The Social & Ethical Issues around Infertility - Right or Wrong?

What are some of the ethical issues surrounding the new reproductive technologies ?

The new reproductive technologies have spawned new ethical concerns. These are controversial subjects, which have attracted wide media attention and public debate. However, the law and public opinion all over the world have lagged behind the advances in artificial conception which have created a "brave new world" of possibilities of giving birth, never before considered possible - using a mix and match combination of sperms, eggs and uteri. In fact, today we have the technology to be able to help any couple to get pregnant - no matter what their medical problem may be ! However, whether or not they should adopt these options is a decision each couple needs to make for themselves !

Artificial conception raises the possibilities of myriad problems - legal or otherwise, which may need resolution by legislation or national guidelines. These relate to :

  • The question of embryo research and the time limits to be placed on it
  • Basic questions such as - when does life begin ? and what are the rights of an embryo ? remain unanswered.
  • Guidelines on semen banking
  • The child's right to access to information about his/her genetic background and mode of conception
  • The legality of surrogacy
  • The registration and monitoring of IVF clinics to ensure that infertile couples are not exploited.
How do the different religions look upon infertility treatment ?

Theologians the world over differ sharply on the subject. For example, to the Catholic Church, adoption is acceptable; as are the use of fertility drugs. GIFT procedures are allowed when the sperms and eggs of the couple are placed in the woman's own Fallopian tubes. However, surrogacy; artificial insemination by husband or donor; and IVF are not allowed, because procreation without sexual union in considered unnatural, and the Church has been quite vocal about its criticism.

In Judaism, donor insemination is forbidden and a child is considered to be the offspring of the biological father. Artificial insemination using husband's sperm and IVF are accepted when there is need to heal the illness of infertility.

Islam does not permit the use of donor sperm.

Most individuals have their personal beliefs regarding the "rightness " or otherwise of many of these techniques. Many people believe that embryos should not be used for research because they have the potential to become human beings - and in fact, embryo research is banned in Germany by law.

Other feel that to restrict research is unfair to infertile couples, who should be allowed to make their own choices.

There will always be two views of looking at the technology of assisted conception. At one end of the spectrum, will be people who feel that this technology allows couples to manipulate Nature to produce children and will object to it. At the other end will be people who believe that this technology is a triumph of man's ingenuity which can be used to overcome Nature's constraints. It will never be possible to reconcile these viewpoints - since these are based on deeply held personal beliefs ( and not facts) - and we will have to learn to live with this moral dichotomy. At least this explains the heated debates about when life begins ! Since it may never be possible to have a consensus on this issue, this decision should not be left to moralists, or philosophers - or the government, or the doctors. Instead, the decision should be left to each individual couple, who provide the reproductive apparatus to create the baby.

Remember, there are no "right" or "wrong" answers - you must follow your own conscience.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.