Assisted reproduction and genetic technologies
According to New Zealand fertility clinic figures, roughly 650 children every year are conceived with the aid of a Petri-dish. 130 of these children are born from the use of donor gamete conception methods. (1) This figure does not include those few offspring from gestational surrogate pregnancy arrangements, sperm donors contribute to around 100 births per annum. Egg donation makes up the remaining 20-30 births. Because gamete donation requires the services of fertility clinics to facilitate in vitro fertilisation (IVF) techniques, these births are medically complex. IVF techniques are considered a boon by people who use these procedures, as they are grateful for the opportunity to help build or create families they would not otherwise have.
Regardless of the benefits, it is not unreasonable to suppose that if (heterosexual) couples using fertility services could reproduce without technological intervention many would choose to do so. One pivotal reason is that IVF services are expensive. Cost varies with treatment and between clinics, but the average cost for single IVF treatments in New Zealand is around $7800 (which includes freezing spare embryos), and $9000 when ICSI (sperm microinjection) is used. (2) Although the New Zealand government now publicly funds two infertility treatment cycles as of 1 October 2004, eligibility criteria are strict and the success rate for those eligible, while steadily improving, remains low. (3) In contrast, consensual copulation (or low-tech self-insemination with donated sperm) costs nothing. All things being equal, old-fashioned reproductive methods offer various benefits over assisted reproductive technologies (ART). (4) From the perspective of heterosexual women, sex between consenting adults for the purposes of reproduction is more dignified, less uncomfortable, less painful, (presumably) less anxiety-inducing, and time-consuming than using assisted reproductive strategies such as IVF.
In addition to the financial, physical, and emotional costs, there are also ethical and social objections to ART. Since many of these objections are publicly voiced, they may exacerbate existing existential anxieties for those who seek ART services. Some critics object to ART because it wrests life itself from women, thereby appropriating women's reproductive labour by placing control into the hands of men and the medical profession. Even in situations where male infertility is the problem, women's bodies remain the raw material for assisted reproduction procedures (e.g. IVF). In this largely feminist view, the pursuit of human reproduction is criticised for its objectification and instrumentalisation of the female body, and for failing to redress existing power differentials between men, women, and the medical profession in the application of ART. Others, mainly non-feminist critics, object to ART on the grounds that they interfere with so-called natural or god-given processes, and this wrongful intervention signals another step on a slippery slope separating reproduction from sexual activity.
While these debates warrant independent consideration, (5) the manipulation of life itself has recently taken a new twist. Not only can biomedical technicians conjure the beginnings of life in a Petri-dish, since its development in the United Kingdom during the mid 1980s (6) and first success in 1990, via a technique known as pre-implantation genetic diagnosis (PGD), they have had the ability to diagnose the potential viability and quality of that life.
PGD, used in conjunction with IVF, involves the separation of one or two cells (blastomeres) from an eight cell stage embryo in order to test for genetic defects. Only unaffected embryos are then implanted in the uterus for gestation. While PGD has been primarily used to reject embryos carrying specific genes or traits, a more recent use has been to positively select for so-called desirable traits, as in cases of saviour siblings (for example, the birth of James Whitaker in the UK, 2003). …