Inconceivable Conceptions: Psychological Aspects of Infertility and Reproductive Technology

By Jane Haynes; Juliet Miller | Go to book overview

Chapter 2

Assisted reproductive technology and the fertility clinic

Dickinson B. Cowan

Dickinson B. Cowan is Medical Director of the Fertility Unit at the Portland Hospital, London.

It is so easy for us to take pride in our selves and our achievements, often without a thought for where we came from. Yes, there are parents and grandparents and the family tree and all of that, but what about the specific process which created us, you and me? The single egg and sperm that led to us? Romantic conception at its best. But this is a mere fairy-tale version of what happened. The reality is that we are all fortunate survivors of conception and birth processes. The notion that either of these might be difficult to accomplish seems inappropriate when we are living through a technological revolution. Egocentric self-perception assumes that those processes, which led to our conception, must be perfect too. Human reproduction, like reproduction observed elsewhere in nature, is excessive and often imperfect. For every normal conception there are many attempts that fail. We know that it takes only one egg, only one sperm, but what of these attempts, how do they fare in the cold world of science, statistics, and fertility treatments?

Is it true that man was created in the image of God? Viewed from the harsh reality of the infertility clinic we can observe that there are so many oddities about the physiology of our natural reproduction, so many features of bad design, that, sadly, our natural creation is unmasked as lacking the perfect, or divine, touch. Research into assisted reproductive technology (ART) has shown that up to 40 per cent of eggs may be chromosomally abnormal in women of normal reproductive age. As women creep past the age of 40 the proportion of chromosomally abnormal eggs increases-perhaps to 85 per cent. The sperm story is similar; about 35 per cent of sperm are chromosomally abnormal but this figure may be higher for some men. If a high proportion of eggs and sperm are chromosomally abnormal and we are perfect, then a conclusion must be that chromosomally abnormal eggs or sperm cannot participate in the reproductive process, but it is quite possible for a chromosomally abnormal egg to be fertilised by a chromosomally normal sperm or vice versa. Having fertilised, the embryo (as it is now called) may begin to divide and it may subsequently implant, sometimes for an instant, sometimes for a few weeks, until miscarriage occurs. This relates to chromosomes, but what about the role of genes-those little foci of important genetic information that hide in the arms and convolutions of the chromosomes? Genes are more difficult to see and to quantitate than chromosomes. But it is possible that a chromosomally normal

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Inconceivable Conceptions: Psychological Aspects of Infertility and Reproductive Technology
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Acknowledgements x
  • Introduction 1
  • Chapter 1 - Introduction 3
  • Chapter 2 - Assisted Reproductive Technology and the Fertility Clinic 11
  • Experiencing Infertility 17
  • Chapter 3 - Clinical Waste 19
  • Chapter 4 - One Man's Story 27
  • Psychological Aspects 31
  • Chapter 5 - Eros and Art 33
  • Notes 45
  • Chapter 6 - Mourning the Never Born and the Loss of the Angel 47
  • Chapter 7 - The Battle with Mortality and the Urge to Procreate 60
  • Bibliography 72
  • Chapter 8 - Myths and Reality in Male Infertility 73
  • Bibliography 84
  • Chapter 9 - Love, Hate and the Generative Couple 86
  • Changing Patterns of Kinship 103
  • Chapter 10 - The Story of Seth's Egg 105
  • Chapter 11 - Seth 109
  • Chapter 12 - Gifts of Life in Absentia 120
  • Chapter 13 - Women's Work 143
  • Bibliography 165
  • Chapter 14 - Egg Donation 166
  • The Shadow 179
  • Chapter 15 - Dark Reflections 181
  • Afterword 205
  • Chapter 16 - Afterword 207
  • Appendix 217
  • Glossary of Terms Used in Art (Assisted Reproductive Technology) 219
  • Index 227
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