Reproductive Technology

Reproductive technology Reproductive technology also known as Assisted reproductive technology (ART) is what encircles the majority of current use of technology in human and animal reproduction. This technology has turned many dreams into reality due to its aid in conceiving children for infertile couples.() The first use of a technique considered reproductive technology was in 1978 and the first time ART became legalized in the United States was in 1981. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261493/ It has been shown that this technology gives safe, healthy, and improved reproduction. (1)Anonymous donation is a big part of reproductive technology; there are many donors who choose to stay unidentified, however, the system of keeping an anonymous identity is different in different parts of the world. Each country has its own system in how they legalize the anonymity of the donors.() Due to the fact that in certain parts of the world it is hard to keep a hidden identity it has raised many concerns on how ethical ART is in regards to personal and private information.()

Overview

Reproductive technology is used to assist with infertility and low fertility. There are many different types of techniques associated with reproductive technology. The most common is in vitro fertilization.

In vitro fertilization

In vitro means outside the body. In vitro fertilization is the combination of an egg and a sperm in a glass tube. This takes time because it requires the wait for a woman’s ovulatory process and then removing the eggs from their ovaries, when this is done and mixed with sperm a zygote undergoes embryo culture and then it is implanted back in the uterus to establish pregnancy and the development of a baby. This technique requires a long time due to the complicated method. ()

Types of Reproductive Technology

Assisted Reproductive Technology (ART): It uses medical procedure and involves in vitro fertilization (which is where a female’s egg is combined with a male’s sperm outside of the body). It also includes gamete intrafallopian transfer (GIFT) which is an in vivo process by obtaining an egg from an ovary and mixing it with sperm in the body then reinserting it into the fallopian tube by GIFT. A similar procedure is called Zygote intrafallopian transfer (ZIFT) the only difference is that the egg and the sperm are mixed in a lab setting rather than in the body. These techniques help low fertility or no fertility individuals to be able to have children. It also provides same sex relationships to conceive children.

Ethics

Recipients

Recipients have the ability to choose specific egg/sperm donors depending on various characteristics such as race, ethnicity, educational background, and/or religion. Recipients are also required to undergo evaluations where the physician must obtain a full medical history from the recipient and their partner, as well as a complete demanded physical exam and blood testing along with various gynecologic testings.() The recipients must also be screened for different disease such as syphilis, hepatitis B and C, HIV, West Nile and more.() Personal information on the recipients must also be saved, such as, name, date of birth, address, and all of the medical history.() This process alters human enhancement and plays with bioethics. In the 1980's, there were many concerns regarding ART for its safety, its consistency of various data from clinics regarding pregnancy success rate, and its accessibility for different economic backgrounds.(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261493/#B8) Due to such concerns the government legislated the Fertility Clinic Success Rate and Certification Act in 1992 requiring all ART clinics to inform the CDC with all the data regarding performed procedures and success rates. The data transferred also includes personal information of all recipients and donors.() These laws were made to ensure that patients are well informed of the different clinics’ success rates, however this has taken a different route in which clinics started to indirectly manipulate their data. Clinics started to “cherry pick” their patients in order to increase their success rate.() This has led patients with a poor pregnancy prognosis to not have as much access to reproductive technology relative to those who have a higher chance of getting pregnant (). In order to avoid false optimism and unnecessary fears, patients value counseling and accurate information, therefore, the inaccurate measurements that were being made using various computer systems have affected those who are using reproductive technology to have children, giving them false hope.()

Third party system

This term explains the idea that a third individual other than the two main couples will be assisting in giving either eggs or sperm for the couple’s use.() This can be socially, legally, and ethically complex. There are many who perform anonymous donation which is donating without the reveal of their identity.() Some people, however, do choose to be known.()

Donors

All embryo donors are required to undergo intensive screening processes that include history and physical medical exams, as well as detailed genetic testings for diseases.() They also have to answer question regarding their sexual history, substance use, history of family disease and psychological history.() Such private information is mainly stored in computer system with access from the clinic.() However, one mistake is able to reveal much information.()

Special Case

Two couples, A and B, A the donors and B the recipients did not know each other. Couple A donated eggs to couple B and B left the country.() As couple A wanted to have children they found out that she cannot have kids anymore due to health reasons and now she was seeking to find couple B and ask if she is able to use some of the oocytes that she has donated before.() However, as couple A gets in contact with the clinic, the clinic makes an error and wife A learns the names of couple B.() She also learns that husband B is suffering from drug addiction withdrawal. Couple A also learns that couple B is international now.() This information was meant to be super private for couple B as that is what was communicated to them when they agreed to go on this journey with couple A. The level of anonymity couple B was promised was not true as when the clinic made one mistake of giving away the names of couple B there was a lot found out due to some internet search.()

Hidden Identity

There has been many controversies regarding the choice of a donor remaining anonymous. Many donor conceived adults have reported that they are using a combination of techniques where they are able to eventually find their original parents.() Many countries have abolished the anonymity of donors at a certain age for the conceived children.() There are many online utilities where with genetic/blood testing the donor’s identity could be easily found.() The use of ancestry registries is also beneficial in finding donor’s information.() Moreover, there are many online websites that are being developed and are already made and filled with a bunch of personal information of different individuals that could be found by doing a simple genetic test.() websites such as donorconeption.com, which help donors and the conceived children to find each other by combining various information.() This incredible use of technology decreases the likelihood of the donor’s identity to stay anonymous regardless of whether or not they wish to do so.() websites such as ancestry.com with family testa and register could easily find the donors.() Therefore, the offering of being an anonymous donor is not fully true in this day and age due to the developed online websites and technology that could find related individuals.()

Issues

An experiment was conducted to measure how accurate the information the donors received prior to performing the procedure and how much they have suffered from long term side effects. A small majority of donors said that their experiences aligned with what they were told regarding the process, however about 30% of donors disagreed and stated that their experiences did not match the expectations.() Over 55% of the participants indicated that they did not receive accurate information about the long and short term effects of egg donations.() about 60% reported that they did had immediate medication side effects while approximately 40% stated that they have suffered prolonged side effects and were misinformed of such details.() These issues affect the trust and reliability of fertility clinics when it comes to donating eggs/sperms. Misinformation regarding individual’s health is crucial and could eventually lead to death.()

Legal Issues

Third-party reproduction involves several legal issues. Written consent should be obtained for any procedure. In situations of known sperm or egg donors, both donors, as well as intended parents, are advised to have separate legal counsel and sign a legal contract that defines the financial obligations and rights of the donor with respect to the donated gametes.