The Practice and Implications of In Vitro Fertilization

Select network

                   

In vitro fertilization is a medical practice that is sometimes used for fertility purposes when a woman attempts to conceive a child but experiences difficulty doing so. The purpose of the present sample essay is to delve further into the practice and implications—both medical and moral—of in vitro fertilization.

The essay will begin with an overview of the practice of in vitro fertilization from the technical, medical perspective. Then, the essay will describe the history of and current trends in the use of in vitro fertilization. Finally, the essay will reflect on some of the moral implications and considerations that may potentially bear on the practice. 

Overview of in vitro fertilization

It would perhaps be worth beginning with a description of what in vitro fertilization actually is. The process begins with the woman being prescribed fertility medications in order to stimulate the production of eggs in the ovaries; the eggs are then retrieved by doctors. Then the man produces a sample of his sperm. The crucial step of the process is described by the American Pregnancy Association in the following way:

"In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory to encourage fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos" (paragraph 7).

At this point, the fertilized egg—that is, the embryo—is reinserted into the woman's womb, so that it can proceed to grow and develop in a natural way, until the pregnancy comes to term and the woman is ready to give birth. The infant born in this way is generally expected to lead a normal life. 

Compared to the ordinary process of fertilization, the main difference of in vitro fertilization is, of course, the location of the fertilization process. In the ordinary process, the man's sperm enters into the woman's uterus upon completion of the sex act, and a sperm then fertilizes an egg within the uterus, if the woman happens to be in the right phase of her menstrual cycle.

With in vitro fertilization, on the other hand, the fertilization process happens within laboratory equipment, outside of the woman, after both the woman and the man have contributed reproductive cells to the doctors. This is why an infant who is produced in this way is colloquially sometimes referred to as a "test-tube baby:" the moment of conception occurs not within the uterus of the mother but rather within the relevant laboratory tools. 

In vitro fertilization, while it can in fact successfully produce an embryo, has several risks that the woman should perhaps consider before following through with the process. This has to do both with the side effects of the fertility medications prescribed to the woman as well as the somewhat invasive nature of first retrieving eggs from the woman and then reinserting an embryo into the woman. The U.S. National Library of Medicine, for example, has indicated that

"a woman taking fertility medicines may have bloating, abdominal pain, mood swings, headaches, and other side effects" (paragraph 17).

This is due to the simple fact that the woman is essentially being provided with an excessive of hormones on a regular basis in order to promote the process of ovulation. Moreover, there is a risk of infection and other complications during the process of retrieving eggs and reinserting the embryo, due to the very nature of these medical procedures. However, if a woman and a man are committed to having a child and are incapable of doing so in the natural way, then it is quite possible that they will decide that these short-term risks are minimal in importance relative to the prospect of actually being able to have a child. 

Pregnancy history and trends

James wrote in the year 2013 that

"Louise Brown, the world's first test-tube baby, was born 35 years ago today, revolutionizing the field of reproductive medicine and giving infertile women hope that they could become mothers. Brown was born at Oldham General Hospital in Britain on July 25, 1978" (paragraph 5).

The procedure of in vitro fertilization was thus first invented 37 years ago from the present day. The scientists who were responsible for this development were Patrick Steptoe and Robert Edwards; they were British, and they won the Nobel Prize for their pioneering efforts. Over the last several decades, the procedure of in vitro fertilization has become much more widespread, with it having become a fairly routine medical procedure for woman who are seeking to have a child but are experiencing difficulties with conceiving in the natural way. 

In fact, the statistical evidence indicates that there are more women, especially within the United States, are opting for in vitro fertilization today then ever before. According to Christensen,

"this growing trend doesn't necessarily mean Americans are having more trouble having children. It may point to the fact that couples are having babies later. American women are having babies a lot later in life than they used to: In 1980, the average age of a new mom was about 22. Now, the average age of a new mom is closer to 26" (paragraph 6).

If one bears in mind that these numbers are averages, then it has salient implications for the growth of the practice of in vitro fertilization, due to the fact that fertility tends to decline as women age. There are sociological factors, such as the nature of the modern economy, that are causing demographic changes regarding the age at which men and especially women now feel comfortable having a child; this has effects on fertility; and in order to address these effects, more and more couples are turning to in vitro fertilization. 

There are, however, objective financial limits that many couples face when it comes to the decision of whether to pursue in vitro fertilization. This has to do with the fact that many insurance companies do not offer coverage for in vitro fertilization in particular or fertility treatments in general; such treatments are sometimes conceptualized as matters of preference rather than need, and thus beyond the scope of what insurance companies can be reasonably obligated to cover by law (James; Christensen).

There are in fact some states that require insurance companies to offer coverage in this regard, but many do not. Without the help of health insurance, in vitro fertilization could become prohibitively costly for couples who may otherwise wish to pursue this course of fertility treatment. In this context, it is somewhat remarkable that the numbers regarding in vitro fertilization are still what they are, even in spite of the existence of this financial barrier to accessing the practice. 

Moral implications of in vitro fertilization

Turning away from the medical and pragmatic side of in vitro fertilization now, it is worth discussing the fact that the practice—at least as far as some stakeholders are concerned—has significant moral implications. Referring to the Bible, for example, Lahl has pointed out that

"in Scripture, God affirms that what happens in utero matters and cannot be casually or disrespectfully dismissed. The womb, where God first knits us together . . . is not an arbitrary place for a child to grow and develop" (paragraph 5).

This could be understood as a kind of argument from the basis of perceived natural law: the idea would be that a child is meant to be conceived within the mother's womb, and that if this proves to be impossible, then it is not the place of science to provide a different venue for the miracle of conception to occur. Of course, this moral logic would only be binding on those who believe in the relevant premises; but nevertheless, it is surely compelling for at least certain segments of the American population. 

From a broader perspective, ethical questions regarding in vitro fertilization have been raised on the basis of the fact that it could potentially lead to the commodification of human life, with embryos being "sold" to parents and many embryos having no place to go and thus being put into deep freeze for future medical purposes. This is related to the basic fact that "one of the by-products of the typical IVF treatment is the creation of supernumerary embryos.

More embryos are brought into existence than can be safely replaced in the first cycle. The remaining embryos are frozen to be used later if the first trial proves unsuccessful or when the couple wants another child" (Banerjee, paragraph 22). In other words, in vitro fertilization generally does not produce just one embryo; it produces several embryos, one of which is chosen for reinsertion into the woman's womb; and the rest are simply stored away for future purposes. 

It is at this juncture that in vitro fertilization dovetails with the moral issue of abortion. According to the perspective of anti-abortion advocates, life begins at conception; this means that an egg that has been fertilized by a sperm (i.e. an embryo) has the same moral status as a full-fledged human being. In this context, it would be utterly unacceptable for in vitro fertilization to produce several embryos and then just choosing one of them, as if the other embryos had no intrinsic value of their own.

The extra embryos are generally kept in deep freeze or channeled into stem cell research ventures, where the research involves the destruction of the embryos (Andrews). If it is accepted that an embryo is a full human life, though, the implication that follows is that in vitro fertilization (at least the way it is currently done) almost necessarily entails the destruction of human life that is perceived as "extraneous" to the process of creating a single embryo for the man and woman in question. At least in principle, this raises several of the same moral issues that are raised by the practice of abortion; and in both cases, a key problem pertains to the potential devaluation of human life. 

Interestingly, though, it would seem that most Americans do not perceive in vitro fertilization as a morally charged issue. As the Pew Research Center has found:

"The percentage of U.S. adults who consider abortion morally wrong (49%) far exceeds the percentage who express this view about in vitro fertilization (12%)" (paragraph 3).

Two reasons could be postulated for why this may be the case.

1. Firstly, many Americans may not be fully aware of what in vitro fertilization actually consists of, at the technical level; they may just simply know that it is a fertility treatment, without being aware of its implications for the fates of embryos.
2. Secondly, the issue of abortion is closely tied to the issue of sexuality, or sexual activity; and this is likely to arouse far stronger emotions than the essentially scientific and technological procedure of in vitro fertilization.

Conceptually, though, irrespective of the fact that Americans do not in general perceive in vitro fertilization as a moral issue, the issue does have an intrinsic moral dimension, insofar as one has strong convictions regarding the moral status of a human embryo.

Conclusion

In summary, the present essay has consisted of a discussion of the practice and implications of in vitro fertilization. The essay has described the practice and reviewed the history and trends of the practice; and it has also considered the moral implications of the practice. At the present time, in vitro fertilization seems to be growing in popularity, for those who can afford it.

A financial barrier exists, though, that may prevent many couples who want to pursue the procedure for being objectively able to access it. Moreover, although Americans do not generally perceive the moral dimension of in vitro fertilization, it nevertheless does exist, and it is possible that it could come to the forefront of public attention at some time in the future. This is the state of in vitro fertilization at the present time. 

Works Cited

American Pregnancy Association. "In Vitro Fertilization (IVF): Side Effects and Risks." Author, Sep. 2015. Web. Oct. 17, 2015. 

Andrews, Bess. "Stem Cell Lines Created from Discarded IVF Embryos." Harvard Gazette. 30 Jan. 2008. Web. 18 Oct. 2015. 

Banerjee, Amit. "An Insight into the Ethical Issues Related to In Vitro Fertilization." Internet Journal of Health 6.1 (2006). Web. 17 Oct. 2015. 

Christensen, Jen. "Record Number of Women Using IVF to Get Pregnant." CNN. 18 Feb. 2014. Web. 17 Oct. 2015. 

James, Susan Donaldson. "Test Tube Baby Louise Brown Turns 35." ABC News. 25 Jul. 2013. Web. 17 Oct. 2015.

Lahl, Jennifer. "The Overlooked Ethics of Reproduction." Christianity Today. Aug. 2013. Web. 17 Oct. 2015. 

Pew Research Center. "Abortion Viewed in Moral Terms: Fewer See Stem Cell Research and IVF as Moral Issues." Author, 15 Aug. 2013. Web. 18 Oct. 2015. 

U.S. National Library of Medicine. "In Vitro Fertilization." MedlinePlus. 11 Mar. 2014. Web. 17 Oct. 2015.