Assisted Reproductive Technology
Approximately 11% of women in the United States between the ages of fifteen and forty-four have difficulty conceiving a child due to the infertility of one or both of the partners. Many of these couples turn to assisted reproductive technology as a potential way to help them have a child. Reproductive technology is the use of medical techniques to enhance fertility and increase the probability of conceiving a child. Methods of reproductive technology include artificial insemination, gamete intrafallopian transfer (GIFT), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), surrogacy, and zygote intrafallopian transfer (ZIFT). Although these technologies offer hope, they also are expensive, can cause psychological harm, and are often not successful. Feminists in particular are concerned about the social and psychological ramifications of assisted reproductive technology on women, and see their use as a way to reinforce traditional gender roles and expectations and for women to give up their power and control over their own bodies. More research is needed to better understand the psychosocial effects of assisted reproductive technologies on infertile couples in general and women in particular.
Keywords Artificial Insemination; Cloning; Ethics; Feminism; Gamete Intrafallopian Transfer (GIFT); Gender Role; Gender Stratification; Genetic Engineering; Intracytoplasmic Sperm Injection (ICSI); In Vitro Fertilization (IVF); Infertility; Reproductive Technology; Society; Surrogate Mother; Zygote Intrafallopian Transfer (ZIFT)
Infertility is the inability to get pregnant after trying for one year. It has been estimated that approximately 11% of women in the United States have difficulty conceiving a child. According to the Centers for Disease Control and Prevention, in 2013, approximately 6 percent of married women between the ages of fifteen and forty-four in the United States are unable to get pregnant after a year of unprotected sex. Previously, this usually meant that the couple would continue to try by natural means to have a child or make the decision to adopt or remain childless. However, medical science has advanced to the point where a number of technologies are available that can help women conceive. These assisted reproductive technologies comprise the use of medical techniques to enhance fertility and increase the probability of conceiving a child. Methods of reproductive technology include artificial insemination, gamete intrafallopian transfer (GIFT), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), surrogacy, and zygote intrafallopian transfer (ZIFT). The use of assisted reproductive technology becomes increasingly important as greater numbers of women postpone childbearing.
Two of the most widely known methods of assisted reproductive technology are artificial insemination and in vitro fertilization. Artificial insemination is a medical or surgical procedure in which a catheter is used to deposit sperm collected from a donor directly into the uterus of the woman trying to become pregnant. As with unassisted reproduction, artificial insemination often needs to be repeated before pregnancy occurs. In vitro fertilization, on the other hand, is a laboratory procedure in which an egg is removed from a woman's body, fertilized with donated sperm, and transferred to the woman's uterus to begin pregnancy. The externally fertilized egg does not need to be transplanted immediately, but may also be cryogenically frozen for future use. In vitro fertilization literally means fertilization that takes place "in glass" (i.e., a Petri dish) as opposed to in vivo fertilization that takes place in a live organism. In vitro fertilization is often combined with drug therapy to increase the probability of the woman conceiving. Zygote intrafallopian transfer is an in vitro fertilization technique in which the egg and sperm are combined in a laboratory and the fertilized eggs (i.e., zygotes) are implanted into the woman's fallopian tubes. Gamete intrafallopian transfer is an artificial reproductive technique in which eggs and sperm are directly injected into a woman's fallopian tubes. Gamete intrafallopian transfer is an alternative to in vitro fertilization. In vitro fertilization can also be used to create a baby that is gestated by a surrogate mother. This is a woman who fulfills the basic functions of a biological mother in gestating and bearing a child, but not the social role of mother in rearing the child after birth. In particular, a surrogate mother is a woman who gestates an artificially inseminated egg and gives birth to a baby for another.
In vitro fertilization In vitro fertilization increases the probability of multiple births. For example, between the years of 1980 and 1998, the rate of triples or larger multiples increased 420% (Schaefer, 2002). In 2011the twin birth rate was 8.1 percent; the rate for triplets or a higher-order multiple birth rate was 137 per 100,000. Although some couples readily embrace the idea of multiple births, not all do and not all are financially able to support and raise the potentially large multiples of children that can result from in vitro fertilization. Despite the old adage that two can live as cheaply as one, multiple babies require similar multiples for food, clothing, health care, education, and other needs. In addition, in vitro fertilization itself is a costly and time consuming process. In 2012, according to the American Society for Reproductive Medicine, it was estimated that the cost of in vitro fertilization is approximately $12,400 per procedure without any guarantee of success. This makes in vitro fertilization an option only for those who can afford the costs. Conflict theorists in particular note that women in lower economic strata are unable to afford these treatments although they are typically allowed access to low cost contraception.
Fertilizing an egg with a sperm is not the only type of reproductive technology, however. Advances in cloning technologies and genetic engineering may offer those wishing to have children other options in the near future. Cloning is the process of making a genetically identical copy (i.e., a clone). When applied to human beings for the purposes of creating a new human being, cloning is typically referred to as human cloning or human reproductive cloning. Human cloning is of great ethical concern to most observers. According to the American Medical Association, cloning may someday be a viable reproductive technology requiring minimal genetic input from another person (AMA, 1999). However, at this time the techniques used in human cloning could potentially endanger the developing fetus. Somatic cell nuclear transfer has not been refined nor yet proven to be safe in the long term. In addition, it is expected that there would be a high miscarriage rate from the transplantation of cloned fetuses. Further, the state of the art in cloning technology is such that the risk of developmental anomalies precludes the use of cloning as a reproductive technology at this time. However, even if all the technological difficulties are resolved, human cloning is thought to be potentially harmful to individuals from a psychosocial perspective. There are thirteen US states—Arkansas, California, Connecticut, Iowa, Indiana, Massachusetts, Maryland, Michigan, North Dakota, New Jersey, Rhode Island, South Dakota, and Virginia—that have bans on reproductive cloning.
Another technology that shows promise for use in assisted reproduction in the future is genetic engineering. This comprises a set of techniques by which the genetic contents of living cells are directly and intentionally altered. Genetic engineering can be used to modify existing genes or to introduce new material from another organism. Genetic engineering is used for a number of purposes, including attempts to modify defective human cells in an effort to treat certain genetic diseases. Many observers have serious ethical concerns about genetic engineering in general, and with the application of genetic engineering to humans in particular. For example, the use of genetic technology could potentially lead to the creation of "designer babies" which have been genetically manipulated to have higher IQs or various other desired physical or personality traits. This could lead to increasing disparity between the upper and lower classes, a situation of questionable ethics.
Infertility is considered by most observers to constitute a major life crisis. The question, however, is why this is so. Although in the recent past, many in the medical community believed infertility to be a psychological problem in most cases, today it is believed that infertility stems from physiological causes. As such, infertility has been medicalized, as has many routine situations experienced by women: dysmenorrheal (painful menstruation), premenstrual syndrome, pregnancy, and childbirth. Although on the one hand this means that pain may be controlled and the health and safety of both mother and child better ensured during gestation, labor, and delivery, on the other hand, many feminist theorists dislike this trend, believing that it views...
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