In Vitro Fertilization: Advantages and Disadvantages

 Some may argue that In Vitro Fertilization, commonly referred to as IVF, is immoral and wrong, as it is thought it could possibly damage the health of the mother or the embryo during the process. Women should not face opposition in choosing In Vitro Fertilization due to the beliefs of others. People think that this is immoral for the woman, in which it attacks her self-respect since the barrier of human dignity through contraception has been broken, but I argue that it is not immoral because it is still contraception, just through a different way. Others believe that IVF should be funded fully by the government, as it is part of healthcare.

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 “The definition of a fetus is a being of at least 8 weeks of gestation, and before said gestation it is classified as an embryo. This is after the major structures have formed, including the vertebrae structure, limbs, and mouth and eye indents” (Shiel Jr). With IVF, the embryos are transferred into the uterus after they have been fertilized, and will attach to the uterine walls six to ten days after implantation. The total process will takes roughly four to six weeks. People have been using this method to conceive since 1978, which gives it a great track record with rare complications. Techniques will be progressing near the future, as technology is invented and improved every day.

 IVF is an option for everyone, although it is mainly used by those who have no other way of conceiving a baby. Women-usually over 40- may have problems with ovulating, or their egg quality may be poor or low. Their fallopian tubes could be underdeveloped. Of course not all problems consist of females, men can have problems such as being stressed, a narrow urethra, or celiac disease. In Vitro Fertilization is bringing new hope to these couples who want to start a family. If you or your significant other has a genetic disorder that could be passed down to the baby, you may choose IVF for the pre-implantation genetic screening to make sure the embryo you transfer is healthy. IVF is the most common Assisted Reproductive Technology (ART) procedure. ART is specifically an umbrella term that includes all types of fertility treatments in which both the eggs and the sperm are handled. Eighty-five to Ninety percent of infertile couples in treatment do not require IVF, in which case a different form of ART may want to be used including Intracytopasmic Sperm Injection, Assisted Hatching, Frozen Embryo Transfer, Sperm or Egg Donations, Surrogates, or Gestational Carriers. You may want to choose on your own, but your fertility specialist, your endocrinologist, or your physician will work with you to choose the correct treatment for you.

 The first In Vitro Fertilization baby conceived was Louise Joy Brown, born July 25, 1978 in Lancashire, England. Her parents had been trying to conceive for 9 years but were unable to due to blocked fallopian tubes. In 2010, a Nobel Prize for Physiology went to medical researcher Robert Edwards for his work to impregnate Louise’s mother, Lesley Brown. “Dubbed a “test-tube baby” by the press, Louise Brown was the subject of persistent media attention, not only during the pregnancy and after her successful birth but also many years later” (Manganaro). After her birth, which was hailed as a medical miracle, IVF has been used multiple times with over eight million babies born worldwide.

“On January 6, 1984 in Melbourne Australia, the world’s first IVF quadruplets were born, and they were all boys. “The babies, delivered by Caesarian section, were born six weeks premature in one-minute intervals beginning at 10:47 a.m.” (UPI).

The mother’s identity was kept secret for her safety.

 The idea of IVF first began in when a paper published by Gregory Pincus and EV Enzmann at Harvard University raised the possibility that mammal eggs could still proceed through development in vitro. In 1959 that claim was finally laid to rest when Min Chueh Chang was the first to achieve live births of a mammal, a rabbit, by using IVF. The first reported In Vitro pregnancy was reported by the Monash research team in Australia in 1973, but resulted in an early miscarriage. Just 5 years later the first IVF birth happened in England of 1978, baby Louise Joy Brown. In 1983 it was proven the eggs don’t even need to be yours, just compatible with your body, as a woman without ovaries became pregnant using donor eggs with IVF.

 Many believe In Vitro Fertilization to be wrong. Of course this is just due to their beliefs and religion. It all comes down to what the woman wants first, and what she believes. The common belief of IVF is that frozen eggs will prevent infertility. This is false; the biological clock is always ticking. Egg freezing may just slow down time enough. People think this is wrong for the egg to be frozen, as it is unnatural and uncared for. Eggs would be locked up in cold hard bins and left in storage for years untouched until used again. The longest successful thaw period was 14 years, meaning a woman had her eggs retrieved, then had them thawed and implanted 14 years later. Eggs are safely stored in a high secure facility, usually in a long-term storage unit. When you are ready, the eggs will be thawed in a lab environment. The egg will be fertilized and allowed to develop into an embryo for a few days. The embryos will then be transferred back in to your uterus.

 There is major concern that some women may be pressured into using In Vitro Fertilization as so many people around them are pushing them to get that treatment that no other options are considered. Asides from IVF, some other options available are adoption, Intrauterine Insemination, Gamete Intrafallopian Transfer, and Gestational surrogacy. People should not be pulled towards one direction because everyone else is getting it. Many women are in fact pressured in to just having children in general.

As a result of the high value of children, the social consequences of infertility can be severe. For example, infertile women often face considerable stigma, mental distress, and potential exposure to domestic violence (Parent24).

This is why so many women are stressed into getting help to try to have children, to help themselves not get hurt.

“Social pressure, especially on women, is at the heart of much of the drive for biologic parenthood. Nevertheless, the fact that many infertile couples are willing to spend thousands of dollars and risk the physical and mental demands of IVF rather than adopt a child suggests a strong emotional need for biologic offspring that is not influenced by social pressures” (Goldworth).

People believe having a baby and going through the whole process together will strengthen the relationship with your significant other, so they may want to focus on this when searching for solutions for their infertility.

Women shouldn’t have to face these problems. Men do not face the same backlash from infertility as females, as there is a social stigma that society provides that sets a double standard. In fact, childless women are now becoming a trend. More and more women are realizing that they don’t want to have children, especially when others push their ideas onto them of what is the right thing to do in their position of society. The American birthweight has gone down to 3.8 million babies in 2017, and it’s expected to get lower. That was a historic low, and a new record. Only 60.2 births per 1,000 women, which had gone down from 62 in 2016. Women are also more active in the workforce in the present day, leaving less time to have a baby, much less to care for it. “Women are blaming themselves as individuals for something that is a deeply structural and societal problem” (Collins qtd in Forde). American women aren’t having enough babies to replace the current population, but experts weren’t at all surprised, citing the causes as the lack of mandatory paid family leave, supportive workplace policies, and affordable childcare.

Most people are unaware that gender selection doesn’t even exist, but with In Vitro Fertilization the option to choose the sex of your baby happens very often in fertility clinics. “When those embryos are a few days old, the prospective parents can choose to have them screened for genetic abnormalities using pre-implantation genetic diagnosis” (MacMillan). This means that the embryos are looked at closely underneath a microscope and a few cells are peacefully removed to be inspected to ensure they have the proper genetic makeup by looking at the pairs of chromosomes. Doctors look at the X and Y chromosomes for abnormalities, and in doing this the sex of the embryo will become obvious. Patients can choose which embryos to use, although their fertility doctor may suggest otherwise, or may choose to freeze other healthy embryos in later treatments.

Although IVF is an option for everyone, it is mainly used by those who have no other way of conceiving a baby. Women-usually over 40- may have problems with ovulating, or their egg quality may be poor or low. Their fallopian tubes could be underdeveloped. Of course not all problems consist of females; men can have problems such as being stressed, a narrow urethra, or celiac disease. In Vitro Fertilization is bringing new hope to these couples who want to start a family. If you or your significant other has a genetic disorder that could be passed down to the baby, you may choose IVF for the pre-implantation genetic screening to make sure the embryo you transfer is healthy. IVF is the most common Assisted Reproductive Technology (ART) procedure. ART is specifically an umbrella term that includes all types of fertility treatments in which both the eggs and the sperm are handled. Eighty-five to Ninety percent of infertile couples in treatment do not require IVF, in which case a different form of ART may want to be used including Intracytopasmic Sperm Injection, Assisted Hatching, Frozen Embryo Transfer, Sperm or Egg Donations, Surrogates, or Gestational Carriers. You may want to choose on your own, but your fertility specialist, your endocrinologist, or your physician will work with you to choose the correct treatment for you.

 Despite the large number of live births due to IVF, the success rate doesn’t go over 40%. For women 34 and below the success rate is 40%. For women 35-37 it’s 31%. For women 38-40 it’s 21%. For women 41-42 it’s 11%, and lastly for women 43 and over the success rate is only 5%. Despite these small percentages, In Vitro Fertilization has an excellent track record. It’s the oldest assisted reproductive technology (ART) procedure. As of 1978, there have been no medical problems linked to this treatment. At first early studies did suggest that fertility drugs could lead to a risk of ovarian cancer or cancer of the female reproductive system but that has since been disproven. Many IVF treatment centers provide family planning options for the selection of donor eggs or donor sperm for those who are completely infertile, or for the LGBTQ+ community. In Vitro Fertilization success rates have been increasing more rapidly than its other partners of contraception. Intrauterine Insemination, for example has not gone through the same level of improvement of IVF and no ART procedure has had a record lasting as long as this. IVF is the suggested first option for single women and for same-sex couples.

 Along with the happy stories come the sad. And that’s the reality of things, that IVF only works roughly 40% of the time if you’re lucky. You’re at a great risk for multiples, although this may be great news depending on the kind of person you are. The chance of having more than one baby increases by 20%, but this also increases your risk for miscarriage and preterm labor. Your chance of an ectopic pregnancy- when a fertilized egg implants outside the uterus-increases, and can severely injure the mother. Not only can IVF be risky for you and your baby, but it can cost a lot of time and money. There’s always the chance that your treatment may be cancelled simply because not enough follicles had developed, which in most cases happens up to 20% of the time. Sometimes In Vitro Fertilization side effects are undesired, painful, or humiliating. Some smaller side effects include headaches, hot flashes, bloating, irritability, bruising, acne, weight gain, and fatigue. More serious side effects include nausea, ectopic pregnancies, dizziness, and ovarian hyper stimulation. IVF takes up a lot of time and requires several trips to the doctor’s office to track the treatment process. This includes ultrasound imaging, blood tests, suppositories, retrieval of the eggs, and placement of the embryos.

 On average in the United States, one cycle of In Vitro Fertilization costs roughly $12,400 for a couple using their own sperm and eggs. In Canada, the government is starting to fund parts of the IVF treatments, but only with limited coverage. “The Pre-Implantation Genetic Screening (PGS) costs on average $3,500 in the United States. Embryo Biopsies can charge $1,000-2,200. For single gene defects there will be additional costs” (Advanced Fertility Center of Chicago). Combining IVF with PGS usually costs between $17,000-25,000 in the United States including the hormonal medications needed for ovarian stimulation. Using donor sperm, donor eggs, or a gestational carrier would have additional costs. Families are looking for a way to lower the costs of IVF treatments and medications. Some parts of the treatments of cycles, such as ultrasounds or bloodwork, may be covered by your insurance. The older a woman gets; the more cycles she may need. This means that with each cycle, she will be forced to pay thousands of dollars more to conceive a child. In Vitro Fertilization is partially funded by the government in parts of Canada, so you will not have to pay for your treatments there. Four provinces- Ontario, Manitoba, New Brunswick, and Quebec- provide financial assistance for In Vitro Fertilization. Each province has a separate policy, and you must live in said province to gain credit. In other parts of Canada, treatments can cost about $10,000- $15,000.

 Many believe that infertility is just the fault of the woman in the relationship, as she is the one in charge of growing and carrying the baby.

Infertility affects men and women equally. In couples experiencing infertility, approximately 35% is due to male factors, 35% is due to female factors, 20% of cases have a combination of both male and female factors, and the last 10% are unexplained causes (Reproductive Medicine Associates of Pennsylvania).

 Therefore, it must be noted that both man and woman should be evaluated before drawing false conclusions, as it is fairly equal in tests that infertility affects both genders. Some lifestyles can contribute to infertility, like smoking, drinking, extreme heat, and drug use. Male infertility, along with some female infertility, can possibly be treated with lifestyle chances, medication, or surgery. “When modern men can fail in myriad ways in the eyes of society, even today, a woman is deemed by many to fail most conclusively, tragically and grotesquely when she hasn’t been able to bear children” (Ellen). One in 20 men have a low sperm count, and yet there are rarely any fundings on researches for the male fertility system. It was originally believed that since sperm is made over time in the male body, the quality is always high. The Harvard Medical School in Boston reported that sperm quality declines with age which makes it harder to father a child, and could affect the health of a child. Men’s sperm counts have reportedly reduced by more than 50% since 1970s, according to a study by Hebrew University of Jerusalem. Professor Sharpe said:

Apart from its dependency on high levels of testosterone, the mechanism of sperm production remained a “big black box” (Knapton)

Not much is known about male conception or contraception, and it is a running joke that there hasn’t been a new acceptable male contraceptive since the condom. Although it’s just as common as female infertility, male infertility usually goes undiagnosed and untreated more regularly. Fertility clinics must also accept that men are part of the problem and treatment as well. Some clinics suggest using their counselling services to deal with their responses and feelings to infertility and treatments.

 It’s a known fact that multiple pregnancies can occur from IVF treatments when more than one embryo is implanted into the uterus. “Full government funding of IVF treatment would lower rates of multiple pregnancies and their associated risks of complications for mothers and babies…” (Cockerell). This would be healthier for the mother and baby, and it is recommended that the Government fund a full three cycles worth of IVF.  According to Tarek El-Toukhy, the lead author of the report:

Multiple pregnancies are the greatest avoidable risk of IVF. The health and financial burden it places on women, families and the NHS cannot be overstated (qtd. in Cockerell).

Recently in Ontario, Canada, it has been announced that there will be limited coverage for In Vitro Fertilization, making it the third Canadian province. “Sure, infertility isn’t a life-threatening problem, but reproduction is an indelible part of human functioning” (Dvorsky). Not being able to have a child is heartbreaking to some people. If they do not have enough money to be able to pay for the treatment of IVF, they will do irrational things. Therefore, when the government steps in to fund the treatment, families will be grateful and happy.

 Whether it was fully or partially, if In Vitro Fertilization was funded by the government it would certainly cause repercussions to the economy. Although common, IVF is an expensive way of remedying infertility in the United States, and it does not address the cause of fertility, only allows reproduction. The European Society of Human Reproduction an Embryology in Prague as recently been researching in infertility, IVF treatments, and government funding. According to Professor William Ledger from the University of Sheffield, leader of the team:

 “For each baby born, the economy makes a net gain. The average $17,088 that it costs to create a baby using IVF is far exceeded by the average of $210,318 in taxes and insurance that will be paid by an adult in full-time employment. Thus for each state-funded IVF baby, our economy apparently benefits by a net gain of $193,244” (qtd in Smajdor)

This is not at all accurate, as Smajdor relays in her report. If large numbers of people are born through IVF rather than through natural conception, than this loss would continue growing and become rather significant. Therefore, citizens who are not born as a result of IVF save the economy $17,088 per person born compared with that of In Vitro babies, only if it is NOT state or government funded. Some want the government to fund IVF purely to reduce the number of multiple births. It is a well-known fact that IVF treatments significantly increase the woman’s chance of giving birth to multiple babies, which could lead to miscarriages, complications, or could be fatal. If this is the case, why do physicians not already do these procedures? Of course, if the government did in fact gain control of funding in IVF treatment they would be able to control the embryo transferal rate. In Quebec, Canada the state pays for a single IVF treatment and doctors will implant only one embryo. “Multiple births in Quebec have dropped from roughly 30% to 5% after IVF coverage from 2010 to 2015” (Hendry).

 Although IVF may be irrelevant, immoral, or disgusting to some, it can be heartbreaking, frustrating, and debilitating to others. Men and women are already suffering enough through the In Vitro Fertilization process, any opposition would be unbearable. Therefore, nobody should face any trouble or discrimination when going through the IVF treatment. It is their own choice and they are their own human beings with legal rights.

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