IVF and Surrogacy

Editor: Justin Healey ISBN 978 1 920801 18 2 Year 2004 Price: $19.95		IVF and Surrogacy Volume 209, Issues in Society Ironically, while Australia’s birth rate has decreased, demand for reproductive medical techniques such as in vitro fertilisation has increased. However the recent advances in fertility treatment have raised not only the chances of successful assisted conception, but also the number of ethically complex issues including: genetic screening, the use of excess IVF embryos for stem cell research and possible human cloning, embryo adoption and destruction, designer babies, sex selection, same-sex parenting, even the birth of children by deceased fathers. The process of surrogacy is another option which has raised ‘fertile’ debate. This book provides a fascinating overview on how the human desire to reproduce has also given birth to new ethical dilemmas. Chapter 1 Assisted Conception in Australia Assisted conception treatment; Reproductive technology – legislation around Australia; Infertility and reproductive technology; About infertility; Treatments for infertility; IVF procedures; Misconception. Chapter 2 IVF – Attitudes and Ethical Issues Community attitudes to assisted reproductive technology; Do we tell our children about their method of conception?; Children of a lesser dad; The new egg donor trend: meet and greet before wading in the gene pool; No fatherhood from grave: judge; Making parents of the dead; Sex selection; ‘Designer’ baby goes ahead; Church warns of designed children; The human fertility industry: creating and destroying human life for profit? Chapter 3 Surrogacy Issues Surrogacy – a look at the issues; Surrogacy: born for another; Some arguments for and against surrogacy; No deal on export embryos; Father figures: gay men go overseas for surrogate babies; Gran surrogate for daughter. Glossary; Facts and Figures; Additional Resources; Index

		FAST FACTS from this volume
In the 10-year period 1992-2001, the total number of treatment cycles (oocyte retrievals and embryo transfers) for all types of assisted conception has increased by 76.8% from 16,288 in 1992 to 28,797 in 2001. The largest increase of 158.3% was in transfers of frozen embryos, compared to 49.0% for fresh transfers. In 2001, one in five transfer cycles achieved a viable pregnancy (a pregnancy of at least 20 weeks gestation). The viable pregnancy rate (per 100 transfer cycles) has increased from 13.0% in 1992 to 20.6% in 2001, an increase of 58.5%. In 2001, there were 11,338 IVF transfer cycles. The overall viable pregnancy rate (per 100 transfer cycles) of IVF treatment method increased from 9.4% in 1992 to 20.8% in 2001. This reflects an average increase of 9.3% per year. In 2001, there were 13,836 ICSI transfer cycles. The overall viable pregnancy rate (per 100 transfer cycles) for ICSI treatment method has increased from 17.4% in 1996 to 25.9% in 2001. From 1991 to 2000 there were a total of 11,417 ICSI pregnancies including other microinsemination techniques such as SUZI. There were 10,855 ICSI infants born in this period. In 2000, there were 2,640 ICSI pregnancies, resulting in the birth of 2,548 infants. The number of transfer cycles using the GIFT method decreased from 3,757 cycles in 1992 to 341 in 2001. The decline in the use of GIFT by many IVF units during the last 10 years is likely due to the increased acceptability and success rates of other assisted conception methods. From 1991 to 2000 the GIFT method produced a total of 6,717 pregnancies. There were 6,584 GIFT infants born in this period. In 2000, 235 pregnancies resulted from GIFT treatment and 225 infants were born. In 2001 there were 2,181 transfer cycles using blastocyst embryos. The viable pregnancy rate (per 100 transfer cycles) for this technique increased from 17.5% in 1998 to 31.4% in 2001. Between 1996 and 2000 a total of 369 pregnancies using blastocysts were reported with 358 infants delivered. In 2000, there were 173 pregnancies and 125 births from using blastocyst embryos. This resulted in 161 infants, which included 38 sets of multiples. In 2001 there were 10,705 transfer cycles using frozen embryos, a 158.3% increase from 1992 (4,144 frozen embryo transfer cycles). The viable pregnancy rate (per 100 frozen transfer cycles) has steadily improved over the past 10 years. It ranged from 9.8% in 1992 to 15.0% in 2001. Between 1991 and 2000, there were 10,162 frozen embryo pregnancies delivering 8,895 infants. In 2000 there were 1,729 frozen embryo pregnancies and 1,345 births. This resulted in 1,556 infants, including 203 sets of multiples. The total number of embryos in storage continued to rise in 2001. The trend of the number of embryos frozen exceeding the number thawed continued. In 2001, 46,835 embryos were frozen and 31,194 stored frozen embryos were thawed. Of these thawed embryos, 18,777 were used in transfer cycles. As of 31 December, 2001, 38 IVF units had reported 81,627 frozen embryos in storage. In 2001 a total of 11,393 cycles of artificial insemination were performed in IVF and GIFT units. Insemination with partner’s sperm accounted for two-thirds (66.5%) of all artificial inseminations. In 2001, the viable pregnancy rate (per 100 treatment cycles) was 7.2% with partner’s sperm and 7.7% with donor sperm. Women’s age is a major factor in conception. The older a woman is the less chance she has of conceiving naturally. The delay in childbearing in Australia has been mirrored by an increasing trend of women aged 35 years or older entering the IVF program. In 2000, of all pregnant women after assisted conception treatment, more than one woman in nine (11.2%) was 40 years or older and one in three (34.5%) was 35 to 39 years. The likelihood of achieving a live birth after assisted conception decreases as a woman’s age advances. Women aged 40 years and older had the lowest livebirth pregnancy rate of 61.4% in 2000. Until 20 years ago, there were only two remedies available for infertile couples: remaining childless or adopting a baby. Whilst remaining childless is a legitimate choice made by a number of couples, many men and women experience a strong desire to have a child. The inability to have a child can be devastating and involve a lengthy process of loss and grief. In about 40% of infertile couples, the problem of infertility is a male factor, in about 40% it is a female one, and for the remaining 20% it is a joint problem, or the cause is unknown (‘idiopathic’). The causes of infertility are many and varied. They include problems with the production of sperm or eggs, with the fallopian tubes or the uterus, endometriosis, frequent miscarriage, as well as hormonal and autoimmune (antibody) disorders in both men and women. Surrogacy can be seen as an alternative form of reproductive technology that can assist infertile couples. However, many people argue that it is difficult to compare surrogacy with other reproductive methods, as the surrogate mother is undergoing all the emotional, mental and physical feelings of pregnancy, not simply donating an ovum.

In the 10-year period 1992-2001, the total number of treatment cycles (oocyte retrievals and embryo transfers) for all types of assisted conception has increased by 76.8% from 16,288 in 1992 to 28,797 in 2001. The largest increase of 158.3% was in transfers of frozen embryos, compared to 49.0% for fresh transfers.
In 2001, one in five transfer cycles achieved a viable pregnancy (a pregnancy of at least 20 weeks gestation). The viable pregnancy rate (per 100 transfer cycles) has increased from 13.0% in 1992 to 20.6% in 2001, an increase of 58.5%.
In 2001, there were 11,338 IVF transfer cycles. The overall viable pregnancy rate (per 100 transfer cycles) of IVF treatment method increased from 9.4% in 1992 to 20.8% in 2001. This reflects an average increase of 9.3% per year.
In 2001, there were 13,836 ICSI transfer cycles. The overall viable pregnancy rate (per 100 transfer cycles) for ICSI treatment method has increased from 17.4% in 1996 to 25.9% in 2001.
From 1991 to 2000 there were a total of 11,417 ICSI pregnancies including other microinsemination techniques such as SUZI. There were 10,855 ICSI infants born in this period. In 2000, there were 2,640 ICSI pregnancies, resulting in the birth of 2,548 infants.
The number of transfer cycles using the GIFT method decreased from 3,757 cycles in 1992 to 341 in 2001. The decline in the use of GIFT by many IVF units during the last 10 years is likely due to the increased acceptability and success rates of other assisted conception methods.
From 1991 to 2000 the GIFT method produced a total of 6,717 pregnancies. There were 6,584 GIFT infants born in this period. In 2000, 235 pregnancies resulted from GIFT treatment and 225 infants were born.
In 2001 there were 2,181 transfer cycles using blastocyst embryos. The viable pregnancy rate (per 100 transfer cycles) for this technique increased from 17.5% in 1998 to 31.4% in 2001.
Between 1996 and 2000 a total of 369 pregnancies using blastocysts were reported with 358 infants delivered. In 2000, there were 173 pregnancies and 125 births from using blastocyst embryos. This resulted in 161 infants, which included 38 sets of multiples.
In 2001 there were 10,705 transfer cycles using frozen embryos, a 158.3% increase from 1992 (4,144 frozen embryo transfer cycles). The viable pregnancy rate (per 100 frozen transfer cycles) has steadily improved over the past 10 years. It ranged from 9.8% in 1992 to 15.0% in 2001.
Between 1991 and 2000, there were 10,162 frozen embryo pregnancies delivering 8,895 infants. In 2000 there were 1,729 frozen embryo pregnancies and 1,345 births. This resulted in 1,556 infants, including 203 sets of multiples.
The total number of embryos in storage continued to rise in 2001. The trend of the number of embryos frozen exceeding the number thawed continued. In 2001, 46,835 embryos were frozen and 31,194 stored frozen embryos were thawed. Of these thawed embryos, 18,777 were used in transfer cycles. As of 31 December, 2001, 38 IVF units had reported 81,627 frozen embryos in storage.
In 2001 a total of 11,393 cycles of artificial insemination were performed in IVF and GIFT units. Insemination with partner’s sperm accounted for two-thirds (66.5%) of all artificial inseminations. In 2001, the viable pregnancy rate (per 100 treatment cycles) was 7.2% with partner’s sperm and 7.7% with donor sperm.
Women’s age is a major factor in conception. The older a woman is the less chance she has of conceiving naturally. The delay in childbearing in Australia has been mirrored by an increasing trend of women aged 35 years or older entering the IVF program. In 2000, of all pregnant women after assisted conception treatment, more than one woman in nine (11.2%) was 40 years or older and one in three (34.5%) was 35 to 39 years.
The likelihood of achieving a live birth after assisted conception decreases as a woman’s age advances. Women aged 40 years and older had the lowest livebirth pregnancy rate of 61.4% in 2000.
Until 20 years ago, there were only two remedies available for infertile couples: remaining childless or adopting a baby. Whilst remaining childless is a legitimate choice made by a number of couples, many men and women experience a strong desire to have a child. The inability to have a child can be devastating and involve a lengthy process of loss and grief.
In about 40% of infertile couples, the problem of infertility is a male factor, in about 40% it is a female one, and for the remaining 20% it is a joint problem, or the cause is unknown (‘idiopathic’).
The causes of infertility are many and varied. They include problems with the production of sperm or eggs, with the fallopian tubes or the uterus, endometriosis, frequent miscarriage, as well as hormonal and autoimmune (antibody) disorders in both men and women.
Surrogacy can be seen as an alternative form of reproductive technology that can assist infertile couples. However, many people argue that it is difficult to compare surrogacy with other reproductive methods, as the surrogate mother is undergoing all the emotional, mental and physical feelings of pregnancy, not simply donating an ovum.