset diseases like breast cancer or arthritis, and may some day make it possible to select for intelligence or eye colour — not to mention sex — pro-choice disability advocates are finding hard to draw the line.”It so buys into this consumer perspective on our children,” says Marsha Saxton, of the World Institute on Disability, in Oakland, an abortion-rights supporter.
Some religious conservatives say that they trust God to give them the child that is meant to be,” wrote Ann Althouse, a law lecturer at the University of Wisconsin, on her legal blog. “But isn’t there something equivalent for social liberals? Shouldn’t they have moral standards about what reasons are acceptable for an abortion?” ~ New York Times, May 13
The average payment in the US for egg donation was US$4,217, according to a recent article in the journal Fertility and Sterility. However, at least one centre told the authors that it paid $15,000 for eggs and stories abound of college students being paid tens of thousands of dollars. The American Society of Reproductive Medicine has set guidelines which stipulate that payments of $5,000 or more “require justification” and that payments over $10,000 are not appropriate.
No one is comfortable with payments for eggs, an invasive and uncomfortable process at best, and painful and dangerous at worst. Little research has been done on the long-term effects of fertility drugs.
Bioethicists also worry whether the allure of dollars to cover college fees or credit card bills might cloud young women’s judgement. “We hear about egg donors being paid enormous amounts of money, $50,000 or $60,000,” Josephine Johnston, of The Hastings Center told the New York Times. “How much is that person actually giving informed consent about the medical procedure and really listening and thinking as it’s being described and its risks are explained?”
The problem is that without compensation, women are unlikely to donate eggs, either for fertility treatment or for research. “I just completed an outreach initiative to 21 institutions across the state that we’ve funded,” Dr Geoffrey Lomax, of the Institute of Medicine, said. “No one has had an egg donated specifically for research.” ~ New York Times, May 15
Opponents were scathing. Josephine Quintavalle, of the lobby group Comment on Reproductive Ethics, said bluntly: “It is appalling that the government has bowed to pressure from the random collection of self-interested scientists and change its prohibitive stance. This is a highly controversial and terrifying proposal, which has little justification in science and even less in ethics. Endorsement by the UK government will elicit horror in Europe and right across the wider world.”
The possibility of creating hybrid embryos was just one amongst many proposals which would have seemed radical when the 1991 decision was first made to permit embryo research and establish the Human Fertilisation and Embryology Authority. These include:
* A child can be created without a legal father, but two legal mothers. Children do not necessarily need a father in IVF procedures.
* Embryos can be screened for serious medical conditions.
* Eggs or sperm can be removed from incompetent persons without their consent.
* Not-for-profit surrogacy agencies will be able to charge reasonable expenses for organising surrogate mothers.
Although the list of procedures which the government proposes to legalise and regulate is long, a few are explicitly banned. Sex selection is still on the black list, as are artificial gametes, genetic modification of IVF embryos and deliberately selecting a disease or disorder (such as deaf parents choosing to have a deaf child). ~ BBC, May 17; Guardian, May 17