In+Vitro+Fertilization

Elizabeth Tucci In Vitro Fertilization

**What is In Vitro Fertilization** In vitro fertilization is an assisted reproductive technology in which the fertilization of a female’s egg by a sperm is conducted from scientific, laboratorial processes outside of the human body. The first baby born of in vitro fertilization occurred on January 25, 1978. The developer of the technique, Dr. Robert Edwards of Cambridge University, England, was awarded the 2010 Nobel Prize in medicine (Ravilious, 2010). There are many steps in the process of successfully producing an embryo, called the IVF treatment cycle (Jeffries, 2008). The first step, according to Jeffries (2008), is “ovarian stimulation”. In this step, the woman must create more eggs per menstrual cycle. This is achieved through the use of hormones, or fertility drugs, prescribed by a physician who monitors the egg production and determines the time the woman’s eggs should be retrieved. The next step in the process is the surgical egg removal from the woman’s body. Once removed, sperm must be prepared for the insemination step, while the physician must determine and select which eggs have the greatest potential for fertilization. The sperm and eggs are then combined in an incubator. The cycle continues when the sperm fertilizes the egg and the growth and development are observed. Finally the embryo(s) are implanted into the female’s uterus (Jeffries, 2008). A pregnancy test will typically be taken two weeks after the procedure (Nihira, 2009). The cost of in vitro fertilization varies, but is on average $12,000 (Jeffries, 2008). **Embryo Freezing** If a woman or couple chooses, they may freeze the embryos that were not used in the first treatment ( Nihira, 2009 ). If the treatment is unsuccessful, this allows for the ability to implant the frozen embryos rather than going through the entire process again. If the treatment is successful, this poses a problem of what to do with any unused embryos. Some options include donating to another couple or destroying them (Nihira, 2009). **Reasons for In Vitro Fertilization** In vitro fertilization allows infertile couples to have the chance to reproduce (Ponnuru, 2009). Infertility can have various causes such as endometriosis, damage or issues with female reproductive organs, and problems with ovulation (Nihira, 2009). In addition, according to Kelley (2005), “up to 50% of infertility can be attributed to men”. This can be due to the amount of sperm a male has or “the inability of sperm to penetrate or survive in the cervical mucus” (Nihira, 2009). Another cause for infertility, and reason for women to seek out in vitro fertilization, is illness and disease, such as cancer. Shear (2010) reports that treatments for cancer, such as radiation and chemotherapy, negatively affect both the quality and quantity of a woman’s eggs. Women with cancer who want to be able to have a family may be informed of in vitro fertilization as a suggestion from their doctor. **Concerns** Success rates for in vitro fertilization are not high. According to Nihira (2009), the 2007 CDC reported pregnancy achievement in 32% of all IVF cycles, and live births in 25.6% of all cycles. Since fertility in women decreases with age, the chances of in vitro fertilization being successful also decreases with the increase in a female’s age. For instance, women over 40 years old have a very small, 11.5%, chance of giving birth from in vitro treatment (Nihira, 2009). In vitro fertilization also causes stress for patients and couples. It stems from the stress that first builds due to the reason for undergoing in vitro fertilization, infertility. According to Alice Domar, health psychologist and director of the Mind/Body Program for Infertility at Beth Israel Deaconess Medical Center, Harvard Medical School, “it affects their relationship with their husbands because men and women don’t respond to infertility in the same way” (Haworth, n.d.). The frustration of being infertile while others are fertile can affect the couple as well as their outside relationships, while the pressure of becoming pregnant and determining when the best time to try can also affect the couple’s sex life (Haworth, n.d.). Once the decision to pursue in vitro fertilization is made, more stressors arise. According to research by Boivin and Lancastle (2010), the process of treatment and waiting for results “has all the elements associated with appraising a situation as stressful (i.e. uncontrollable, unpredictable and potentially negative)”. The Boivin and Lancastle (2010) study also found that frustration and distressing emotions intensified for women near their outcome dates. **Controversy** The Catholic Church has been vocal in its opposition of in vitro fertilization. Goodstein and Povoledo (2008) reported that in 2008 the Vatican released “Dignitas Personae”, “The Dignity of the Person”, a document explaining its stance on biomedical issues, including in vitro fertilization. It is their belief that human reproduction should only occur through a married couple’s sexual interactions, not in a laboratory. Obstetrician and gynecologist Kathleen M. Raviele, president of the Catholic Medical Association explains, “what in vitro does, is it separates the creation of a child from the marital act” (Goodstein & Povoledo, 2008). According to Ponnuru (2009), the Catholic Church also sees in vitro fertilization as a way of removing the value of children as a gift. The Church is also opposed to frozen embryos. Goodstein and Povoledo (2008) report that “it raises the problem of what to do with frozen embryos that are not implanted”. In vitro fertilization has led to embryo selection by parents for certain genetic traits or to achieve a desired gender, also known as creating “designer babies”, which many find unethical (Ponnuru, 2009). These concerns bring uncertainty to Catholics and non-Catholics alike, questioning their personal moral stance on the issue in relation to their personal struggle with infertility. **Octomom** A famous story of in vitro fertilization that received a multitude of media coverage because of its controversy is that of California woman, Nadya Suleman, known as “octomom”. Suleman gave birth to octuplets in January 2009 through in vitro treatment, but had already had six children (Celizic, 2009). Not only does her number of children give question to the reasoning behind treating this woman, but she was also single, unemployed, and living in her parents’ under foreclosure home (Bates, 2009). Suleman’s previous six children were also conceived through in vitro fertilization at the same clinic that planted the embryos that resulted in her octuplets (Celizic, 2009). The Medical Board of California declared an investigation of the case, and the president of The Pacific Coast Reproductive Society wrote, “In response to the birth of the octuplets, we should punish the rogue physician who completely ignored established standards of care in the field of reproductive medicine” (Bates, 2009). This case brought attention to the morally difficult question of who should be a mom that physicians struggle to determine when faced with their potential in vitro fertilization patients (Bates, 2009). **References** Bates, B. (2009). Octuplet births raise ethical dilemmas in IVF. //OB GYN News//, 44, 9. p.14(1). Retrieved April 10, 2011, from Academic OneFile via Gale:  http://find.galegroup.com.proxy2.library.illinois.edu/gtx/start.do?prodId=AONE&userGroupName=uiuc_uc Boivin, J., & Lancastle, D. (2010). Medical waiting periods: imminence, emotions and coping. //Women's Health//, 6, 1. p.59(11). Retrieved April 09, 2011, from Academic OneFile via Gale:  http://find.galegroup.com/gtx/start.do?prodId=AONE&userGroupName=uiuc_uc Celizic, M. (2009, February 6). Octuplet mom defends ‘unconventional’ choices - Parenting - TODAY.com.//TODAY.com//. Retrieved April 10, 2011, from http://today.msnbc.msn.com/id/29038814/ns/today-parenting/ Goodstein, L., & Povoledo, E. (2008, December 13). Vatican Issues Sweeping Bioethics Document. //The New York Times//, 158, 54523. <span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">p.A6(L). Retrieved April 09, 2011, from Academic OneFile via Gale:  <span style="font-family: 'Times New Roman',serif; font-size: 16px; line-height: 32px;">http://find.galegroup.com/gtx/start.do?prodId=AONE&userGroupName=uiuc_uc Haworth, A. (n.d.). Infertility Tests Every Aspect of a Couple's Life. // WebMD //. Retrieved April 09, 2011, from http://www.webmd.com/infertility-and-reproduction/features/infertility-tests-couples-life //<span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">In vitro fertilization //<span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">[Photograph]. Retrieved from http://www.sciencephoto.com/images/imagePopUpDetails.html?pop=1&id=778020233&pviewid=&country=56&search=icsi&matchtype=EXACT Jeffries, M. (2008, February 1). Discovery Health "How In Vitro Fertilization Works". // Discovery Health "Health Guides" //. Retrieved April 09, 2011, from http://health.howstuffworks.com/pregnancy-and-parenting/pregnancy/fertility/in-vitro-fertilization.htm <span style="font-family: 'Times New Roman',serif; font-size: 16px; line-height: 32px;">Kelley, R. (2005, July 4). Health: Going Straight for IVF. //Newsweek//, p.55. Retrieved April 10, 2011, from Academic OneFile via Gale: http://find.galegroup.com.proxy2.library.illinois.edu/gtx/start.do?prodId=AONE&userGroupName=uiuc_uc Nihira, M. (2009, September 21). In Vitro Fertilization (IVF) Treatment for Infertility. //WebMD//. Retrieved April 09, 2011, from http://www.webmd.com/infertility-and-reproduction/guide/in-vitro-fertilization?page=2 <span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">Ponnuru, R. (2009, April 6). Out of the freezer: at last, some questions on in vitro fertilization. //National Review//, 61, <span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">6. <span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">p.36. Retrieved April 09, 2011, from Academic OneFile via Gale:  <span style="font-family: 'Times New Roman',serif; font-size: 16px; line-height: 32px;">http://find.galegroup.com/gtx/start.do?prodId=AONE&userGroupName=uiuc_uc Ravilious, K. (2010, October 4). Nobel Prize in Medicine Awarded for In Vitro Fertilization. // National Geographic News //. Retrieved April 09, 2011, from http://news.nationalgeographic.com/news/2010/10/101004-nobel-prize-medicine-ivf-science-health/ <span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">Shear, A. (2010). Fertility preservation: an option for women with cancer?. //Clinical Journal of Oncology Nursing//, 14, <span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">2. <span style="font-family: 'Times New Roman',serif; font-size: 12pt; line-height: 200%;">p.240(3). Retrieved April 09, 2011, from Academic OneFile via Gale:  <span style="font-family: 'Times New Roman',serif; font-size: 16px; line-height: 32px;">http://find.galegroup.com/gtx/start.do?prodId=AONE&userGroupName=uiuc_uc