Assisted Conception

Editor: Justin Healey
ISBN 978 1 921507 26 7
Year 2010

Price: $20.95

  

Assisted Conception
Volume 315, Issues in Society

The use of assisted reproductive technologies (ART) may be the only way people who experience infertility can have a child. ART techniques include artificial insemination, in vitro fertilisation, intracytoplasmic single sperm injection and surrogacy. A number of questions are raised regarding assisted conception – practical, financial, ethical and personal. This book examines the science behind reproductive technologies and explores a range of concerns and opinions. What are the emotional impacts of infertility on prospective parents and the health risks for the artificially conceived child? Should women delay motherhood? What are the identity issues for the offspring of donor conception? Does genetic screening promote ‘designer babies’ and sex selection for the wrong reasons? Does surrogacy commodify other people’s wombs? Should same-sex couples and single parents have taxpayer-funded access to this technology?

Chapter 1: Assisted Conception in Australia
About infertility; Types of infertility; Infertility and reproductive technology; Assisted conception; Risks and considerations; IVF bundles of joy, 30 years in making; Assisted reproductive technology in Australia and New Zealand; The science of putting motherhood on hold; IVF doubles pregnancy rate; IVF: an emotional journey.

Chapter 2: Assisted Conception – Ethics and Opinions
Fertile ground for doubt; The gift of motherhood through egg donation; The gene genie; Breeding perfect babies; Those unethical ethicists; Aussies coughing up for designer babies; Choose the sex of your baby; Designing principles at birth of a new era; You choose your baby's name, why not choose their face?; New 'designer babies' make life a commodity, bioethecist says; Men urged to make sperm will; Should singles and homosexuals have the right to children?; Rainbow children; Doctors warn on lesbian IVF win; The ethics of surrogacy; Calls to debate 'fertility outsourcing'; Surrogacy – the issues; Family groups to fight surrogacy laws.

Glossary; Fast Facts; Web Links; Index



fast facts
FAST FACTS from this volume
  • A couple is regarded as infertile when they have not conceived after 12 months of regular unprotected sexual intercourse.
  • About 15% of Australian couples of reproductive age have a fertility problem.
  • Three out of five couples conceive within 6 months of trying; 1 in 4 take between 6 months and a year. For the rest, conception takes more than a year which means that there may be a problem.
  • Up to 20% of couples will have no explainable cause for their infertility.
  • Among couples who are infertile, about 40% of cases are exclusively due to female infertility, 40% exclusively to male infertility, and 10% involve problems with both partners.
  • A delicate balance of sex hormones (oestrogen, progesterone, luteinizing hormone, follicle stimulating hormone) is needed for the timely growth and release of the egg from the ovary (ovulation).
  • Reproductive function declines as a woman ages, particularly after the age of 35. Women are born with a finite number of eggs, unlike men who produce sperm most of their adult life.
  • Reproductive technology is the term used to describe the range of medical treatments available to assist couples to conceive.
  • The success of reproductive technologies depends on a number of factors including the cause of infertility, the age of the woman, whether fresh or thawed embryos are used and the number of embryos transferred back to the uterus/fallopian tubes.
  • The perinatal death rate for all assisted conception births in 2006 was higher than that for all Australian births, 17.5 per 1,000 compared to 10.2 per 1,000.
  • It is estimated that around 10 to 15% of couples have some type of fertility problem during their reproductive years and of these about 20% are diagnosed with a physical problem that requires surgery or advanced interventions such as IVF to assist conception.
  • Assisted Reproductive Technology refers to the application of laboratory or clinical technology to sperm, eggs and/or embryos (fertilised eggs) to assist the conception of a baby. About 10 to 20% of couples with diagnosed infertility are offered ART.
  • As a guide, the general success of ART resulting in the birth of a live baby for women under 35 years is around 25%, for women from 35 to 39 it is around 18% and for women aged 40 to 44 it is around 6%.
  • IVF is usually recommended for women whose fallopian tubes are blocked or if other fertility treatments have not worked and has a multiple pregnancy rate of about 22%.
  • Assisted conception does not increase the risk of miscarriage. Miscarriage occurs in up to 25% of all pregnancies whether conceived naturally or by IVF.
  • National figures show twins occur in up to 20%, and triplets in less than 1%, of successful ART cycles.
  • Ovarian cancer occurs in approximately 1 in 90 women in the general community and is known to be more common in women who have not had children.
  • Between 6,000 and 7,000 babies were born as a result of IVF in Australia last year, with a further 3,000 born by ‘assisted conception’ techniques such as artificial insemination.
  • There were 56,817 ART treatment cycles reported in Australia and New Zealand in 2007. This represents a 12.5% increase in the number of cycles undertaken in 2006 and a 53.7% increase in the number of cycles undertaken in 2003.
  • More older women are joining IVF programs – 16% of patients in 2006 aged 40 or older, compared with 14% in 2002, according to the statistics that are collected from all assisted reproductive technology clinics in Australia and New Zealand.
  • Since 1995 more than 600 young women undergoing fertility-threatening cancer treatment have had eggs, embryos and ovarian tissue frozen and stored in stainless-steel tanks at Melbourne IVF’s headquarters and at the Royal Women’s Hospital.
  • About 50% of IVF babies are delivered by caesarean section.
  • An egg donor is a woman who offers her eggs as an altruistic gift to an infertile woman so that she may experience the gift of motherhood.
  • In New South Wales, Victoria and Queensland, anyone who donates eggs must go on a register, agreeing to the possibility of being contacted by any children aged 18 and over who were conceived from the donation.
  • Prenatal testing for Down syndrome is now routine and 95% of affected pregnancies are terminated.
  • The (AU$3,440) test, called karyomapping, which should be available as early as next year, will allow couples at risk of passing on gene defects to conceive healthy children using IVF treatment.
  • A basic scan for major genetic illnesses costs $US20,000 ($A30,680).
  • Using a technique known as pre-implantation genetic diagnosis (PGD), specialists can select a couple’s healthy embryo for implantation in the womb and discard ones that are damaged.
  • A US clinic has announced that it will help couples undergoing a form of fertility treatment screen their embryos for sex and desired physical characteristics such as eye color and height.
  • Across Australia, there were almost 2,400 families with at least one gay or lesbian parent, a jump of about 26%.
  • Surveys show that from 1993 to 2000, the number of people who approved of the use of donor sperm to help single women conceive more than doubled to 38%. Almost a third supported the use of donor sperm by gay couples, compared with only 7% in 1993.
  • Waldby says it costs the western couples around $15,000 or $20,000 for an Indian surrogate, whereas they would pay around $100,000 for a surrogate from the US.
  • A surrogate mother is someone who gestates (conceives and carries within the uterus) and then gives birth to a child for another person, with the full intention of handing the child over to that person after the birth.
  • The Federal Government is considering introducing national legislation for surrogacy to ensure consistency across the country.