Reproductive Reproductive TechnologiesTechnologies

James G. Anderson, Ph.D.James G. Anderson, Ph.D.

Purdue UniversityPurdue University

DefinitionDefinition• Assisted reproductive technology

(ART) procedures include fertility treatment in which both eggs and sperm are handled in the laboratory, (i.e., in vitro fertilization and related procedures)

GlossaryGlossary• Artificial Insemination (AI) - Introduction

of sperm into the uterus through ways other than sexual intercourse

• In vitro Fertilization (IVF) - Fertilization of the egg outside of the body in a laboratory dish

• Surrogate Mother - A woman who conceives and/or bears a baby for another

GlossaryGlossary• Gamete Intrafallopian Transfer (GIFT)

- Gamates (egg or sperm) are injected directly into a woman’s fallopian tubes

• Zygote Intrafallopian Transfer (ZIFT) - Zygotes (fertilized egg) resulting from IVF are introduced directly into the fallopian tubes

GlossaryGlossary

• Intrauterine Insemination (IUI) – Introducing sperm directly into the uterus

• Intracytoplasmic Sperm Injection (ICSI) - A single sperm is injected directly into the center of an egg

• Human Cloning - A cell from a person is injected into a donor’s egg whose nucleus and DNA have been removed

The Baby Making Industry The Baby Making Industry 20012001

• 5.3 million infertile couples

• 421+ fertility clinics

• 107,587 ART cycles

• 29, 344 live birth deliveries in 2001

• 40,687 live babies

• 1 % U.S. infants born in 2001 used assisted reproduced technologies

ART ProceduresART ProceduresPatient’s eggs

Fresh 75%

Thawed 13.7%

Donor Eggs

Fresh 8.0%

Thawed 3.2%

Outcomes of ART 2001Outcomes of ART 2001No. of ART procedures 107,587

No. of transfer procedures

89,239

No. of pregnancies 35,726

No. of live birth deliveries

29,344

No. of infants born 40,687

Ratio of ART procedures per population (million)

371.1

RegulationRegulation• 1979 Government ban on federally

funded embryo research• 1992 Fertility Clinic Success Rate and

Certification Act• 1995 Law enacted that requires clinics

to maintain standardized records of all procedures

• Seven states have mandated insurance coverage

• Many states regulate surrogate contracts

Proposed RegulationsProposed Regulations• Mandate insurance coverage• Restrict the use of reproductive

technologies to married couples• Restrict the use of reproductive

technologies to infertile couples• Require couples to sign a form that

declares them the legal parents upon birth

Proposed RegulationsProposed Regulations• Legislate procedures for disposal of

discarded embryos• Sperm banks would be required to keep

records linking donors and recipients, and to screen donors for infectious diseases

• Prohibit egg donations to women over 50

Social IssuesSocial Issues• Medicalization• Parentage• Regulation of Clinics• Insurance coverage• Disposal of frozen embryos• Eugenics• Cloning• Unregulated industry

IssuesIssues• Clinics• Disclosure • Donor/patient selection• Informed Consent• Record Keeping• Legal rights/obligations of

participants

IssuesIssues• Eugenics• Multiple births• Selective reduction of embryos• Disposition of frozen unused embryos

• Child’s right to know about genetic

parents