Academic journal article Ethics & Medicine

Assisted Procreation: Too Little Consideration for the Babies?

Academic journal article Ethics & Medicine

Assisted Procreation: Too Little Consideration for the Babies?

Article excerpt

Abstract

Recent studies have revealed much higher risks of cerebral palsy and malformations in babies conceived by in vitro fertilization (IVF) than in babies conceived naturally. Here we question whether parents can legitimately accept this risk on behalf of offspring. We argue that parents can expose their baby to a risk only to preserve it from a worse possibility, and this is not the case of IVF, which is not a therapeutic tool for children because when the IVF decision is taken, the child has not yet been conceived . It is concluded that procreative techniques require considerably more research before being made available to couples.

Keywords: in vitro fertilisation, newborn, embryo

About 1% of children in developed countries are now conceived through in vitro fertilization (IVF). In 2002 at least 8000 IVF babies were born in the UK. In the period 2000 to 2001, 21.8% of all IVF cycles were successful and 25.1% of those in women under 38 years. About 1600 pairs of twins and 100 sets of triplets were born.1 The bioethical debate has been very hard in two fields. First, on the field of human reproduction control. On this argument feminist bioethicists also expressed their opinion. For instance Australian feminist Robyn Rowland contends that threats to the welfare of women have received too little attention in discussions about embryo experimentation: "Other elements of the social context that raise the potential for abuse of women's bodies are the increasing commercialisation of reproductive technologies and the increasing control by the male-dominated medical profession over the process of procreation."2 second, on the field of the debate on human right to life, since usually during or after each fertilisation cycle some embryos have to be eliminated with the aim of obtaining the desired baby or a healthy baby. Of course the supporters of the idea that embryos are persons do not accept that human embryos may be sacrificed, while those who argue that future parents' autonomy overwhelm embryos' right to live, do. Now, recent studies have revealed risks for babies conceived by in vitro fertilisation, so what is the extent of these risks, and what is the ethics of choosing a risk the consequences of which will be paid not only by those who accepts the risks but also by the baby?

The State of the Art

In February 2002 a group from Uppsala, Sweden, reported a retrospective cohort study linking and comparing neurological disorders among 5,680 infants born after IVF with 11,360 matched controls. In general children born following IVF were more likely to require the services of a habilitation centre than controls, and the odds ratio for cerebral palsy was 3,7. Most of the difference was among singletons. In a study from Australia, 8.6% infants conceived by intracytoplasmic sperm injection (ICSI) and 8.9% infants conceived by IVF had major birth defects, two-fold greater than controls.3 It appears that the risk of having a baby with a major handicap is higher after assisted reproduction, compared to natural conception.4

Infants who have low birth weight are at increased risk for short- and long-term disabilities and death. Three large studies were published in 2002 which showed that the use of assisted reproduction technology is an important contributor to the rate of low birth weight in the United States: there is a higher rate of low birth weight among singleton infants conceived with assisted reproduction technology than among naturally conceived singleton infants.5 Children born after IVF have an increased risk of developing neurological problems, especially cerebral palsy,6 and infants conceived with use of ICSI or IVF have twice as high a risk of a major birth defect as naturally conceived infants.7 These studies were followed by others and many of these show that being born with IVF is more risky than with common conception.

These observations are obvious to neonatologists: multiple births and prematurity, though trivialized by the mass-media (remember the exultation for the birth of quintuplets), pose severe risks for mothers and babies. …

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