In Vitro Fertilization

n Vitro Fertilization (IVF), is the procedure whereby human babies are conceived, not in the womb but in a test tube or a Petri dish. This procedure has become one of the greatest developments in the world of medical technology. In Vitro Fertilization has given infertile couples the chance to conceive and bear a child from a full term of pregnancy. Without this procedure, their infertility would render them childless.

There are many aspects of the IVF program that have been both praised and criticized. The legal, ethical and social repercussions of the IVF program have created great debate and controversy. This essay will demonstrate the procedures used in the IVF program and set out the arguments for and against it.

There are many reasons why couples cannot conceive or bear a child for a full term of pregnancy. The process of natural fertilization can only be achieved if the male and female reproductive organs are functioning without any abnormalities.

The reproduction process begins with the male producing sperm in the testes and the female producing an egg in the ovaries. Once every 28 days or so, an egg matures in the ovary, bursts from its follicle and enters the Fallopian tube.

Once sexual intercourse has taken place, millions of sperm released from the penis swim up the vagina, through the uterus and into the Fallopian tube. 'A single sperm fertilizes the egg; the others are locked out.' (Time, 1997, pg. 66) Once the egg has been fertilized, cell division begins and the embryo drifts down the Fallopian tube. The embryo reaches the uterus in about a week. The embryo anchors itself to the wall of the uterus where it develops into a foetus. The foetus feeds off nutrients and oxygen provided by the placental lining in the uterus.

There are several conditions in both males and females that cause abnormalities in the functioning of natural fertilization.

Firstly, a condition in women called Endometriosis causes infertility. 'It is a condition where pieces of uterine tissue leak out of the uterus into the Fallopian tube.'(Fertility Rights, 1993, pg. 6) It causes blockages in the Fallopian tubes and 'is associated with infertility even when the Fallopian tubes are not actually blocked.' (Fertility Rights, 1993, pg6)

Secondly, the cause of infertility in men is a reduced sperm count, or low sperm motility, which greatly reduces the chances of successful fertilization.

And lastly, 'about 10% of infertility is due to unknown causes.' (Fertility Rights, 1993, pg. 6) After one year of infertility, couples whose infertility has been investigated without ascertaining cause may be admitted to IVF.

The three causes of infertility mentioned are the most common among infertile couples, although, problems such as a loss of production of eggs due to radiation treatment or damage to the reproductive organs due to bad accidents can also be a reason for infertility.

Many of the conditions which cause infertility can be overcome and pregnancy can be achieved by using one of the many artificial impregnating techniques and treatments. These include:

IVF - in Vitro Fertilization is the process 'where eggs are harvested from the ovary and fertilized in a Petri dish. After embryos begin to develop, they are placed in the uterus.' (Time, 1997, pg. 66) This process is carried out while the patient is under general anesthetic and fine needles and tubes are used to retrieve eggs and implant embryos. The treatment cycle for IVF is as follows:

'1 Follicle growth (stimulated by injections).

2 Timing of ovulation (based on blood tests and ultrasound

scan).

3 Egg collection from the follicles (egg pick-up), using the

ultrasound machine.

4 Fertilization of eggs with partner's sperm.

5 Embryo transfer to the uterus (ET).

6 Pregnancy test (a blood test)' (Fertility Rights, 1993, pg. 9)

GIFT - Gamete Intra-Fallopian Transfer is a procedure which resembles a more natural conception. 'In GIFT, eggs are collected from the female but instead of being fertilized in the laboratory, the eggs and sperm are placed directly into a normal Fallopian tube using a fine plastic tube.'(Fertility Rights, 1993, pg. 7) Implantation of the embryo following this procedure is more successful than in IVF. The treatment cycle for GIFT is as follows:

'1 As for IVF.

2 As for IVF.

3 Egg collection from the follicles, using the ultrasound machine.

Mixing with partner's sperm, and placement in the Fallopian tubes. In the case of the Delayed Gift procedure, an egg collection using the ultrasound machine is performed. About five hours later, the woman has a laparoscopy and the eggs and sperm are placed into the Fallopian tubes.

4 Pregnancy test.' (Fertility Rights, 1993, pg.9)

TEST - Tubal Embryo Stage Transfer combines the IVF and GIFT techniques. 'The eggs are fertilized as in IVF and grown in a culture medium in the laboratory until the embryo reaches the four-cell stage.'(Fertility Rights, 1993, pg. 7) As in the GIFT procedure the embryos are returned to the Fallopian tubes. The treatment cycle for TEST is as follows:

1 As for IVF.

2 As for IVF.

3 Egg collection from the follicles, using the ultrasound machine.

4 As for IVF.

5 Embryo transfer to the Fallopian tubes using the laparascope or via guidance with the ultrasound.

6 Pregnancy test.' (Fertility Rights, 1993, pg.9)

This procedure is used for women whose Fallopian tubes are normal, but whose partners have sperm unsuitable for the GIFT procedure. 'In cases where one or both of the Fallopian tubes are not blocked, then GIFT may be used unless the sperm is of too poor a quality, in which case TEST is recommended.' (Fertility Rights, 1993, pg. 7)

Fertility Drugs - Women usually produce one egg a month. Drugs can cause multiple eggs to ripen